Characteristics of Neonatal Abstinence Syndrome (NAS) in a rural clinic population: Tracking with Electronic Medical Health Records (EHR)

Abstract

PurposeThe impact of intrauterine exposure of opioids and other addictive substances on pediatric patients is concerning for health care providers in rural WV. NAS patients must be identified, screened, and treated during the pediatric years to facilitate improved outcomes. The purpose of this research was to evaluate the ability of rural providers to use EHRs to identify, describe, and monitor aspects of NAS across the pediatric health span. 
 MethodsThe research team used de-identified data of patients that had the NAS diagnosis from a rural clinic. One hundred fifty-five charts were evaluated. Demographics, clinical characteristics, and developmental milestone status were extracted from charts.
 ResultsThere were differences in characteristics across age groups. Reported secondhand smoke was higher among the 0-3 year olds. Normal BMI percentile was highest among 4-5 year olds. The Ages and Stages Developmental screening was abnormal more in those aged 6-19 years. Foster care was highest among the ages 0-3 years. The 4-12 age groups highest amount of no show visits. Respiratory illness was the most frequent diagnosis and was highest in the 4-5 age group. Eye and ear diagnosis were noted as a recurrent diagnosis in the 4-5 year old group. Diagnosis related to mental health were highest in the 6-18 age group. 
 DiscussionThe EHR can be used to describe and track special populations such as NAS in rural areas. Tagging and tacking patients with NAS can help primary care providers manage care and anticipate age related health care needs. Tracking high risk populations assures that the patient care is maintained. Tracking no show rates assists providers in assuring that patient’s caregivers are compliant in necessary treatments and referrals. Child Protection can also be involved if medical neglect is noted. EHRs are useful in identifying high risk populations such as NAS to facilitate treatments and continuity of care. 
 DOI: http://doi.org/10.14574/ojrnhc.v20i2.625

Clinical deterioration as a nurse sensitive indicator in the out‐of‐hospital context: A scoping review

“…Cochran et al. (2017) also reported on an electronic health records system which allowed the capture of quality assessment activities to improve patient care.…”

“…Approximately 41% of articles were published 2000–2013 and 59% in the last decade. The United States (Battaglia, 2017; Cochran et al., 2017; Ekong et al., 2016; Georgiev et al., 2019; Issel & Bekemeier, 2010; Lindsay et al., 2009; Poghosyan et al., 2017; Rusli et al., 2021; Wenger et al., 2011) and the United Kingdom (Baker, 2022; Barrett, 2012; Boyd et al., 2009; Forbes et al., 2006; McGraw, 2019; Nazarko, 2019; Pritchard & Velayudhan, 2011; Start et al., 2016; Sworn & Booth, 2020; Tucker & Lusher, 2018) accounted for 56% of the study locations, followed by the Netherlands (de Vries et al., 2013; Gingele et al., 2021; Smit et al., 2013), Canada (Domm & Urban, 2020; Irvine et al., 2000; McCourt & Griffin, 2000), and Australia (Gray et al., 2018; Katterl et al., 2012; Marley et al., 2012). Other locations included China (Chin et al., 2011), Ireland (Phelan et al., 2018), Norway (Strømme et al., 2020), Spain (Lopez‐Dicastillo et al., 2020), New Zealand (Waterworth et al., 2015) and Japan (Taniguchi et al., 2020).…”

“…Approximately 53% ( n = 18) of included studies involved primary research (Boyd et al., 2009; Cochran et al., 2017; de Vries et al., 2013; Domm & Urban, 2020; Ekong et al., 2016; Forbes et al., 2006; Gray et al., 2018; Irvine et al., 2000; Lindsay et al., 2009; Marley et al., 2012; McGraw, 2019; Phelan et al., 2018; Poghosyan et al., 2017; Smit et al., 2013; Strømme et al., 2020; Taniguchi et al., 2020; Waterworth et al., 2015; Wenger et al., 2011) and were quantitative by design ( n = 11). The remaining included papers involved secondary research ( n = 6) (Chin et al., 2011; Katterl et al., 2012; McCourt & Griffin, 2000; Pritchard & Velayudhan, 2011; Rusli et al., 2021; Sworn & Booth, 2020) and narrative accounts ( n = 9) (Baker, 2022; Barrett, 2012; Battaglia, 2017; Georgiev et al., 2019; Issel & Bekemeier, 2010; Lopez‐Dicastillo et al., 2020; Nazarko, 2019; Start et al., 2016; Tucker & Lusher, 2018).…”