Newborn preventive care and screening — formative SAQs

SAQ 1 — Early discharge with incomplete package (20 marks, ~15 minutes)

A well term newborn is planned for discharge at 20 hours of life. Examination is documented. Intramuscular vitamin K was given. There is no record of dried bloodspot collection, hearing screening or CCHD pulse-oximetry. The family lives 90 minutes from hospital. Mother says she has no car until tomorrow evening. ^[8]

Questions

1. List the core components of the newborn preventive package and state the status of each in this infant. (4 marks) ^[8]
2. Explain why early discharge changes risk for CCHD detection, bloodspot validity/timing and jaundice surveillance. (5 marks) ^{[4] [14]}
3. Write a safe disposition plan, including what must be completed before leaving or how incomplete items will be owned. (6 marks) ^[8]
4. State the safety-net advice you would give and how you would check understanding. (5 marks) ^[14]

Model answer (must-hit)

1. Examination done; vitamin K done; bloodspot incomplete; hearing incomplete; CCHD oximetry incomplete; jaundice/DDH risk not yet closed. Package is incomplete. ^[8]
2. CCHD algorithms often prefer testing after transition; very early discharge can force deferred or early testing with more false positives if done too soon. Bloodspot has programme timing windows. Jaundice risk needs hour-specific assessment and timed follow-up, harder when travel is delayed. ^{[4] [14]}
3. Prefer complete critical screens before discharge when feasible. ^[8] If service policy allows deferred completion, name owner, exact venue/time, transport plan, and do not rely on “attend GP sometime.” Consider keeping the infant until bloodspot/hearing/oximetry can be completed if follow-up is not realistic today. ^[8]
4. Red flags: poor feeding, colour change, breathing difficulty, increasing jaundice, sleepiness, fewer wet nappies. Where and how to return. Teach-back. ^[14]