Routine Occult Testing of Stool in Neonates
Western Governors University
Occult testing of stool in neonates has become a widely practiced screening tool for the detection of hidden, or “occult” blood in the stool of infants in the newborn period and in the neonatal intensive care. Occult blood is blood not visible to the naked eye and can be indicative of a serious problem in infants. Testing for this blood has been largely questioned by medical professionals to determine whether or not it is a cost-effective test to be included in routine care. Latest clinical research has led to the conclusion that while it is an effective screening tool in some situations, it is not necessarily an effective tool to be used on a routine basis on the general neonatal population. Not only is it not a cost-effective test (Pinheiro, Clark, & Benjamin, 2003), it also can lead to unwarranted worry by staff and family and unnecessary further testing of the neonate (Bisquera, Cooper, & Berseth, 2002, p. 424).
Stool testing for occult blood was first introduced in the adult population as a screening tool for colon cancer, as blood in the stool may be the only early symptom of colon cancer ("Fecal occult blood test," 2011). While only used as a screening tool, it has been incorporated into yearly adult physical exams. Early in its use in adults, neonatologists and pediatricians felt that this testing could be useful to screen neonates for an abundance of clinical conditions but most certainly for necrotizing enterocolitis (Bagci et al., 2010).
The testing was non-invasive, using only stool that had already been expelled. The most commonly used testing is the hemmocult type slide testing. To perform the test, the “tester”, most often the bedside nurse would collect a small sample from two areas of the soiled diaper and place each specimen on the tester slide. This slide is made of a type of chemical embedded paper. A reactant liquid is then...
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