Failed newborn hearing test

Setting

  • WIPER  (wash hands, introduce yourself, permission, expose patient, reposition)
  • Ensure a paediatric Nurse available

Perception

  • Recap on past events – pregnancy, infections, vaccinations, overall health, family history, hearing problems

Invitation 

  • “Can I go over my examination findings with you now?”
  • “Is there anybody else you want to be present?”

Knowledge

  • Use an audiogram if present.
  • “Unfortunately it is not good news.”
  • “This tells us that X is severely deaf in both ears. Unfortunately this is permanent.” PAUSE!

Empathy

  • “I can see this is a huge shock” Pause and wait
  • Ask about ideas, concerns and expectations

Strategy and summary

Answer questions

  • Deaf for life? What kind of hearing aids? What about cochlear implants?
  • What are the risks involved?

Reassure

  • We have a plan –  Tough diagnosis but highlight the positives
  • Identified early – best chance at normal speech and development but if part of a syndrome prognosis depends on other factors
  • Further investigations (scans, blood tests, eye tests, family audiogram – may be subtle hearing losses, EUA ears, renal ultrasound scan, genetics referral) to find out cause and offer management specific to your child’s needs
  • We have a team looking after you from now on, will refer to tertiary centre – ENT, audiology, geneticists, paediatricians, school teachers, speech and language

Round up 

  • Leaflets
  • Contact details
  • Direct to  National Deaf Child Society – a charity which provides information for families and children as they grow older. e.g borrow useful technology, sign language.
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