Hawaii State Legislature Awareness

Going to Hawaii State Capitol website is very empowering. The website allows the
concerned-citizens to find their respective legislator. This is a very important part of getting
involve with voicing out the issues that matters, especially if the concern is closest to home. For
example, a mother who has a toddler that had heart surgery at 1 year old. This mother is now
expected to care differently from her other children. This child with congenital heart defect will
require a lot of visits to different doctors, activities and food are altered so not to compromised
the heart. This mother may feel empowered to make a change in the community to honor
childs situation. She may contact her legislator and express her thoughts about how to screen
newborns on identifying critical congenital heart defect even before they are sent home. There
is a bill in the house called HB467 HD1. In details, HB467 HD1 requires all birthing facilities in
the state to provide a screening exam for critical congenital heart defect using a pulse oximeter
or other medically accepted screening (Hawaii, 2015).

Pulse oximetry is a non-invasive

procedure and inexpensive. It provides reading of how much saturation of oxygen in the blood
with the use of a probe with infrared light on to the newborns skin for the cost of $5 to $14
(CDC, 2014).

According to American Heart Association, this test is reliable and

a great

screening tool in preventing further complication as the child grows or death (2015).
Let us discuss congenital heart defect. This is a malformation of the heart during its
development while in the womb. The range of malformation can be from a small hole in the
heart to missing a valve or chamber and are not fully developed. A critical congenital heart

defect is considered severe and needs prompt surgery. Newborn with CCHD may not show
clinical manifestations during their stay at the hospital since birth according to CDC (2014).
That is why it is highly recommended to have this test done before the mother and baby goes
home.
If this bill ever get enacted, this could hurt the insurance companies at first. One heart
valve surgery could cause approximately $50,000 that includes hospital, physician, and
anesthesia coverage (Healthcare, 2015). If surgery is eliminated due to early detection and
treatment of critical congenital heart defect, nurses would have limited hands-on experience of
post-op care related to heart valve surgery and even heart transplant. If this bill get passed,
nurses on mother and baby unit will have to know this bill and explain to parents the purpose of
the screening test. This procedure would be an additional responsibility of the nurse before a
couplet be discharged. Aside from screening test for phenylketonuria (PKU), the nurse would
add this in to her task.
In addition, CDC identified that there are 37 states that passed this law. Other states
who are not mandated by law to screen newborns for CCHD are offering this service regardless
(2014). At Kapiolani Medical Center in Fall 2014, a student doing clinical rotation found few
newborns tested their foot to obtain oxygen saturation via pulse oximetry. With that said, this
law sounds promising more so that it has passed the First Reading in January 26, 2015 and
being recommended for Second Reading on February 6, 2015 with (Hawaii, 2015).

References
American Heart Association. (2015). Screening for critical congenital heart disease in new
borns. Retrieved from http://circ.ahajournals.org/content/130/9/e79.full
Centers for Disease Control and Prevention. (2014). Facts about critical congenital heart de
fect. Retrieved from http://www.cdc.gov/ncbddd/heartdefects/cchd-facts.html
Hawaii State Capitol. (2015). HB467 HD1. Retrieved from
http://www.capitol.hawaii.gov/measure_indiv.aspx?billtype=HB&billnumber=467&year=2015

Healthcare Bluebook. (2015). Heart valve surgery. Retrieved from https://healthcareblue

book.com/page_ProcedureDetails.aspx?
id=283&dataset=md&g=Heart+Valve+Surgery