Deborah Aldridge.
St Georges Medical School. |
| Introduction |
Recent literature suggests that current checks for congenital heart defects have low detection rates and that screening newborns with pulse oximetry would raise these. My report looked into the practicalities of implementing pulse oximetry screening on all newborn babies on the postnatal ward at St Georges.
Pulse oximetry has recently been rolled out as a national pilot and it is likely it will become mandatory in the future in all hospitals. Therefore, this project is interesting for all hospitals as it provides information on how best to implement it in the future. |
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| Methods |
| Over 10 days, pulse oximetry was performed on all babies before they were discharged from the postnatal ward at St Georges. Oxygen saturations were checked in the right hand and either foot. Saturations were tested using a handheld pulse oximeter with either reusable pulse oximetry equipment or single use. If oxygen saturations were <95% or there was a difference of more than 2% between hand and foot readings (if both were ≥95%) this was abnormal and the baby was assessed further. |
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| Results |
| Single use equipment had the shortest mean time and gave higher saturation readings, but was extremely expensive. The reusable equipment was not much slower and was a lot cheaper, but had a high failure rate and gave lower saturation readings. The reusable equipment mainly failed when the baby was moving. |
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| Discussion |
| Pulse oximetry is a quick, painless test that does not adversely affect quality of care. Screening could be introduced more cheaply if a policy of using reusable equipment on asleep or non-moving babies and single use equipment on awake or moving babies was employed. However, the effect on staff time of the reusable equipment potentially producing a significant number of false positives should be considered. |
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