A Qualitative Study of Family Experience With Hospitalization for Neonatal Abstinence Syndrome

Abstract

A B S T R A C T BACKGROUND AND OBJECTIVES:Although the incidence of neonatal abstinence syndrome (NAS) in the United States quintupled between 2000 and 2012, little is known about the family perspective of the hospital stay. We interviewed families to understand their experiences during the newborn hospitalization for NAS and to improve family-centered care. CONCLUSIONS: Families face many challenges during newborn hospitalization for NAS. Addressing parental needs through improved perinatal education, increased involvement in the care team, consistent care and communication, and minimized transitions in care could improve the NAS hospital experience. The results of this qualitative study may allow for improvements in family-centered care of infants with NAS. METHODS:

The Joys and Frustrations of Breastfeeding and Rooming-In Among Mothers With Opioid Use Disorder: A Qualitative Study

“…Similar to Atwood et al, 14 we found that any separation of the infant from the mother at any stage of the birth hospitalization, competing medical demands by the mother, and logistical transportation issues impacted mothers' ability to remain at the bedside. These data can be used to emphasize the importance of hospital policies to minimize mother-infant separation during the birth hospitalization and of assistance with transportation as key aspects of future interventions to maximize rooming-in.…”

“…In a single qualitative study of families of infants with NAS, the authors reported that the physical environment, transportation issues, and mothers' medical needs impacted roomingin. 14 This study was performed at a large academic center in a rural area at a time when infants with NAS who received pharmacologic treatment were removed from their mothers' rooms and cared for in an open-layout NICU. 14 Mothers' experiences with rooming-in within different models of NAS care (in which infants do not routinely receive treatment in the NICU) or mothers living in urban settings have not been explored.…”

Rooming-In to Treat Neonatal Abstinence Syndrome: Improved Family-Centered Care at Lower Cost

“…18 In the second PDSA cycle, we conducted qualitative interviews with families of newborns hospitalized with NAS, which yielded information that shaped further PDSA cycles (Table 1). 19 Families informed us that some infants were being awakened from sleep for scoring, given points for crying when hungry, and removed from family members' arms to be assessed. PDSA cycle 3 changed the timing of NAS scoring to every 2 to 4 hours just after each feeding, during skin-to-skin holding, while the infant and family were already awake ("infant-centered scoring").…”

“…PDSA cycle 3 changed the timing of NAS scoring to every 2 to 4 hours just after each feeding, during skin-to-skin holding, while the infant and family were already awake ("infant-centered scoring"). Because families desired more education about NAS and direct involvement in care, 19 PDSA cycle 4 involved prenatal preparation sessions at 2 local perinatal substance abuse treatment centers and updated education materials on NAS for obstetric clinic appointments. In PDSA cycle 5, we incorporated parent symptom recording into care processes.…”

“…We based many of our interventions on data gleaned from family interviews. 19 Our approach to physician score interpretation was innovative and focused on increased attention to NAS symptoms most detrimental to infants and most concerning for parents while limiting the weight of items less likely to effect outcomes (Table 2). We began the change in score interpretation in the fall of intervention year 1, after nurse score training transiently led to a higher proportion of infants being treated (Figs 2 and 3B).…”