Impact of Expansion in Newborn Screening on Hospital Performance and Provider Perceptions in Georgia Open Access

Rentmeester, Shelby (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/xk81jk86x?locale=en
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Abstract

In 2011, the U.S. Secretary of Health and Human Services recommended universal screening for CCHD; in response, the Georgia Department of Public Health (GA DPH) mandated routine screening for CCHD starting January 2015. The GA DPH also mandated screening and reporting of hearing loss for all infants. Utilizing the PRECEDE-PROCEED Model, the current study evaluated the impact and process for completing the new screens and reporting the results to the GA DPH using the Newborn Screening Specimen Card (NBS Card). Utilizing the GA DPH active surveillance system for newborn screening results, data from six months before and six months after the transition to the updated NBS Card were analyzed for percentage submitted and for percentage positive screens. Hospitals with Level III nurseries and cards submitted by a Neonatal Intensive Care Unit (NICU) had the lowest rates of reporting the results of each test to the GA DPH. Of the infants that were screened, NICUs had higher rates of positive screens. If all unscreened NICU admissions had been screened for CCHD and hearing loss, an estimated 33 additional infants would have screened positive for CCHD and 267 would have been referred for hearing loss. For the process evaluation, a survey was developed and sent to nurse managers of all Labor and Delivery hospitals. Forty-nine nurse managers responded to the survey (response rate of 62.8%). The majority of respondents indicated that the NBS Card was not confusing to complete and it does not take time away from providing the best care to patients, but over half of the respondents indicated that the card does not impact providing the best care. Increased reporting help to identify the true burden of disease in Georgia, which can better inform medical interventions and health policy.

Table of Contents

Table of Contents

Chapter I Introduction 1

Background 1

Problem Justification 2

Purpose - Program evaluation 4

Research Questions 6

Chapter II Literature Review 7

Introduction 7

Background & Significance 7

PRECEDE-PROCEED Model 10

Chapter III Methodology 12

Research Design 12

Impact on Prevalence 12

Data Collection and Management 12

Data Analysis 14

Provider Perceptions 14

Participants 14

Data Collection and Management 15

Data Analysis 15

Chapter 4 Results 17

Impact on Prevalence 17

Provider Perceptions 20

Chapter 5 Discussion 30

Introduction 30

Positioning Findings in Theoretical Context 30

Impact Evaluation (Phase 7) 30

Process Evaluation (Phase 6) 33

Implications and Limitations 34

Recommendations for Future Research 36

Conclusion 37

References 39

Appendix A 44

Appendix B 51

Appendix C 52

Appendix D 53

Appendix E 56

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