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Quality Assessment and Improvement of the UMassMemorial Health Congenital CMV Screening Protocol in the Newborn Nursery and ICU
Abstract Summary
Background: UMassMemorial Health is a tertiary care center in central Massachusetts with approximately 4600 births/year and 700 Level III NICU admissions. A hearing-targeted screening protocol for congenital CMV (cCMV) was developed collaboratively and implemented as of September 15, 2017. However, a formal quality assessment and improvement activity has not yet been performed to monitor adherence. The purpose of this project is to assess the efficacy of the protocol at major risk points and to improve the protocol by sharing the results and revision process with clinical teams. Methods: Eligibility for CMV screening is hearing screen refer (Nursery) and gestational age <34 weeks or >34 weeks and hearing screen refer (NICU). Screening tests are saliva CMV PCR and if positive then confirmatory urine CMV PCR. Protocol steps at highest risk for errors form the project variables, which primarily include omissions in performance or communication about screening tests or results. Data is extracted from retrospective chart review. Project findings and protocol optimization for current workflows will be shared with clinical teams in settings that facilitate real-time discussion. Results: A database was created to reflect three broad categories of variables: demographics, protocol adherence, and follow-up care. Specific variables are included within each category, such as saliva PCR done before discharge or before 3 weeks of age, saliva PCR pending or resulted in discharge summary, and for confirmed cCMV cases, specialty referrals and full evaluation completed before 4 weeks of age. Data collection and analysis are ongoing with estimated completion by September 2023. Conclusion: This project will identify gaps in cCMV care and communication and prompt improvement of the cCMV screening protocol at our hospital.
Learning Objectives
- Assess the efficacy of the CMV screening protocol at major risk points.
- Share results from quality assessment with relevant staff and solicit feedback for improvement.
- Refine protocol to better fit current workflow within the applicable healthcare units.
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Presenters
Kaitlyn Ngo | Co-Author
kaitlyn.ngo1@umassmed.edu;
Kaitlyn is a first year medical student (MD Candidate, Class of 2026) at University of Massachusetts Chan Medical School.
ASHA DISCLOSURE
Financial -
Nonfinancial -
AAA DISCLOSURE
Financial - No relevant financial relationship exists.
Laura Gibson | POC-Point of Contact, Co-Author
laura.gibson@umassmed.edu;
The current Med/Peds division chief, Laura returned to UMass Memorial Medical Center for a fellowship in Infectious Diseases after completing her Med/Peds residency at Baystate Medical Center. She is a graduate of Yale University and the University of Massachusetts Medical School. She remained at UMass after finishing her fellowship in 2001 to pursue research on cellular immune responses to human cytomegalovirus and other herpesviruses. She also serves on the general and transplant Infectious Diseases services in both the Departments of Medicine and Pediatrics.
ASHA DISCLOSURE
Financial - Receives Consulting fee,Grants for Membership on advisory committee or review panels,Independent contractor from Moderna Therapeutics, Inc.
Nonfinancial - Has a Professional (Sci Adv Board (paid activity before 2019)) relationship for Volunteer membership on advisory committee or review panels.
AAA DISCLOSURE
Financial - Receives support from Moderna Therapeutics, Inc for Grant funding for research being presented No Scientific Advisory Board activity since 2019.
Mary Naples | Co-Author
mary.naples@umassmemorial.org;
Mary Naples, BSN, RN is a project manager with over 20 years of experience in nursing, clinical quality project management, maternal/newborn standards of care, data management, education, and public reporting. She has been recognized for her contributions to multidisciplinary endeavors to provide optimal patient care.
ASHA DISCLOSURE
Financial -
Nonfinancial -
AAA DISCLOSURE
Financial - No relevant financial relationship exists.
Lori Sahakian | POC-Point of Contact, Primary Presenter, Author, Co-Author
lori.sahakian@umassmed.edu;
Lori is a third year medical student (MD Candidate, Class of 2025) at University of Massachusetts Chan Medical School.
ASHA DISCLOSURE
Financial - No relevant financial relationship exists.
Nonfinancial - No relevant nonfinancial relationship exists.
AAA DISCLOSURE
Financial - No relevant financial relationship exists.