Improving Outcomes in Infants With Neonatal Abstinence Syndrome With the Eat, Sleep, Console Method

Area of Science:

• Neonatal care
• Pharmacology
• Quality improvement science

Background:

• Neonatal Abstinence Syndrome (NAS) presents a significant public health challenge.
• Prolonged hospitalization and medication exposure are key concerns for infants with NAS.
• A quality improvement initiative was undertaken in a neonatal intensive care unit (NICU) to address these issues.

Purpose of the Study:

• To evaluate the efficacy of the Eat, Sleep, Console (ESC) method in reducing length of stay (LOS) and morphine utilization.
• To compare the ESC method with the traditional Finnegan Neonatal Abstinence Scoring System (FNASS) for NAS management.

Main Methods:

• The study included infants with a gestational age of 36 weeks or more exposed to opiates in utero.
• The Finnegan Neonatal Abstinence Scoring System (FNASS) was replaced by the ESC method, emphasizing nonpharmacologic interventions.
• Data were collected for six months pre- and post-implementation for comparative analysis.

Main Results:

• Average LOS decreased by 47%, from 25.9 to 13.7 days.
• Scheduled morphine initiation reduced by 88% (58% to 7%), and as-needed initiation by 79% (33% to 7%).
• Adjunctive medication use decreased by 100% (17% to 0%).

Conclusions:

• The ESC method demonstrated significant improvements in LOS and reduced morphine usage compared to FNASS.
• Findings support the expansion of the ESC program to well newborn populations and similar healthcare settings.
• Further research is warranted to investigate long-term neurodevelopmental outcomes in infants managed with the ESC method.