Newborn Screening Information for Providers:
Pulse Oximetry Screening in the NICU
Minnesota state law (Statute 144.1251) requires that premature infants (defined as infants less than 36 weeks of gestation) and infants admitted to a higher-level nursery (special care or intensive care) receive newborn pulse oximetry screening when medically appropriate, but prior to discharge.
Currently, no nationally-standardized protocols for screening premature infants and infants in the NICU exist. The screening algorithm we recommend in Minnesota applies to healthy-appearing infants and does not apply to babies who were prenatally diagnosed with a CCHD or to premature or sick babies in the NICU.
Although providing pulse oximetry screening to infants in the NICU is important, national workgroups have stated that developing a simple algorithm for all NICU settings is challenging due to the heterogeneity of the underlying conditions, such as prematurity and sepsis. In general, the following recommendations exist for pulse oximetry screening in the NICU population:
- Screening should be performed at 24 to 48 hours of age or as soon as medically-appropriate
- Screening should be performed prior to transfer or discharge from the hospital
- If the infant never required supplemental oxygen, proceed with the screening algorithm for newborns in the well-baby nursery
- Delay screening for infants requiring supplemental oxygen until the infant is stable in room air
- For infants who are to be discharged home on supplemental oxygen, perform a screen or echocardiogram prior to discharge
Minnesota state law (Statute 144.1251) requires that all pulse oximetry screening results be reported to the Minnesota Department of Health. All results should be reported electronically using the mechanism established by MDH.
As of December 2014, we are in the process of implementing MNScreen statewide. MNScreen is an electronic reporting system for both pulse oximetry and hearing screening results. Program staff contacted all Minnesota birth facilities in the fall/winter 2014 in order to begin implementation of this system. All state birth facilities should be working toward full implementation of MNScreen in 2015 in order to comply with reporting requirements for newborn hearing and pulse oximetry screening.