Newborn Screening Practitioner's Manual

1y ago
29 Views
2 Downloads
567.61 KB
62 Pages
Last View : 14d ago
Last Download : 2m ago
Upload by : Casen Newsome
Transcription

State of IllinoisIllinois Department of Public HealthNewborn ScreeningPractitioner’s ManualSeptember 2015

1Table of ContentsIntroductionOverviewIllinois Newborn Screening Disorder ListImportant Contact InformationPage3456Practitioner’s Newborn Screening ResponsibilitiesSpecimen CollectionNewborn Screening FeeRepeat Specimens, Diagnostic Testing and ReferralsRefusal of Newborn ScreeningNewborns Born Outside State of Mother’s Residence778888Collection of Newborn Screening SpecimensFilter Paper Collection FormTiming of Specimen CollectionTips for Specimen CollectionCollection of Repeat Specimens1010101213Handling and Submission of Newborn Screening SpecimensSubmitting SpecimensTimeliness141414Reporting of Screening ResultsNormal ResultsAbnormal ResultsUnsatisfactory Specimens15151515Referrals to Pediatric Medical Specialists and Other AgenciesPediatric Medical SpecialistsServices for Newborns with Sickle Cell Disease/Other Hemoglobin DisordersUniversity of Illinois at Chicago, Division of Specialized Care for Children (DSCC)Local Public Health Departments1616161616Newborn Screening DisordersAmino Acid/Urea Cycle DisordersBiotinidase DeficiencyCongenital Adrenal HyperplasiaCongenital HypothyroidismCritical Congenital Heart DiseaseCystic FibrosisFatty Acid Oxidation DisordersGalactosemiaHearingHemoglobin Sickling Disorders; Alpha and Beta Thalassemias(FS, FSC, FSa, FNA, Bart’s)Hemoglobin Sickling TraitsHemoglobinopathies-Other Types and Low Fetal HemoglobinLysosomal Storage DisordersOrganic Acid 505356

2Severe Combined Immune DeficiencyResourcesReferences586061

3IntroductionNewborn screening is a public health activity aimed at early identification of newborns affected with certaingenetic and/or metabolic conditions. Early diagnosis and treatment of these conditions has been shown in manycases to reduce morbidity, premature death and other developmental disabilities. Newborn screening isrecognized as one of the most successful recent public health accomplishments, and was the first populationbased genetic screening program to become an integral component of public health practice.While newborn screening disorders are individually rare, collectively the incidence of these disorders is aroundone in 500 births. In Illinois, each year around 350-400 newborns are diagnosed with a condition identified bynewborn screening. Newborn screening affects all health care practitioners who work with children and theirfamilies. During their practice of medicine, most pediatric and family medicine health professionals will receivea notice that a child in their care has a serious abnormal newborn screen, or has been diagnosed with a newbornscreening disorder.Health care practitioners are vital links within an effective newborn screening system, a system that includeshospitals, the state newborn screening laboratory and follow-up program, parents, health care providers, medicalspecialists and community service agencies. Health care providers serve as the front line in assuring allnewborns receive adequate screenings and, when necessary, appropriate follow-up services within a medicalhome.The Illinois Department of Public Health (Department) Newborn Screening Program developed this manual forhealth care professionals as a reference guide to newborn screening in Illinois. This resource provides protocolsfor specimen collection, laboratory testing, follow-up services, and the Department’s reporting of both normaland abnormal screening results. Information about the disorders included in the current newborn screening testpanel also are provided. This manual is intended to provide background information and general guidance onissues related to newborn screening, but does not replace the case specific medical advice available throughconsult with pediatric medical specialists, including those who may be contacted at the medical centers that canbe obtained by contacting the Department’s Newborn Screening Follow-up Program at 217-785-8101.

4OverviewThe Newborn Metabolic Screening Act (410 ILCS 240/) mandates newborn screening for all newborns born inIllinois. This act authorizes the Department to promulgate administrative rules for newborn screening (Title 77:Public Health, Chapter 1: Department of Public Health; Subchapter i: Maternal Child Health; Part 661 NewbornMetabolic Screening and Treatment Code). The Newborn Metabolic Screening Act and the newborn screeningadministrative rules may be viewed at the Department’s website, www.idph.state.il.us.All Illinois newborn newborns are mandated to have a blood sample collected on the special filter paperspecimen cards supplied by the Department. The only valid exception is parental refusal based on religiousbeliefs and practices; in which case, a written refusal must be signed by the parents and documented in thenewborn’s medical record.Newborn screening blood spot specimens should be collected as soon as possible after the first 24 hours of life.If the newborn is to be discharged from the birth center prior to 24 hours of age, the specimen should becollected before discharge. After drying, the specimen cards should be sent by courier to the Department’sNewborn Screening Laboratory in Chicago for testing. When testing is completed, a report of all test results isissued by the Department’s Newborn Screening Laboratory to the specimen submitter, usually the birthingfacility. Birthing facilities are expected to place the original screening report in the newborn’s medical recordand to relay a copy of the results to the newborn’s primary care provider.In addition to this laboratory report, abnormal, unsatisfactory and invalid test results are reported by theDepartment’s Newborn Screening Follow-up Program to the physician of record, the physician whose nameappears on the specimen card. In some cases, hospitals may authorize reporting of results to a specified hospitalcontact person. The physician of record or the birthing hospital newborn screening contact person is expected toinform the parent or guardian. If the newborn has a new primary care provider, the new physician should followup on any abnormal test results and facilitate any recommended follow-up activities. Necessary follow-up mayinclude evaluation of the newborn’s medical condition and collection of a repeat newborn screening specimen orreferral to a pediatric medical specialist for diagnostic testing. If the mother cannot be contacted, the assistanceof the birth hospital and/or the local public health department may be needed to help locate the family. TheDepartment’s Newborn Screening Program should be informed of any difficulties in locating the family. Everyeffort should be made to assure each newborn who has an abnormal newborn screen receives the appropriatefollow-up services in a timely manner.For newborns with any abnormal results requiring immediate referral to a pediatric medical specialist, a list ofDepartment designated specialists, information about the suspected disorder and the actual test results will beprovided to the physician of record or the hospital newborn screening contact. The American College ofMedical Geneticists (ACMG), www.acmg.net, provides detailed action plans for follow-up of suspectednewborn screening disorders. The University of Illinois at Chicago, Division of Specialized Care for Children(DSCC), www.uic.edu/hsc/dscc, provides additional information about these conditions and the importance ofmedical homes for children with special health care needs.In addition to these resources, the Maternal and Child Health Bureau of the Health Resources and ServicesAdministration provided grant funding to create the Region 4 Genetics Collaborative, which includes Illinois,Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin. The goals of this multi-state collaborativeinclude efforts to address inequities in genetics’ resources and to improve the quality of genetics’ services,including newborn screening throughout the region. The Region 4 Genetics Collaborative website,www.region4genetics.org, provides information about newborn screening, medical homes, specialty careresources and genetic counseling services available within this seven-state region.

5Illinois Newborn Screening Disorder ListAmino Acid DisordersHomocystinuria (HCU)/Hypermethioninemia - 2002Maple syrup urine disease (MSUD) - 2002Phenylketonuria (PKU)/Hyperphenylalaninemia - 1965Tyrosinemia (TYR) - 20025-Oxoprolinuria (5OXP) - 2002Biotinidase deficiency (BIO) – 1986Critical Congenital Heart Disease (CCHD) - 2013Cystic fibrosis (CF) - 2008Endocrine DisordersCongenital adrenal hyperplasia (CAH) - 1987Congenital hypothyroidism (HYP) - 1979Fatty Acid Oxidation Disorders - 2002Carnitine/acylcarnitine translocase deficiency (CACT)Carnitine palmitoyl transferase deficiency, type 2 (CPT2)Carnitine palmitoyl transferase deficiency, type 1A (CPT1A)Carnitine uptake defect (CUD)Glutaric aciduria, type 2 (GA2)/Multiple acyl-CoA dehydrogenase deficiency (MADD)Isobutyryl-CoA dehydrogenase deficiency (IBCD)Medium chain acyl-CoA dehydrogenase deficiency (MCADD)Medium/Short chain L-3-hydroxyacyl-CoA dehydrogenase deficiency (M/SCHADD)Long chain 3-hydroxyacyl-CoA dehydrogenase deficiency (LCHADD)Short chain acyl-CoA dehydrogenase deficiency (SCADD)Trifunctional protein deficiency (TFP)Very long chain acyl-CoA dehydrogenase deficiency (VLCADD)Galactosemia (GALT) - 1984Hearing Loss - 2002HemoglobinopathiesSickle cell disease, trait conditions and other hemoglobinopathies (SC) - 1989Alpha thalassemia - 2008Beta thalassemia major - 1989Lysosomal storage diseases (LSD) - 2015PompeFabryGaucherKrabbe – This disorder is not currently on the Illinois newborn screening panel.Niemann-PickMPS I (Hurler’s Syndrome)MPS II (Hunter’s Syndrome) – This disorder is not currently on the Illinois newborn screening panel.Organic Acid Disorders - 20022-methylbutyryl-CoA dehydrogenase deficiency (2MBCD)3-methylcrotonyl-CoA carboxylase deficiency (3MCC)3-hydroxy-3-methylglutaryl-CoA lyase deficiency (HMG)3-methylglutaconic aciduria (3MGA)Beta-ketothiolase deficiency (BKT)Glutaric aciduria, type 1 (GA1)Isovaleric acidemia (IVA)Malonic aciduria (MA)Methylmalonic acidemia (MMA)Multiple carboxylase deficiency (MCD)Propionic acidemia (PA)Severe Combined Immune Deficiency - 2014Urea Cycle Disorders - 2002Argininemia (ARG)Argininosuccinic aciduria (ASA)Citrullinemia (CIT)

6Important Contact InformationNewborn Screening Follow-up ProgramIllinois Department of Public HealthGenetics/Newborn Screening Program535 W. Jefferson St., Second FloorSpringfield, IL 62761Phone 217-785-8101FAX 217-557-5396Newborn Screening LaboratoryIllinois Department of Public HealthDivision of Laboratories2121 W. Taylor St.*Chicago, IL 60612Phone 312-793-4752FAX 312-793-1054Accounting ServicesIllinois Department of Public HealthAccount Services Billing Manager535 W. Jefferson St., Fourth FloorSpringfield, IL 62761Phone 217-524-5780WebsitesIllinois Department of Public Health Genetics/Newborn Screening Programwww.idph.state.il.us/HealthWellness/newborn screening/index.htmIllinois Department of Public Health Newborn Screening tories/manual/Manual of Services OHP LABS.pdf#page 53*Note: Newborn Screening Shipping LabelsSpecial courier service shipping labels are available to birthing facilities. To order labels and newbornscreening specimen collection forms, contact the IDPH Laboratory in Springfield at 217-524-6222. To establishthis courier service, contact the Department’s Newborn Screening Follow-up Program at 217-785-8101.Other submitters of newborn screening specimens are encouraged to utilize a courier service for prompt deliveryof these dried blood samples, and shipping labels should be addressed to the IDPH Newborn ScreeningLaboratory listed above.

7Practitioner’s Newborn Screening ResponsibilitiesSpecimen Collection Attending physician at birth or in the immediate newborn period has primary responsibility forcollection of a specimen for newborn screening. The physician’s responsibility may bedelegated to the hospital administrator or the administrator’s designee. If the birth is attended by a licensed nurse midwife, the midwife has primary responsibility forcollection of a specimen for newborn screening. Parents should be informed a blood specimen will be collected from their newborn and printedinformation about newborn screening and how parents can access screening results should beprovided.ooo Newborn Screening Guide for Parents: Newborn's First Steps in Life document isavailable through the Department’s Genetics/Newborn Screening Program. Anelectronic file of this document may be downloaded from the Department’s website,www.idph.state.il.us, and reprinted for distribution.Documentation that a newborn screening specimen was collected and a copy of thescreening results should be placed in the newborn’s medical record.Parents should be informed that accurate contact information (emergency contact,current address and valid phone number) is vital should their newborn’s newbornscreening test be abnormal and additional testing or referral of the newborn to aspecialist become necessary.Physician or health care provider caring for the newborn during the first month of life isresponsible for newborn screening if:ooBirth occurs outside of a hospital or medical facility.Birth occurs without a physician or licensed midwife in attendance. The American Academy of Pediatrics, August 2000 supplement to Pediatrics, “Serving theFamily from Birth to the Medical Home,” suggests the role of the medical home health careprofessional include establishment of office protocol to retrieve the results of newbornscreening for newborns admitted to the practice when scheduling the first appointment. Whenscreening results cannot be documented, a newborn screening specimen should be collectedfrom the newborn and submitted for testing. The Department encourages primary care practitioners to provide medical homes, and tofacilitate follow-up services for newborns with abnormal newborn screening results.o The federal Maternal and Child Health Bureau of the Health Resources and ServicesAdministration (HRSA) funded Region 4 Genetics Collaborative website,www.region4genetics.org, provides information about newborn screening, medical homes,pediatric specialty care resources and genetic counseling services available within thisseven-state region.Primary care providers have an obligation to verify newborn screening results and should notassume lack of notification indicates the newborn’s screen was normal.

8ooo Reports may be sent to the wrong health care provider.Specimens may be lost in transit to the Department laboratory.Hospitals may fail to collect a newborn screening specimen prior to hospitaldischarge or transfer.If there is no physician caring for the newborn, the parents are responsible for obtainingnewborn screening for their newborn. Contact the IDPH Newborn Screening Follow-upProgram at 217-785-8101 for specimen collection cards and instructions.Newborn Screening Fee A fee will be charged for each specimen submitted to the Department Newborn ScreeningLaboratory for testing. This fee provides funding for testing, follow-up services for newbornswith abnormal results and provision of certain medically necessary dietary treatment formulas. The Department bills hospitals, health care agencies and any specimen submitter on a monthlybasis for newborn screening specimens submitted during that month.Repeat Specimens, Diagnostic Testing and Referrals Physician of record or hospital designee is responsible for informing parents and/or newborn’sprimary care/medical home provider of abnormal or unsatisfactory test results. If repeatscreening is necessary, the physician of record is responsible for obtaining and submitting arepeat specimen and/or informing the newborn’s primary care provider of the need foradditional testing. If referral of the newborn to a pediatric medical specialist is necessary, the physician of recordor hospital designee is responsible for assisting the newborn’s family and facilitating thereferral. The Department recommends the physician’s office contact the medical specialist andprovide the screening results to assure the referral is completed, and the screening results areaccurately reported. Physicians and hospital staff should not refer to the newborn metabolic screen as the “PKUtest.” Use of this outdated terminology has resulted in confusion about newborn screeningresults among primary care providers, medical specialists and parents.Refusal of Newborn Screening Parents may refuse newborn screening only on the basis of religious beliefs and practices.If parents refuse newborn screening of their newborn, parent education about the benefits ofnewborn screening should be provided, and the newborn’s primary care provider should beinformed about the refusal. A written objection statement is to be signed by the parents andplaced in the newborn’s medical record.Newborns Born Outside State of Mother’s Residence Any newborn born in Illinois will have an Illinois newborn screening specimen submittedregardless of the mother’s state of residence. Illinois residents whose newborns are born in other states may obtain newborn screeningthrough the Department’s Newborn Screening Laboratory. The physician should obtain the

9Department’s filter paper specimen forms or order the screening test through an Illinois birthingfacility. If an initial screening was performed in another state, a second newborn screeningspecimen may be submitted to the Department. Specimens should be collected and submittedas soon as possible after 24 hours of age. Newborn screening of newborns older than 6 monthsof age is not recommended as the Department’s values are based on normal analytes,distributions and controls for newborns. If you have questions about screening an oldernewborn, contact the Newborn Screening Follow-up Program at 217-785-8101 Newborns born in Illinois whose mothers reside in another state must have a specimen sent tothe Department’s Newborn Screening Laboratory.

10Collection of Newborn Screening SpecimensFilter Paper Collection Form Only Department filter paper specimen collection forms are accepted by theDepartment’s Newborn Screening Laboratory. The U.S. Food and Drug Administrationnow requires printed expiration dates on specimen cards, and health care providers areadvised to check the card prior to specimen collection. Newborn screening filter paper specimen collection forms may be requested bycontacting the Department’s Division of Laboratories Springfield office, 217-524-6222,or by faxing a request with appropriate contact information to 217-558-3476. Filter paper specimen cards should be stored in a cool, dry location out of direct sunlight.Cards should be stored in their original wrappings and stacked in a manner that avoidscompressing the paper. When properly stored, specimen cards have a shelf life ofapproximately two years. Each card has a printed expiration date and once expired, thespecimen cannot be considered valid. When expired cards are received, although testingis performed, the Department must issue a report requesting submission of a new samplefor a valid screening. Birth history and identifying information requested on specimen collection forms shouldbe complete, legible and written in black ink only. Accurate personal health informationis necessary for valid and reliable test results. Current personal contact information is needed for identifying the newborn andcontacting the parents, should abnormalities be detected in the blood sample.Timing of Specimen Collection Newborn screening specimen collection from healthy newborns should occur as soon aspossible after 24 hours of age, preferably within the first 24-48 hours of life. Specimensshould not be collected prior to 24 hours of age, except in special circumstances. Special circumstancesooo Early discharge: If the newborn is to be discharged at less than 24 hours of age,collect specimen prior to discharge. The attending physician, or designee, shallcollect a second blood specimen for testing between 48-72 hours of age. Informparents the newborn must be rescreened during the second day of life.Transfers: If the newborn requires transfer to another facility, if at all possible, aspecimen should be collected prior to transfer, regardless of newborn’s age. If aspecimen cannot be collected prior to transfer due to the medical instability of theneonate, the transferring facility is responsible for informing the admittingfacility of the need for specimen collection prior to transfusion and/or within first24-48 hours of life.Newborns born outside of hospital/medical facilities: These newborns shouldhave a specimen collected at 24-48 hours.If a specimen is collected prior to 24 hours of age, repeat specimen collection is

11necessary as soon as possible during the second day of life. Preterm, Low Birth Weight, and Sick Newborns: Any newborn admitted to the neonatalintensive care unit (NICU), special care newborn unit (SCBU), newborn’s who areyounger than 34 weeks’ gestation and/or 2,000 gramsooooo Newborns admitted to a NICU or SCBU should have a blood specimen collectedregardless of age, medical condition or feeding status upon admission.A second specimen shall be collected between 48-72 hours of age.A third specimen shall be collected at 28 days of age or prior to discharge fromthe NICU or SCBU, whichever situation precedes.The “NICU” check box on the specimen card should be marked on specimensfrom all newborns admitted to a NICU or SCBU.The “Retest” check box should be marked for all repeat specimens.Special feedings: Newborns requiring soy formula, hyperalimentation or total parenteralnutrition (TPN), and those not yet receiving milk (galactose) feedings at the time ofspecimen collection require documentation of feeding type or status on the specimencard.o The feeding type check box should be clearly marked for “Breast,” “Soy,” “TPN,”“Carnitine,” “NPO” (nothing by mouth) or “Other.” This information is important tonewborn screening laboratory staff and the newborn’s physician should anabnormality be detected.o Soy formula or lack of milk feeding may affect screening for galactosemia.o Hyperalimentation and TPN may affect tandem mass spectrometry screening forsome amino acid, fatty acid oxidation and organic acid disorders. If screening results suggest TPN effects, another specimen is requested whenthe newborn has been off TPN for 48 hours or on day 28 of life if thenewborn was admitted to NICU or SCBU. Antibiotics: When newborns are receiving antibiotics at the time of specimen collection,the “Antibiotic” check box on the specimen collection card should be marked, as thepresence of antibiotics and some other medication metabolites (valproic and benzoicacids) may be detected by tandem mass spectrometry. In these cases, a repeat samplewill be requested. Transfusions: If at all possible, collect an initial specimen prior to transfusion regardlessof the newborn’s age. If this is not possible and the newborn was transfused prior tospecimen collection, indicate the last transfusion date prior to the specimen collection onthe filter paper collection form.oooTransfusions may affect screening for classical galactosemia, biotinidasedeficiency, hemoglobinopathies and lysosomal storage disorders.If the newborn’s initial specimen was collected post-transfusion, a secondspecimen should be collected 48-72 hours post-transfusion, and a third specimenis required 120 days after the final transfusion.If the newborn has multiple blood transfusions after birth, a newborn screeningspecimen should be collected at 48-72 hours of age regardless of timing of lastblood transfusion.

12Tips for Specimen Collection Electronic copies of the newborn screening specimen collection posters “NeonatalScreening: Blood Specimen Collection and Handling Procedure” and “Simple SpotCheck” are available for download and printing through the Department’sGenetics/Newborn Screening Program, or for purchase through the Clinical LaboratoryStandards Institute (CLSI) at ionproducts/ A copy of the Clinical Laboratory Standards Institute (CLSI) document, “BloodCollection on Filter Paper for Neonatal Screening Programs; Approved Standard”(NBS01-A6) can be purchased /id.1659/.f?sc 7&category 8514. Heel stick is the preferred mode of collection for newborn screening whenever possible.oooooo After the heel has been punctured, wipe away the first drop of blood with a sterilegauge pad or cotton ball and allow a large drop of blood to form.Touch the filter paper gently against the large blood drop and allow a sufficientquantity of blood to soak through and completely fill preprinted circle on thefilter paper.Do not press the filter paper against the puncture site on the heel.Blood should be applied only to one side of the filter paper.Excessive squeezing of the puncture site may cause hemolysis of the specimen orresult in an admixture of tissue fluids with the specimen adversely affecting thetest result.Do not apply layers of successive blood drops to already partially dried bloodspots. This causes nonuniform analyte concentrations and invalidates thespecimens.Collection of specimens in capillary tubes is not the method of choice but can be used asa mode of collection.ooooooSpecimens can be obtained by applying blood collected in sterile heparinizedcapillary tubes to the collection device.Use a fresh capillary tube for each circle to be filled on the screening card.Immediately apply blood in the tube to the center of a single, preprinted circleon the filter paper, completely filling the circle.The capillary tube should not come in contact with the filter paper.Apply blood to only one side of the filter paper.Do not apply layers of successive blood drops to already partially dried bloodspots. This causes non-uniform analyte concentrations and invalidates thespecimens. If a heel stick is not possible, umbilical catheters may be used to obtain blood fornewborn screening, provided the line is cleared of IV fluids, heparin, antibiotics and otherextraneous substances. Blood should not be drawn from an extremity into which IV fluids are being or have beeninfused.

13 Although not the method of choice, blood collected from a venous needle puncture andits application directly onto the preprinted circles of the filter paper is possible. Properprocedure of venous collection:oooo After blood is drawn, remove the needle from the syringe and apply the blood tothe center of each preprinted circle on the filter paper, completely filling eachcircle.The syringe should not come in contact with the filter paper.Apply blood to only one side of the filter paper.Do not apply layers of successive blood drops to already partially dried bloodspots. This causes non-uniform analyte concentrations and invalidates thespecimen.The routine practice of venous collection is discouraged for the following reasons:oooTest results may be affected by blood from different vessel sources.Veins might be needed for IV fluids.Venous sampling is more invasive than a heel stick puncture.Collection of Repeat Specimens Repeat screening is requested by the Department when results of the original specimenwere borderline abnormal, the specimen was declared unsatisfactory for testing, or thespecimen was declared invalid due to delayed submission or incomplete information onthe specimen card. Routine repeat screening also is required for all newborns admitted to the NICU orSCBU. See Section “Preterm, Low Birth Weight, and Sick Newborns.” Submittersshould mark the “Retest” box on the specimen card. Submitters should provide adequate information to allow matching of any retestspecimens to the newborn’s original newborn screening record. All known names of thenewborn (beginning with the birth name), the mother’s full name, date of birth and thenewborn’s medical record number will greatly assist Newborn Screening Program staff inmatching the specimens.

14Handling and Submission of Newborn Screening SpecimensSubmitting Specimens It is recommended that newborn screening specimen collection forms be air dried for aminimum of three to four hours and submitted to the Department laboratory for testingwithin 24 hours of collection using a courier service. Newborn screening disorders are serious and can be life threatening, therefore earlydetection and treatment is vital. Failure to submit specimens promptly mayunnecessarily delay detection and treatment of affected newborns. Batching ofspecimens from multiple collection days is unacceptable. Illinois birthing facilities may utilize the Department supported courier service forpickup of newborn screening specimens and shipment to the Department’s Chicagolaboratory. Specimens should be submitted to the Department’s Division of Laboratories on adaily basis, during regular business days Monday through Friday. Saturday courierservice pickup of specimens for next business day delivery also is available tobirthing facilities, but must be requested in advance and arranged directlywith the courier service. Tracking courier service delivery of specimens to the Department’s Chicago laboratoryis the responsibility of birthing facilities. It is recommended that birthing facilitieskeep a log of their courier tracking numbers, along with the newborn screeningspecimen medical record numbers. Contact the Newborn Screening Program at 217785-8101 for more information about tracking deliveries and reporting courier serviceproblems. Reports on the timeliness of specimen delivery for each hospital submitting specimensto the Department are available through the Department’s Newborn ScreeningProgram’s website athttp://www.idph.

Practitioner's Newborn Screening Responsibilities 7 . Specimen Collection 7 . . a notice that a child in their care has a serious abnormal newborn screen, or has been diagnosed with a newborn . health care professionals as a reference guide to newborn screening in Illinois. This resource provides protocols

Related Documents:

A Guide for Newborn Care Providers. Table of contents Section 1 Background information 1.1 Introduction 1.2 NSO history 1.3 NSO contact information 1.4 Newborn screening essentials 1.5 Newborn screening timeline 1.6 Newborn screening results 1.7 List of disorders included in the NSO screening panel

P007 Newborn affected by oth medical procedures on mother, NEC P0081 Newborn affected by periodontal disease in mother P0089 Newborn affected by oth maternal conditions P009 Newborn affected by unsp maternal condition P010 Newborn (suspected to be) affected by incompetent cervix P011 Newborn (suspected to be) affected by premature ROMFile Size: 1MB

diagnostic testing by an audiologist or physician in accordance with the Georgia Newborn Screening Program Policy and Procedure Manual’s approved instrumentation, protocols and pass/refer criteria; (l) “Newborn Screening and Genetics Advisory Committee (NBSAC)” is a multi-disciplinary group of

Newborn examination . As part of this project, you will be conducting a newborn examination. All births (both live and still births) that occur within the study will need to have a newborn exam completed. A newborn examination has many purposes including: It allows us to quickly identify certain problems the baby may have been born with, and

Newborn Care: A Guide to the First Six Weeks Facilitator’s Guide 2013 InJoy Productions, Inc. Permission to copy granted. 2 Introduction (0:59) a. Parenting a newborn may seem mysterious at first, but with time and experience, new parents will learn how to best care for their baby 1. Your Newborn (3:09) a. Newborn Appearances – baby’s .

1.1 Development of the Nigeria Every Newborn Action Plan 6 1.2 Overview of the Nigeria Every Newborn Action Plan 6 1.3 The Global Picture 7 2.0 The State of Nigeria's Newborns 8 2.1 Newborn Mortality Trends and Disparities 8 2.2 Causes of Neonatal Mortality 9 2.3 Stillbirths 10 2.4 The Maternal and Newborn Health Continuum of Care 10

4.4 Emerging and re-emerging infections 43 4.5 Clinically insignificant transfusion-transmissible infections 44 5 Blood screening, quarantine and release 45 5.1 Blood screening process 45 5.2 Approaches to blood screening 45 5.3 Pooling for serological assays 47 5.4 Sequential screening 47 5.5 Blood screening and diagnostic testing 48 5.6 Emergency screening 48 5.7 Screening plasma for .

electromagnetic compatibility and product safety. 5 3. Test plan Before proceeding with any testing, the vendor needs to submit a test plan for approval by the designated Project Officer, who will assess the test plan and notify the vendor in writing as to whether the test plan has been approved or rejected. If rejected or incomplete, the Project Officer will state the reason and allow the .