Hernandez, Jessica A, BSN, RN

Weihbrecht, Emily, BSN, RN

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingEating, Sleeping, Consoling Tool Compared withNeonatal Abstinence Syndrome (NAS) PathwayJessica A. Hernandez BSN, RNLehigh Valley Health Network, Jessica.Hernandez@lvhn.orgEmily Weihbrecht BSN, RNLehigh Valley Health Network, Emily.Weihbrecht@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/patient-care-services-nursingThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtHernandez, J. A., Weihbrecht, E. (2019, Sept 26). Eating, Sleeping, Consoling Tool Compared with Neonatal Abstinence Syndrome (NAS)Pathway. Poster Presented at: LVHN Vizient/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network,Allentown, PA.Lehigh Valley Health Network, Allentown, PennsylvaniaJessica Hernandez, BSN, RN Emily Weihbrecht, BSN, RN• With the growing opioid epidemic in the United States, there has been an increase in the number of opioid exposed newborns.  For example, Yale New Haven Children’s Hospital saw a 74% increase in infants exposed to methadone in utero between 2003 – 2009 (Grossman et al, 2018).• Purpose:  To combat these rising numbers, Lehigh Valley Health Network should use the most effective treatment tool for Neonatal Abstinence Syndrome (NAS) supported by up-to-date research.REFERENCESBagley, S. M., Wachman, E. M., Holland, E. & Brogly, S. B. (2014). Review of the assessment and management of neonatal abstinence syndrome. Addiction Science & Clinical Practice, 9 (10), 1-10.Grossman, M. R., Lipshaw, M. J., Osborn, R. R. & Berwitt, A. K. (2018). A novel approach to assessing infants with neonatal abstinence syndrome. Hospital Pediatrics, 8 (1), 1-6.Grossman, M.R., Berkwitt, A.K., Osborn, R.R., Xu, Y., Esserman, D.A., Shapiro, E.D., Bizzarro, M.J. (2017).  An Initiative to Improve the Quality of Care of Infants With Neonatal Abstinence Syndrome.  PEDIATRICS 139 (6), 1-10.Wachman E.M., Grossman, M., Schiff, D.M., Philipp, B.L., Minear, S., Hutton, E., Saia, K., Nikita, F., Khattab, A., Nolin, A., Alvarez, C., Barry, K., Combs, G., Sticknet, D., Driscoll, J., Humphreys, R., Burke, J., Farrell, C., Shrestha, H., Whalen, B.L. (2018).  Quality Improvement Initiative to Improve Inpatient Outcomes for Neonatal Abstinence Syndrome.  Journal of Perinatology, Wachman, E., Whalen, B., Minear, S., MacMillan, K. & Grossman, M. (2017). Caring for opioid-exposed newborns using the eating, sleeping, consoling (esc) care tool. Boston Medical Center Corporation.For infants at risk for NAS on the Mother Baby Unit, will implementation of Eating, Sleeping, and Consoling (ESC) Care Tool as compared to the current Neonatal Abstinence Guidelines from Birth to Discharge Pathway decrease the use of pharmacological agents?LVHN will carry out the standardization of care for infants suffering from NAS, as decided on by the state of PennsylvaniaBACKGROUND/PURPOSEP I C OOUTCOMES/EVIDENCE IMPLEMENTATONNEXT STEPSEating, Sleeping, Consoling Tool Compared with Neonatal Abstinence Syndrome (NAS) PathwayAverage Length of Stay (Days) Infants Treated with Morphine (%) Cost of Hospitalization (Thousands) Infants Admitted Directly to NICU (%)22.49844.8241005.91410.28920PHARMACOLOGICAL VS. NON-PHARMACOLOGICAL TREATMENT OF INFANTS WITH NEONATAL ABSTINENCE SYNDROME   Infants in the Pre-Intervention Period Infants in the Post-Intervention PeriodDue to the state of Pennsylvania currently working toward the standardization of care for infants experiencing NAS, there was no implementation of the ESC Care Tool at LVHN.  In place of implementation, research on other hospitals’ implementation process was conducted and reported on.• Less than 10-40% of infants with prenatal long-acting opioid exposure require pharmacologic treatment using the ESC assessment and non-pharm care method. In contrast, most studies report initiating pharmacologic therapy for NAS at a rate of 50-80% when using a numerical, score based-approach (Wachman et al., 2017).• Grossman et al demonstrated “supportive, non-pharmacologic interventions combined with assessments that focused on the functional well-being of infants with NAS,” such as the ESC tool, “reduced resource use, including less use of morphine and fewer NICU stays” (8).  • Per Grossman et al, “using the ESC approach exposed significantly fewer infants to pharmacologic treatment than if we used the Finnegan Neonatal Abstinence Scoring System approach” (4).Data from Yale New Haven Children’s Hospital

Eating, Sleeping, Consoling Tool Compared with Neonatal Abstinence Syndrome (NAS) Pathway

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Eating, Sleeping, Consoling Tool Compared with Neonatal Abstinence Syndrome (NAS) Pathway

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