●      Develop an action plan with a timeline with concrete milestones to implement universal newborn screening.
○      Select technology proven to be effective for newborn screening
■      Use SET pulse oximetry screening strategy15-21,23-27
○      Determine the screening protocol
■      Age at screening: >24 hours or prior to discharge
■      Obtain pulse oximetry measurements from preductal (right hand) and postductal (either foot) sites
■      Screening results which will be considered positive and require further investigation27
➢     SpO2 <90% from any site; or
➢     SpO2 <95% from the right hand or either foot
○      If initial SpO2 measurement is <95%, proceed with up to two additional SpO2 measurements.
○      If the second and third SpO2 measurements read >95% the screening is negative.
○      If the second and third SpO2 measurements are <95% the screening is positive.
➢     >3% difference in SpO2 measurements between the right hand and either foot (repeat three times as described in the bullet above)
○      Additionally, if Perfusion Index (PI) <0.7 that should increase the need for assessment of the baby (if <0.4 the baby should be immediately assessed)
●      Implement interdisciplinary strategies and educational activities for all members of the neonatal healthcare team
○      Proper screening methods
○      Strategies for family education and engagement
○      Follow-up investigation protocols for positive screens
○      Public health results reporting policy
●      Implement optimization and workflow guidelines to ensure performance of adequate screening.
○      As a quality indicator, each week randomly assess the number of babies that have should have been screened but were not. Communicate with staff and, based on results, implement measures to improve processes in order to meet the goal of screening all newborns. Utilize clinical decision support tools and software whenever available to avoid misinterpretation or screening results or faulty data entry
●      Report screening results per state and federal requirements