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Nonpharmacologic Tx Enhances Care of Opioid-Exposed Newborns

TUESDAY, April 30, 2019 -- Implementing a care path for newborns with fetal opioid exposure that emphasizes nonpharmacologic interventions can reduce hospital stay and pharmacologic treatment, according to a study presented at the annual meeting of the Pediatric Academic Societies, held from April 24 to May 1 in Baltimore.

Susan Townsend, M.D., from the University of Colorado School of Medicine in Denver, and colleagues initiated a quality improvement process using the "Eat, Sleep, and Console" (ESC) tool for all opioid-exposed newborns admitted to a neonatal intensive care unit (NICU). A multidisciplinary team met to implement change from Finnegan Score to ESC, emphasize nonpharmacologic care, increase family involvement, and use morphine on an as-needed basis instead of tapering methadone.

The researchers found that during the preintervention period in 2017, 71 of 635 infants admitted to the NICU had fetal opioid exposure, and 64.7 percent were treated with methadone for neonatal abstinence syndrome (NAS), with an average length of stay (LOS) of 22.7 days. Fifty NICU admissions with fetal opioid exposure were recorded during Jan. 1 to Oct. 31, 2018. From the first to the third quarter, LOS decreased from a median of 21 to 5.5 days, while use of medication to treat NAS decreased from 75.0 to 27.8 percent and median length of medication exposure reduced from 16 to two days.

"This approach was effective in rapidly reducing hospital stay for this large group of patients," Townsend said in a statement.

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Posted: April 2019

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