Implementation of a Nurse-Driven Eat-Sleep-Console (ESC) Treatment Pathway at a Community Hospital for Treatment of Neonatal Opioid Withdrawal Syndrome in an Effort to Improve Short-term Outcomes.

IF 1.6 4区 医学 Q2 NURSING Advances in Neonatal Care Pub Date : 2024-06-01 Epub Date: 2023-12-21 DOI:10.1097/ANC.0000000000001123
Hamza Halloum, Brooke J Daniels, Dawn Beville, Kathleen Thrasher, Gregory C Martin, Marc A Ellsworth
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Abstract

Background: The Chandler Regional Medical Center (CRMC) neonatal intensive care unit (NICU) began a phased implementation of Eat-Sleep-Console (ESC) for the management of those at risk for neonatal opioid withdrawal syndrome (NOWS).

Purpose: The purpose of this initiative is to track short-term outcomes as well as the program's effect on nursing workflow and job performance rating/satisfaction.

Methods: A retrospective review of the ESC implementation process at CRMC from the years 2018-2020. The study consisted of 3 epochs: (1) traditional pharmacologic management; (2) parent-led ESC management; and (3) parent/nurse-led ESC management. Length of stay (LOS), treatment pathway assignment, and proportion of infants treated with pharmacologic agents were compared between epochs. In addition, a survey of NICU nursing staff was distributed to measure nurses' perceptions and attitudes towards the ESC program and the management of infants with NOWS.

Results: The proportion of infants treated via ESC increased (0%, 53%, and 100%), with an associated decrease in LOS (18.4, 10.5, and 9.3 days) during each epoch of the study period. Thirty-seven nurses completed the survey, with 94% of nurses reporting being comfortable caring for ESC patients and 89% feeling supported in their ESC nursing assignments, with only 11% stating that caring for ESC patients significantly alters their other nursing care processes.

Implications for practice and research: Implementation of an ESC treatment program for infants with NOWS significantly decreased LOS and the proportion of infants treated pharmacologically. This phased implementation process was not associated with self-reported negative nursing perceptions of the program and its treatment goals/outcomes.

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在一家社区医院实施以护士为主导的 "吃-睡-控制台(ESC)"治疗路径,以治疗新生儿阿片类药物戒断综合征,从而改善短期疗效。
背景:钱德勒地区医疗中心(CRMC)新生儿重症监护室(NICU)开始分阶段实施 "吃-睡-控制台"(ESC),用于管理新生儿阿片类药物戒断综合征(NOWS)的高危人群。目的:该举措旨在跟踪短期结果以及该计划对护理工作流程和工作绩效评分/满意度的影响:回顾性回顾 2018-2020 年 CRMC 的 ESC 实施过程。研究包括3个阶段:(1)传统药物管理;(2)家长主导的ESC管理;(3)家长/护士主导的ESC管理。比较了不同时期的住院时间(LOS)、治疗路径分配和接受药物治疗的婴儿比例。此外,还对新生儿重症监护室的护理人员进行了调查,以了解护士对ESC项目和NOWS患儿管理的看法和态度:结果:在研究期间的每个阶段,通过ESC治疗的婴儿比例都有所上升(0%、53%和100%),相关的住院时间也有所缩短(18.4天、10.5天和9.3天)。37名护士完成了调查,其中94%的护士表示在护理ESC患者时感到舒适,89%的护士在ESC护理任务中感到得到支持,只有11%的护士表示护理ESC患者会显著改变他们的其他护理流程:对患有 NOWS 的婴儿实施 ESC 治疗计划可显著缩短住院时间,并减少接受药物治疗的婴儿比例。这种分阶段实施的过程与护理人员对该计划及其治疗目标/结果的自我报告负面看法无关。
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来源期刊
CiteScore
2.60
自引率
5.90%
发文量
101
期刊介绍: Advances in Neonatal Care takes a unique and dynamic approach to the original research and clinical practice articles it publishes. Addressing the practice challenges faced every day—caring for the 40,000-plus low-birth-weight infants in Level II and Level III NICUs each year—the journal promotes evidence-based care and improved outcomes for the tiniest patients and their families. Peer-reviewed editorial includes unique and detailed visual and teaching aids, such as Family Teaching Toolbox, Research to Practice, Cultivating Clinical Expertise, and Online Features. Each issue offers Continuing Education (CE) articles in both print and online formats.
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