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Diagnosis and management of permanent childhood hearing impairment (PCHI) using the newborn hearing screen
  1. D I Kevitiyagala,
  2. A Dighe,
  3. V Mainstone
  1. Community Child Health, Bath and North East Somerset PCT, Bath, UK

Abstract

Aim To look at the relevant standards set by the newborn hearing screening programme and assess how compliant our audiology team were in meeting those standards.

Methods Retrospective audit of all the patients diagnosed with permanent childhood hearing impairment (PCHI) through the newborn hearing screening process over a 4 year period from 1st January 2005 to 31st December 2009. An audit proforma examined the notes and looked at the time taken between various parts of the screening process and the demographics of our area's PCHI cohort (including risk factors). 48 patients were identified in this timeframe and the notes of 40 were examined (8 were unavailable).

Results Time from Birth to screen completion or AABRs (target 5 weeks) – 100% compliance for those from Neonatal Intensive Care Unit (NICU) but only 70% compliance for ‘well baby’ community. Time from AABR to ABR (target 4 weeks) – 100% compliance from ‘well baby’ community and 93% compliance from NICU population. 100% compliance for lead audiological contact with family on day of assessment. Only 55% of children referred to teachers of the deaf (ToD) within the recommended timeframe of 24 h. First visit by teachers of the deaf should within 48 h of first contact – only 43% compliance. Hearing aid fitting should occur within 4 weeks of confirmation of PCHI – only 54% compliance with this. 95% compliance with follow-up within 8 months.

Conclusions We performed well in several areas but there are aspects that need improvement. Our data was over a 4 year period. This has given a larger data pool but doesn't allow us to see the year-by-year improvements. Data for late 2009 to early 2010 shows that we have 97% compliance with time from birth to AABR in ‘well baby’ population. Poorest performance with the involvement with teachers of the deaf. Referrals were haphazard and visits to families are dependent on parent availability and contactability. Hearing aid fitting timeframes were also affected by parental indecision. This has highlighted several shortfalls but also some successes within our audiology service. New casenotes, careful documentation and better awareness of timeframes may improve service but it is important that we remain patient-led in our approach.

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