Impact of Expansion in Newborn Screening on Hospital Performance and Provider Perceptions in Georgia 公开
Rentmeester, Shelby (2016)
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
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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