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What are the guidelines for conducting hearing screenings in the well-baby nursery?
It is best practice to screen an infant between 24- 48 hours of age. If a re-screen is needed because the infant did not pass the initial screen, re-screen (both ears) as close to discharge as possible.

Screen when:

  • Infants are quiet or sleeping; optimally following feeding
  • Ensure a quiet environment for screening, away from background noise
  • Follow standard precautions for infection control (e.g. hand washing, appropriate cleansing of equipment, etc.).

What are the guidelines for conducting hearing screenings in the NICU?

Infants in the NICU should not have a hearing screen completed prior to 34 weeks gestation. The initial screen should be conducted as close to discharge as possible. If the infant does not pass the initial screen, a re-screen (both ears) should be completed.

Screen when:

  • Infants are quiet or sleeping; optimally following feeding
  • Ensure a quiet environment for screening, away from background noise
  • Follow standard precautions for infection control (e.g. hand washing, appropriate cleansing of equipment, etc.).

Transferred infants

If an infant was transferred to your facility, please ensure a hearing screen is completed prior to infant being discharged home.

What is the birth facilities responsibility if an infant does not pass on the final screen?

  1. Inform the family, verbally and in writing, that the infant did not pass the newborn hearing screening and needs further audiological testing
  2. Provide the family with the “Diagnostic Hearing Test” (link to: hearingtest.pdf) brochure
  3. Provide family with pediatric audiology diagnostic center list
  4. Fax referral to audiology diagnostic center of parents’ choice or follow hospital policy for referral to diagnostic center
  5. Fax screening and referral information to the Early Hearing Detection and Intervention Program

How to share results with families:

Do say a positive message:

“Your baby didn’t pass the newborn hearing screening (indicate which ear/s) which means further testing is needed about your baby’s hearing. The next step is to have a diagnostic test, which is performed by an audiologist.”

“Here is a brochure that explains what a diagnostic test is.” Discuss with the family how to schedule a follow-up diagnostic appointment according to your birth facilities protocol.

Don’t say misleading messages:

  • Your baby failed
  • Your baby has a hearing loss
  • There probably nothing wrong
  • A lot of babies don’t pass (NH has a 2% refer rate)
  • The baby doesn’t need follow up testing
  • The equipment wasn’t working
  • Its fluid or vernix
  • Do not preform multiple screens to attempt to get a pass

What is the responsibility of the birth facility for newborns that did not receive a hearing screening before discharge?

It is the responsibility of the birth facility to follow their newborn hearing screening protocol. Most birth facility protocols indicate that infants need to be brought back for an outpatient screening if they did not receive an inpatient hearing screen or only completed one hearing screen and did not pass.

What information should be reported to the NH Department of Health and when does it need to be reported?

Birth facilities are required to enter into Auris, state database system, all infants born at your facility within two weeks.

If an infant does not pass the second hearing screen, birth facilities are encouraged to fax infants screening results and diagnostic referral information to the EHDI Program within 48hrs.

What are the risk factors for late-onset and early childhood hearing loss?

Below are some examples of hearing loss risk indicators:

  • NICU stay greater than 5 days
  • Family history of permanent CHILDHOOD hearing loss
  • Atresia and Microtia
  • Bacterial meningitis
  • CHARGE
  • Chemotherapy
  • Craniofacial anomaly
  • Culture positive postnatal infection
  • Head Trauma
  • Hyperbilirubinemia with exchange transfusion
  • Neurodegenerative disorders
  • Parental concern
  • Syndromes associated with hearing loss
  • Other

For more information on risk factors please refer to the Joint Commission on Infant Hearing.

 
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New Hampshire Department of Health and Human Services
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