In this section
Note: This guideline is currently under review. Introduction
Definition of Terms
Timing of the Test
Refusal of Consent
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, and over 20 other rare conditions. These tests ensure early detection and treatment of these conditions.
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 48 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.
** If collection is delayed due to the infant receiving multiple transfusions, it is acceptable to delay repeat sample, however do not delay repeat collection for too long.
If recollection has been missed, collect sample as soon as this is recognised.
If in doubt or you have any queries in regards to timing of screening, contact the Newborn Bloodspot Screening Laboratory: Ext 16272.
Nursing staff on each shift are responsible for checking that screening is performed or has been performed on infants in their care.
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:
Parents/guardian must be offered the opportunity to meet with a newborn bloodspot screening counsellor (VCGS Call Center: 1300 118 247). Contact the newborn bloodspot screening counsellor as soon as possible.
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 NormoylePhone: (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 September 2019.