High-Risk Neonatal Hearing Screening Program Using Automated Screening Device Performed by Trained Nursing Personnel at Siriraj Hospital: Yield and Feasibility
Pimol Srisuparp MD*, Ruemporn Gleebbur RN**, Sopapan Ngerncham MD*, Jintana Chonpracha RN**, Jeeranan Singkampong RN**
Affiliation : * Division of Neonatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University. ** Pediatric Nursing Division, Department of Nursing, Siriraj Hospital
Objectives : To determine the prevalence and significant risk factors for pathologic hearing screening test
results in high-risk neonates and the feasibility of implementing hearing screening program using automated
otoacoustic emission (OAE)/ auditory brain stem response (ABR) device performed by trained nursing staffs.
Study
Design : Single-center prospective, descriptive study.
Materials and Methods : All neonates admitted to the Division of Neonatology, Department of Pediatrics,
Faculty of Medicine Siriraj Hospital, Mahidol University, who met the high-risk criteria according to Joint
Committee of Infant Hearing 1994, American Academy of Pediatrics, were screened with one-step protocol
using an automated OAE/ABR device (AccuScreen, GN Otometrics, Denmark). Infants who failed 2 consecu-
tive OAE tests were reconfirmed by ABR prior to discharge. Descriptive analysis was used for the prevalence
of pathologic hearing test results, age at screening, duration of procedure, number of risk factors per infant.
Univariate analysis using Chi-square test and multiple logistic regression analysis were used for identification
of significant risk factors.
Results : Five hundred and seven infants were identified to be at-risk in an 18-month study period. The preva-
lence of pathologic hearing screening test was 6.7% with unilateral and bilateral pathologic results in 13 and
21 infants (2.6% and 4.1%). Only craniofacial anomalies and mechanical ventilation > 5 days were shown to
be independent significant risk factors (42-fold and 4-fold increased risk). Median age at screening test per-
formed was 19 days (range 1-149 days) and almost all infants (97.3%) were screened within 3-month postnatal
age. The mean time for hearing screening procedure was 10.7 + 8.0 minutes (range 2-60 minutes), 98.1 %
of procedure was accomplished within 30 minutes.
Conclusion : Hearing screening using automated OAE/ABR devices in high-risk neonates revealed approxi-
mately 7% of pathologic results with almost two-thirds having bilateral affected. The significant independent
risk factors in this study population were craniofacial anomalies and mechnical ventilation > 5 days. The
protocol of having trained nursing staffs to perform the screening yielded good results, i.e., the coverage of
screened infants within 3 months of age (97%), feasible duration of procedure.
Keywords : Hearing screening, High-risk neonates, Automated OAE/ABR device
