TY - JOUR T1 - Project Console: a quality improvement initiative for neonatal abstinence syndrome in a children’s hospital level IV neonatal intensive care unit JF - BMJ Open Quality JO - BMJ Open Qual DO - 10.1136/bmjoq-2020-001079 VL - 10 IS - 2 SP - e001079 AU - Kathryn L Ponder AU - Charles Egesdal AU - Joanne Kuller AU - Priscilla Joe Y1 - 2021/05/01 UR - http://bmjopenquality.bmj.com/content/10/2/e001079.abstract N2 - 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. ER -