Our First Steps: A QI Project to Reduce NICU Admissions of Infants With NAS

Area of Science:

• Neonatal care
• Pediatric pharmacology
• Quality improvement initiatives

Background:

• Neonatal Abstinence Syndrome (NAS) affects 6.3 per 1000 US newborns, straining NICU resources.
• Ohio reported a higher NAS rate of 9.5 per 1000 newborns in 2020.
• Existing care models are overwhelmed by the increasing incidence of NAS.

Purpose of the Study:

• To evaluate the Eat, Sleep, Console (ESC) model's efficacy in managing neonates with NAS.
• To determine if ESC reduces neonatal intensive care unit (NICU) admissions compared to the Finnegan Scale.
• To assess the potential of ESC for guiding NAS management and reducing pharmacological treatment.

Main Methods:

• A pilot quality improvement project utilized the Plan-Do-Study-Act (PDSA) methodology.
• Staff received comprehensive education on the ESC model of care.
• The Mother/Infant Unit (MIU) provided ongoing support and resources for ESC implementation.

Main Results:

• Fifteen neonates were managed using the ESC model.
• Two out of five neonates who would have required NICU admission under the Finnegan Scale were successfully managed and discharged home via ESC.
• The ESC model demonstrated potential in reducing NICU admissions for NAS.

Conclusions:

• The Eat, Sleep, Console (ESC) model is a valuable tool for assessing and managing neonates with NAS.
• Optimizing non-pharmacological interventions requires careful assessment of resource allocation for NAS care.
• Further research into ESC's impact on resource utilization and patient outcomes is warranted.