Newborn Screening Test - | Health



Canberra Hospital and Health ServicesClinical ProcedureNewborn Screening TestContents TOC \h \z \t "Heading 1,1" Contents PAGEREF _Toc417306227 \h 1Purpose PAGEREF _Toc417306228 \h 2Alerts PAGEREF _Toc417306229 \h 2Scope PAGEREF _Toc417306230 \h 2Section 1 – Newborn Screening Test PAGEREF _Toc417306231 \h 2Implementation PAGEREF _Toc417306232 \h 4References PAGEREF _Toc417306233 \h 5Search Terms PAGEREF _Toc417306234 \h 5PurposeNewborn screening tests are performed to diagnose genetic metabolic disorders in all newborns. The newborn screening blood sample is to be collected when the infant is 48-72 hours of age.ScopeAlertsA neonatal screen must be taken prior to transfusion of any blood products and a repeat test is to be taken 48 hours following the last transfusion. A third sample is to be taken 3 weeks post transfusion.ScopeThis document pertains to the following:Medical OfficersNurses and Midwives who are working within their scope of practice (Refer to Scope of Practice for Nurses and Midwives Policy)Student Nurses under direct supervision.Section 1 – Newborn Screening TestEquipmentAlcohol Based Hand Rub (ABHR)Equipment for collecting blood as per the umbilical artery catheter or heel lance standards, depending on the infants clinical statusNewborn Screening CardPathology formProcedure MethodNewborn Screens are to be taken at the following times:SamplePatient groupTimeframe1st sampleAll infants (including palliative or deceased infants)48-72 hours2nd sample Infants who have received blood transfusions/exchange transfusions/platelets/FFP, albumin, from birth to 72 hours of lifeObtain sample pre-transfusion (even <48 hours of age), then > 48 hours post transfusion-NB: need to obtain 3rd sample2nd sampleInfants on Total parenteral Nutrition (TPN)48 hours post cessation of TPN2nd samplePremature infants birth weight <1500gms3 weeks3rd sampleInfants who have had transfusions of blood within the 1st 48-72 hours of life3 weeks post transfusionA twin or triplet of a neonate who weighs <1500gms requires a second screen at 3 weeks of age Explain to parents why the neonate requires the test and provide written information pamphlet “tests to protect your baby” Obtain verbal consent and document in medical records Attend hand hygiene before touching patient by either washing hands or using ABHRPain relief: recommend the woman breastfeeds her baby prior to or preferably during procedure to minimise pain. If baby is not breastfeeding or is tube fed, give baby own mothers’s breast milk (up to 0.25mls) prior to procedure or if not available, or not breastfeeding give oral Sucrose (20%) solution( 0.25mls) 2 minutes prior to procedure Collect equipmentCheck neonate’s identification tagsComplete identification details on Newborn Screen Card IN PEN. ENSURE ALL FIELDS ARE COMPLETED ON CARDPlace pathology identification label on back of card well clear of the blood spots and sign by nurse/midwife completing testPathology request form which can be signed by nursing/midwifery staffCheck neonate’s identification tagsComplete identification details on Newborn Screen Card IN PEN. ENSURE ALL FIELDS ARE COMPLETED ON CARDPlace pathology identification label on back of card well clear of the blood spots and sign by nurse/midwife completing testPathology request form which can be signed by nursing/midwifery staffAlertWhen completing card for multiple births write Twin/Triplet 1, Twin/Triplet 2 or Triplet 3 and their name even if a death of one or more sibling has occurred Obtain blood from arterial line or heel lanceFill the three circles from one side only AlertDo not layer blood or contaminate the card with an substance e.g. alcohol, heparin, water or milkComfort and settle the infantDispose of used equipment according to OH&S guidelinesPlace completed NNS card in drying rack and allow to dry for 4 hours then send to first floor pathology in an envelope not plasticMust not go via pathology shute as it will only go to the second floorAlertDocument in:Progress notes with stamp (NICU/SCN)Baby feed chart (Maternity)Discharge planning and transfer information sheet(NICU/SCN)Sign and date in ward register(NICU/SCN) Personal Health RecordBOS (Maternity)If repeat newborn screening is required then the date of repeat is to be written on the “Discharge planning and transfer information sheet” (NICU/SCN only)When the repeat is taken then the documentation is the same as above (NICU/SCN only)Neonatal AlertWhere parents do not give consent for test write REFUSED and INFANTS DETAILSOn the newborn screening card send to pathology. The parents are requested to complete refusal questionnaire (found at CMC’s desk) as per SOP Newborn Screen Refusal, document in medical record sign and send a copy to pathologyBack to Table of Contents Implementation This procedure will be outlined during orientation of new staff.Back to Table of ContentsReferencesMatthews, A and Robin, N. (2006) “Genetic disorders, malformations, and inborn errors of metabolism.” In Merenstein G and Gardner, S Ed Handbook of Neonatal Intensive Care 6th Ed. Mosby Inc St Louis.Newborn Screening Guideline, NSW Policy Directive 24 march 2005Spiel JK. (1997) Capillary blood collection for neonatal screening tests should require a certificate of competence. Journal - Australian College of Midwives. 10(2) 8-13.Back to Table of ContentsSearch Terms TestNewborn ScreenGuthrie testSpecial Care NurseryGeneticCystic fibrosisGalactoscaemiaPhenylketonNeonatal Intensive CareBack to Table of ContentsDisclaimer: This document has been developed by ACT Health, <Name of Division/ Branch/Unit> specifically for its own use. Use of this document and any reliance on the information contained therein by any third party is at his or her own risk and Health Directorate assumes no responsibility whatsoever. ................
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