Congenital heart disease (CHD) — a problem with the heart’s structure — is the most common type of birth defect. Every year approximately 40,000 babies in the US are born with hearts whose walls, valves, arteries, or veins are abnormal.

While the chances of survival for the overwhelming majority of infants born with these conditions in the US are strong, severe CHDs can be life threatening and lead to health problems later in life.

But they don’t have to, and Elizabeth Mikula, MSN, RN, CPN, CPHQ, a nurse who has worked in pediatric cardiology, knew that.

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Catching and treating CHDs early can help lead to better health outcomes for infants, and so while caring for babies with CHDs at Children’s National, a medical center in Washington, D.C., Mikula teamed up with cardiologist Gerard Martin to find a way to screen infants for CHDs earlier.

The team wanted a test that would be accessible and affordable, so it could be used in community hospitals that tend to have fewer resources than facilities that typically test for CHDs. And they wanted a test that would be non-invasive and painless to minimize the stress of the test on infants.

Mikula and her research team landed on the pulse oximeter, a small and soft sensor that can be wrapped around a baby’s hand and foot to measure its heart rate and oxygen level, also called a “pulse ox.”

Using the pulse ox, Mikula and her team were able to detect low oxygen levels in babies’ blood, a sign of CHDs, before they showed signs of being ill. Based on their success using the pulse ox at their medical center, Mikula and her team developed a guide, the CHD Screening Program (CHDSP) Toolkit, to help other hospitals do the same.

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But Mikula didn’t stop there. She became a champion for the method, advocating for its use across the country. To date, the method has been adopted using the CHDSP Toolkit in 47 states, and in countries outside the US, including the United Arab Emirates.

A recent study, found that critical CHD-related infant deaths have dropped by more than 33% in states that now require babies to be screened with Mikula’s pulse ox method. And that couldn’t have happened without the efforts of nurses like Mikula.

“Nurses were hugely involved in the implementation process because they are so heavily involved in patient care. At almost all facilities, the nurses led the implementation and continue to lead the screening now,” Mikula told Johnson & Johnson, a global leader in health care that proudly advocates for nurses and their profound impact on patient outcomes.

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Throughout history, nurses, working on the front-lines of healthcare have been responsible for  developing life-saving practices that have changed the course of human health. For instance, Florence Nightingale advocated for the sterilization of equipment to minimize infections, which today is standard practice in medical facilities. But the innovative contributions of nurses to patient care and treatment often go unrecognized. 

Since its founding, over 130 years ago, Johnson & Johnson has supported and advocated for the nursing profession, as the backbone of our healthcare system. Because Nurses change lives. And that changes everything. Find out more about how Johnson & Johnson supports nurses at


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