MCN Am J Matern Child Nurs. 2022;47(4):182-188. doi: 10.1097/NMC.0000000000000833.
Neonatal opioid withdrawal syndrome is pervasive, reflected in a case rate increase among most demographics in the United States from 4.0 newborns per 1,000 hospitalized births in 2010 to 7.3 newborns per 1,000 hospitalized births in 2017. Historically, assessments have been based on present symptomatology, excluding the mother's input, and increasing the likelihood of pharmacotherapy. The Eat, Sleep, Console approach provides an opportunity for the mother to act as the treatment for her newborn as she performs nonpharmacologic interventions that reduce withdrawal severity. Maternal confidence to help her newborn grows with this level of involvement and mother/infant dyad care improves, as do nurse and mother interactions. Assessments are less subjective and less time-consuming for nurses to conduct than those of the often-used Finnegan tool, and are conducted in collaboration with the mother. Facilities implementing this approach have seen a reduction in newborn hospital length of stay, pharmacotherapy, associated medical costs, and improved breastfeeding rates. Implementing an Eat, Sleep, Console protocol involves a stepwise approach to ensure all stakeholders are effectively prepared for the transition. We present strategies to implement an Eat, Sleep, and Console clinical protocol. A stepwise approach to implementation along with a clinical nursing maternal education protocol exemplar is included. Methods to overcome barriers to implementation and recommendations for further development are discussed.
新生儿阿片类戒断综合征普遍存在，这反映在美国大多数人群中，2010 年每千名住院分娩的新生儿中有 4.0 例，到 2017 年增加到每千名住院分娩的新生儿中有 7.3 例。从历史上看，评估是基于当前的症状，不包括母亲的意见，并增加了药物治疗的可能性。“吃、睡、抚慰”方法为母亲提供了一个机会，让她作为治疗新生儿的人，因为她进行非药物干预，减轻戒断的严重程度。随着这种参与程度的提高，母亲对帮助新生儿的信心增强，母婴二人组的护理得到改善，护士和母亲之间的互动也得到改善。与经常使用的芬尼根工具相比，护士进行评估的主观性和耗时性都较低，并且是与母亲合作进行的。实施这种方法的机构已经看到新生儿住院时间、药物治疗、相关医疗费用的减少和母乳喂养率的提高。实施“吃、睡、抚慰”方案需要采取逐步的方法，以确保所有利益相关者都为过渡做好充分准备。我们提出了实施“吃、睡、抚慰”临床方案的策略。包括实施的逐步方法和临床护理产妇教育方案范例。讨论了克服实施障碍的方法和进一步发展的建议。
