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

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 ≥ 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. © 2024 Isfahan University of Medical Sciences(IUMS). All rights reserved.