NURSING PATIENT CARE POLICY & PROCEDURE
August 30, 2016
Nursing Manual (Red)
Policy #: 13.26P
Title: Newborn Hearing Screening
The purpose of this policy is to provide guidance in completing the mandatory
newborn hearing screen during an infant’s birth hospitalization.
A. The ALGO® 5 Newborn Hearing Screener will be used to screen infants prior to
discharge. The provider will order the “Newborn Hearing Screen” order in Health
Link to notify nursing staff that a hearing screen is needed.
B. Nurses who perform this task should complete education using the competency
checklist. See “Competency Assessment Tool: Newborn Hearing Screen” in the
Related section on U-Connect.
C. Infants appropriate for screening include:
1. 34 weeks gestational age and not older than six months of age who have
not had a hearing screen performed previously
2. Have intact ear, absence of open wounds or drainage
3. Sleeping or in a relaxed state (usually after a recent feeding)
A. Set-up screener
1. Turn on the screener.
a. First, push the main power switch to the on (I) position.
b. If the Panel PC does not start up, then press and hold the computer
power switch until the computer power light comes on. The
screener will begin its startup routine.
c. Press the printer power switch. The printer power light turns on.
The printer will also automatically turn on when printing the first
d. After a series of startup messages, the Login or Main window
2. Select the “screen baby” command button or F1.
a. Enter patient information: (Infants with no previous screening
i. Type the patient’s medical record number and press the tab
ii. Repeat for Last Name, First Name, Gender, and DOB
Page 2 of 4
b. Enter information into any other fields that are set as mandatory by
the system administrator, or any additional information you desire
to capture. (Infants with previous screening history).
i. Type the patient’s medical record number and press the tab
ii. Confirm the correct patient and medical record number has
iii. Review all information that automatically appears in the
data fields; correct or update entries as necessary.
3. Enter the risk factors information by highlighting the + button for yes,
the - button for no, or the “?” button for unknown.
4. Select a screening method. The device is defaulted to screen both ears
5. Once the screener set-up is complete, select Continue (F1) to proceed to
the Baby Preparation Window.
B. Prepare the Infant for Screening
1. Collect supplies.
a. Flexicoupler disposable earphones (a pair)
b. Jelly Tab sensors (a triplet)
c. Prepping materials as needed (for example, soap, gauze sponge or
2. Attach the sensor cable clips to the sensors.
3. Identify three sites for sensor placement and clean or prepare skin.
4. Place sensor/clips over sites.
a. Sensor with white clip to nape site (center and back of the neck)
b. Sensor with green clip to common site (shoulder)
c. Sensor with black clip to vertex site (center forehead, as high as
possible without placing above the natural hair line)
5. Check to make sure both impedance readings are less than 12 kOhms. If
not, prep site further.
6. Attach acoustic transducers to earphones and apply earphones to infant .
a. Red transducer: Right ear
b. Blue transducer: Left ear
C. Running the Screening Procedure
1. Once the infant is in a quiet or sleep state, select Continue (F1) to be
directed to the screening window.
2. Select Begin Screening (F1).
3. Monitor interference and impedance and adjust sensors if impedance
becomes too high.
4. If needed, pause the screen by selecting Pause Screening (F1).
5. Resume screening after intervention by selecting Resume Screening
6. Observe and record results.
a. Pass Condition:
i. The screener will generate a PASS result when it collects
sufficient data to establish with >99% statistical confidence
that an ABR signal is present and consistent with the
template at a minimum of 1,000 sweeps.
b. Refer Condition:
Page 3 of 4
i. The screener will continue to collect data up to 15,000
sweeps. If it has not established with 99% statistical
confidence that the ABR signal is present at 15,000 sweeps,
the screener will generate a refer result.
7. Provide parents with results using Hearing Screening Health Facts
8. If an infant refers, rescreen once when the infant is in a relaxed state.
9. Set up follow-up outpatient consultation for infants that refer.
D. Clean-up and Shutdown
1. Remove the clips from the sensor cable.
2. Remove sensors from the skin. Dispose of single patient use sensors.
3. Clean sensor cable with hospital disinfectant, according to hospital
guideline, for cleaning equipment that has come into contact with
4. Store sensor cable in the cart storage drawer or on the cable hanger
assembly at the back of the cart.
5. Remove earphones and acoustic transducers together from the infant.
6. Remove the acoustic transducers from earphones and dispose of
Flexicoupler single patient use earphone.
7. Clean earphone cables according to manufacturer’s instructions for
cleaning equipment that has come into contact with patients.
8. Store earphone cable in the cart drawer.
E. Turn off screener
1. Navigate to the Main Window. Choose F10 – Exit and then appropriate
option among Hibernate, Power Off, or Log Off. Press the main power
switch at the back of the screener to the off (O) position. Note: Wait 15
seconds after the completion of the final screen and printing of the
results label to ensure proper computer storage of the last screening
2. Disconnect and store power cord by draping power cord loosely around
the top of the mast behind the monitor.
1. Nurse completing the hearing screen will document in the appropriate
rows in the clinical record.
IV. UWHC CROSS REFERENCES
A. Competency Assessment Tool: Newborn Hearing Screen (see Related section on
B. Health Facts For You 7487, Results of Your Baby’s Hearing Screen
A. Bush, J. S. (2003). Practice guidelines. AAP issues screening recommendations to
identify hearing loss in children. American Family Physician, 67(11), 2409.
B. Houston, K. T., Bradham, T., Munoz, K. F., & Hutsell Guignard, G. (2011).
Newborn hearing screening: An analysis of current practices. Volta Review,
Page 4 of 4
VI. REVIEWED BY
Clinical Nurse Specialist, NICU
Clinical Nurse Specialist, Universal Care Unit
Director, Pediatric Nursing
Nurse Manager, NICU
Nursing Patient Care Policy and Procedure Committee, August 30, 2016
Beth Houlahan, DNP, RN, CENP
Senior Vice President Patient Care Services, Chief Nursing Officer