Improving Nursing Care in Infants With Neonatal Abstinence Syndrome
Laura Ruth Watson, MSN, RNC-OB
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Purpose: The purpose of the project is to improve the nursing care of infants with neonatal abstinence syndrome (NAS) through staff education and peer assessment.
Objectives: The project objective is to provide education for the healthcare staff at two Midwestern hospitals to ensure consistent care is provided to NAS infants. By providing consistent care, NAS infants will be made more comfortable and improve quicker, decreasing their length of stay.
Expanded Content Outline: Sublett (2013), identifies since 1980 the incidence of the NAS has increased by 300%. Literature has shown that infants with neonatal abstinence syndrome (NAS) encounter serious medical complications resulting in prolonged hospital stays and expensive interventions. The average hospital stay for these neonates is 22-26.1 days (Lind et al., 2015).
NAS is a collection of multi-systems withdrawal signs and symptoms experienced by the neonate due to exposure in utero to substance use and dependency by the pregnant mother. Once the infant is born, the substance is no longer available, placing the infant at risk for withdrawal. The central nervous, respiratory, gastrointestinal, and autonomic systems are negatively affected in infants with NAS. Differentiation of care may affect the progression of the NAS infant (Lucas & Knoble, 2012).
In a three year study the cumulative hospital cost at a hospital in Gainesville, Florida for 40 infants diagnosed with NAS was 1.1 million dollars for the first year. By the third year the cost was 1.8 million for 63 diagnosed infants. For infants not diagnosed with NAS, by the third year of life, 63 infants’ average healthcare cost was $109,998. That is a total variance of $1,691,325 (Hall et al, 2014). Literature confirms that by instituting and adhering to clinical practice guidelines, a decrease in the length of hospital stay may be noted, thereby, decreasing the cost of care for the infants (Hall et al., 2014; Patrick et al., 2012).
Improvement of infant care will occur through educating staff about neonatal abstinence syndrome and the standard of care required by NAS infants. Education focusing on the value of inter-observer reliability/peer assessment will be provided. The project will lead to the development and adoption of evidence-based practice and policies recognizing the special needs of infants with NAS. Upon completion of the project, analyses will be performed to ensure the project objectives are being met and maintained. Length of hospital stay will be evaluated one year before, and one year following project implementation. Data will be collected from nursing staff to determine true effectiveness of staff education.
Evidence recommends strict care guidelines be adopted in institutions caring for NAS infants (Hall et al., 2014). The outcome for this study is to institute guidelines for the care of NAS infants admitted to nurseries of two Midwestern hospitals, with the goal to expand the project to other healthcare systems providing care to NAS infants.
|Review Type||None: Event Material, Invited Presentation|
neonatal abstinence syndrome;
nursing peer assessment
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