Implementation of a Nurse-Driven Eat-Sleep-Console (ESC) Treatment Pathway at a Community Hospital for Treatment of Neonatal Opioid Withdrawal Syndrome in an Effort to Improve Short-term Outcomes.

Autor:	Halloum H; University of Arizona College of Medicine, Tucson (Mr Halloum); Chandler Regional Medical Center, Chandler, Arizona (Mss Daniels, Beville, and Thrasher); Phoenix Children's Hospital, Phoenix, Arizona (Drs Martin and Ellsworth); and University of Arizona College of Medicine-Phoenix (Drs Martin and Ellsworth)., Daniels BJ, Beville D, Thrasher K, Martin GC, Ellsworth MA
Jazyk:	angličtina
Zdroj:	Advances in neonatal care : official journal of the National Association of Neonatal Nurses [Adv Neonatal Care] 2024 Jun 01; Vol. 24 (3), pp. 212-218. Date of Electronic Publication: 2023 Dec 21.
DOI:	10.1097/ANC.0000000000001123
Abstrakt:	Background: The Chandler Regional Medical Center (CRMC) neonatal intensive care unit (NICU) began a phased implementation of Eat-Sleep-Console (ESC) for the management of those at risk for neonatal opioid withdrawal syndrome (NOWS). Purpose: The purpose of this initiative is to track short-term outcomes as well as the program's effect on nursing workflow and job performance rating/satisfaction. Methods: A retrospective review of the ESC implementation process at CRMC from the years 2018-2020. The study consisted of 3 epochs: (1) traditional pharmacologic management; (2) parent-led ESC management; and (3) parent/nurse-led ESC management. Length of stay (LOS), treatment pathway assignment, and proportion of infants treated with pharmacologic agents were compared between epochs. In addition, a survey of NICU nursing staff was distributed to measure nurses' perceptions and attitudes towards the ESC program and the management of infants with NOWS. Results: The proportion of infants treated via ESC increased (0%, 53%, and 100%), with an associated decrease in LOS (18.4, 10.5, and 9.3 days) during each epoch of the study period. Thirty-seven nurses completed the survey, with 94% of nurses reporting being comfortable caring for ESC patients and 89% feeling supported in their ESC nursing assignments, with only 11% stating that caring for ESC patients significantly alters their other nursing care processes. Implications for Practice and Research: Implementation of an ESC treatment program for infants with NOWS significantly decreased LOS and the proportion of infants treated pharmacologically. This phased implementation process was not associated with self-reported negative nursing perceptions of the program and its treatment goals/outcomes. (Copyright © 2024 by The National Association of Neonatal Nurses.)
Databáze:	MEDLINE
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