PT  - JOURNAL ARTICLE
AU  - Kathryn L Ponder
AU  - Charles Egesdal
AU  - Joanne Kuller
AU  - Priscilla Joe
TI  - Project Console: a quality improvement initiative for neonatal abstinence syndrome in a children’s hospital level IV neonatal intensive care unit
AID  - 10.1136/bmjoq-2020-001079
DP  - 2021 May 01
TA  - BMJ Open Quality
PG  - e001079
VI  - 10
IP  - 2
4099  - http://bmjopenquality.bmj.com/content/10/2/e001079.short
4100  - http://bmjopenquality.bmj.com/content/10/2/e001079.full
SO  - BMJ Open Qual2021 May 01; 10
AB  - Objective To improve care for infants with neonatal abstinence syndrome.Design Infants with a gestational age of ≥35 weeks with prenatal opioid exposure were eligible for our quality improvement initiative. Interventions in our Plan–Do–Study–Act cycles included physician consensus, re-emphasis on non-pharmacological treatment, the Eat Sleep Console method to measure functional impairment, morphine as needed, clonidine and alternative soothing methods for parental unavailability (volunteer cuddlers and automated sleeper beds). Pre-intervention and post-intervention outcomes were compared.Results Length of stay decreased from 31.8 to 10.5 days (p<0.0001) without an increase in readmissions. Composite pharmacotherapy exposure days decreased from 28.7 to 5.5 (p<0.0001). This included reductions in both morphine exposure days (p<0.0001) and clonidine exposure days (p=0.01). Fewer infants required pharmacotherapy (p=0.02).Conclusions Our study demonstrates how a comprehensive initiative can improve care for infants with neonatal abstinence syndrome in an open-bay or a high-acuity neonatal intensive care unit when rooming-in is not available or other comorbidities are present.Data are available upon request.