Background: The COVID-19 pandemic disrupted our practice of outpatient methadone weaning for pharmacologic management of infants with neonatal abstinence syndrome (NAS), resulting in increased average length of stay (ALOS). In response, we integrated a responsive Bassinet (SNOO), into our Eat, Sleep, Console (ESC) care model.
Purpose: Our primary aim through this quality improvement work was to explore whether integration of SNOO within our ESC care model had an impact.
Methods: Using quality improvement methodologies, a retrospective chart review was conducted for neonates admitted to the NICU for NAS from December 2020 to September 2022 ( N = 109). Study inclusion criteria were primary diagnosis of NAS, birth gestational age ≥35 weeks, and absence of other co-morbid diagnoses. Neonates were organized into two groups based on date of bassinet implementation. An online survey was sent to 76 NICU nurses 6 months post-implementation. Outcome measures included ALOS, number of sleep-related "yes" scores (indicating poor sleep), and nurse experience.
Results: Of 109 infants, 13 met inclusion criteria ALOS declined by 17.38% ( P= .57), and "yes" scores decreased by 41.72% ( P =.52). Nurses reported an average of 2.43 hours saved per 12-hour shift.
Implications for practice and research: The addition of SNOO as a non-pharmacologic intervention within ESC care models for infants with NAS may lead to a decreased average length of stay, improved infant sleep, and improved nursing experience (such as time savings).
Keywords: COVID-19; eat sleep console; neonatal abstinence syndrome; nursing experience; opioid; responsive bassinet; safe sleep.
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