Outcome Differences in Neonates Exposed In-Utero to Opioids Managed in the NICU Versus Pediatric Floor

Lembeck, Amy L.; Tuttle, Deborah; Locke, Robert; Lawler, Laura; Jiménez, Pamela Lazo; Mackley, Amy; Paul, David A.

doi:10.1097/adm.0000000000000455

Cited by 10 publications

(8 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings are consistent with those of other authors who have reported the effects of rooming-in. 15 16 17 18 19 25…”

Section: Discussionmentioning

confidence: 99%

“…These findings are consistent with those of other authors who have reported the effects of rooming-in. [15][16][17][18][19]25 Our subjective experience suggests some of this improvement may be due in part to an increasing confidence among the clinicians (A.I.N. and L.N.)…”

Section: Discussionmentioning

confidence: 99%

“…A total of 12 studies have evaluated the utility of this intervention across the United States, Canada, and Europe, using retrospective and quality improvement study designs. [15][16][17][18][19][20][21][22][23][24][25][26] Seven review articles published in 2018 and 2019 alone [27][28][29][30][31][32][33] provide rich summaries of the subject. In a systematic mixed-study review analyzing both quantitative and qualitative data, MacVicar and Kelly found that optimizing nonpharmacological management of NAS (including consolation therapy and rooming-in) improved outcomes by lessening the need for pharmacotherapy and reducing hospital length of stay.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Rooming-in for Infants at Risk for Neonatal Abstinence Syndrome: Outcomes 5 Years following Its Introduction as the Standard of Care at One Hospital

et al. 2020

View full text Add to dashboard Cite

Objective The practice of rooming-in for opioid-dependent infants was introduced as the standard of care at our hospital following a pilot study which demonstrated that such infants had shorter lengths of stay and were less likely to require pharmacological treatment. We sought to determine whether these benefits have continued, and whether outcomes support continuing to use rooming-in as standard care. Study Design Opioid-dependent infants delivered at 36 weeks gestation or later between January 1, 2015, and December 31, 2019, were eligible for rooming-in. Charts were reviewed and data were extracted regarding maternal and infant conditions, whether neonatal pharmacological treatment was required, and total length of hospital stay. Outcomes were compared with two historical groups reported in a previous pilot study: 24 healthy near-term opioid-dependent newborns who were admitted directly to the neonatal intensive care unit (NICU) prior to the introduction of rooming-in (May 1, 2012–May 31, 2013), and 20 similar opioid-dependent infants who were the first to room-in at our hospital (September 1, 2013–September 30, 2014). Results Only 3.5% of 57 infants who roomed-in during the 5-year study period required pharmacological treatment, compared with 15% who roomed-in during the first year of the program's introduction and 83.3% who had been admitted directly to the NICU. The median length of stay remained 5 days for infants rooming-in, compared with 24 days for opioid-dependent infants in the cohort admitted to the NICU. Conclusion Early observations of the benefits of rooming-in on neonatal outcomes were sustained. Infants allowed to room-in were significantly less likely to require initiation of pharmacotherapy and a prolonged hospital stay than similar infants prior to the implementation of rooming-in as standard care. A large proportion of the infants who might have benefited from rooming-in required admission to the NICU for reasons other than neonatal abstinence syndrome (NAS). Key Points

show abstract

“…These findings are consistent with those of other authors who have reported the effects of rooming-in. 15 16 17 18 19 25…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Rooming-in for Infants at Risk for Neonatal Abstinence Syndrome: Outcomes 5 Years following Its Introduction as the Standard of Care at One Hospital

et al. 2020

View full text Add to dashboard Cite

show abstract

“…A 10-question survey was created and distributed to members of SONPM, the Section on Hospital Medicine, and the Section on Pediatric Trainees. We hypothesized wide variation exists in the inpatient and follow-up referral practices for infants with NAS across pediatric subspecialty (neonatal intensive care unit (NICU) vs. non-NICU) due to the shift in the care of infants with NAS from the NICU to non-NICU units in recent years [2].…”

Section: To the Editormentioning

confidence: 99%

Neonatal abstinence syndrome practice variations across pediatric subspecialty

et al. 2020

View full text Add to dashboard Cite

“…However, gaps in the evidence base are rapidly being addressed, and consensus is building around best practices and treatment strategies [11][12][13][14][15], providing new momentum to reassess hospitals' current management of NAS. Studies suggest decreased use of pharmacologic treatment and decreased length of birth hospitalizations are associated with written protocols [16,17]; infant physiologic measures to assess NAS; [18] promotion of maternalinfant bonding interventions such as breastfeeding [19,20], "rooming-in" (keeping the mother with the infant during the birth hospitalization) [21], and decreased use of the neonatal intensive care unit (NICU) [22]. These new initiatives have been linked to reductions in hospital cost [23,24].…”

Section: Introductionmentioning

confidence: 99%

Neonatal abstinence syndrome management in California birth hospitals: results of a statewide survey

et al. 2020

View full text Add to dashboard Cite

Objective Assess management of neonatal abstinence syndrome (NAS) in California hospitals to identify potential opportunities to expand the use of best practices. Study design We fielded an internet-based survey of 37 questions to medical directors or nurse managers at 145 birth hospitals in California. Results Seventy-five participants (52%) responded. Most respondents reported having at least one written protocol for managing NAS, but gaps included protocols for pharmacologic management. Newer tools for assessing NAS severity were not commonly used. About half reported usually or always using nonpharmacologic strategies; there is scope for increasing breastfeeding when recommended, skin-to-skin care, and rooming-in. Conclusions We found systematic gaps in care for infants with NAS in a sample of California birth hospitals, as well as opportunities to spread best practices. Adoption of new approaches will vary across hospitals. A concerted statewide effort to facilitate such implementation has strong potential to increase access to evidence-based treatment for infants and mothers.

show abstract

Outcome Differences in Neonates Exposed In-Utero to Opioids Managed in the NICU Versus Pediatric Floor

Cited by 10 publications

References 17 publications

Rooming-in for Infants at Risk for Neonatal Abstinence Syndrome: Outcomes 5 Years following Its Introduction as the Standard of Care at One Hospital

Rooming-in for Infants at Risk for Neonatal Abstinence Syndrome: Outcomes 5 Years following Its Introduction as the Standard of Care at One Hospital

Neonatal abstinence syndrome practice variations across pediatric subspecialty

Neonatal abstinence syndrome management in California birth hospitals: results of a statewide survey

Contact Info

Product

Resources

About