A quality improvement initiative to implement the eat, sleep, console neonatal opioid withdrawal syndrome care tool in Massachusetts' PNQIN collaborative.

Autor: Wachman EM; Department of Pediatrics, Boston Medical Center, Boston, MA, USA. Elisha.Wachman@bmc.org., Houghton M; Newborn Medicine, Beth Israel Deaconness Medical Center, Boston, MA, USA., Melvin P; Center for Applied Pediatric Quality Analytics, Children's Hospital Boston, Boston, MA, USA., Isley BC; Department of Pediatrics, Boston Medical Center, Boston, MA, USA., Murzycki J; Department of Pediatrics, Lowell General Hospital, Boston, MA, USA., Singh R; Department of Pediatrics, Baystate Children's Hospital, Springfield, MA, USA., Minear S; Department of Pediatrics, Boston Medical Center, Boston, MA, USA., MacMillan KDL; Department of Pediatrics, MassGeneral Hospital for Children, Boston, MA, USA., Banville D; South Shore Hospital, Weymouth, MA, USA., Walker A; Cooley Dickinson Hospital, Northampton, MA, USA., Mitchell T; Department of Pediatrics, Mercy Medical Center, Springfield, MA, USA., Galimi-Hayes R; Milford Regional Medical Center, Milford, MA, USA., Jorgensen S; Division of Newborn Medicine, Boston Children's Hospital, Boston, MA, USA., Gomes DR; Department of Neonatology, Boston Children's Hospital, Boston, MA, USA., Hodgins F; Massachusetts Health Policy Commission, Boston, MA, USA., Whalen BL; Department of Pediatrics, Children's Hospital at Dartmouth-Hitchcock, Lebanon, NH, USA., Diop H; Massachusetts Department of Public Health, Boston, MA, USA., Gupta M; Newborn Medicine, Beth Israel Deaconness Medical Center, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2020 Oct; Vol. 40 (10), pp. 1560-1569. Date of Electronic Publication: 2020 Jul 16.
DOI: 10.1038/s41372-020-0733-y
Abstrakt: Objective: To support hospitals in the Massachusetts PNQIN collaborative with adoption of the ESC Neonatal Opioid Withdrawal Syndrome (NOWS) Care Tool© and assess NOWS hospitalization outcomes.
Study Design: Statewide QI study where 11 hospitals adopted the ESC NOWS Care Tool©. Outcomes of pharmacotherapy and length of hospital stay (LOS) and were compared in Pre- and Post-ESC implementation cohorts. Statistical Process Control (SPC) charts were used to examine changes over time.
Results: The Post-ESC group had lower rates of pharmacotherapy (OR 0.35, 95% CI 0.26, 0.46) with shorter LOS (RR 0.79, 95% CI 0.76, 0.82). The 30-day NOWS readmission rate was 1.2% in the Pre- and 0.4% in the Post-ESC cohort. SPC charts indicate a shift in pharmacotherapy from 54.8 to 35.0% and LOS from 14.2 to 10.9 days Post-ESC.
Conclusions: The ESC NOWS Care Tool was successfully implemented across a state collaborative with improvement in NOWS outcomes without short-term adverse effects.
Databáze: MEDLINE
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