minnesota newborn screening program
Newborn Hearing Screening in the Hospital
Minnesota state law (Statute 144.966) outlines the following core responsibilities for all birth hospitals in Minnesota:
- Communicate newborn hearing screening and parental options information to parents prior to screening
- Test all babies for hearing loss prior to discharge
- Document the results of all hearing screens in the nursery
- Inform parents, primary care provider, and MDH of the hearing screening results within 10 days of screening
- Plan for alternative testing strategies when equipment breaks – the hospital discharging the infant home is responsible for hearing screening, regardless of circumstances!
Communicating to Parents
Hearing screening should be discussed with parents before screening takes place. Information on discussing hearing screening with parents can be found on the Communicating to Parents page.
Infants can be screened in the nursery with the following technology:
- Automated Auditory Brainstem Response (AABR)
- Otoacoustic emissions (DPOAEs or TOAEs)
Each technology has its own set of advantages and disadvantages, but both are most effective when staff are well trained and good techniques is used by all professionals doing the screening. More information on these two screening technologies can be found in the fact sheet below:
Suggested parameters for screening with these two technologies have been developed by the Newborn Hearing Screening Advisory Committee:
Your facility needs to have a protocol for screening newborns for hearing loss. The protocol should cover the following:
- Screening Procedure
- Follow-up for infants with abnormal results
- Communication with Parents
- Staff Training
- Staff Re-training
- Result reporting to MDH and primary care
- Plan for Equipment failure
Hearing screening results should be documented in a hearing logbook in the nursery, in the baby’s medical chart, and sent to the MDH Newborn Screening Program and the baby’s primary care provider within 10 days after screening.
Sending hearing screening results to MDH:
The Newborn Screening cards used for collection of blood from each baby in the nursery are also designed for reporting hearing screening results.
* Write on the top copy of the multi-layered card with a ball-point pen allows MDH staff to easily read the hearing screening information. One of the paper layers of the card is printed with a drawing of an ear and the words Hearing Screening Copy on the end.
If Hearing Screening is done BEFORE collecting the blood sample
- Send results in on the newborn screening card
- The area in the lower right hand corner of the card is designed to collect hearing information
- If hearing screening is completed before the blood sample is put on the card, fill in the hearing result and send it to MDH with the blood specimen. There is NO need to detach the hearing copy in these cases
If Hearing Screening is done AFTER collecting and submitting the blood sample
- Send results in separately, on the ‘Hearing Screening Copy’ form
- First, complete the demographic information on the specimen card
- Remove the second page of the card labeled ‘Hearing Screening Copy’
- Fill out the hearing copy when hearing screening results are available and send in to MDH
- Send the hearing slips to MDH with other screening cards for fastest delivery
If Hearing Screening is done AFTER collecting and the ‘Hearing Screening Copy’ form is not available
- Send results in separately, on another form
- If the ‘Hearing Screening Copy’ is lost or the baby was transferred to your facility, fax hearing screen result to MDH
- Either print the result directly from your screening equipment or write the information on hospital letterhead
- Include information needed to identify baby
- Date of birth
- Mother's name
- Screening results
- Fax screening result to 651-215-6285
Minnesota law requires hospitals to send hearing screening results to MDH – send results as soon as they are available.
- Hearing results, especially those requiring follow-up should be communicated to the infant’s primary care provider. It is best practice to provide hearing results in writing
- Results can be sent on a form from your facility OR on the one-page document created by MDH. There are separate documents for pass and refer results, both of which can be faxed to the primary care clinic and also used to inform parents of the newborn hearing screening results
Informing parents of newborn hearing screening results:
- Best practice is to inform all parents of the hearing screening results on their infants
- Results can be provided in writing or given to parents verbally, while encouraging them to record them
- Provide parents with MDH-created Parent and Provider Information Sheet
- REFER results NEED to be communicated to parents with a plan for follow-up
- Tips for communicating results to families (PDF: 68KB/1 page)
REFER results should be handled in the following way:
- Send REFER result to primary care provider
- Report REFER result to MDH
- Help family make a plan to follow-up on results
Families of infants who refer on hearing screening should be educated about the hearing screening results and what follow-up is needed.
Talking points for families:
- Verify with family who the primary care provider will be
- Importance of discussing hearing results with baby’s doctor at first appointment
- Why the baby might have referred
- The importance of follow-up
- How to schedule an appointment for hearing rescreening or audiological evaluation
Babies who require intensive care after birth are at higher risk for hearing loss than are other babies. It is very important to make sure that all babies who have spent time in the NICU have their hearing screened.
Suggested parameters for screening infants in the NICU have been developed by the Newborn Hearing Screening Advisory Committee:
Hearing screens may be missed when babies are transferred from one facility to another. MDH has created a special form to help ensure that all Minnesota babies receive the benefit of early hearing screening.
Often, babies are not mature or stable enough for hearing screening to be completed before transfer from the NICU to another facility.
If an infant is transferred to your facility, please determine if the baby’s hearing was screened before transfer and that results were sent to MDH. If you cannot verify that a baby has not been screened, it is better to rescreen the baby than to miss the opportunity.
It is the responsibility of the hospital staff that discharges baby to home to make sure that hearing screening is done and reported.