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Abstract

Newborn intensive care unit (NICU) patients are at risk for hearing loss. Early detection mitigates consequences of speech and language delay. The Joint Committee on Infant Hearing (JCIH) recommends hearing screening (HS) on all infants by 1 month of age. Often hearing screening is performed around the time of NICU discharge, often beyond JCIH recommendations. Automated auditory brainstem response (AABR) screening can be performed once an infant reaches 32 to 34 weeks corrected gestational age (GA). Our project aimed to reduce HS delay among NICU infants. We created and implemented a HS assessment tool defining gestational age and medical stability parameters for initial HS. Data were compared between 100 infants pre-implementation and 325 infants post-implementation. After implementation, infants had HS performed 4 days earlier in days of life (p=0.28) and 4 days earlier, prior to discharge (p14 days earlier prior to discharge (p < 0.0001). More preterm infants completed HS at < 1 month of age (34% vs 61%, p=0.06). Earlier HS is associated with a 6.3% increase in false positive screens among premature neonates, requiring repeat screening. While evidence suggest the tool may promote earlier HS for preterm infants, additional work on optimizing the HS technique is needed to lower false positive results.

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