Abstract：
BACKGROUND: National recommendations in the United States specify that all infants with hearing impairment should be identified by 3 months of age. Infants who fail universal newborn hearing screening (UNHS) require follow up testing after hospital discharge. Follow up testing may be difficult to obtain in some communities within the ideal time frame. A rapid access multidisciplinary clinic was established for failed UNHS. The objective of this study is to report outcomes and patient satisfaction from an early access hearing detection clinic.
METHODS: Infants that failed UNHS were seen in the multidisciplinary clinic between 1/1/19 and 2/28/22. Patients underwent automated auditory brainstem response (ABR) and distortion product otoacoustic emissions testing and consulted with an otolaryngology nurse practitioner. Failed results were followed by diagnostic ABR. Surveys were administered at the beginning and end of the appointment.
RESULTS: In total, 169 infants were seen at a mean age of 8.4 weeks (95%CI 7.5, 9.4). Repeat testing was abnormal in 38 (22.4%). Diagnostic ABR was performed at an average age of 13.7 weeks (n = 34, 95% CI: 10.8, 16.6) and led to a diagnosis of hearing loss in 18 infants. Twenty-seven parents completed surveys at the initial visit. Anxiety level among patients with normal repeat testing (n = 20) decreased from 1.9 to 1.2 (p = .002), while anxiety level among those with abnormal repeat testing (n = 7) was not statistically different before and after (2.1 vs 2.7, p = .2). Satisfaction level was 3.7 ± 0.7 (scored 1-4). All parents reported having a better understanding of their child\'s hearing problem after the visit.
CONCLUSIONS: This novel nurse practitioner-led early hearing detection clinic enabled timely diagnosis of hearing loss and reassurance to families without hearing loss. Age at hearing loss diagnosis compares favorably to published cohorts.
METHODS: Infants that failed UNHS were seen in the multidisciplinary clinic between 1/1/19 and 2/28/22. Patients underwent automated auditory brainstem response (ABR) and distortion product otoacoustic emissions testing and consulted with an otolaryngology nurse practitioner. Failed results were followed by diagnostic ABR. Surveys were administered at the beginning and end of the appointment.
RESULTS: In total, 169 infants were seen at a mean age of 8.4 weeks (95%CI 7.5, 9.4). Repeat testing was abnormal in 38 (22.4%). Diagnostic ABR was performed at an average age of 13.7 weeks (n = 34, 95% CI: 10.8, 16.6) and led to a diagnosis of hearing loss in 18 infants. Twenty-seven parents completed surveys at the initial visit. Anxiety level among patients with normal repeat testing (n = 20) decreased from 1.9 to 1.2 (p = .002), while anxiety level among those with abnormal repeat testing (n = 7) was not statistically different before and after (2.1 vs 2.7, p = .2). Satisfaction level was 3.7 ± 0.7 (scored 1-4). All parents reported having a better understanding of their child\'s hearing problem after the visit.
CONCLUSIONS: This novel nurse practitioner-led early hearing detection clinic enabled timely diagnosis of hearing loss and reassurance to families without hearing loss. Age at hearing loss diagnosis compares favorably to published cohorts.
摘要：
背景：美国的国家建议规定，所有有听力障碍的婴儿应在3个月大时进行识别。未通过新生儿通用听力筛查（UNHS）的婴儿在出院后需要进行后续检查。在理想的时间范围内，某些社区可能很难获得后续测试。为失败的UNHS建立了快速访问多学科诊所。这项研究的目的是报告早期进入听力检测诊所的结果和患者满意度。
方法：在1/1/19和2/28/22之间的多学科诊所中观察到UNHS失败的婴儿。患者接受了自动听觉脑干反应（ABR）和失真产物耳声发射测试，并咨询了耳鼻喉科护士。失败的结果之后是诊断ABR。在任命开始和结束时进行了调查。
结果：总计，169名婴儿的平均年龄为8.4周（95CI7.5，9.4）。38例(22.4%)重复检测异常。诊断ABR在平均年龄13.7周时进行（n=34，95％CI：10.8，16.6），并导致18名婴儿的听力损失诊断。27名父母在初次访问时完成了调查。重复测试正常（n=20）患者的焦虑水平从1.9降至1.2（p=0.002），而重复测试异常者（n=7）的焦虑水平在前后没有统计学差异（2.1vs2.7，p=2）。满意度为3.7±0.7（得分1-4）。所有的父母都报告说，他们的孩子的听力问题有一个更好的了解后访问。
结论：这个由执业护士领导的早期听力检测诊所能够及时诊断听力损失，并向没有听力损失的家庭保证。听力损失诊断的年龄与已发表的队列相比具有优势。
方法：在1/1/19和2/28/22之间的多学科诊所中观察到UNHS失败的婴儿。患者接受了自动听觉脑干反应（ABR）和失真产物耳声发射测试，并咨询了耳鼻喉科护士。失败的结果之后是诊断ABR。在任命开始和结束时进行了调查。
结果：总计，169名婴儿的平均年龄为8.4周（95CI7.5，9.4）。38例(22.4%)重复检测异常。诊断ABR在平均年龄13.7周时进行（n=34，95％CI：10.8，16.6），并导致18名婴儿的听力损失诊断。27名父母在初次访问时完成了调查。重复测试正常（n=20）患者的焦虑水平从1.9降至1.2（p=0.002），而重复测试异常者（n=7）的焦虑水平在前后没有统计学差异（2.1vs2.7，p=2）。满意度为3.7±0.7（得分1-4）。所有的父母都报告说，他们的孩子的听力问题有一个更好的了解后访问。
结论：这个由执业护士领导的早期听力检测诊所能够及时诊断听力损失，并向没有听力损失的家庭保证。听力损失诊断的年龄与已发表的队列相比具有优势。
