Investigating the Implementation Process of Clinical Guidelines for Early Diagnosis of Critical Congenital Heart Disease at Birth Using Pulse Oximetry in Isfahan

Document Type : Original Article(s)

Authors

1 Professor, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

2 MSc of Health Education, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

3 Associate Professor, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

4 Assistant Professor, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

5 Assistant Professor, Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

6 Professor, Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

7 Bachelor of Nursing, Shahid Beheshti OB & GYN Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Congenital heart disease is one of the most common birth defects. This study aims to examine the process of clinical guideline implementation to identify strengths and weaknesses.
Methods: In this cross-sectional study, healthy term and term neonates born from January 2023 to July 2023 were evaluated at Shahid Beheshti Hospital in Isfahan. The data collection tool was a checklist. The pulse oximetry (POX) was performed for healthy newborns within the first 24 hours after birth and before discharge from the hospital. Oxygen saturation (SpO2) < 89% in the baby's hand and foot was considered positive screening. If the SpO2 level was between 90-94%, the screening was repeated one hour later and if in the case of the same results, the newborn was referred to a specialist for further assessment. Healthy neonates with positive test results were followed up two months after primary POX screening.
Findings: Out of 500 neonates, 472 (94.4%) had a SpO2 level ³ 95%. Among the 21 cases who had a positive screening, one case had cardiac diseases (i.e., complete atrioventricular septal defect/pulmonary hypertension). Two healthy neonates with a positive screening were diagnosed with PFO after two months of follow-up. The assessment of the implementation process of newborn screening based on the checklist recommendations of clinical guidelines increased from 58.3 % to 91.6 % within six months.
Conclusion: The implementation of the critical congenital heart disease clinical guideline was found to be favorable and acceptable in this study and recommended for other hospitals to implement.

Highlights

Alireza Ahmadi: Google Scholar, PubMed

Zohreh Sadat Navabi: Google Scholar, PubMed

Mohammad Reza Sabri: Google Scholar, PubMed

Mehdi Ghaderian: Google Scholar, PubMed

Bahar Dehghan: Google Scholar, PubMed

Chehre Mahdavi: Google Scholar, PubMed

Zohreh Badiee: Google Scholar, PubMed

Keywords

Main Subjects

References

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Journal of Isfahan Medical School
Volume 41, Issue 751
3rd Week, March
March and April 2024
Pages 1192-1202

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History

  • Receive Date: 08 January 2024
  • Revise Date: 14 April 2024
  • Accept Date: 20 April 2024

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