1.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 1
Level 3 Diploma for health screeners
(Newborn Hearing)
Assessment criteria
The Level 3 Diploma for health screeners (Newborn Hearing) qualification is a national
qualification for all screening staff, who are not qualified healthcare professionals currently
on a professional register, working within the NHS Newborn Hearing Screening Programme
(NHSP). The qualification is designed to reflect work-based learning and compliment
previous methods of training.
To comply with the NHSP advisory board and national programme specifications learners
are required to successfully undertake the mandatory qualification assessment criteria which
includes an Observed Structured Clinical Examination (OSCE) delivered by the national
NHSP programme or by an NHSP recognised centre using appropriately qualified
assessors.
Health visitors (HV) Registered Nurses (RN) and Midwives (MWs) who carry out automated
auditory brainstem responses (AABRs) are not required to complete the Level 3 Diploma for
health screeners, but are required to successfully undertake an OSCE.
This document details the:
• qualification assessment criteria: mandatory and recommended
• performance observation checklists

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 2
Qualification assessment criteria
Unit: The ear and hearing
Level: 3 Credit: 2
Unit aim:
The aim of this unit is to enable learners to develop knowledge of the structures that make
up the hearing pathway and how they function.
Introduction:
This unit will give learners a basic understanding of the components of the ear and how the
ear works. Learners will also gain an understanding of how sound is perceived, how hearing
is measured and the consequences, for an individual, of dysfunction along the hearing
pathway.
Mandatory Specific Evidence
NHSP e-learning screener module:
http://portal.e-lfh.org.uk/
Unit 2: The ear Multiple choice
questions (MCQs) -
certificate
NHSP e-learning screener module Unit 3: Hearing loss MCQs - certificate
e-Learning unit discussions –
assessor/expert witness
Units 2 & 3 Documentation
Reflective log
Observed Structured Clinical
Examination (OSCE)
Station 1: Anatomy
(label diagram of
hearing pathway)
Station 5: Multiple
choice questions
OSCE documentation
Recommended Specific Evidence
Observation Audiology
department/clinic
Reflective log/summary
Discussion – feedback from audiology
department
Family history
questionnaire
Expert witness
Discussion – local learning mentor 3D model - hearing
pathway
Documentation
Case study Deaf awareness Written

3.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 3
Unit: Prepare to undertake a newborn hearing screen
Level: 3 Credit: 5
Unit aim:
The aim of this unit is to enable learners to develop knowledge of the newborn hearing
screening programme and confidently provide information to parents, professionals and
others.
Introduction:
This unit will enable learners to develop an understanding of family friendly working, potential
screen outcomes and what these may mean. Learners will also develop knowledge of the
newborn hearing screening programme protocols, quality assurance checks and optimal
screening conditions.
Mandatory Specific Evidence
NHSP e-learning screener module:
http://portal.e-lfh.org.uk/
Unit 1: Screening Multiple choice
questions (MCQs)
- certificate
NHSP e-learning screener module Unit 4: Screening
techniques
MCQs - certificate
NHSP e-learning screener module Unit 5: NHSP
protocols
MCQs - certificate
NHSP e-learning screener module Unit 6: NHSP in
practice
MCQs - certificate
NHSP e-learning screener module Unit 7: NHSP IT
system
MCQs - certificate
e-Learning unit discussions – assessor/expert
witness
Units 1,4,5,6,7 Documentation
reflective log
Workplace observation: Performance
Observation Assessment Checklists
Informing parent:
• Well Baby
• NICU baby
Completed
checklists
Observed Structured Clinical Examination
(OSCE)
Station 4: Informed
consent and
ascertaining family
history
OSCE
documentation
Local induction Infection control;
information
governance policies
Induction
certification
Recommended Specific Evidence

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 4
Active practice:
• presentation to NICU; antenatal classes
• Role play
• Why screen?
• Benefits and
limitations of
screening
• What involved?
Expert witnesses
Reflective log
Discussion - local learning mentor
Quality Assurance (QA)
• Equipment
• Data accuracy
• QA log
• NHSP
searches
Discussion: Maternity/NICU • Baby handling
• Privacy &
dignity
Expert witnesses
Reflective log
Case study Examples:
• English not
preferred
language
Written

5.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 5
Unit: Undertake an Automated Oto-Acoustic Emissions (AOAE) newborn
hearing (NBH) screen
Level: 3 Credit: 5
Unit aim:
The aim of this unit is to enable learners to develop the knowledge and skills to undertake a
newborn hearing screen using Automated Oto-Acoustic Emissions (AOAEs).
Introduction:
This unit will enable learners to develop an understanding of what AOAEs are, what affects
AOAE screening and the skills to optimise screening conditions and undertake an AOAE
newborn hearing screen. The learner will also develop knowledge of the entire newborn
hearing screening pathway and confidently provide information to parents, professionals and
others.
Mandatory Specific Evidence
NHSP e-learning screener module:
http://portal.e-lfh.org.uk/
Unit 4: Screening
techniques
Multiple choice questions
(MCQs) - certificate
NHSP e-learning screener module Unit 5: NHSP protocols MCQs - certificate
NHSP e-learning screener module Unit 6: NHSP in practice MCQs - certificate
NHSP e-learning screener module Unit 7: NHSP IT system MCQs - certificate
e-Learning unit discussions –
assessor/expert witness
Units 4,5,6,7 Documentation
Reflective log
Workplace observation:
Performance Observation
Assessment Checklists
• AOAE screening
• Using IT system
Completed checklists
Observed Structured Clinical
Examination (OSCE)
Station 3: AOAE clinical
skills
Station 9: AABR required
OSCE documentation and
certificate
Recommended Specific Evidence
Active practice: Role play AABR required Expert witnesses
Reflective log
Discussion: Quality Assurance
(QA)
Data accuracy NHSP searches
Case study Example: challenging
screen
Written

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 6
Unit: Undertake an Automated Auditory Brainstem Response (AABR) NBH
Screen
Level: 3 Credit: 4
Unit aim:
The aim of this unit is to enable learners to develop the knowledge and skills to undertake a
newborn hearing screen using Automated Brainstem Responses (AABRs).
Introduction:
This unit will enable learners to develop an understanding of what AABRs are, what affects
AABR screening and the skills to optimise screening conditions and undertake an AABR
newborn hearing screen. The learner will also develop knowledge of the entire newborn
hearing screening pathway and confidently provide information to parents, professionals and
others.
Mandatory Specific Evidence
NHSP e-learning screener module:
http://portal.e-lfh.org.uk/
Unit 4: Screening
techniques
Multiple choice questions
(MCQs) - certificate
NHSP e-learning screener module Unit 5: NHSP protocols MCQs - certificate
NHSP e-learning screener module Unit 6: NHSP in practice MCQs - certificate
NHSP e-learning screener module Unit 7: NHSP IT system MCQs - certificate
e-Learning unit discussions –
assessor/expert witness
Units 4,5,6,7 • Documentation
• Reflective log
Workplace observation:
Performance Observation
Assessment Checklists
• AABR screening
• Using IT system
• Referral
Completed checklists
Observed Structured Clinical
Examination (OSCE)
Station 6: AABR Clinical
Station 9: AABR Required
Station 10: Referral to
audiology required
OSCE documentation and
certificate
Recommended Specific Evidence
Active practice: role play Referral to Audiology Expert witness
Reflective log
Discussion: quality assurance (QA) Data accuracy NHSP searches
Case study Examples:
• Family journey
• NICU baby
Written/Parent survey

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 7
Performance observation checklists
The following screener assessment checklists have been developed:
1. Informing parent – Well Baby
2. Informing parent – NICU Baby
3. AOAE screening
4. AABR screening
5. Referral to audiology
6. Using the NHSP national IT system
The table below provides guidance on how to complete the checklists.
The comments section should be used to record details of how the screener met each of the
statements.
Annotations indicate where the statement supports Level 3 Health Screener Diploma
assessment criteria. E.g.: (2.4.3) = Unit 2; learning outcome 4; assessment criteria 3.
Completed checklists should form part of the screener portfolio of achievement.
Level of
Achievement
Competence demonstrated
NA Skill/activity not applicable or not assessed.
O Screener observed skill/activity without practical participation.
A
Screener performed skill/activity with assistance.
Demonstrated limited knowledge and understanding.
Recognised own limitations.
I
Screener performed skill/activity independently.
Demonstrated knowledge and understanding, but improvement
required.
Evaluates/reflects on own practice and identifies support needs.
C Screener performs skill/activity competently, confidently,
independently and safely.
Provides rationale to underpin practice.

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 8
Hearing Screener Observation Assessment: informing parent
Well Baby protocol
Hearing screener name:
Signature:
Assessor/expert witness name:
Job title:
Signature:
Date of assessment:
Level of Achievement Competence demonstrated
NA Skill/activity not applicable or not assessed.
O Screener observed skill/activity without practical participation.
A
Screener performed skill/activity with assistance.
Demonstrated limited knowledge and understanding.
Recognised own limitations.
I
Screener performed skill/activity independently.
Demonstrated knowledge and understanding, but improvement required.
Evaluates/reflects onown practice and identifies support needs.
C Screener performs skill/activity competently, confidently, independently and safely.
Provides rationale to underpin practice.

9.
Hearing Screener Observation Assessment: informing parent Well Baby protocol
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 9
Identification of population Level Comments: How screener met the statement
Establishes if baby is eligible for hearing screen (23.1.1)
Takes action if baby not eligible for hearing screen (direct referral to audiology) (3.3.1, 7.2.2, 23.1.2)
Identifies Screening protocol (Well Baby or NICU) (23.1.3)
Identifies who has parental responsibility (23.2.1)
Establishes if appropriate to approach parent (discussion with midwifery team)
(2.3.5, 7.3.2, 7.3.4, 23.2.2.)
The new parent is offered the screen – Well Baby protocol Level Comments: How screener met the statement
Introduces self and role (2.2.1, 4.8.2)
Checks identity of parent and accuracy of recorded information (address, GP, telephone numbers)
(2.24, 4.8.1, 23.2.3, 23.4.4.)
Screen offered to all babies (parent aware optional) (7.2.3)
Explains why hearing screening for newborns is important (early ID, improved outcomes, parent
support) (6.4.3, 22.3.1, 23.2.7)
Explains disadvantages of hearing screening for newborns (time takes, potential anxiety) (23.2.7)
Explains AOAE screen (soft clicks, response from ear) (23.2.6)
Explains AOAE screen process (disposable tip, snug earpiece fit, time takes - can feel longer, baby
settled, no visible response from baby) (23.2.6)
Warns of possible NCR (hearing loss, debris/fluid, unsettled baby, noise) (22.4.1, 23.2.8)
Informs parent of action if NCR (what, when) (7.2.3)
Risk factors identified Level Comments: How screener met the statement
Ascertains mother’s family history of permanent childhood hearing loss (6.2.1, 23.3.2)
Ascertains father’s family history of permanent childhood hearing loss
Correctly identifies and records baby core risk factors (23.3.1)
Correctly identifies and records baby national risk factors (23.3.3, 23.3.4)

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 10
Gaining informed consent Level Comments: How screener met the statement
Answers questions from parent/s (use of open questions) (2.2.3, 6.5.1, 6.5.2, 6.6.3, 23.2.9)
Establishes if parent wishes hearing screen for their baby (6.2.2)
Explains use of data (national access, only authorised individuals, programme audit purposes)
(8.3.1, 13.2.11)
Records consent or decline on baby’s proforma/records (13.2.10, 13.2.11, 23.2.4)
Informed consent to hearing screen obtained:
Negotiates when would be convenient time to screen (2.3.3)
Parent declines hearing screen:
Explains decline process (3.3.2, 6.2.3, 13.2.9, 23.2.11)
Explains parent role in ongoing monitoring (shows and discusses NHSP checklists) (2.3.4, 6.4.4)
Key skills Level Comments: How screener met the statement
Established rapport with parent (3.2.2, 23.4.2)
Showed care and consideration to parent and baby (6.2.2)
Parent and baby privacy and confidentiality respected (2.4.2)
Worked well with other members of staff (7.2.3, 7.3.2)
Recognises own limitations and seeks advice as necessary (13.5.2)

11.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 11
Questions and professional discussion
The following questions and areas were discussed:
Reflective practice
The following areas have been identified for further practice/training:

12.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 12
Hearing Screener Observation Assessment: informing parent
NICU Baby protocol
Hearing screener name:
Signature:
Assessor/expert witness name:
Job title:
Signature:
Date of assessment:
Level of Achievement Competence demonstrated
NA Skill/activity not applicable or not assessed.
O Screener observed skill/activity without practical participation.
A
Screener performed skill/activity with assistance.
Demonstrated limited knowledge and understanding.
Recognised own limitations.
I
Screener performed skill/activity independently.
Demonstrated knowledge and understanding, but improvement required.
Evaluates/reflects on own practice and identifies support needs.
C Screener performs skill/activity competently, confidently, independently and safely.
Provides rationale to underpin practice.

13.
Hearing Screener Observation Assessment: informing parent NICU Baby protocol
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 13
Identification of population Level Comments: How screener met the statement
Establishes if baby is eligible for hearing screen (23.1.1)
Takes action if baby not eligible for hearing screen (direct referral to audiology)
(3.3.1, 7.2.2, 23.1.2)
Identifies screening protocol (Well Baby or NICU) (23.1.3)
Identifies who has parental responsibility (23.2.1)
Establishes if appropriate to approach parent (discussion with midwifery team)
(2.3.5, 7.3.2, 7.3.4, 23.2.2)
The new parent is offered the screen – NICU/SCBU protocol Level Comments: How screener met the statement
Introduces self and role (2.2.1, 4.8.2)
Checks identity of parent and accuracy of recorded details (2.2.4, 4.8.1, 23.2.3, 23.4.4)
Informs midwifery team/ward administrative staff of any changes (7.2.3, 7.3.2)
Explains screen offered to all babies (parent aware optional) (7.2.3)
Explains advantages of hearing screening for newborns (early ID, improved outcomes,
parent support) (23.2.7)
Explains NICU protocol (AOAE & AABR, baby at higher risk of hearing loss)
Explains disadvantages of hearing screening for newborns (time takes, potential anxiety)
Explains AOAE screen (soft clicks, response from ear) (23.2.6)
Explains AOAE screen process (equipment, snug earpiece fit, time takes, no visible
response from baby) (23. 2.6)
Explains AABR screen (soft clicks, response from hearing nerve) (23.2.6)
Explains AABR screen process (equip, sensor placement, skin preparation, time takes,
settled baby)
Warns of possible NCR (hearing loss, debris/fluid, unsettled baby, noise) (22.4.1, 23.2.8)
Informs parent of action if NCR (what, when) (7.2.3)

14.
Hearing Screener Observation Assessment: informing parent NICU Baby protocol
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 14
Risk factors identified Level Comments: How screener met the statement
Ascertains mother’s family history of permanent childhood hearing loss (6.2.1, 23.3.2)
Ascertains father’s family history of permanent childhood hearing loss
Correctly identifies and records baby core risk factors (23.3.1)
Correctly identifies and records baby national risk factors (23.3.3, 23.3.4)
Gaining informed consent Level Comments: How screener met the statement
Answers questions from parent/s (use of open questions) (2.2.3, 6.5.1, 6.5.2, 6.6.3, 23.2.9)
Establishes if parent wishes hearing screen for their baby (6.2.2)
Explains use of data (national access, only authorised individuals, programme audit
purposes)
Records consent or decline on baby’s proforma/records (13.2.10, 13.2.11, 23.2.4)
Informed consent to hearing screen obtained:
Negotiates when would be convenient time to screen (2.3.3)
Parent declines hearing screen:
Fully explains decline process (3.3.2, 6.2.3, 23.2.11)
Completes decline documentation
Explains parent role in ongoing monitoring (shows and discusses NHSP checklists)
(2.3.4, 6.4.4)
Informs primary care of screen decline
Key skills Level Comments: How screener met the statement
Established rapport with parent (3.2.2, 23.4.2)
Showed care and consideration to parent and baby (6.2.2)
Parent and baby privacy and confidentiality respected (2.4.2)
Worked well with other members of staff (7.2.3, 7.3.2)
Recognises own limitations and seeks advice as necessary (13.5.2)

15.
Hearing Screener Observation Assessment: informing parent NICU Baby protocol
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 15
Questions and professional discussion
The following questions and areas were discussed:
Reflective practice
The following areas have been identified for further practice/training:

16.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 16
Hearing Screener Observation Assessment: AOAE screening
Hearing screener name:
Signature:
Assessor/expert witness name:
Job title:
Signature:
Date of assessment:
Level of Achievement Competence demonstrated
NA Skill/activity not applicable or not assessed.
O Screener observed skill/activity without practical participation.
A
Screener performed skill/activity with assistance.
Demonstrated limited knowledge and understanding.
Recognised own limitations.
I
Screener performed skill/activity independently.
Demonstrated knowledge and understanding, but improvement required.
Evaluates/reflects on own practice and identifies support needs.
C Screener performs skill/activity competently, confidently, independently and safely.
Provides rationale to underpin practice.

17.
Hearing Screener Observation Assessment: AOAE screening
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 17
Equipment checks Level Comments: How screener met the statement
Accurately carries out all routine AOAE equipment QA checks (visual, cavity, real ear)
Takes action if AOAE equipment does not pass QA check/s (23.5.2)
Records AOAE QA checks (23.5.4)
Clinical ‘area’ and equipment preparation Level Comments: How screener met the statement
Checks and cleans clinical ‘area’ to ensure it meets all local infection control policy
requirements (4.2.3, 4.2.6, 4.6.2, 9.5.1)
Checks AOAE system and consumables (battery check, sufficient consumables)
(4.2.4, 23.5.5, 25.2.11)
Prepares and maintains tidy and family friendly clinical ‘area’ (AOAE) (4.2.5, 4.7.2, 4.7.4)
Baby data entry onto AOAE system Level Comments: How screener met the statement
Enters complete and accurate baby data onto AOAE system
Re-checks accuracy of baby data entered onto AOAE system against baby
proforma/recorded details
Optimising conditions Level Comments: How screener met the statement
Explains AOAE screen process (snug earpiece fit, time takes - can feel longer, baby
settled) (23.4.1, 25.1.1, 25.1.2, 25.1.3, 25.1.4, 25.2.1)
Reminds parent of possibility of NCR outcome (hearing loss, debris/fluid, unsettled
baby, noise) (23.6.2, 25.1.6, 25.2.4)
Answers questions from parent/s (use of open questions)
(6.6.4, 25.1.1, 25.1.2, 25.1.3, 25.1.4)
Confirms now is convenient time to screen baby (baby comfortable) (6.5.3)
Minimises environmental noise (23.6.2, 23.6.3, 25.2.11)
The baby is screened Level Comments: How screener met the statement
Demonstrates effective hand hygiene (4.4.2, 4.4.3, 9.6.2)

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 18
First ear
Positions self and baby to observe ear canal (clearly visible, parent involved, parent
can see activity ) (4.5.3, 25.2.2)
Selects largest ear-tip and places on earpiece (fully positioned on earpiece and
gripping) (25.2.3, 25.2.5)
Manipulates baby’s pinna to facilitate earpiece placement (upwards and back) (25.2.6)
Inserts earpiece firmly using ¼ turn (baby ‘wriggles’, holds earpiece until baby settled)
Assesses earpiece fit (stays securely in place without support, AOAE system
‘feedback’ signal) (25.2.7)
Takes action if unsatisfactory earpiece fit (removes, observes, changes tip,
reassembles, refits) (25.2.9)
Correctly positions earpiece cable (upwards away from baby; no ‘rubbing’) (25.3.10)
Second ear
Positions baby and observes ear canal (clearly visible, parent involved, parent can see
activity) (25.2.2)
Selects largest ear-tip and places on earpiece (fully positioned on earpiece and
gripping) (25.2.3, 25.2.5)
Manipulates baby’s pinna to facilitate earpiece placement (up and back, ear canal
clearly visible) (25.2.6)
Inserts earpiece firmly using ¼ turn (baby ‘wriggles’, holds earpiece until baby settled)
Assesses earpiece fit (stays securely in place without support, AOAE system
‘feedback’ signal) (25.2.7)
Takes action if unsatisfactory earpiece fit (removes, observes, changes, reassembles,
refits) (25.2.9)
Correctly positions earpiece cable (upwards away from baby; no ‘rubbing’) (25.2.10)

19.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 19
During screen Level Comments: How screener met the statement
Monitors test conditions( baby, noise, earpiece fit, AOAE system indicators) (25.1.1)
Takes action to maintain optimum conditions (settles baby; reduces room noise)
Demonstrates ongoing support for/ awareness of parent (anxious, comfortable,
questions) (6.2.2)
Baby completes the screen Level Comments: How screener met the statement
Keeps earpiece in place until checks, and re-checks, test is saved to correct ear
After each ear completed checks result on AOAE system display before informing
parent of outcome (25.3.1)
Clearly explains AOAE result of each ear to parent (25.3.2)
Answers questions from parent/s (use of open questions) (25.3.3)
Informs midwifery team of any parent or professional concerns as necessary (25.3.7)
Bilateral Clear Response (CR) outcome
Correctly identifies if targeted follow-up at 8 months of age required
If appropriate: explains need for targeted follow-up at 8 months (why and importance)
Explains parent role in ongoing monitoring (shows and discusses NHSP checklists)
(25.3.4)
Unilateral or bilateral No Clear Response (NCR) outcome
Next stage of screening process (see AABR screening/referral to audiology required
checklists)

20.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 20
Outcome of baby’s screen: documentation Level Comments: How screener met the statement
After each ear completed, checks result and records outcome on baby’s
proforma/record (25.3.5)
Accurately completes baby’s Personal Child Health Record documentation (8.2.3)
Clear Response (CR): Provides parent with CR documentation (CR letter, targeted
follow-up letter, PCHR form, checklists) (25.3.6)
Records hearing screen outcome in baby’s hospital notes/sheet (25.4.1)
Data entry into the NHSP national IT system (see NHSP national IT system checklist)
(25.5.1)
Post screen: clinical area and equipment Level Comments: How screener met the statement
Checks and cleans clinical ‘area’ to ensure it meets all local infection control policy
requirements
Checks and cleans equipment to ensure it meets all local infection control policy
requirements (wipes from earpiece end)
Disposes of used consumables as per all local infection control policy requirements
Demonstrates effective hand hygiene that meets all local infection control policy
requirements
Stores equipment safely & makes arrangements to charge/change as necessary (25.3.13)
Key skills Level Comments: How screener met the statement
Established rapport with parent (3.2.2, 23.4.2)
Showed care and consideration to parent and baby (6.2.2)
Handled baby in safe and confident manner
Respected parent and baby privacy and confidentiality (2.4.2)
Worked well with other members of staff (7.2.3, 7.3.2)
Showed health and safety awareness of working environment (5.5.3)
Recognises own limitations and seeks advice as necessary (13.5.2)

21.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 21
Questions and professional discussion
The following questions and areas were discussed:
Reflective practice
The following areas have been identified for further practice/training:

22.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 22
Hearing Screener Observation Assessment: AABR screening
Hearing screener name:
Signature:
Assessor/expert witness name:
Job title:
Signature:
Date of assessment:
Level of Achievement Competence demonstrated
NA Skill/activity not applicable or not assessed.
O Screener observed skill/activity without practical participation.
A
Screener performed skill/activity with assistance.
Demonstrated limited knowledge and understanding.
Recognised own limitations.
I
Screener performed skill/activity independently.
Demonstrated knowledge and understanding, but improvement required.
Evaluates/reflects on own practice and identifies support needs.
C Screener performs skill/activity competently, confidently, independently and safely.
Provides rationale to underpin practice.

23.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 23
Equipment checks Level Comments: How screener met the statement
Accurately carries out all routine AABR equipment Quality Assurance (QA) checks
(visual; clicks; (data deleted/applicable))
Takes action if AABR equipment does not pass QA check/s (23.5.2)
Records AABR QA checks (23.5.4)
Clinical ‘area’ and equipment preparation Level Comments: How screener met the statement
Checks and cleans clinical ‘area’ to ensure it meets all local infection control policy
requirements (4.2.3, 4.2.6, 4.6.2, 9.5.1)
Checks AABR system and consumables (battery check, sufficient consumables)
(4.2.4, 23.5.5, 25.2.11)
Prepares and maintains tidy and family friendly clinical ‘area’ (AABR) (4.2.5, 4.7.2, 4.7.4)
Baby data entry onto AABR system Level Comments: How screener met the statement
Enters complete and accurate baby data onto AABR system
Re-checks accuracy of baby data entered onto AABR system against baby
proforma/recorded details
Optimising conditions Level Comments: How screener met the statement
Reminds parent of AABR screen (soft clicks, response from hearing nerve)
(23.4.1, 24.1.1, 24.1.2, 24.1.3, 23.1.4, 24.1.5, 24.1.6)
Explains AABR screen process (equip, sensors (shows parent), sensor placement
(where), skin preparation (what involved), headphones, time takes, settled baby)
Reminds parent of possibility of NCR outcome (hearing loss, debris/fluid, unsettled baby,
noise) (23.6.2, 24.2.5)
Informs parent of action if NCR (what, when)
Answers questions from parent/s (use of open questions) (6.6.4, 24.1.1, 24.1.2, 24.1.3,
24.1.4, 24.1.5, 24.1.6)

24.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 24
Confirms now is convenient time to screen baby (baby comfortable) (6.5.3)
Minimises environmental and electrical noise (23.6.2, 23.6.3)
The baby is screened Level Comments: How screener met the statement
Demonstrates effective hand hygiene (4.4.2, 4.4.3, 9.6.2)
Positions baby and clothes to ensure access to sensor areas (forehead, nape,
shoulder ) (24.2.2.)
Skin preparation and sensor placement
Observes sensor areas prior to preparation (moisture, vernix absorbed as necessary)
(24.2.3)
Holds skin taut throughout preparation ( 3-5 firm wipes in 1 direction using prep-pad/ x
3 sensor sites) (4.4.1, 24.2.4)
Keeps parent involved/informed throughout (24.2.1)
Holds skin taut throughout sensor placement x 3
Does not contaminate sensors with fingers
Correctly places sensors: (24.2.6) Forehead – up to (but not into) hairline
Nape - up to (but not into) hairline, not on skull
Shoulder – on ‘fleshy’ area
Checks impedance levels – appropriate for testing (24.2.7)
Re-preps and replaces sensors as necessary
Headphone placement
Fully inserts transducers and checks they are not blocked
Places headphone (moves baby’s hair away; rolls on from back to front) (24.2.9)
Checks baby’s ears are completely enclosed within headphones (not up against
transducer entry )
Checks headphones on correct ears (red =right, blue = left)

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 25
Connections
Connects cables to correct sensors
Correctly positions cables (upwards away from baby, not crossed/twisted) (24.2.10)
During screen Level Comments: How screener met the statement
Monitors test conditions (baby, noise, connections, Myogenic = low, Impedances = low)
(24.2.11)
Takes action to maintain optimum conditions (settles baby; reduces room noise; lights)
Demonstrates ongoing support for, and awareness of, parent (anxious, comfortable, Qs)
Baby completes the screen Level Comments: How screener met the statement
After each ear completed checks result on AABR system display before informing
parent of outcome (24.3.1)
Clearly explains AABR results parent (24.3.2)
Answers questions from parent/s (use of open questions) (24.3.3)
Gently removes sensors x 3 (not pulling; ‘walks’ sensors off) (24.2.1, 24.2.4)
Gently removes headphones x 2 (not rushed; ‘walks’ headphones off) (24.2.13, 24.1.14)
Bilateral Clear Response (CR) outcome
Correctly identifies if targeted follow-up at 8 months of age required
If appropriate: explains need for targeted follow-up at 8 months (why and importance)
Explains parent role in ongoing monitoring (discusses NHSP checklists) (24.3.2)
Answers questions from parent/s (use of open questions)
Informs midwifery team of any parent or professional concerns as necessary (24.3.7)
Unilateral or bilateral No Clear Response (NCR) outcome
Next stage of screening process (see referral to audiology required checklists) (24.3.4)

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 26
Outcome of baby’s screen - documentation Level Comments: How screener met the statement
Records AABR outcome on baby’s proforma/record (24.3.5)
Accurately completes baby’s Personal Child Health Record (PCHR) (8.2.3)
CR: Provides parent with CR documentation (CR letter, targeted f-up letter, PCHR
form, checklists) (24.3.6)
Records hearing screen outcome in baby’s hospital notes/sheet (24.4.1)
Data entry into the NHSP national IT system (see NHSP national IT system checklist)
(24.5.1)
Post screen: clinical area and equipment Level Comments: How screener met the statement
Checks and cleans clinical ‘area’ to ensure it meets all local infection control policy
requirements
Checks and cleans equipment to ensure it meets all local infection control policy
requirements (wipes cables from clip end)
Disposes of used consumables as per all local infection control policy requirements
Demonstrates effective hand hygiene that meets all local infection control policy
requirements
Stores equipment safely and makes arrangements to charge/change as necessary
(24.2.15)
Key skills Level Comments: How screener met the statement
Established rapport with parent (3.2.2, 23.4.2)
Showed care and consideration to parent and baby (6.2.2)
Handled baby in safe and confident manner
Respected parent and baby privacy and confidentiality (2.4.2)
Worked well with other members of staff (7.2.3, 7.3.2)
Showed health and safety awareness of working environment (5.5.3)
Recognises own limitations and seeks advice as necessary (13.5.2)

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 27
Questions and professional discussion
The following questions and areas were discussed:
Reflective practice
The following areas have been identified for further practice/training:

28.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 28
Hearing Screener Observation Assessment: referral to audiology
Hearing screener name:
Signature:
Assessor/expert witness name:
Job title:
Signature:
Date of assessment:
Level of Achievement Competence demonstrated
NA Skill/activity not applicable or not assessed.
O Screener observed skill/activity without practical participation.
A
Screener performed skill/activity with assistance.
Demonstrated limited knowledge and understanding.
Recognised own limitations.
I
Screener performed skill/activity independently.
Demonstrated knowledge and understanding, but improvement required.
Evaluates/reflects on own practice and identifies support needs.
C Screener performs skill/activity competently, confidently, independently and safely.
Provides rationale to underpin practice.

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 29
Outcome of baby’s screen Level Comments: How screener met the statement
Clearly explains AABR screen outcome to parent
Reminds parent of possible reasons for NCR outcome:
• hearing loss
• as appropriate (debris/fluid, unsettled baby, noise)
Clearly explains need for referral to audiology
Answers questions from parent/s (use of open questions)
Baby is referred to audiology Level Comments: How screener met the statement
Provides parent with leaflet ‘Your Baby’s Visit to Audiology’
Explains what tests at audiology will involve (23.4.1)
Informs parent of appointment duration (approx 2 hours) (24.3.6, 25.3.6)
Explains need for baby to be settled (feeds, nappies)
Emphasises importance of attending appointment (try not to cancel)
Directs parent to audiology contact details (for future questions)
Suggests parent takes partner/friend to appointment
Negotiates audiology appointment (when partner available, sibling at nursery, need for
fluid absorption)
Provides parent with screen outcome/audiology appointment letter
Provides parent with clinic details (location, parking costs, bus route)
Checks parent’s understanding of why their baby has been referred to audiology
Answers questions from parent/s (use of open questions)
Informs parent of how they can contact screener/screening service if have further
questions

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 30
Contact Level Comments: How screener met the statement
Checks parent contact details (mobile number, discharge address, OK to text
reminder?)
Informed midwifery team regarding baby’s referral to audiology (23.2.5)
Informed HV/GP regarding baby’s referral to audiology
Informed audiology regarding baby’s referral to audiology
Informed audiology regarding need for interpreting services
Key skills Level Comments: How screener met the statement
Established rapport with parent (3.2.2, 23.4.2)
Respected parent and baby privacy and confidentiality (2.4.2)
Worked well with other members of staff (7.2.3, 7.3.2)
Recognises own limitations and seeks advice as necessary (13.5.2)
Questions and professional discussion
The following questions and areas were discussed:
Reflective practice
The following areas have been identified for further practice/training:

31.
Level 3 Diploma for health screeners (Newborn Hearing) March 2019 31
Hearing Screener Observation Assessment: using the NHSP national IT system
Hearing screener name:
Signature:
Assessor/expert witness name:
Job title:
Signature:
Date of assessment:
Level of Achievement Competence demonstrated
NA Skill/activity not applicable or not assessed.
O Screener observed skill/activity without practical participation.
A
Screener performed skill/activity with assistance.
Demonstrated limited knowledge and understanding.
Recognised own limitations.
I
Screener performed skill/activity independently.
Demonstrated knowledge and understanding, but improvement required.
Evaluates/reflects on own practice and identifies support needs.
C Screener performs skill/activity competently, confidently, independently and safely.
Provides rationale to underpin practice.

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 32
Preparation Level Comments: How screener met the statement
Log into the NHSP national IT system (8.2.2)
Log into intermediate software
Uses the search page to: Level Comments: How screener met the statement
• Search for a baby using NHS number
• Search for a baby using confidential ID
• Search for a baby by name, including use of wildcard search and names with an
apostrophe
• Search for a list of babies born within a date range
Sorts the search results
Prints out proformas for babies requiring screening
Updates demographic data using: Level Comments: How screener met the statement
‘Edit patient’ (8.2.3)
• to change or correct a name
• to change protocol to NICU
• to add gestational age (GA) if missing
‘View Add contacts’
• to change or correct an address
• to add another contact e.g. foster mother
• to change the Primary contact
• to set the consent signatory
‘Add Professional contact’
• Add or change GP practice
• Add an audiology service
‘Interpreter’ field
Uses the demographics page to: Level Comments: How screener met the statement

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 33
• Add a case note
Selects appropriate ‘importance’ level of case note
• Mark a baby as deceased
• Change the location of a baby e.g. to outpatients
• Update risk factor information
• Set the screen outcome
Uses the hearing page to: Level Comments: How screener met the statement
• Set the screening outcome
When setting the screen outcome can:
• Add an audiology referral to the audiology page
• Add an offered appointment to the audiology page
Uses the patient journey page to: Level Comments: How screener met the statement
Identify babies who have not started screening
Identify babies who have not completed screening
Identify records where the screen outcome has not been set
Enters appointment details for: Level Comments: How screener met the statement
Outpatient screening appointment
Audiology follow up appointment
Records the screening results by: Level Comments: How screener met the statement
Uploading the test results via the intermediate software
Processing the directly imported data by: (25.4.1, 25.5.1)
• matching an unmatched record in a different facility
• resolving errors such as ‘protocol on the NHSP national IT system different to
protocol on screening equipment’
• setting consent status
• Setting risk factors
• checking a GP practice is present
• setting the screen outcome or deferring

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Level 3 Diploma for health screeners (Newborn Hearing) March 2019 34
Assigning test results that were not automatically matched
Correcting any other errors
Generates NHSP national IT system letters for
• parents
• professionals e.g. GP practice
Key skills Level Comments: How screener met the statement
Showed knowledge of data confidentiality
Demonstrated keyboard skills
Displayed IT literacy
Recognises own limitations and seeks advice as necessary (13.5.2)
Questions and professional discussion
The following questions and areas were discussed:
Reflective practice
The following areas have been identified for further practice/training: