Improving Neonatal Abstinence Syndrome Outcomes and Nurse Experiences: Integrating Responsive Bassinets With Eat, Sleep, Console.

BACKGROUND

The COVID-19 pandemic disrupted our practice of outpatient methadone weaning for pharmacologic management of infants with neonatal abstinence syndrome (NAS), resulting in increased average length of stay (ALOS). In response, we integrated a responsive Bassinet (SNOO), into our Eat, Sleep, Console (ESC) care model.

PURPOSE: Our primary aim through this quality improvement work was to explore whether integration of SNOO within our ESC care model had an impact.

METHODS

Using quality improvement methodologies, a retrospective chart review was conducted for neonates admitted to the NICU for NAS from December 2020 to September 2022 ( N = 109). Study inclusion criteria were primary diagnosis of NAS, birth gestational age ≥35 weeks, and absence of other co-morbid diagnoses. Neonates were organized into two groups based on date of bassinet implementation. An online survey was sent to 76 NICU nurses 6 months post-implementation. Outcome measures included ALOS, number of sleep-related "yes" scores (indicating poor sleep), and nurse experience.

RESULTS

Of 109 infants, 13 met inclusion criteria ALOS declined by 17.38% ( P= .57), and "yes" scores decreased by 41.72% ( P =.52). Nurses reported an average of 2.43 hours saved per 12-hour shift.

IMPLICATIONS FOR PRACTICE AND RESEARCH: The addition of SNOO as a non-pharmacologic intervention within ESC care models for infants with NAS may lead to a decreased average length of stay, improved infant sleep, and improved nursing experience (such as time savings).