Capital Budget Request

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CAPITAL BUDGET REQUEST

A Case for Portable Pulse Oximetry in the OB Unit –

A Capital Budget Request

Ashlee Lake

HCS 571

December 17, 2012
Professor Joe Rudd

A Case for Portable Pulse Oximetry in the OB Unit –

A Capital Budget Request
According to the Centers for Disease Control, Critical Congenital Heart Disease (CCHD) accounts for approximately twenty-four percent of all infant deaths related to birth defects (2011). Congenital heart defects in infants may not be diagnosed until after the patent ductus arteriosus closes which typically occurs after the infant is discharged to home. Every year approximately 4,800 infants are born with CCHD and if left untreated these infants can suffer serious health issues and or death (Centers for Disease Control, 2011). It is the recommendation of both the CDC and the American Academy of Pediatrics to screen all infants for CCHD prior to discharge. Pulse oximetry screening can help to identify children with CCHD before they show symptoms of CCHD. The mission of Licking Memorial Hospital is “To Improve the Health of the Community”. In order to ensure that the mission is successfully achieved; the maternity department is proposing to purchase portable pulse oximetry units for newborn screening. The portable pulse oximetry units would ensure that all babies delivered at Licking Memorial Hospital would have access to Critical Congenital Heart Disease screening prior to discharge.

Critical Congenital Heart Disease Screening

Critical Congenital Heart Disease screening is a non-invasive pulse oximetry test to determine the amount of oxygen circulating in the baby’s blood. The pulse oximetry probe is placed on the infant’s right hand (pre-ductal reading) and this result is compared to a pulse oximetry reading on the infant’s foot. The pulse oximetry reading must be greater than 90% and less than a difference of 5 points between the hand and foot in order to consider the pulse oximetry screen a pass. If there is a discrepancy of greater than 5 points or the infant screen is less than 90% on either the hand or foot the infant pulse oximetry screen is a fail and must be repeated. After two failed attempts; the pediatrician must be notified and a cardiology consult ordered.

Critical Congenital Heart Disease or defects if left undiagnosed or untreated can result in serious injury or death. To properly assist in screening; reliable equipment must be utilized. The Masimo Rad5 technology has been FDA approved for use in screening infants for CCHD. Masimo Rad5 handheld pulse oximeters retail for $500 each. Due to the geographic layout of the unit and separation of departments (Labor & Delivery, Postpartum, Nursery) it is necessary to purchase 6 units. The purchase of 6 units allows for each area to have a pulse oximeter with one back up. Each pulse oximeter requires either the use of a disposable probe or reusable probe. Because the patient population is immuno-compromised; the recommendation is to use a disposable one time probe. Disposable probes are sold in boxes of 20 and each probe costs $12. Licking Memorial delivers 1200 babies annually and to accommodate the number of infants delivered it is anticipated that the total cost of probes will be $14,400. To accommodate the number of babies and daily patient census; the recommendation is to purchase 6 Masimo Rad5 handheld units for a total purchase price of equipment $3000. In addition to equipment purchase; education and competency review is needed for staff. Education and competency for use can be provided to staff in 6 sessions for a total price of $1000. To date; the state of Ohio does not require CCHD screening and therefore insurance does not reimburse for the cost of the testing. All costs for materials, equipment and nursing time are incurred by unit.

Anticipated Total Cost of the project for CCHD screening:

Masimo Rad5 Handheld Pulse Oximeter...
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