Texas Department of State Health Services. Newborn Screening Branch. Newborn Screening Program. Specimen Collection Presentation January 2007. Texas Newborn Screening. Table of Contents: The Specimen Collection Form Blood Sample Collection The Voice Response System.
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Newborn Screening Branch
Table of Contents:
The Specimen Collection Form
Blood Sample Collection
The Voice Response System
The newborn screening test kit includes a specimen collection device, a form for demographic information and a special envelope.
What is a screening test kit?
How do I order lab supplies?
The expiration date on all newborn screening kits is shown on the cover, demographic sheets and the filter paper.
Is the form we have current?
Yes. The mother’s Medicaid number may be used on the form to indicate that the newborn is Medicaid-eligible. DSHS recognizes that it may take months to issue a Medicaid number for the newborn.
Can I use the mother’s Medicaid number for the newborn?
The charity care newborn is a patient who is not insured and is not covered or eligible to be covered for newborn screening services by Medicaid or any other government program.
How does DSHS define charity care?
Wear gloves when handling form.
Use black ink and print in block capital letters.
Use the same“baby’s last name” on the first and second filter collection form.
Complete Infant’s Last Name, First Name and Date of Birth
For 1st screen:
Remove the PARENT COPY and give to the parent. Inform the parent that they MUST take this form to their infant’s doctor at the baby’s 1-2 week check-up.
For 2nd screen:
Write the serial number from the 1st screen PARENT COPY (brought to you by the parent) in the box labeled “Serial Number” in the Newborn Information area of the demographic form for the specimen being submitted.
Retain the PARENT COPY from the 2nd screen in the patient chart. If an additional screen is requested, use this serial number on the additional screen form.
When filling out the filter collection form for the second screen, ask mom what name was used on the form for the first screen in the “Baby’s last name” box and use the same name.
The NBS case management staff uses the baby’s last name, mother’s last name, and date of birth to link the second screen to the first.
This information is vital for identification and location of infants for follow-up of abnormal tests results.
To prevent specimen contamination, do not touch any part of the filter paper circles before, during or after collection. Disposable gloves can contaminate the specimen and powdered residue from the gloves can contaminate the hands.
It may be necessary to reach the family in a hurry when you are not available. Also, the State Laboratory receives so may specimens that often there are several babies with the same last name and the same birth date.
Why do I have to fill out all the information when I know the baby?
Premature babies may have immature enzyme systems or thyroid functioning. It may be necessary to monitor their progress to be certain they reach normal levels.
Why is it necessary to retest some babies several times?
A normal screen in an infant who has insufficient enteral intake does not rule out metabolic disease.
Fill in both first and last name in the “Physician’s Name” box.
Use grams in the “Birthweight” box.
(This information is crucial for newborn screening disorders because many interpretations of results are based on the birth weight of the infant).
Fill in the physician’s telephone number in the box directly below the medical record number box.
A free weight conversion chart is available from the Newborn Screening Program.
Fill in the boxes for:
The NBS follow-up staff may contact submitters by fax, phone, and/or letter to request a repeat screen.
Make sure all boxes are:
Each screening test kit qualifies as a medical device. If a kit does not perform as it should, please notify the Quality Assurance Officer at 512-458-7318. DSHS will replace defective kits free of charge.
What if the screening test kit is no good?
DSHS has never paid postage for the newborn screening test kits and does not contemplate doing so in the future.
Will DSHS pay postage?
Effective May 14, 2007 the USPS raised postage rates, and initiated new postage pricing rules based on mail size and shape. The changes will require you to carefully evaluate your newborn screening specimen shipping practices to ensure that correct postage is used. Envelopes with insufficient postage may be returned, leading to critical newborn screening delays or rejection of specimens.
NBS Specimen Rejection Possible
NEW POSTAL REGULATIONS
1 specimen card in an envelope (Letter) used to cost $0.39 but will now cost $0.41 to ship.
The following are examples only. Please verify exact postage from your facility.
Wrap a warmed, moist towel around the heel puncture site for 3 to 5 minutes.
Increase Blood Flow
Positioning the infant with feet lowered below the heart will help to increase blood flow.
Allow site to air dry.
(Alcohol residue left on the skin may dilute the specimen and affect test results)
Clean & Dry
Position a sterile disposable lancet (2.0 – 2.4 mm tip) or an automatic lancet at a slight angle to perform a swift clean puncture.
Wipe away the first drop of blood with dry sterile gauze.
Lightly touch blood drop to filter paper.
Allow blood to soak through and completely fill circle.
If blood flow slows, repeat procedure selecting a different site and using sterile equipment.
Fill Remaining Circles
There must be an even penetration of blood for the test to be accurate. This means soaking through the filter paper with one application and filling the whole circle so the blood is evenly distributed on both sides of the filter paper.
Why are so many specimens marked unsatisfactory when I can see plenty of blood in the circles?
Apply blood to one side of the filter paper only, allowing full saturation of each circle before proceeding to the next circle.
To enhance blood flow during collection, very gentle intermittent pressure may be applied to the area surrounding the puncture site.
Excessive “milking” causes an admixture of tissue fluids with the blood specimen, invalidating the specimen.
Do not layer successive small drops of blood on top of each other. Let each drop touch the paper about 1/8 inch away from the previous one. This prevents layering of the paper, which is one cause of unsatisfactory results.
Allow the blood specimens to air-dry for at least 4 hours on a flat, nonabsorbent surface protected from heat or direct sunlight.
Do not refrigerate the samples or put in plastic sleeves. (Plastic sleeves allow accumulation of condensation and can contribute to contamination, elution, and bleeding of theblood spots).
Place dried specimen collection form in special envelope and mail within 24 hours.
The VRS provides 24-hour access to newborn screening laboratory information on all patients screened at the DSHS Laboratory.
(1) Licensed Texas newborn screening submitter number
(2) Personal identification number (PIN)
(3) Newborn screening form serial number or social security number of infant’s mother
(4) Touch tone phone
Instructions for use of the VRS are presented in logical order during the call. Interaction with the system is by means of the telephone key pad. Keys are identified as follows:
Numbers……………………….1-9 and 0
Form serial number (from specimen form)
Last name (spelled)
Sex (male, female, unknown)
Date of birth
How do I get a PIN number?
Yes. An add-on feature to the VRS allows results to be sent via FAX to a physician requiring a hard copy of the voice session.
May I receive a hard copy of the screen?
Where do I find our submitter number?
24 - HOUR ACCESS
Telephone:1- 800 – 252 - 8023
Fax: 512 - 458 -7450
512 - 458 - 7578
Cases confirmed by testing done at laboratories other than the Texas Department of State Health Services Laboratory must be reported to the Newborn Screening Case Management Program at
Educational materials for providers and parents are available free of charge from the Newborn Screening Program.