Newborn screening is mandated by each state. Screening tests are ordered by the infant’s primary healthcare provider.
A registered nurse (RN) or licensed practical nurse (LPN) may perform newborn screening.
All newborns complete newborn screening before discharge from the newborn nursery, preferably between 24 and 72 hours of age, and in no case later than 7 days of life. Some states require a second specimen is collected between 2 and 6 weeks of age. Check individual state requirements.
If the initial specimen for newborn screening is collected before 12 hours of age, a second specimen should be collected at 1 to 2 weeks of age.
Screening of premature or sick infants is completed as close as possible to the time of discharge from the nursery or at or near the seventh day of age, regardless of feeding status.
Complete screening before transfusion or dialysis, if the infant’s condition permits. If the infant requires a blood transfusion or dialysis before the specimen is collected, complete newborn screening 24 hours after completion of the blood transfusion/dialysis.
If the newborn is transferred to another facility for continuing care on or before the seventh day of age, the receiving hospital will obtain the specimen. A “Hospital Report of Newborn Specimen Not Obtained” form must be completed and sent immediately to the Department of Health Services, Genetic Disease Branch.
Newborn screening is repeated as soon as possible if the initial sample was inadequate.
Parents/legal guardians may refuse the test on the basis of religious beliefs or practices. A “Newborn Screening Test Refusal” form must be signed and copies sent as directed on the form. Notify the infant’s primary healthcare provider if parents decline newborn screening.
Newborn screening results are forwarded to the infant’s primary healthcare provider.
The parent/legal guardian is provided with results of newborn screening by the infant’s primary healthcare provider.
Abnormalities found through newborn screening are referred to the appropriate provider for follow-up and treatment by the infant’s primary healthcare provider.
Nonsterile gloves
Supplies needed for heel stick blood draw (see Chapter 17)
Newborn screening blood collection form per state regulation
Educational materials about newborn screening tests
Pacifier or sucrose-coated pacifier
Instruct parent/legal guardian about procedure and reason for screening.
Provide family printed information about the screening tests that will be completed.
Some states require informed consent from parents/legal guardians to perform newborn screening. Check with the state laws to verify regulations before performing this procedure. In almost all states, required testing can be overridden by invoking a religious exception.
To decrease procedural pain provide the infant a pacifier or sucrose-coated pacifier (see Chapter 7).
PROCEDURENewborn Screening
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