texas department of state health services newborn screening branch
TRANSCRIPT
![Page 1: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/1.jpg)
Texas Texas Department of State Department of State
Health ServicesHealth Services
Newborn Screening Newborn Screening BranchBranch
![Page 2: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/2.jpg)
Newborn Screening Program
Specimen Collection
Presentation
January 2007
![Page 3: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/3.jpg)
Texas Newborn Texas Newborn ScreeningScreening
Table of Contents:
• The Specimen Collection Form
• Blood Sample Collection
• The Voice Response System
![Page 4: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/4.jpg)
The The NNewborn ewborn SScreeningcreening
SSpecimen pecimen CCollection ollection FFormorm
![Page 5: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/5.jpg)
What is a screening test kit?
The newborn screening test kit includes a specimen collection device, a form for demographic
information and a special envelope.
![Page 6: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/6.jpg)
How do I order lab supplies?
CALL: 512 – 458 - 7661
![Page 7: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/7.jpg)
N B S C o l l e c t i o n F o r mP a r e n t C o p y
A l l o w s f o r ‘ l in k in g ’ o f m u l t i p l e s p e c im e n sN e w f o r m a v a i la b l e in D e c e m b e r
![Page 8: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/8.jpg)
N B S C o l l e c t i o n F o r mD e m o g r a p h i c s F o r m
T im e o f B ir thT im e o f C o lle c tio n
P C P in fo rm a tio n 1 s t S c re e n S e r ia l N o .
![Page 9: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/9.jpg)
NBS Collection FormFilter Paper for Blood Collection
![Page 10: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/10.jpg)
NBS Collection FormCollection Instructions
![Page 11: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/11.jpg)
Is the form we have current?
The expiration date on all newborn screening kits is shown on the cover, demographic sheets and the
filter paper.
![Page 12: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/12.jpg)
Expiration Date
![Page 13: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/13.jpg)
Expiration Date
![Page 14: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/14.jpg)
Can I use the mother’s Medicaid number for the newborn?
Yes. The mother’s Medicaid number may be used on the form to indicate that the newborn is Medicaid-eligible. DSHS recognizes that it may take months to issue a Medicaid number
for the newborn.
![Page 15: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/15.jpg)
Medicaid Eligible
(1=Yes, 2=No)Medicaid No.
![Page 16: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/16.jpg)
How does DSHS define charity care?
The charity care newborn is a patient who is not insured and is not covered or eligible to be
covered for newborn screening services by Medicaid or any other government program.
![Page 17: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/17.jpg)
Specimen Collection Check List
Wear gloves when handling form.
Use black ink and print in block capital letters.
Use the same “baby’s last name” on the first and second filter collection form.
![Page 18: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/18.jpg)
Specimen Collection Kit Cover Sheet
Provider/Submitter Instructions:
Complete Infant’s Last Name, First
Name and Date of Birth
![Page 19: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/19.jpg)
Specimen Collection Kit Cover Sheet (con’t.)
Provider/Submitter Instructions:
For 1st screen:
Remove the PARENT COPY and give to the parent. Inform the parent that they MUST take this form to their infant’s doctor at the baby’s 1-2 week check-up.
![Page 20: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/20.jpg)
Specimen Collection Kit Cover Sheet (con’t.)
Provider/Submitter Instructions:
For 2nd screen:
Write the serial number from the 1st screen PARENT COPY (brought to you by the parent) in the box labeled “Serial Number” in the Newborn Information area of the demographic form for the specimen being submitted.
Retain the PARENT COPY from the 2nd screen in the patient chart. If an additional screen is requested, use this serial number on the additional screen form.
![Page 21: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/21.jpg)
Baby’s Last Name
When filling out the filter collection form for the second screen, ask mom what name was used on the form for the first screen in the “Baby’s last name” box and use the same name.
The NBS case management staff uses the baby’s last name, mother’s last name, and date of birth to link the
second screen to the first.
This information is vital for identification and location of infants for follow-up of abnormal tests results.
![Page 22: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/22.jpg)
Gloves
To prevent specimen contamination, do not touch any part of the filter paper circles before, during or after collection. Disposable gloves can contaminate the specimen and powdered residue from the gloves can contaminate the hands.
![Page 23: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/23.jpg)
Why do I have to fill out all the information when I know the
baby?
It may be necessary to reach the family in a hurry when you are not available. Also, the State Laboratory receives so may specimens that often there are several babies with the
same last name and the same birth date.
![Page 24: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/24.jpg)
Why is it necessary to retest some babies several times?
Premature babies may have immature enzyme systems or thyroid functioning. It may be necessary to monitor their progress to be
certain they reach normal levels.
AND
![Page 25: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/25.jpg)
A normal screen in an infant who has insufficient enteral intake does not rule out metabolic disease.
Total parenteral nutrition may cause a false positive result.
![Page 26: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/26.jpg)
Check List Fill in both first and last name in the
“Physician’s Name” box.
Use grams in the “Birthweight” box.(This information is crucial for newborn
screening disorders because many interpretations of results are based on the birth weight of the infant).
Fill in the physician’s telephone number in the box directly below the medical record number box.
![Page 27: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/27.jpg)
A free weight conversion chart is available from the Newborn
Screening Program.
1-800-252-8023
extension 2129
Birth Weight
![Page 28: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/28.jpg)
Check List
Fill in the boxes for: Status Test Date of birth Date of specimen (specimen will be rejected
without a date of collection) Infant’s age at specimen collection Mother’s social security number
![Page 29: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/29.jpg)
Repeat Screen
The NBS follow-up staff may contact submitters by fax, phone, and/or letter
to request a repeat screen.
![Page 30: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/30.jpg)
Check List
Make sure all boxes are:
legible, accurate, and complete.
![Page 31: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/31.jpg)
What if the screening test kit is no good?
Each screening test kit qualifies as a medical device. If a kit does not perform as it should, please notify
the Quality Assurance Officer at 512-458-7318. DSHS will replace defective kits free of charge.
![Page 32: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/32.jpg)
Will DSHS pay postage?
DSHS has never paid postage for the newborn screening test kits and does not contemplate doing
so in the future.
![Page 33: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/33.jpg)
NBS Specimen Rejection Possible
due to
NEW POSTAL REGULATIONS
Effective May 14, 2007 the USPS raised postage rates, and initiated new postage
pricing rules based on mail size and shape. The changes will require you to carefully
evaluate your newborn screening specimen shipping practices to ensure that correct
postage is used. Envelopes with insufficient postage may be returned, leading to critical
newborn screening delays or rejection of specimens.
![Page 34: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/34.jpg)
General Information
• 1 specimen card in an envelope (Letter) used to cost $0.39 but will now cost $0.41 to ship. • The price increases as you add cards.
• 6 cards or more will require the more expensive flat rate pricing.
• Envelopes with metal clasps will be charged an additional $0.17 surcharge if the clasps are used to close the envelope. Leave the clasp flat and close with tape only.
![Page 35: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/35.jpg)
The following are examples only. Please verify exact postage from
your facility.
• 1 specimen card in an envelope (Letter) will now cost $0.41 to ship.
• 2 specimen cards in an envelope (Letter) will cost $0.58 to ship.
• 10 specimen cards in an envelope (now considered Flats) used to cost $1.35 but will now cost $1.48 to ship.
![Page 36: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/36.jpg)
Obtain a copy of the new pricing schedule for your
Mail Zone at
http://pe.usps.gov/
![Page 37: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/37.jpg)
Collecting a Blood Sample
![Page 38: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/38.jpg)
Equipment
•Sterile lancet with tip (2.0 – 2.40 mm)
•sterile alcohol prep
•sterile gauze pads
•soft cloth
•blood collection form
•gloves
![Page 39: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/39.jpg)
Increase Blood Flow
Wrap a warmed, moist towel around the heel puncture site for 3 to 5 minutes.
![Page 40: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/40.jpg)
Positioning the infant with feet lowered below the heart will help to increase
blood flow.
![Page 41: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/41.jpg)
Clean & Dry
Cleanse site with sterile alcohol pad.
Allow site to air dry.
(Alcohol residue left on the skin may dilute the specimen
and affect test results)
![Page 42: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/42.jpg)
Puncture Site
Hatched area indicates safe areas for puncture
site.
![Page 43: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/43.jpg)
Puncture
Position a sterile
disposable lancet (2.0 –
2.4 mm tip) or an
automatic lancet at a
slight angle to perform a
swift clean puncture.
Wipe away the first drop
of blood with dry sterile
gauze.
![Page 44: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/44.jpg)
Fill Circle
Allow a second large drop of blood to form.
Lightly touch blood drop to filter paper.
Allow blood to soak through and completely
fill circle.
![Page 45: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/45.jpg)
Fill Remaining Circles
Fill remaining circles with successive blood
drops.
If blood flow slows, repeat procedure
selecting a different site and using sterile
equipment.
![Page 46: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/46.jpg)
Why are so many specimens marked unsatisfactory when I can see plenty of
blood in the circles?
There must be an even penetration of blood for the test to be accurate. This means soaking through the
filter paper with one application and filling the whole circle so the blood is evenly distributed on
both sides of the filter paper.
![Page 47: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/47.jpg)
Apply blood to one side of the filter paper only, allowing full saturation of each circle before proceeding to the next circle.
To enhance blood flow during collection, very gentle intermittent pressure may be applied to the area surrounding the puncture site.
Excessive “milking” causes an admixture of tissue fluids with the blood specimen, invalidating the specimen.
![Page 48: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/48.jpg)
Do not layer successive small drops of blood on top of each other. Let each drop touch the paper about 1/8 inch away from the previous one. This prevents layering of the paper, which is one cause of unsatisfactory results.
![Page 49: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/49.jpg)
Drying Specimen
Allow the blood specimens to air-dry for at least 4 hours on a flat, nonabsorbent surface protected from heat or direct sunlight.
![Page 50: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/50.jpg)
Do not refrigerate the
samples or put in plastic sleeves. (Plastic sleeves
allow accumulation of
condensation and can contribute to
contamination, elution, and
bleeding of the blood spots).
![Page 51: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/51.jpg)
Place dried specimen collection form in special envelope and mail within 24
hours.
![Page 52: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/52.jpg)
The Voice Response System
![Page 53: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/53.jpg)
Voice Response System(VRS)
The VRS provides 24-hour access to newborn screening laboratory
information on all patients screened at the DSHS Laboratory.
![Page 54: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/54.jpg)
Requirements:
(1) Licensed Texas newborn screening submitter number
(2) Personal identification number (PIN)
(3) Newborn screening form serial number or social security number of infant’s mother
(4) Touch tone phone
![Page 55: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/55.jpg)
Instructions for use of the VRS are presented in logical order during the call. Interaction with the system is by means of the telephone key pad. Keys are identified as follows:
Numbers……………………….1-9 and 0Pound………………………….#Star…………………………….*
![Page 56: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/56.jpg)
Information about the infant is presented as:
Form serial number (from specimen form)Last name (spelled)Sex (male, female, unknown)Date of birthTest resultsInterpretation
![Page 57: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/57.jpg)
How do I get a PIN number?
Call: 512-458–7111extension 6988
or1-888-963-7111extension 6988
orEmail: [email protected]
![Page 58: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/58.jpg)
May I receive a hard copy of the screen?
Yes. An add-on feature to the VRS allows results to be sent via FAX to a physician
requiring a hard copy of the voice session.
![Page 59: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/59.jpg)
A message may be repeated at any time by pressing the pound (#) key.
After hearing results for an infant, you will be given the opportunity to speak with a member of the newborn screening staff. Then, or at any time thereafter during normal business hours (8:00-5:00), you may press the star (*) key to have your call transferred to a staff member.
If you are calling after hours, or if all the lines are busy,you will be invited to leave a message with a member of the newborn screening staff.
VRS Message
![Page 60: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/60.jpg)
Where do I find our submitter number?
Call: 512 – 458 – 7111extension 2421
![Page 61: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/61.jpg)
Texas Newborn Screening Program
Voice Response System
(512) 458-7300(512) 458-7300
oror
1-888-963-71111-888-963-7111
extension 7300extension 7300
24 - HOUR ACCESS
![Page 62: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/62.jpg)
The Newborn Screening Program
Case Management Staff can be reached at
Telephone:Telephone: 1- 800 – 252 - 80231- 800 – 252 - 8023
Fax:Fax: 512 - 458 -7450512 - 458 -7450
![Page 63: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/63.jpg)
For information regarding newborn screening results between the hours of 8:00 - 5:00, Monday - Friday you
may call the DSHS Lab at
512 - 458 - 7578512 - 458 - 7578
![Page 64: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/64.jpg)
FYI
Cases confirmed by testing done at laboratories other than the Texas Department of State Health
Services Laboratory must be reported to the Newborn Screening Case Management Program at
1-800-252-8023
![Page 65: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/65.jpg)
Newborn Screening Literature
Educational materials for providers and parents are available free of charge from the Newborn Screening Program.
1-800-252-8023
extension 2129
or
Email: [email protected]
![Page 66: Texas Department of State Health Services Newborn Screening Branch](https://reader031.vdocument.in/reader031/viewer/2022020921/551567e955034674578b4c7a/html5/thumbnails/66.jpg)
Newborn Screening Website
www.dshs.state.tx.us/newborn