In all fields, when it comes to papers, everyone is certainly familiar with them. Thesis is a tool for academic communication. What kind of paper can be called an excellent paper? The following is the operation and nursing papers of newborn hearing screening that I collected for you, for reference only, hoping to help you.
Newborns; Hearing screening; nurse
Newborn hearing screening is a technical service for maternal and child health care carried out by the state according to law. Hearing impairment is one of the common abnormalities in newborns. Neonatal hearing screening can find the hearing impairment of infants early, so as to intervene early and reduce the impact of hearing impairment on infants in all aspects. Our hospital started hearing screening for newborns in 2008, and achieved good results, and the operation and nursing were constantly improved. The report is as follows.
1 data and methods
Subjects1.1All newborns born in our hospital from June 2008 to April 2009, including normal newborns and high-risk newborns, were screened for hearing.
1.2 Specific criteria for screening mode According to the Technical Specification for Newborn Hearing Screening issued by the Ministry of Health, it is a two-stage screening mode.
Newborns are screened first before leaving the hospital. Those who fail the screening will be re-screened within 42 days. Those who fail the re-examination will be re-examined three months later. Those who still fail will be transferred to the hearing testing center for diagnosis to determine whether there is hearing loss, the degree of loss and the intervention plan. Even if newborns with high risk factors pass the screening, they should be followed up every 6 months for 3 years.
1.3 specific methods
1.3. 1 The equipment adopts German hand-held MAICO otoacoustic emission hearing screening instrument, and the transient sound induces otoacoustic emission. The preparation of testing instruments mainly includes: ① The testing instruments should be maintained and inspected regularly. Before each test, check whether the instruments are normal, whether the power supply is sufficient, and whether the probe holes are unobstructed. (2) Prepare a special cotton swab for otology to clear the obstruction of external auditory canal. (3) Prepare special fine needle and disinfectant for the probe, so that the probe hole can be cleaned in time when it is blocked.
1.3.2 The specific time and frequency of the two-stage screening mode shall be implemented according to the Standards of the Ministry of Health: newborns shall be screened before leaving the hospital, and those who fail shall be screened 42 days later. The best time for newborn hearing screening: 48-72 hours after birth [1], because with the extension of birth time, amniotic fluid and effusion in the ear canal are gradually absorbed, thus improving the pass rate.
1.3.3 preparation of the test environment, it is best to keep the test room relatively quiet and the noise does not exceed 40 decibels [2]. Turn off the surrounding sound sources during operation to ensure the smooth detection. Parents' preparation: fully respect parents' right of informed consent, and educate parents about relevant knowledge before the exam. Many parents don't know much about newborn hearing screening. Some parents think that their children will respond to external sound stimuli, so their hearing will be fine and they are unwilling to do this test. At this time, we should patiently explain to parents that newborn hearing screening has always been one of the newborn screening items stipulated by the Ministry of Health, so that they can understand the purpose, significance and methods of screening and the consequences of hearing impairment, and let them know that most hearing-impaired newborns can hear some sounds, but it is not enough to promote the good development of speaking ability, so as to gain the understanding and support of parents.
The state of the newborn is very important. If the baby is crying and upset, it is easy to affect the test results, and even the test cannot be carried out. Therefore, the best test should be carried out when the baby is nursing and falling asleep naturally. A few are tested in a quiet state when feeding, and the baby's head is fully stroked to make it fall asleep quietly. 1.3.5 Specific operation of earplug placement: the newborn lies on its side or holds it in its arms, with the test ear facing upwards, gently pulls the auricle backward to straighten the ear canal, cleans the ear canal of both ears with sterile dry cotton swabs, then selects the earplug of the appropriate model according to the size of the ear hole, then gently puts the probe into the ear canal of the newborn, places the earplug in the same direction as the external auditory canal, and pays attention to sticking it in the external auditory canal, and then monitors the other side in the same way. Prevention of cross infection: Wash your hands before and after giving the baby a test. When testing the baby, if there is no suspicious infection, you can use the same earplug in both ears. If infection is suspected, replace earplugs and disinfect them in time. The probe should be kept clean during the whole process, and the used earplugs should be cleaned and disinfected every day for later use. There is no cross infection in hearing screening in our hospital.
1.3.6 other strict checking systems: strictly check the name and bed number of the newborn mother, and make records on the test result sheet in time; Some newborns cry and fret after testing one ear, and can't continue to test the other ear. They should mark it in time to avoid missing the test. Keep the test environment quiet, comfort the baby and try to avoid false positives. Psychological guidance of parents: According to different examination results, parents' psychological state should be considered to reduce their psychological burden, so as to obtain parents' cooperation and enable each newborn to complete the screening procedure.
Two results
Newborns born in our hospital, including normal newborns and high-risk newborns, have been screened for hearing. The primary screening failed in 65,438+020 cases, and the secondary screening passed in 42 days in 65,438+065,438+00 cases. The secondary screening failed in 3 cases, failed in 3 months and failed in 4 cases. It is recommended to go to a higher hospital for diagnosis and examination.
3 Conclusion
Neonatal hearing screening can find children with hearing impairment early and give timely intervention to reduce the impact on language development and other neuropsychiatric development. At present, the goal of newborn hearing screening is: permanent binaural or monaural, sensitive or transmissible, and the average hearing loss is equal to or greater than 30-40dB in the language frequency range (0.5-4KHz). A large number of studies have confirmed that hearing loss within this range has a great impact on children's communication, cognition, behavior, emotional development, study and future employment, so it is necessary to diagnose and deal with it as soon as possible to minimize this negative impact. Therefore, it is hoped that these suspicious patients will be diagnosed within 3 months and intervened within 6 months through universal screening.
The whole hearing screening process should be carried out in strict accordance with the operating specifications to ensure that the stability rate and artifact rate of the instrument are within the normal range. Providing a quiet environment, ensuring the newborn to sleep soundly, and having a high sense of responsibility and skilled operation skills are the keys to reduce false positive results. At the same time, careful work plan can improve work efficiency, and good health education can improve parents' compliance with hearing screening.
refer to
Cai Guorong. Timing of newborn hearing screening. Nursing research, 2003, 17 (9): 1086.
[2] Jiang. Analysis of the influence of neonatal examination time on the results [J]. China Journal of Practical Nursing, 2004,20 (1): 28-29.
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