CE Credit

Critical Congenital Heart Disease


Welcome to the training on Critical Congenital Heart Disease provided by the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).

Credit hours: 1.50 CE


The goal of this module is to equip Texas Health Steps providers and others to perform state-mandated newborn screening for critical congenital heart disease (CCHD), evaluate results, and provide appropriate follow-up.

Target Audience

Texas Health Steps providers and other interested health-care professionals.

Specific Learning Objectives

After completing the activities of this module, you will be able to:

  1. Specify the purpose and components of state-mandated newborn pulse oximetry screening for critical congenital heart disease (CCHD).
  2. Integrate CCHD screening into routine newborn care and provide appropriate follow-up and referrals based on screening results.

Note: This training contains information that is particularly significant to: 1) physicians who treat newborns in birth facilities, 2) physicians in primary care and in subspecialty settings, and 3) nurses and allied health professionals who conduct the CCHD screening in birth facilities and other health-care settings. Some information is more relevant to those who conduct the screening. Testing will be on content that is tailored to both audiences. References to parents in this module also imply guardians or caregivers.

Please note this module expires on 7/23/2022.

This module was released on 7/23/2019.

Accreditation Statement


Browser Requirements

The medical definitions provided in this module were adapted or obtained from the federal Health Resources and Services Administration; the University of California, San Francisco; the U.S. National Library of Medicine; and WebMD.

American Academy of Pediatrics. (2013, reaffirmed 2016). Policy Statement: Planned Home Birth.

American Academy of Pediatrics. (2011). Policy Statement: Strategies for implementing screening for critical congenital heart disease.

American Academy of Pediatrics. (2019). Newborn Screening: Critical Congenital Heart Defects: Answ​ers and Resources for Primary Care Pediatricians.

Critical Congenital Heart Disease and the NICU:

Manja, V., Mathew, B., Carrion, V., & Lakshminrusimha, S. (2015), Critical Congenital Heart Disease Screening by Pulse Oximetry in a Neonatal Intensive Care Unit. Journal of Perinatology, 35(1): 67–71.

Murphy, D., Pak, Y., & Cleary, J. P. (2016), Pulse Oximetry Overestimates Oxyhemoglobin in Neonates with Critical Congenital Heart Disease. Neonatology, 109(3):213-8. 

Texas Pulse Oximetry Project’s CCHD Toolkit. It includes an algorithm card, bilingual informational brochures for families, and sample screening log.

Texas Department of State Health Services. Newborn Screening for Critical Congenital Heart Disease in Texas web page with resources.

Texas Medicaid & Healthcare Partnership. Online Provider Lookup.

U.S. Department of Health and Human Services, Agency for Healthcare Research Quality (AHRQ). Toolkit to help improve the safety of fragile newborns with complex congenital conditions as they transition from the NICU to home.


Baby’s First Test. CCHD information and videos.

Texas Department of State Health Services. Critical Congenital Heart Disease bilingual Parent Education Brochures.

Texas Department of State Health Services. Texas Health Steps, information about finding a health-care provider and getting a ride to a checkup. 

Texas Health and Human Services Commission. My Children’s Medicaid website, information for families about Medicaid benefits and pediatric health-care services.

Texas Pulse Oximetry Project. Video on CCHD

Utah Department of Health. FAQs and other CCHD information for families.