Reliability of nurse-administered infant hearing screening using otoacoustic emissions.
Mukovhe Phanguphangu, Andrew J Ross
PMID 40776725WHAT IT FOUND
After training, two nurses' infant hearing screening results matched an audiologist almost perfectly.
But 26% of infants failed screening. Nine had middle ear infections, two had normal hearing, one had bilateral moderate-to-severe hearing loss, and one had unilateral severe hearing loss.
Key findings
01The nurses' overall pass/refer agreement with an audiologist was almost perfect (k=0.81, p<0.001).
02Thirteen infants (26%) failed screening: 11 had bilateral refers and 2 had unilateral refers.
03Of the infants who failed screening, 9 had otitis media, 2 presented with normal hearing, one had bilateral moderate-to-severe sensorineural hearing loss, and one had unilateral severe sensorineural hearing loss.
STILL TO COME
How it was doneWhat they found
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What it does not show
This was a pilot study at one primary health care clinic, so the results may not apply to other clinics, nurses, or regions. Only two nurses were purposely selected because they already gave immunisations and met experience and certification criteria, so they may not represent all nurses. The study screened 50 infants (100 ears), which was 20% of the 500 ears calculated for a full study, so the agreement estimates are uncertain. The initial referral rate was 26%, above the national guideline target of less than 5%, and many failures were due to middle ear infections or normal hearing. The study did not test whether nurse-administered screening improves early intervention, hearing, speech, language, or communication outcomes.
The easy way to misread this
Do not conclude that nurse-administered hearing screening has been shown to improve infant hearing or communication outcomes. This pilot only compared screening pass/refer decisions with an audiologist in a small clinic sample, and many failures were due to middle ear infections rather than permanent hearing loss.