Critical Congenital Heart Disease Screening Practices Among Licensed Midwives in Washington State

Evers, Patrick D.; Vernon, Margaret M.; Schultz, Amy H.

doi:10.1111/jmwh.12274

Cited by 6 publications

(7 citation statements)

References 8 publications

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“…Results suggest that pulse oximeter loan programs, such as the one set up by the Michigan NBS Program, may help increase pulse oximetry screening rates for out‐of‐hospital births. These results also corroborate past studies, noting that further intervention or further education is needed in the midwife community with regard to the impact and benefit of pulse oximetry screening for detecting CCHDs . Next steps for Michigan's NBS Program include contacting midwives to alert them of low reporting rates and surveying midwives to learn more about barriers with the goal of identifying strategies to improve pulse oximetry screening and reporting rates.…”

Section: Discussionsupporting

confidence: 81%

“…To the best of our knowledge, only 2 other studies have examined pulse oximetry screening rates of midwife‐attended out‐of‐hospital births . Results suggest that pulse oximeter loan programs, such as the one set up by the Michigan NBS Program, may help increase pulse oximetry screening rates for out‐of‐hospital births.…”

Section: Discussionmentioning

confidence: 99%

“…Low screening rates suggest that future intervention is needed to enable the midwife‐attended out‐of‐hospital births community to increase pulse oximetry screening rates. Studies have found that the primary barriers to pulse oximetry screening were the cost of equipment, lack of training, and difficulties associated with the timing of needed rescreenings . One possible solution to the timing barrier of pulse oximetry screening is use of a modified pulse oximetry screening algorithm with a single repeat screening instead of 2 repeat screenings.…”

Section: Discussionmentioning

confidence: 99%

“…Examination of the barriers that exist specifically for the subgroup with loaned pulse oximeters will help to determine whether the pulse oximeter loan program is alleviating any barriers for screening and reporting. Although studies have been conducted to evaluate barriers to pulse oximetry screening in the out‐of‐hospital birth population, it is unclear which barriers exist for the midwives in Michigan with regard to pulse oximetry screening and screening submission. Creation and implementation of a survey tailored to the midwife population in Michigan may help answer this question.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Pulse Oximetry Screening Rates Among the Midwife‐Attended Out‐of‐Hospital Birth Community in Michigan

Withrow

Fussman

Thompson

et al. 2019

J Midwife Womens Health

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Introduction:In Michigan, pulse oximetry screening rates for critical congenital heart defects (CCHDs) are assessed for birthing hospitals but have not been assessed for the midwife-attended births that occur in the out-of-hospital birth community. This analysis was conducted to determine pulse oximetry screening rates among the midwife-attended out-of-hospital birth community in Michigan overall, and among midwives provided with loaned pulse oximeters from the Michigan Department of Health and Human Services (MDHHS). Methods:Records for midwife-attended out-of-hospital births between April 1, 2014, and December 31, 2016, were linked via probabilistic matching with newborn screening records. Pulse oximetry screening rates were calculated for the midwife-attended out-of-hospital birth population overall, by midwife, and stratified by receipt of loaned pulse oximeters from MDHHS. Births from midwives who attended 5 or more nonhospital births during the study period were included in this analysis. Results:Of the 3410 midwife-attended out-of-hospital births, 20.8% (n = 710) reported as having received a pulse oximetry screening for CCHDs. For births attended by midwives who received pulse oximeters from MDHHS, 50.5% had pulse oximetry screening results reported, compared with 12.7% among births attended by midwives without a loaned pulse oximeter. Of the 78 total midwives, 18% (n = 14) reported pulse oximetry screening results on more than half of the births they attended. Of the 14 midwives who received a pulse oximeter from MDHHS, 50.0% (n = 7) reported screening results for more than half of all births they attended. Discussion:Our findings indicate that CCHD screening rates are low among midwife-attended out-of-hospital birth community. Screening rates were higher among midwives who received a pulse oximeter from MDHHS, but fewer than half of the attended births had a reported pulse oximetry screening. Further discussions with the midwife-attended out-of-hospital birth community to better understand screening barriers may be beneficial.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Pulse Oximetry Screening Rates Among the Midwife‐Attended Out‐of‐Hospital Birth Community in Michigan

Withrow

Fussman

Thompson

et al. 2019

J Midwife Womens Health

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“…39 Feasibility for CCHD screening of US home births has been documented on a voluntary basis. 40 An outpatient pediatric office is not the ideal location for screening or evaluation, but screening is acceptable if the facility has proper equipment and trained staff.…”

Section: Special Settingsmentioning

confidence: 99%

Lessons Learned From Newborn Screening for Critical Congenital Heart Defects

et al. 2016

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Newborn screening for critical congenital heart defects (CCHD) was added to the US Recommended Uniform Screening Panel in 2011. Within 4 years, 46 states and the District of Columbia had adopted it into their newborn screening program, leading to CCHD screening being nearly universal in the United States. This rapid adoption occurred while there were still questions about the effectiveness of the recommended screening protocol and barriers to follow-up for infants with a positive screen. In response, the Centers for Disease Control and Prevention partnered with the American Academy of Pediatrics to convene an expert panel between January and September 2015 representing a broad array of primary care, neonatology, pediatric cardiology, nursing, midwifery, public health, and advocacy communities. The panel’s goal was to review current practices in newborn screening for CCHD and to identify opportunities for improvement. In this article, we describe the experience of CCHD screening in the United States with regard to: (1) identifying the target lesions for CCHD screening; (2) optimizing the algorithm for screening; (3) determining state-level challenges to implementation and surveillance of CCHD; (4) educating all stakeholders; (5) performing screening using the proper equipment and in a cost-effective manner; and (6) implementing screening in special settings such as the NICU, out-of-hospital settings, and areas of high altitude.

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The Value of Pulse Oximetry as a Screening Tool for Congenital Heart Disease

Meberg

2015

Curr Treat Options Peds

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Critical Congenital Heart Disease Screening Practices Among Licensed Midwives in Washington State

Abstract: Although voluntary implementation of CCHD screening by licensed midwives in Washington is increasing, it lags behind the implementation rates reported for in-hospital births.

Cited by 6 publications

References 8 publications

Evaluation of Pulse Oximetry Screening Rates Among the Midwife‐Attended Out‐of‐Hospital Birth Community in Michigan

Evaluation of Pulse Oximetry Screening Rates Among the Midwife‐Attended Out‐of‐Hospital Birth Community in Michigan

Lessons Learned From Newborn Screening for Critical Congenital Heart Defects

The Value of Pulse Oximetry as a Screening Tool for Congenital Heart Disease

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