With
more than 6,000 births each year, Hvidovre Hospital is the largest location for primary baby screening
in Copenhagen. It also has a sizeable staff of biomedical analysts and its consulting pediatrician,
Dr. Klaus Boerch, has played a pivotal role in the startup phase of UNHS in Denmark.
To efficiently manage the hearing/PKU screening of an average of 32 babies per day, 10 biomedical analysts went on a 5-day training course and currently perform screening duty once a week, two at a time. While the screening process has to run like clockwork, the trick is to achieve that without stress, and without delays. Or as Kirsten Marie phrases it: “we project a very relaxed and settled environment, with a calm tempo. You can’t force the pace.”
Screening starts every weekday at 8.a.m. and continues until 2 p.m. with breaks for lunch and coffee. Screening also includes testing of NICU and prematurely born infants, and thus sometimes comprises both OAE and AABR measurements.
A highly successful screening program
The schedule the biomedical analysts have run throughout most of 2005 has proved more than effective: after 7 months, they had screened approximately 3,500 babies, and referred 53, or less than 2%.
While many factors can account for the successful start of the screening program, Mona’s view is: “I think that the success of the program can largely be explained by the fact that it’s voluntary and the parents are coming of their own free will. And then the midwives, who have the first contact with the parents, have also been very positive.”
Handling parents takes experience, and tact
Thorough training coupled with the capable, confident way the biomedical analysts handle parents no doubt also plays a large part in the program’s success at Hvidovre. And while parents vary a lot – some are well-informed, some nervous, some curious – just about all of them are positive. And the comprehensive training course included practice at dealing with all types of parent and situation, including the challenge of communicating the bad news signaled by a refer: “For us, the most difficult aspect of this assignment has been talking to the parents and informing them about the status of their baby’s hearing. It’s easy to give positive news, but there are always those we have to re-test or refer further up the system.”
Handling the screening technology is easy
For biomedical analysts who are accustomed to using, and troubleshooting, complex equipment, learning to use the screening technology was the easy part. As Mona says “I found AccuScreen very easy to learn to use. There are just a few easy to navigate menus, and the language is easy to understand.” So easy in fact that the instruction manual is seldom used.
Another major benefit using the AccuScreen has been its fast testing speed – OAE testing is quickest and least sensitive to noise. According to Kirsten Marie “from when the baby is ready for testing, it can take from 10 seconds to max. 5 minutes,” while with AABR “if the baby is a little unsettled, it takes longer – the measurement itself usually takes only about 30 seconds. Sometimes you don’t even get to look at the instrument before the result appears on the display.” Mona adds, “if you’ve got a quiet baby, it’s quick and easy to perform OAE. AABR is a bit more sensitive. Generally, it takes longer and it’s important that the baby is quiet throughout the procedure. One can normally perform OAE even when the baby is a bit unsettled, but not with AABR, which is also sensitive to electrical noise.”