Avoiding NICU Transfers for Newborns With Neonatal Opioid Withdrawal Syndrome (NOWS): A Quality Improvement Initiative to Manage NOWS on the Mother-baby Unit
| Autor: | Rebecca Boedeker, Justin B. Josephsen, Mary Harhausen, Kimberly Spence, Gauri Kaushal, Paula Buchanan |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Neonatal intensive care unit Quality management business.industry 010102 general mathematics 01 natural sciences Unit (housing) 03 medical and health sciences Psychiatry and Mental health Neonatal Opioid Withdrawal Syndrome 0302 clinical medicine Opioid Emergency medicine medicine Gestation Pharmacology (medical) 030212 general & internal medicine 0101 mathematics Level of care Adverse effect business medicine.drug |
| Zdroj: | Journal of Addiction Medicine. 14:401-408 |
| ISSN: | 1935-3227 1932-0620 |
| DOI: | 10.1097/adm.0000000000000607 |
| Popis: | OBJECTIVES To reduce transfers to the neonatal intensive care unit (NICU) for neonates with opioid withdrawal while also reducing length of stay and pharmacologic intervention, and maintaining standards of safety. PATIENTS AND METHODS This was a single-center quality-improvement (QI) initiative in a free-standing maternity hospital comparing outcomes for neonatal opioid withdrawal syndrome (NOWS) before and after a series of QI bundles in infants >36 weeks' gestation age (GA). We compared outcomes to our preintervention period (January, 2013 to December, 2013; n = 42) with outcomes postintervention cycle 1 (October, 2016 to September, 2017; n = 126), and postintervention cycle 2 (November, 2017 to October, 2018; n = 160). Cycle 1 included organizing a multidisciplinary task force who focused on emphasis on nonpharmacologic and dyad-centered care, and also standardized pharmacologic management. Cycle 2 reflects the transition to a functional assessment tool and as-needed morphine administration on the postpartum floor. RESULTS Transfer to the NICU for management of NOWS dropped from 71.4% before the quality improvement project down to 5.6% (P |
| Databáze: | OpenAIRE |
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