Related Experiment Video

Updated: Jan 6, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

87.4K

Clinical Decision Support to Improve Dosing Weight Use in Infants with Neonatal Abstinence Syndrome

C Briana Bertoni1,2, Pavel Prusakov3, Jenna Merandi3

  • 1Department of Neonatology, Nationwide Children's Hospital, Columbus, Ohio.

Pediatric Quality & Safety
|October 2, 2019
PubMed

Insights

Clinical decision support (CDS) tools improved birth weight-based medication orders for neonatal abstinence syndrome (NAS), but workarounds reduced effectiveness. Standardizing weight-based NAS treatment decreased length of stay variability.

Area of Science:

  • Neonatal care
  • Pharmacology
  • Public Health

Background:

  • Opioid abuse is a US public health emergency, with rising prenatal opioid exposure.
  • Up to 80% of opioid-exposed infants require pharmacotherapy for neonatal abstinence syndrome (NAS).

Purpose of the Study:

  • To increase the percentage of NAS medication orders based on birth weight (BW) from 29% to 90% in neonates with NAS.
  • To sustain this improvement for six months.

Main Methods:

  • Utilized Institute for Healthcare Improvement methodology at an academic medical center.
  • Focused interventions on clinical decision support (CDS) tools.
  • Employed Shewhart charts and Nelson rules to analyze data.

Main Results:

  • Implemented CDS interventions increased BW-based medication orders from 29% to 78%.
  • Workarounds led to a decrease in BW-based orders to 48%.
  • A significant decrease in length of stay variability was observed and persisted.

Conclusions:

  • CDS tools can guide prescribing, but workarounds may limit their effectiveness.
  • Standardized, weight-based NAS medication prescribing can reduce length of stay variability.
  • Further research using a human factors approach is needed to minimize CDS workarounds and improve NAS care.
Abstract

More Related Videos

Preclinical Model of Prenatal Delta-9-Tetrahydrocannabinol Exposure to Assess Its Impact on Neurodevelopmental Outcomes05:13

Preclinical Model of Prenatal Delta-9-Tetrahydrocannabinol Exposure to Assess Its Impact on Neurodevelopmental Outcomes

Published on: February 28, 2025

569
A Common Marmoset Model of Mother-Infant Intervention for Breastfeeding Disorders in the Presence of Paternal Inhibition and Maternal Neglect05:04

A Common Marmoset Model of Mother-Infant Intervention for Breastfeeding Disorders in the Presence of Paternal Inhibition and Maternal Neglect

Published on: September 22, 2023

807

Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
226
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
188
Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
189
Factors Affecting Drug Response: Overview01:21

Factors Affecting Drug Response: Overview

When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.8K
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
199
Dosage Regimen: Individualization01:24

Dosage Regimen: Individualization

Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
146