In this section
Newborn bloodspot screening (NBS) (formally known as newborn screening testing) commenced in Victoria in 1966, when screening was introduced for Phenylketonuria. Since then, screening has expanded to testing for Congenital Hypothyroidism, Cystic Fibrosis, Phenylketonuria, Congenital Adrenal Hyperplasia (CAH) and over 22 other rare conditions. These rare but serious conditions cannot be seen by just looking at the baby. These tests ensure early detection and treatment of these conditions to save lives.
This guideline provides an outline for medical and nursing staff to perform screening tests for newborn infants at the Royal Children's Hospital.
All newborn infants are screened regardless of gestational age, weight, feeding or health status between 36 and 72 hours of life. Palliated infants: A sample should still be obtained on palliated infants. This may help to exclude diseases which may have implications for the family in future pregnancies. If the sample is taken after the infant dies, write in red on the screening card that it is a “post-mortem” or “peri-mortem” sample as there is a marked difference in the metabolic profile between a live and a deceased infant.
NBS flowchart - prem sick neonate v2.1 (vcgs.ninja)
****Blood product is now PRBC or whole blood transfusion or ECMO
Nursing staff on each shift are responsible for
checking that screening is performed or has been performed on infants in their
Note: if parent/guardian not available to provide
written consent - writing ‘verbal consent by phone’ is only acceptable with
written explanation as to why no parent/guardian signature obtainable. Written or verbal consent is only
applicable for the first card sample.
For subsequent samples, parents should know it has
been taken, but are not required to
sign each subsequent card.
Occasionally, stored newborn bloodspot screening cards get used for
research. Some examples are the development of new tests or determining normal
levels of a biomarker. This research is de-identified (i.e. no personal details
are released to the researchers) and must be approved by an ethics committee.
Parents can tick the “No Secondary Research Use” box if they do not wish their
child’s card to be available for such research
If parents refuse to have the test the following steps should be followed:
More information on refusal of
consent can be found here – page 5-7.
Record date and time of sample taken in:
Flowsheets > Primary Assessment > Newborn Bloodspot Screening (NBS).
For more information about what happens after
screening, please refer for the Newborn
Bloodspot Screening Information for Parents brochure.
RCH Newborn Screening Clinical Nurse ConsultantsNoelle Giordano, Tabitha Hole, Mia Normoyle
Phone: (03) 9345 6244 or (03) 9345 6062
Newborn Bloodspot Screening Laboratory
Victorian Clinical Genetic Services
Royal Children's Hospital, Parkville 3052
Tel: (03) 8341 6272 Fax: (03) 8341 6339
Newborn Bloodspot Screening Nurse: Email:
Phone: (03) 8341 6460
Newborn Screening Evidence Table
Please remember to
read the disclaimer.
The development of this nursing guideline was coordinated by Lauren Cross, Registered Nurse/Midwife, Butterfly Ward, and approved by the Nursing Clinical Effectiveness Committee. Updated January 2023.