A Quality Improvement Project to Reduce Length of Stay for Neonatal Abstinence Syndrome

Abstract

BACKGROUND AND OBJECTIVE: Neonatal abstinence syndrome (NAS), a self-limiting condition, is associated with clinical symptoms that may require pharmacological intervention. Optimal treatment of NAS remains undetermined, but the hospital length of stay (LOS) for patients with NAS is partially dependent upon a standard treatment protocol used. Prolonged LOS for patients with NAS can lead to adverse patient harm, impaired maternal-infant attachment, and significant health care costs. Therefore, we conducted a quality improvement study to reduce the LOS for infants with NAS. METHODS:In 2009, a multidisciplinary NAS Taskforce was created to implement a standardized treatment protocol, discuss the strengths and weaknesses of the current medical and nursing management, and improve communication among staff. Infants with NAS that required pharmacological intervention were followed throughout their hospitalization. Readmission within 30 days of hospital discharge was tracked as a balancing measure. On average, 10.7% of nonpregnant women of childbearing age and 5.9% of pregnant women reported illicit drug use in the month before the survey.

Breastfeeding and the substance‐exposed mother and baby

“…29 Similarly, other research has concentrated on increasing family involvement in the delivery of nonpharmaceutical therapy and a "care bundle" approach to management. 30,31 These studies assessed intervention efficacy in terms of hospital duration and/or health care costs, and all demonstrated an improvement. It could be argued, therefore, that a model including family focused care which collaboratively fosters a therapeutic mother-child relationship and places breastfeeding at its center should also improve clinical and economic outcomes.…”

A Qualitative Study of Family Experience With Hospitalization for Neonatal Abstinence Syndrome

“…This knowledge may be used to adjust hospital practices to improve families' experiences of the NAS hospitalization. 2,24,25 More research is needed to better understand the complex social and emotional aspects of NAS to further improve family-centered NAS care, both in the hospital and in the community.…”

Rooming-In to Treat Neonatal Abstinence Syndrome: Improved Family-Centered Care at Lower Cost

“…Two recent multicenter Ohio collaborative reports and a single-center study in NICUs showed a decreased LOS to between 18 and 23 days with use of a standardized weaning protocol. 8,26,27 Recent US national data show average LOS for a pharmacologically treated infant is 23 days. 3 Limitations include that the project occurred in a children's hospital within a hospital.…”