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Table 3 Barriers during screening process

From: Feasibility of screening for critical congenital heart disease using pulse oximetry in Indonesia

Type of barriers

Details

Hospital procedure

The standard hospital procedure for the length of postnatal stay is relatively short, and therefore, most of the newborns were screened before 24 hours.

Pulse oximetry measurement has yet to be part of the pre-discharge standard care for healthy newborns, and therefore, several healthcare personnel (especially nurses and midwives) did not routinely conduct measurements despite the ongoing study.

Among subjects with positive screening results, echocardiography examinations were not all immediately performed. This was mainly caused by the availability of echocardiographs only at the tertiary and general hospitals, while some subjects were inpatients at the other two hospitals.

Equipment

The lack of pulse oximetry devices in the common wards, with devices only available at the neonatal ICU.

Tightly fixed sensors using Velcro or rubber fasteners were not widely available, despite being easier and faster to use compared to fingertip-type pulse oximetry.

Adult probes were sometimes utilized due to the limited resources in the ward.

Healthcare personnel

Healthcare personnel were often occupied with other clinical duties causing them to forget to perform the screening.

Condition of the baby

Some newborns were constantly crying or moving, making measurement of SpO2 difficult to perform using pulse oximetry.