Outcomes of Training Nurses Engaged in a Public Sector Newborn Hearing Screening Program in South India.

This study evaluated the outcomes of training nurses engaged in a public sector newborn hearing screening (NHS) program in one urban district in South India. Twenty nurses performing NHS in Corporation Maternity Hospitals (CMH) participated in the training and evaluation. Baseline knowledge and skill of nurses regarding NHS and overall program outcomes were obtained eight months post the initial training. Knowledge was evaluated using questionnaire, skill was evaluated using Objective Structured Clinical Examination (OSCE) and agreement between screening results obtained by audiologist and nurse. Records used for documentation of screening were analysed to evaluate program outcomes. A two-day retraining was designed to address the gaps identified. Evaluations were conducted immediately post and three months post retraining following the same procedure as baseline evaluations. Gaps were identified in knowledge and skill as well as in the program outcomes. Immediate post retraining evaluation results showed overall improvement in nurses' knowledge and skill. Three months post retraining, all the nurses achieved benchmark criteria of 75% in knowledge and skill. Program outcomes, such as coverage (95.3%), refer rate (3.2%) and follow up rate (86.1%) improved post retraining. The findings of this study suggests that knowledge and skill of nurses improved with periodic training. Periodic evaluation and monitoring enhanced the overall outcomes of the program. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-021-02920-2.

Implementation of newborn hearing screening in Rizal, Philippines, and Northern California: Lessons learned

Objective@#The universal newborn hearing screening program has been implemented in the Philippines for the past ten years. However, screening rates in the country are still low. The current study aimed to describe the universal newborn hearing screening program (UNHSP) delivery system in Rizal, Philippines, and Northern California. @*Methods@#The study utilized a case study research design using data triangulation of FGD, KII, and document review to characterize and compare the implementation of the Universal Newborn Hearing Screening Program in Rizal Province and Northern California. @*Results@#Several differences were found in the protocols for newborn hearing screening in Rizal, Philippines, and Northern California, including centralization of the program, availability of surveillance data, screening protocols, and tracking system. @*Conclusion@#There is an immense need to disseminate universal newborn hearing screening among healthcare practitioners and create a system to monitor and evaluate real-time data.

Congenital cochlear deafness in mitochondrial diseases related to RRM2B and SERAC1 gene defects. A study of the mitochondrial patients of the CMHI hospital in Warsaw, Poland.

OBJECTIVES: Although hearing loss is a well-known symptom of mitochondria-related disorders, it is not clear how often it is a congenital and cochlear impairment. The Newborn Hearing Screening Program (NHSP) enables to distinguish congenital cochlear deafness from an acquired hearing deficit. The initial aim of the study was to research the frequency of the congenital cochlear hearing loss among patients with various gene defects resulting in mitochondrial disorders. The research process brought on an additional gain: basing on our preliminary study group of 80 patients, in 12 patients altogether we identified two defected genes responsible for mitochondrial disorders, whose carriers did not pass the NHSP. Finally, these patients were diagnosed with the congenital cochlear deafness. MATERIAL AND METHODS: The results of the NHSP in the patients with mitochondrial disorders diagnosed in our tertiary reference center were analyzed. Only the cases with confirmed mutations were qualified for the study group. The NHSP database included 80 patients with mutations in 31 different genes: 25 nuclear-encoded and 6 mtDNA-encoded. We searched the literature for the presence of a congenital hearing impairment (CHI) in mitochondrial disorders caused by changes in 278 already known genes. RESULTS: For 68 patients from the study group the NHSP test indicated a proper cochlear function and thus suggested normal hearing. For 12 mitochondrial patients, the NHSP test indicated the requirement for the further audiological diagnosis, and finally CHI was confirmed in 8 of them. This latter subset included patients with pathogenic variants in RRM2B and SERAC1, known as "deafness-causing genes". Contrary to our initial expectations, the patients carrying mutations in other "deafness-causing genes": MPV17, POLG, COX10, as well as other mitochondria-related genes, all reported in literature, did not indicate any CHI following the NHSP test. CONCLUSION: Our study indicates that the cochlear CHI is a phenotypic feature of the RRM2B and SERAC1 related defects. The diagnosis of the CHI following the NHSP allows to early distinguish those defects from other mitochondria-related disorders in which the NHSP test result is correct. Wider studies are needed to assess the significance of this observation.

Qualitative aspects of the process of Neonatal Hearing Screening Program in Mexico evaluated from the parental perspective. / Aspectos cualitativos del proceso del Programa de Tamiz Auditivo Neonatal en México evaluados desde la perspectiva parental.

INTRODUCTION: The Universal Newborn Hearing Screening Program in Mexico began in 2010. Its results, published in 2013 by the National Council for the Development and Inclusion of Persons with Disabilities (CONADIS), report low coverage and, currently, there is a dearth of information about its activities. This study describes the process of the program from the epistemological perspective of women whose children participated in the program, evaluating it under the sustenance of the constructivist-respondent model in search of aspects that could help explain its results. METHODS: Descriptive study with a qualitative approach based on the constructivist–respondent paradigm. We elected the 14 women who participated in the study through trial and number until theoretical saturation. After signing an informed consent form and respecting the confidentiality and anonymity, these women underwent semi-structured interviews that were audio-recorded and transcribed as were conducted. The researchers separately analyzed and coded categories and conjointly summarized categories and subcategories. Validity and reliability were obtained through the credibility, transferability and triangulation. RESULTS: From the speeches, we obtained the general profile of the interviewed, evolution of their children in the program process and four categories with 15 subcategories related to the reconstruction of the process: knowledge, needs, feelings and attitudes. One was evaluated as favorable, six without agreement and eight as unfavorable. The latter refer to our own context. CONCLUSIONS: The epistemological perspective of the interviewed women showed aspects that could help explain the low coverage of the program. Attention from public policies could improve this feature. With the establishment of the program, children with deafness are diagnosed and treated at a lower age than before the program.

INTRODUCCIÓN: El Programa de Tamiz Auditivo Neonatal Universal se inició en México en 2010. Sus resultados, publicados en 2013 por el Consejo Nacional para el Desarrollo y la Inclusión de las Personas con Discapacidad, informan baja cobertura. Actualmente hay escasez de información sobre sus actividades. Este estudio describe el proceso del programa desde la perspectiva epistemológica de mujeres cuyos hijos participaron en el mismo, evaluándolo bajo el sustento del modelo constructivista-respondente en busca de aspectos que puedan ayudar a explicar sus resultados. MÉTODOS: Estudio de tipo mixto, con enfoque en el paradigma constructivista respondente. En él participaron 14 mujeres, elegidas por juicio y su número hasta la saturación teórica. A ellas, previa firma de consentimiento informado, respetando la confidencialidad y anonimato; se les aplicaron entrevistas semi estructuradas. Estas fueron audio grabadas y transcritas tal como se expresaron. Las investigadoras analizaron y codificaron categorías por separado; juntas resumieron categorías y subcategorías. La validez y confiabilidad se obtuvieron a través de la credibilidad, transferibilidad y triangulación. RESULTADOS: De los discursos se obtuvieron el perfil general de las entrevistadas, evolución de sus hijos en el proceso del programa y cuatro categorías con 15 subcategorías relacionadas con la reconstrucción del proceso: conocimientos, necesidades, sentimientos y actitudes. Estas categorías se evaluaron como favorable (una), sin acuerdo (seis) y desfavorables (ocho). Estas últimas, son propias de nuestro contexto. CONCLUSIONES: La perspectiva epistemológica de las entrevistadas, mostró aspectos que podrían ayudar a explicar la baja cobertura del programa. Retomarlo desde las políticas públicas puede mejorarlo. Con el establecimiento del programa, los niños con sordera son diagnosticados e intervenidos a menor edad que antes del programa.

Analysis of audiological results of patients referred from newborn hearing screening program.

CONCLUSION: As tools of confirmation of sensorineural hearing loss in neonates who are 'referred' from a newborn hearing screening program, both ASSR and DPOAE have high sensitivity and specificity. In addition, ASSR can be used as a substitute for ABR. OBJECTIVES: To analyze the confirmative audiological results of patients referred from a newborn hearing screening program. PATIENTS AND METHOD: From January 2007 to December 2013, hearing tests were performed on 474 babies (804 ears) who were 'referred' from the hospital or other maternity centers. Auditory brainstem response (ABR), auditory steady-state response (ASSR), and distortion product otoacoustic emissions (DPOAE) were used for hearing evaluation. RESULTS: Of 474 babies (804 ears), 232 had normal hearing, while 242 babies (358 ears) had over 30 dB nHL threshold from ABR. Among the 156 babies (312 ears) who underwent both ABR and ASSR, the mean ASSR threshold had a strong correlation with ABR threshold (r = 0.942, p < 0.001). Assuming that ABR results were the yardstick of abnormal hearing, sensitivity and specificity of ASSR to ABR were 90.6% and 95%. DPOAE tests were performed on 180 babies (360 ears), with sensitivity of 85.9% and specificity of 84.4%.

Comparison of risk factors in newborn hearing screening in a developing country.

The aim of this study is to evaluate the results of the newborn-hearing screening program (NHSP) in our institute, investigate the risk factors and their correlation to congenital hearing loss (CHL). Newborns who admitted to our clinic for NHSP from June 2014 to December 2014 were included in the study. After the test parents were asked to fill a questionnaire about the risk factors of CHL. Test results and referral rate were compared with risk factors. One thousand consecutive babies were included in the study. The overall referral rate was 3.5%. Mechanic ventilation, history of familial CHL and familial consanguinity were found to be significantly related to CHL.In the light of our results we can conclude that getting access to every newborn for hearing screening is mandatory and targeting the risk factors and informing the family about the follow-up period is important for diagnosing the delayed hearing impairment.

Results and Cost-Effectiveness of Newborn Hearing Screening Program in Ajou University Hospital / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is estimated that more than 2 in every 1,000 neonates suffers from hearing loss. Early detection with appropriate rehabilitation of congenital hearing loss can reduce the adverse developmental consequences such as language delays, and behavior and attention deficits. The purpose of this study is to evaluate our newborn hearing screening program using the combined transient evoked otoacoustic emission (TEOAE) and auditory brainstem response (ABR), and to estimate the cost-effectiveness of our program. MATERIALS AND METHOD: 6,634 infants (5,918 well babies and 716 NICU babies) underwent the newborn hearing screening program at Ajou University Hospital for 4 years. Initially well babies were screened with TEOAEs, and those failing the TEOAEs were tested with the rescreening program. Neonates failing the TEOAE rescreening and the NICU babies were examined with ABR. The cost included personnel, fringe benefits, supplies, equipment and overhead. RESULTS: 660 (11%) out of 5,918 well babies failed the initial TEOAE screening and 27 (0.46%) babies failed the TEOAE rescreening. Eleven babies (0.16%), 3 of the well babies and 8 of the NICU babies, were confirmed to have hearing loss of more than 60 dB. We detected four deaf babies out of these eleven. From the four deaf babies, we confirmed a connexin 26-related deafness and an enlarged vestibular aqueduct syndrome. It cost $6 to screen one infant and $3,700 to detect one infant with hearing loss. CONCLUSION: We could detect 11 babies (0.16%) with hearing loss out of 6,634 neonates during the 4 years. Considering the benefits of early identification and rehabilitation of congenital hearing loss, the cost for the newborn hearing screen program is affordable. The newborn hearing screen should be extended as a national health program.