Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 181 - SPECIAL HEALTH PROGRAMS › Chapter 10 - SCREENING OF NEWBORNS FOR CRITICAL CONGENITAL HEART DISEASE › Section 181-10-003 - HOSPITAL AND BIRTHING FACILITY RESPONSIBILITIES

Current through June 17, 2024
All hospital and birthing facilities must.
(A) Have and implement policies and
  procedures consistent with this chapter to screen all newborns for critical
  congenital heart disease. Screening must be done using pulse oximetry at 24
  hours of life or soon after on day 2 of life, or prior to discharge whichever
  occurs first.
(B) Document that it
  notified the receiving hospital of the critical congenital heart disease
  screening results for every newborn transferred. If no results were available,
  the transferring facility must document it notified the receiving facility that
  the critical congenital heart disease screen needs to be completed.
(C) Complete screening for critical
  congenital heart disease using pulse oximetry. The probe and sensors must be
  placed on the right hand and one foot. If reusable probes and sensors are used,
  proper sanitation to prevent infection and communicable disease must be
  maintained. False negatives are possible, so negative screening results must
  not delay referral for pediatric cardiology evaluation of an infant otherwise
  suspected of having critical congenital heart disease. The results of all
  screening must be recorded in the newborn's medical record.
(D) Consider newborns with oxygen saturation
  percentages of 95 percent or more in the right hand or foot and the difference
  between the hand and foot is 3 percent or less as having passed the
  screen.
(E) Consider oxygen
  saturation percentages between 90 percent and less than 95 percent on both the
  right hand and foot, or a difference of more than 3 percent between the hand
  and foot as an inconclusive result. The newborn must not be discharged and must
  be rescreened in one hour. If the rescreen remains inconclusive a third screen
  must be done in one hour. If on the third screen the results continue to not
  meet the pass criteria, this is a failed screen. The hospital or birthing
  facility must immediately notify the newborn's physician of the failed screen
  for critical congenital heart disease.
(F) Consider oxygen saturation percentages
  less than 90 percent on any screen, initial or rescreen, as a failed screen.
  This is an indication of possible critical congenital heart disease. The
  hospital or birthing facility must immediately notify the newborn's physician
  of this failed screen.
(G) Screen
  all newborns admitted to a neonatal intensive care unit for critical congenital
  heart disease. Screening of any newborn admitted to a neonatal intensive care
  unit for less than 8 days must follow the protocol set out in this chapter. For
  any newborn in a neonatal intensive care unit longer than 7 days, the screening
  requirement may be met by the level of care the newborn otherwise routinely
  receives in the unit, which may include including prolonged pulse oximetry
  monitoring, chest x-rays and echocardiogram, continuous intensive monitoring
  and repeated physician exams.
(H)
  Maintain a method of verifying every newborn in its care received a screen for
  critical congenital heart disease. For any newborn discharged without such a
  screen, the hospital or birthing facility must notify the newborn's physician
  and parents or legal guardian, and must reschedule an appointment to complete
  the screen.
(I) Monitor quality
  indicators which must include at a minimum the number and percent of newborns
  with failed screens, newborns transferred without a screen, newborns referred
  for a pediatric echocardiogram, and the age at screening for all newborns who
  failed a screen.