Meeting the Joint Committee on Infant Hearing Standards in a Large Metropolitan Children's Hospital: Barriers and Next Steps
Meeting the Joint Committee on Infant Hearing Standards in a Large Metropolitan Children's Hospital: Barriers and Next Steps
复制标题
DOI：
10.1044/2019_aja-18-0001
复制
发表时间：
2019-06-01
影响因子：
1.8
通讯作者：
Uhler, Kristin M.
中科院分区：
文献类型：
--
作者：
Awad, Rebecca;Oropeza, Johanna;Uhler, Kristin M.
目的：本研究的目的是确定一家大型大都市儿童医院的做法如何与婴儿听力联合委员会(JCIH)1-3-6指南保持一致(在3个月大时诊断听力损失，在确诊后1个月内安装助听器，并在6个月大时参加早期干预)，并检查影响满足这些指南的变量。这家医院不是分娩医院。因此，第一个建议(1个月龄听力筛查)没有被评估。方法：本研究回顾了141例6个月以下婴儿的听觉诱发电位评估。只收集了确认为双侧听力损失的婴儿的数据(n=34)。结果：62%的婴儿在3个月大时被诊断为听力损失，48%的婴儿在4个月大时开始配戴助听器，早期干预的婴儿平均年龄为4.58个月。70%的婴儿在听力损失诊断后1个月内试穿。导致助听器在诊断后1个月以上配戴的变量如下：取消/错过预约、中耳受累和轻度听力损失。结论：本次内部审核的结果显示，在3个月龄前达到或超过JCIH的诊断建议和诊断后1个月内配戴助听器的情况下，助听器的增长机会更大。已根据这些结果对日程安排程序和任命办法进行了调整。需要进一步审查为什么这些建议没有得到满足，以及可以做些什么来实现这些建议。
Purpose: The aim of this study was to determine how a large metropolitan children's hospital's practices align with the Joint Committee on Infant Hearing (JCIH) 1-3-6 guidelines (diagnose hearing loss by 3 months of age, fitted with hearing aids within 1 month of diagnosis, and enroll in early intervention by 6 months of age) and examine variables that have impacted meeting these guidelines. This hospital is not a birthing hospital. Therefore, the first recommendation (hearing screen by 1 month of age) was not evaluated.Method: One hundred forty-one auditory evoked potential evaluations for infants under the age of 6 months were reviewed for this study. Data were only gathered for infants identified with a bilateral hearing loss (n = 34). The following was recorded: degree of hearing loss, number of diagnostic sessions over time, the percentage of infants who transitioned to hearing aid fittings, and the age at which JCIH benchmarks were accomplished.Results: Sixty-two percent of infants were diagnosed with hearing loss by 3 months of age, 48% of infants were fitted with hearing aids by 4 months of age, and the average age of infants enrolled in early intervention was 4.58 months. Seventy percent of infants were fitted within 1 month of the diagnosis of hearing loss. The identified variables that led to the hearing aids being fitted greater than 1 month after the diagnosis are as follows: cancellations/missed appointments, middle ear involvement, and mild hearing loss.Conclusions: Results of this internal audit revealed opportunities for growth in better meeting and exceeding JCIH recommendations of diagnosis by 3 months of age and hearing aid fitting within 1 month of diagnosis. Adjustments in the scheduling process and appointment options have been implemented in response to these results. Additional examination of why these recommendations are not being met and what can be done to achieve them is needed.