Wellspan Health York Hospital, Division of Newborn Medicine, PA, United States of America.
The University of Alabama Capstone College of Nursing, AL, United States of America.
J Pediatr Nurs. 2019 Sep-Oct;48:77-81. doi: 10.1016/j.pedn.2019.07.009. Epub 2019 Jul 25.
The purpose of this quality improvement project was to determine if non-pharmacologic strategies such as a rooming-in approach to care for newborns at risk of developing neonatal abstinence syndrome (NAS) would reduce total length of stay (LOS) and reduce the need for pharmacologic treatment.
This was a quality improvement project utilizing a retrospective chart review. Records of newborns with in-utero methadone or buprenorphine exposure were reviewed who were born between January 2016-July 2017 and July 2017-August 2018 at Wellspan Health York Hospital. Starting in July 2017, newborns exposed to opioids who transitioned normally remained with their mothers for monitoring in the newborn nursery. Monitoring for withdrawal was continued on the pediatric floor after the mother's discharge from the post-partum floor.
The primary outcome of total LOS was reduced from 14 days to 10.1 days (p = 0.014). The total length of pharmacologic treatment decreased from 15.68 days to 9.71 days (p = 0.023).
A rooming-in approach to care including management on a pediatric floor can reduce total length of stay and the duration of pharmacologic treatment in newborns with NAS. Newborns with NAS can be safely managed in an inpatient pediatric floor.
Implementing a rooming-in approach to care of newborns at risk of developing NAS can improve outcomes through a decreased length of hospital stay and decreased duration of pharmacologic treatment. This approach improves access to critical care services by safely monitoring newborns with NAS on an inpatient pediatric floor.
本质量改进项目旨在确定非药物策略（如对有新生儿戒断综合征（NAS）风险的新生儿进行母婴同室护理）是否可以缩短总住院时间（LOS）并减少药物治疗的需求。
这是一个质量改进项目，利用回顾性图表审查。回顾了 2016 年 1 月至 2017 年 7 月和 2017 年 7 月至 2018 年 8 月期间在 Wellspan Health York 医院出生的接受过阿片类药物（如美沙酮或丁丙诺啡）宫内暴露的新生儿的记录。从 2017 年 7 月开始，正常过渡的暴露于阿片类药物的新生儿与母亲一起留在新生儿病房进行监测。母亲从产后病房出院后，在儿科病房继续进行戒断监测。
总 LOS 的主要结果从 14 天减少到 10.1 天（p=0.014）。药物治疗的总时间从 15.68 天减少到 9.71 天（p=0.023）。
包括在儿科病房进行管理的母婴同室护理方法可以缩短 NAS 新生儿的总住院时间和药物治疗持续时间。NAS 新生儿可以安全地在住院儿科病房中进行管理。
实施针对有发生 NAS 风险的新生儿的母婴同室护理方法可以通过缩短住院时间和减少药物治疗持续时间来改善结局。这种方法通过在住院儿科病房安全地监测患有 NAS 的新生儿，改善了获得关键护理服务的机会。
