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Changes for newborn hearing screeners
The changes are part of national changes to the Universal Newborn Hearing Screening and Early Intervention Programme, implementing the recommendations of an independent review completed for the National Screening Unit (NSU) last year.
One of the major changes is the introduction of a single type of equipment for all newborn hearing screening. By June 2016 all newborn hearing screening nationally will be performed using the Beraphone MB11 screening device. The Beraphone was selected following a national tender last year that evaluated devices across a wide range of criteria. DHBs will now be able to take advantage of the savings from a national contract with the supplier company Sonic, which includes purchase of equipment, access to loan devices and maintenance.
NSU Antenatal and Newborn Screening Manager Kathy Bendikson says having one type of equipment will mean national consistency in training and easier monitoring and programme evaluation.
While the Beraphone isn’t new to all DHBs, Kathy says all screeners are getting training and support in its use from a team of people, including an experienced audiologist trainer from Sonic, Jan Pollard.
‘Each screener has to be ‘signed off’ as competent in using the Beraphone. Feedback on the training so far has been positive.’
'Frank’ the trainer doll baby, complete with steel bolts to indicate the mastoid, ground and vertex positioning of the electrodes of the screening head phone, is a star of the training sessions.
‘Beraphone training with cute Frank was excellent,’ says screener Pat Rabe from Northland DHB. ‘I found it really helpful to be shown exactly where the sensors should be put.’
Another major change to the screening programme is to the test regime itself (the type of screening and number of steps). Until now newborn hearing screening in New Zealand has involved two different test types – automated otoacoustic emission (AOAE) testing followed by automated auditory brainstem response (aABR) testing if there isn’t a clear response.
Under the new regime AOAEs will no longer be used and all DHBs will move to ‘double aABR’ testing, as used in many overseas programmes, including Australia.
It’s the most significant change to the programme since its implementation in 2010.
Kathy says while dropping one test type doesn’t sound big it involves many components of the programme infrastructure – screening protocols, scripts, documentation, consumer resources and the frameworks for monitoring and evaluating the programme have all had to change.
The NSU expects all DHBs to be using aABR-only screening by 30 October this year and the new equipment by 30 June 2016.
‘We expect there will be lots of benefits from an aABR-only programme, as aABR tests the whole hearing pathway and is more suited to earlier screening. We expect more babies will pass their first screening, and fewer families will need to come back for outpatient appointments.
‘Having one test type will also simplify things for screeners and families. It won’t be necessary to explain two test types, change screening equipment and train on two tests. It will also simplify quality assurance systems.’
Northland screener Sylvia Graham agrees. ‘Once we have consolidated the changes it will really improve our efficiency.’
There are changes to the programme for audiologists too. Each DHB is making changes to its programme of audiology follow-up for babies who pass screening but have a risk factor for later onset or progressive hearing loss. Evidence from larger screening programmes has shown that some previously specified risk factors are poor indicators of later hearing loss and these have been discontinued.
Wellington region and MidCentral DHB screeners and audiologists are the next to be trained and have all staff ‘signed-off’ as ready to start using the new protocol and equipment.
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