Neonatal Abstinence Syndrome

Substance abuse, including abuse of opioids, have reached epidemic proportions in the United States. The rate of opioid abuse during pregnancy has also seen an approximate three-fold increase in the last few years. Mississippi has seen a sharp increase in Neonatal Abstinence Syndrome (NAS) patients over the last several years with an almost 10-fold increase in identified cases from 2010-2016.  A lack of a formal monitoring system for NAS patients and variable practices in tracking NAS likely underestimates the actual number of NAS patients identified through ICD codes.

Project Objective

Primary Goal:
•To develop a collaborative quality improvement initiative of Mississippi hospitals that will work together using structured quality improvement tools to develop consistent treatment and follow-up plans for infants with or at risk for NAS.
•Overall, the goal is to decrease hospital length of stay for babies and improve outcomes for these babies and their families
•Secondary Aim: Develop a risk assessment tool for OB patients upon admission as well as a newborn evaluation tool for drug exposure
•Family Aim:  To engage families in the care of these infants by providing standardized education o To increase breastfeeding rates of these infants with rooming in
 
Potentially Better Practices
PBP 1: Develop and implement a standardized process for the identification, evaluation, treatment, and discharge of infants with NAS.
PBP 2: Develop and implement a standardized process for measuring and reporting rates of neonatal abstinence syndrome and drug exposure.
PBP 3: Provide care for infants and families in sites that promote parental engagement in care and avoid separation of mothers and infants. 
PBP 4: Engage mothers and family members in providing non-pharmacologic interventions as “first-line” therapy for all substance-exposed infants. 
PBP 5: Develop a standardized process to ensure safe discharge into the community. 
PBP 6: Provide interdisciplinary universal education and training to all caregivers who may encounter substance-exposed infants and families

Measures:

•Average length of stay for infants with NAS
•Breastfeeding rates of infants with NAS
•Rooming-in rates of infants with NAS
•Percent of infants with NAS treated with pharmacologic therapy
•Percent of infants with NAS treated non-pharmacologically
•Percent of staff trained annually on NAS scoring tool

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