HealthDay News — Significant improvements in neonatal abstinence syndrome (NAS) outcomes can result from a comprehensive quality improvement (QI) program, according to a study published in the August issue of the Journal of Perinatology.

Elisha M. Wachman, MD, from Boston Medical Center, and colleagues compared pre- and post-intervention NAS outcomes after a QI initiative in opioid-exposed infants ≥36 weeks. The initiative included a non-pharmacologic care bundle; function-based assessments comprising symptom prioritization and the Eat, Sleep, Console tool; and a switch to methadone for pharmacologic treatment. 

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The researchers observed significant decreases in pharmacologic treatment (from 87.1 to 40%), adjunctive agent use (from 33.6 to 2.4%), hospitalization length of stay (from 17.4 to 11.3 days), and opioid treatment days (from 16.2 to 12.7). Per infant, total hospital charges decreased from $31,825 to $20,668. There was a significant increase in parental presence (from 55.6 to 75.8%). There were no adverse events.

“A comprehensive QI program focused on non-pharmacologic care, function-based assessments, and methadone resulted in significant sustained improvements in NAS outcomes,” the authors write. “These findings have important implications for establishing potentially better practices for opioid-exposed newborns.”

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