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Strategies to Successfully Implement an Eat, Sleep, Console Protocol
Insights
The Eat, Sleep, Console approach empowers mothers to treat neonatal opioid withdrawal syndrome (NOWS) through nonpharmacologic methods. This method improves infant care, reduces hospital stays, and lowers costs.
Area of Science:
- Neonatal care
- Pharmacology
- Maternal-infant health
Background:
- Neonatal opioid withdrawal syndrome (NOWS) is increasing, with rates rising from 4.0 to 7.3 per 1,000 births between 2010 and 2017.
- Traditional assessments for NOWS often exclude maternal input, potentially leading to increased pharmacotherapy.
- Existing assessment tools, like the Finnegan tool, can be subjective and time-consuming for nurses.
Purpose of the Study:
- To introduce the Eat, Sleep, Console (ESC) approach as a mother-centered, nonpharmacologic intervention for NOWS.
- To highlight the benefits of the ESC approach, including improved maternal confidence and mother/infant dyad care.
- To provide strategies for implementing the ESC protocol in clinical settings.
Main Methods:
- The ESC approach involves mothers in nonpharmacologic interventions to manage NOWS symptoms.
- It emphasizes collaboration between mothers and nurses, making assessments less subjective and faster.
- Implementation strategies include a stepwise approach and a clinical nursing maternal education protocol.
Main Results:
- Facilities using the ESC approach have reported reduced infant hospital stays and decreased pharmacotherapy use.
- The ESC method has led to lower associated medical costs and improved breastfeeding rates.
- Enhanced nurse-mother interactions and improved mother/infant dyad care are key outcomes.
Conclusions:
- The ESC approach offers an effective, nonpharmacologic alternative for managing NOWS.
- Successful implementation requires a structured, stepwise plan and comprehensive stakeholder preparation.
- Further development and broader adoption of the ESC protocol can significantly improve neonatal care outcomes.
Abstract:
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.
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