Current Concepts in Universal Newborn Hearing Screening and Early Hearing Detection and Intervention Programs

Karin Gracey, MSN, RNC, CNNP


Adv Neonatal Care. 2003;3(6) 

In This Article

Failing the Initial Hearing Screening

Possible reasons for failing the initial hearing screen include debris (vernix) in the ear canal, fluid in the middle ear, moving or crying during the test, equipment failures, or inexperience of the tester. Repeat hearing screening is recommended as soon as possible, preferably before hospital discharge. A recommended follow-up scenario is outlined in Figure 3.

Sequential approach to testing and follow-up is essential for universal hearing screening effectiveness.

Nursing strategies to implement to ensure accurate test results include positioning the infant on his back to have easy access to both ears, testing while the infant is asleep or in a quiet alert state, and testing in an area in which noise and disruptions can be minimized. If possible, delay testing until after the completion of all ototoxic antibiotic therapy. Minimize distractions as much as possible, avoid busy times on the unit such as rounds, minimize visitors and equipment alarms, and ask the staff to speak in quiet voices.[13]


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