Unsatisfactory Screens and Common Errors

Unsatisfactory CCHD pulse oximetry screens

The screen will be considered unsatisfactory if:

• The algorithm was not followed
• The timing of the screen was not within the recommended window of 24-48 hours for a well infant
• The screening protocol was not followed
• Screening results on the CCHD card were incomplete or incorrect
• Demographics on the CCHD card were incomplete or incorrect

In the case of an unsatisfactory screen where the infant may be at risk, NSO will contact the organization who performed the screen to follow up on the unsatisfactory result and determine if further steps are required. NSO may recommend that the infant requires a repeat CCHD screen or a physical exam.

Common errors in CCHD screening

• Using the left hand instead of the right (pre-ductal site)
• Using the right and left hand instead of the right hand and either foot
• Algorithm misinterpretation, screening protocol errors
• Not waiting for a reliable signal prior to getting a reading
• Incomplete documentation
• Inappropriate timing for the screen (before 24 hours, or after 48 in a well infant)

Recommendations for quality assurance

Quality management responsibilities for CCHD pulse oximetry screening are shared between organizations conducting the screening and NSO. Organizations that are screening are responsible for performing ongoing maintenance of pulse oximeters in accordance with NSO recommendations and providing pulse oximetry screening education and ongoing competency evaluation for health care professionals conducting the CCHD screen.