Identify two (2) variables needed to promote the accuracy of pulse oximetry results in the newborn. Discuss why these variables are important to address.

The identification of congenital heart defects in the newborn can be complicated.

After reading the article The nurse champion model for advancing newborn screening of critical congenital heart disease Discuss the following:

• Identify two (2) variables needed to promote the accuracy of pulse oximetry results in the newborn. Discuss why these variables are important to address.
• Identify two (2) benefits and two (2) limitations to performing a pulse oximetry on all newborns.
• Select one (1) of the six QSEN competencies and discuss how this competency can be used to make pulse oximetry screening in the newborn a reality to improve patient outcomes.

ANSWER

Improving Accuracy and Outcomes in Newborn Pulse Oximetry Screening

Introduction

Pulse oximetry screening has emerged as a valuable tool for detecting critical congenital heart disease (CCHD) in newborns. However, ensuring the accuracy of these results is crucial for early identification and intervention. This article examines the nurse champion model for advancing newborn screening of CCHD and explores variables that promote accuracy, benefits and limitations of universal pulse oximetry screening, and the integration of Quality and Safety Education for Nurses (QSEN) competencies to enhance patient outcomes.

Two Variables Promoting Accuracy of Newborn Pulse Oximetry Results

Sensor Placement: Proper sensor placement is essential for obtaining accurate pulse oximetry readings in newborns. Placing the sensor too loosely or on a limb with excessive movement can lead to unreliable results. Ensuring a secure and snug fit of the sensor on the infant’s foot or hand improves the signal quality, resulting in more precise readings. Healthcare providers must receive training and adhere to standardized guidelines for consistent and correct sensor placement.

Environmental Factors: Environmental factors can significantly influence the accuracy of pulse oximetry readings. Exposure to ambient light, including overhead lights or sunlight, can interfere with the sensor’s ability to detect the newborn’s pulse accurately. Additionally, motion artifacts caused by excessive movement or shivering can lead to misleading readings. To mitigate these factors, screening should be conducted in a dimly lit, quiet, and calm environment to minimize potential sources of error and optimize accuracy.

Importance of Addressing the Variables

Addressing these variables is crucial for promoting accurate pulse oximetry results in newborns. Ensuring consistent and appropriate sensor placement reduces the risk of false negatives or false positives, allowing for timely identification of CCHD. By controlling environmental factors, healthcare providers can minimize the influence of external variables on the readings, enhancing the reliability of the screening process (Engel & Kochilas, 2016). Accurate pulse oximetry results enable early detection and intervention, leading to improved outcomes and reduced morbidity and mortality associated with undiagnosed CCHD.

Benefits and Limitations of Universal Pulse Oximetry Screening: Benefits

Early Detection of CCHD: Universal pulse oximetry screening provides an opportunity to identify CCHD early, even in asymptomatic newborns, enabling prompt medical intervention (Kumar, 2016). This early detection improves outcomes, reduces complications, and saves lives.

Non-Invasive and Cost-Effective: Pulse oximetry screening is a non-invasive, painless, and relatively inexpensive procedure that can be easily integrated into routine newborn care. It does not require specialized equipment or extensive training, making it feasible for implementation in various healthcare settings.

Limitations

False Positives and False Negatives: Pulse oximetry screening can yield false-positive or false-negative results, leading to unnecessary follow-up tests or missed diagnoses. Factors like low birth weight, anemia, and respiratory distress syndrome can affect accuracy. Consequently, close monitoring and additional diagnostic evaluations are necessary to confirm or rule out CCHD.

Limited Detection Scope: While pulse oximetry screening is effective in identifying several CCHD conditions, it may not detect certain cardiac anomalies that do not affect oxygen saturation levels. Therefore, it should be used as part of a comprehensive screening program that includes clinical assessment and other diagnostic tools to ensure comprehensive coverage.

Integration of QSEN Competencies

The Quality and Safety Education for Nurses (QSEN) competency that can contribute to making pulse oximetry screening in newborns a reality and enhancing patient outcomes is “Informatics.” Informatics involves the use of information and technology to improve healthcare delivery and decision-making. In the context of pulse oximetry screening, informatics can facilitate the implementation and standardization of screening protocols, data collection, and analysis.

Through informatics, healthcare providers can establish electronic health record systems that enable efficient data capture, storage, and analysis of pulse oximetry results. This allows for real-time monitoring, identification of trends, and the generation of alerts for abnormal readings, improving the timeliness and accuracy of follow-up interventions (National Academies Press (US), 2000). Furthermore, informatics supports the integration of evidence-based guidelines and decision support tools into clinical practice, ensuring adherence to best practices and reducing errors.

Conclusion 

In conclusion, promoting accuracy in pulse oximetry results through variables such as proper sensor placement and controlling environmental factors is vital for improving the detection of CCHD in newborns. Universal pulse oximetry screening offers benefits such as early detection and cost-effectiveness but also has limitations such as false positives and limited detection scope. By integrating the QSEN competency of informatics, healthcare professionals can leverage technology and information systems to standardize screening protocols, enhance data analysis, and ultimately improve patient outcomes in newborns.

References

Engel, M. L., & Kochilas, L. (2016). Pulse oximetry screening: a review of diagnosing critical congenital heart disease in newborns. Medical Devices : Evidence and Research, Volume 9, 199–203. https://doi.org/10.2147/mder.s102146 

Kumar, P. (2016). Universal Pulse Oximetry Screening for Early Detection of Critical Congenital Heart Disease. Clinical Medicine Insights, 10, CMPed.S33086. https://doi.org/10.4137/cmped.s33086 

National Academies Press (US). (2000). Health Applications of the Internet. Networking Health – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK44714/