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The two goals of newborn hearing screening programs are to accurately identify babies who may have a hearing difference and minimize unnecessary referrals for babies who do not have a hearing difference. Monitoring your newborn hearing screening statistics, particularly the refer rate or the percentage of babies at your facility who do not pass on the newborn hearing screening, is one of the best ways to achieve these goals. Refer rates greater than 4% are considered on the high end. High refer rates may serve as a “red flag” or a sign to re-evaluate your equipment, protocol, and/or daily operations.
Are you noticing high refer rates? Below are a couple of tips to help. By following these steps, your newborn hearing screening process can be more efficient and cost-effective.
Schedule Screenings Smartly
Screen babies when they are relaxed (preferably asleep) in a quiet room. Choosing optimal screening times reduces the time to complete a screening and ensures a more accurate test.
Retry Before Discharge
If a baby doesn't pass the first screening in one or both ears, wait a few hours and then perform a 2nd attempt to screen in both ears. This can significantly reduce the need for additional outpatient screening.
Advocate for Access to Backup Equipment
Having backup equipment in case of equipment breakdowns is a good idea especially in facilities where babies are discharged quickly from the hospital. Quick replacements will prevent your program from missing newborns and reduce the need for additional outpatient rescreening.
Pay Attention to OAE Probe Fit
If you are using Otoacoustic Emissions (OAE) as a screening tool, proper fit of the eartip or probe is crucial. Make sure that the newborn hearing screeners at your facility are properly trained on insertion of the probe into the ear; this ensures an accurate test and reduces referral rates.
Be Mindful of Muscle Activity during AABR
If you are using automated auditory brainstem response (AABR) as a screening tool, make sure to screen when babies are relaxed or asleep. If the baby is not in a relaxed state, muscle tension can lead to increased screening time and result in high refer rates.
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