Newborn Screenings

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Course Objectives

Apply safe preparation and heel stick collection principles
Recognize specimen defects and identify the appropriate next step
Explain screening and follow-up without diagnosing a condition

Course Content

Course Creator: Kirsten Hermens, NCMA-P

Total CE Hours: 1 Credit Hour

Pace Course #: 586-2904-26

Key Terms:

Screening
Dried blood spot
Unsatisfactory specimen
Out of range
Confirmatory testing
CCHD

Outline:
I. Introduction and key terms

Purpose of newborn screening and why healthy appearance is not enough
Blood spot, hearing, and pulse oximetry screening
Collection timing and repeat screening requirements

II. Preparation and safe heel stick collection

Infant identification, collection plan, and screening card information
Approved supplies, expiration dates, positioning, and comfort measures
Safe medial or lateral plantar heel sites and infant-specific devices
Warming, cleansing, drying, puncture, and suitable blood drop formation

III. Specimen quality and handling

One-sided application, full saturation, and avoiding layered blood
Infant aftercare, complete drying, prompt transport, and handoff
Recognizing defects and following correction or recollection procedures
Scenario and review

IV. Hearing and CCHD screening

Automated auditory brainstem response and otoacoustic emissions
Hearing screening, diagnosis, and intervention benchmarks
Pulse oximetry sites, timing, current algorithm, and clinical escalation

V. Parent communication and ethical practice

Consent, refusal, and current state and facility requirements
Privacy, residual blood spot policies, and parent questions
Interpreters, access barriers, and equitable follow-up
Scenario and review

VI. Selected screened conditions

PKU and maple syrup urine disease
Classic galactosemia and MCAD deficiency
Congenital hypothyroidism and congenital adrenal hyperplasia
Sickle cell disease and cystic fibrosis
Homocystinuria and biotinidase deficiency
Prematurity, transfusion, parenteral nutrition, and repeat screening

VII. Results and follow-up

In-range, out-of-range, and unsatisfactory findings
Responsible provider, verified contact information, and a clear action plan
Scenario and review

VIII. Conclusion

References:

Health Resources and Services Administration. (2024, December). Newborn screening process. https://newbornscreening.hrsa.gov/newborn-screening-process
Oregon Health Authority. (2026, January). Oregon newborn bloodspot screening practitioner’s manual.
https://www.oregon.gov/oha/PH/LABORATORYSERVICES/NEWBORNSCREENING/Documents/Practitioner%20Manual.pdf
Health Resources and Services Administration. (2024, December). Newborn screening results and follow-up. https://newbornscreening.hrsa.gov/newborn-screening-process/newborn-screening-results-and-follow
Centers for Disease Control and Prevention. (2025, December 15). Clinical screening and diagnosis for critical congenital heart defects. https://www.cdc.gov/heart-defects/hcp/screening/index.html
Health Resources and Services Administration. (2026, March). Classic phenylketonuria. https://newbornscreening.hrsa.gov/conditions/classic-phenylketonuria
Health Resources and Services Administration. (2026, March). Maple syrup urine disease. https://newbornscreening.hrsa.gov/conditions/maple-syrup-urine-disease
Health Resources and Services Administration. (2026, July). Classic galactosemia. https://newbornscreening.hrsa.gov/conditions/classic-galactosemia
Health Resources and Services Administration. (2026, March). Medium-chain acyl-CoA dehydrogenase deficiency. https://newbornscreening.hrsa.gov/conditions/medium-chain-acyl-coa-dehydrogenase-deficiency
Health Resources and Services Administration. (2026, March). Congenital hypothyroidism. https://newbornscreening.hrsa.gov/conditions/congenital-hypothyroidism
Health Resources and Services Administration. (2026, March). Congenital adrenal hyperplasia. https://newbornscreening.hrsa.gov/conditions/congenital-adrenal-hyperplasia
Health Resources and Services Administration. (2026, July). S,S disease (sickle cell anemia). https://newbornscreening.hrsa.gov/conditions/ss-disease-sickle-cell-anemia
Health Resources and Services Administration. (2026, March). Cystic fibrosis. https://newbornscreening.hrsa.gov/conditions/cystic-fibrosis
Health Resources and Services Administration. (2026, March). Homocystinuria. https://newbornscreening.hrsa.gov/conditions/homocystinuria
New York State Department of Health, Wadsworth Center. (2026, March). Collection of newborn screening specimens. https://www.wadsworth.org/sites/default/files/2026-03/Specimen%20Collection%20Guide%20%28Updated%20March%202026%29.pdf
Centers for Disease Control and Prevention. (2025, May 8). Research summary: Newborn hearing screening can improve reading skills. https://www.cdc.gov/hearing-loss-children/articles/newborn-hearing-screening.html
Baily, M. A. (2023). Newborn screening. The Hastings Center for Bioethics. https://www.thehastingscenter.org/briefingbook/newborn-screening/
Health Resources and Services Administration. (2024, December). Research and quality improvement. https://newbornscreening.hrsa.gov/about-newborn-screening/research-quality-improvement
Health Resources and Services Administration. (2024, December). Recommended uniform screening panel. https://newbornscreening.hrsa.gov/about-newborn-screening/recommended-uniform-screening-panel
Health Resources and Services Administration. (2024, December). Newborn screening results and follow-up. https://newbornscreening.hrsa.gov/newborn-screening-process/newborn-screening-results-and-follow