Evaluating the effect of hospital setting on outcomes for neonatal abstinence syndrome

Grossman, Matthew; Berkwitt, Adam; Osborn, Rachel; Citarella, Brett V.; Hochreiter, Daniela; Bizzarro, Matthew J.

doi:10.1038/s41372-020-0621-5

Cited by 10 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Large variation exists in care for newborns with NAS. Moreover, Grossman et al showed that infants with NAS treated on the general inpatient floor had shorter LOS compared to those who were treated in NICU [ 10 ]. We were not able to assess this as the NIS does not allow identification of NICU admissions from general inpatient floor admissions.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Length of Stay and Cost of Hospitalization of Neonatal Abstinence Syndrome in the United States

Bhatt¹,

Umscheid²,

Parmar³

et al. 2021

Cureus

View full text Add to dashboard Cite

BackgroundThe incidence rate and economic burden of neonatal abstinence syndrome (NAS) are increasing in the United States (US). We explored the link between the length of stay (LOS) and hospitalization cost for neonatal abstinence syndrome in 2018. MethodsThis was a cross-sectional analysis of the 2018 national inpatient sample database. Newborn hospitalizations with neonatal abstinence syndrome and their accompanying comorbid conditions were identified using the International Classification of Diseases, 10th Edition diagnostic codes. Logistic regression was used to determine the impact of length of stay and the co-morbidities on inflation-adjusted hospital costs. ResultsThe incidence of neonatal abstinence syndrome was 7.1 per 1000 births (95% CI 6.8-7.3) in 2018. The majority had Medicaid (84.1%), with a neonatal abstinence syndrome incidence of 13.2 (95% CI: 12.8-13.6). In adjusted analysis, every one-day increase in length of stay increased the hospital cost by $1,685 (95% CI: 1,639-1,731). Neonatal abstinence syndrome hospitalizations with Medicaid had a longer length of stay by 1.8 days (95% CI: 0.5-3.1). Co-morbidities further increased the length of stay: seizures: 13.8 days; sepsis: 4.1 days; respiratory complications: 4.4 days; and feeding problems: 5.8 days. Those at urban teaching hospitals had a longer length of stay by 7.3 days (95%

show abstract

Section: Discussionmentioning

confidence: 99%

Predictors of Length of Stay and Cost of Hospitalization of Neonatal Abstinence Syndrome in the United States

Bhatt¹,

Umscheid²,

Parmar³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…Newborn withdrawal assessments are best conducted out of traditional neonatal intensive care settings and into private rooms where the newborn benefits from a quiet, nonstimulating environment, and mother and family can perform nonpharmacologic interventions out of public view. Grossman et al (2020) found NOWS infants had shorter lengths of stay when predominantly managed on an inpatient pediatric unit following transfer from mother baby unit upon mother's discharge, compared with a traditional neonatal intensive care setting. The mother baby and pediatric units afforded the dyad the benefit of a private room where mother could remain at the newborn's bedside.…”

Section: Potential Barriers To Implementationmentioning

confidence: 93%

“…The mother baby and pediatric units afforded the dyad the benefit of a private room where mother could remain at the newborn's bedside. Clinicians suggest neonatal intensive care units may not be the best environments for newborns with NOWS in general, as these newborns typically do not require intensive medical care, and the open bays of some neonatal intensive care units cannot conform to the established best practice of providing a low-stimulation environment (Grossman et al, 2020).…”

Section: Potential Barriers To Implementationmentioning

confidence: 99%

Strategies to Successfully Implement an Eat, Sleep, Console Protocol

Wortham

Bianchi

2022

McN: The American Journal of Maternal/Child Nursing

View full text Add to dashboard Cite

Neonatal opioid withdrawal syndrome is pervasive, reflected in a case rate increase among most demographics in the United States from 4.0 newborns per 1,000 hospitalized births in 2010 to 7.3 newborns per 1,000 hospitalized births in 2017. Historically, assessments have been based on present symptomatology, excluding the mother's input, and increasing the likelihood of pharmacotherapy. The Eat, Sleep, Console approach provides an opportunity for the mother to act as the treatment for her newborn as she performs nonpharmacologic interventions that reduce withdrawal severity. Maternal confidence to help her newborn grows with this level of involvement and mother/infant dyad care improves, as do nurse and mother interactions. Assessments are less subjective and less time-consuming for nurses to conduct than those of the often-used Finnegan tool, and are conducted in collaboration with the mother. Facilities implementing this approach have seen a reduction in newborn hospital length of stay, pharmacotherapy, associated medical costs, and improved breastfeeding rates. Implementing an Eat, Sleep, Console protocol involves a stepwise approach to ensure all stakeholders are effectively prepared for the transition. We present strategies to implement an Eat, Sleep, and Console clinical protocol. A stepwise approach to implementation along with a clinical nursing maternal education protocol exemplar is included. Methods to overcome barriers to implementation and recommendations for further development are discussed.

show abstract

“…3 These recommendations are based on beneficial outcomes observed among newborns exposed to opioids, such as fewer withdrawal signs, reduced need for pharmacotherapy, and shorter duration of hospital stay. 10,11 Investigations regarding the benefits of breastfeeding as a non-pharmacologic intervention for AD medication-exposed newborns are lacking and/or poorly reported.…”

Section: Introductionmentioning

confidence: 99%

“…Non-pharmacologic interventions, such as breastfeeding, skin-to-skin contact, and providing a quiet, low-light environment, have been suggested as reasonable preventative measures to reduce withdrawal signs 3 . These recommendations are based on beneficial outcomes observed among newborns exposed to opioids, such as fewer withdrawal signs, reduced need for pharmacotherapy, and shorter duration of hospital stay 10,11 . Investigations regarding the benefits of breastfeeding as a non-pharmacologic intervention for AD medication-exposed newborns are lacking and/or poorly reported.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of breastfeeding newborns in the first month of life with in utero selective serotonin reuptake inhibitor medication exposure: a scoping review protocol

Cantin,

Snelgrove-Clarke,

Gaudet

et al. 2023

JBI Evidence Synthesis

View full text Add to dashboard Cite

Objective: The objective of this scoping review is to understand the extent and type of evidence in relation to the characteristics of breastfeeding newborns in the first month of life who have been exposed in-utero to selective serotonin reuptake inhibitor (SSRI) medications. Introduction: SSRIs are the most prescribed antidepressant medication in pregnancy. Up to 30% of newborns who are prenatally exposed to SSRIs demonstrate withdrawal signs. Poor neonatal adaptation syndrome represents a constellation of signs observed in these newborns. Little information has been studied regarding breastfeeding, as it relates to the impact of in-utero SSRI exposure on the newborn. Parents have many questions regarding the safety of taking medications during pregnancy and breastfeeding. It is important for health care providers to collate evidence-based information and facilitate shared-decision making. We aim to identify the approaches researchers have used to investigate in-utero SSRI exposure among breastfed newborns to determine knowledge gaps. Inclusion criteria: Primary peer-reviewed studies will be considered for inclusion according to the following criteria: newborns, 31 days of age or less, with in-utero SSRI exposure in any trimester of pregnancy, who were breastfed or received breast-milk feedings. Methods: MEDLINE, CINAHL, EMBASE, LactMed, the Maternity and Infant Care Database, and Clinical Trials databases will be searched. JBI methodology will be used. Abstracts will be assessed for eligibility and full texts will be retrieved if they meet the inclusion criteria. Two reviewers will independently extract the data from identified studies using a data extraction form and the results will be summarized descriptively and in tabular format. Review registration: Open Science Framework (osf.io/2bt39)

show abstract

Evaluating the effect of hospital setting on outcomes for neonatal abstinence syndrome

Cited by 10 publications

References 14 publications

Predictors of Length of Stay and Cost of Hospitalization of Neonatal Abstinence Syndrome in the United States

Predictors of Length of Stay and Cost of Hospitalization of Neonatal Abstinence Syndrome in the United States

Strategies to Successfully Implement an Eat, Sleep, Console Protocol

Characteristics of breastfeeding newborns in the first month of life with in utero selective serotonin reuptake inhibitor medication exposure: a scoping review protocol

Contact Info

Product

Resources

About