Tia Cooney, Jacqueline Larizza, Ursula Cote, Anne-Sophie Gervais, Lindsey Rae, Joel Warkentin, Sacha Dubois
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引用次数: 0
Abstract
Objective
To improve neonatal outcomes through the implementation of an eat, sleep, console (ESC) assessment and change in hospital policy regarding the monitoring requirements for pharmacologic treatment of neonates with neonatal abstinence syndrome (NAS).
Design
Retrospective chart review and descriptive survey design.
Setting/Local Problem
A hospital in Northwestern Ontario, where an evidence-based practice change was undertaken to improve care for neonates with NAS.
Participants
Neonates being screened for NAS during the Modified Finnegan Neonatal Abstinence Syndrome Scoring System (MFNASSS) protocol (n = 75) and ESC protocol (n = 40). Nurses working in the departments after the implementation of ESC were surveyed.
Measurements
Length of stay (LOS) and morphine administration by intervention status using unadjusted hazard and risk ratios, respectively. Descriptive statistics are also presented. A one-sample t test was completed for the nurses’ perspectives survey questions.
Results
Reduced rate of LOS (HR = 1.66, 95% confidence interval [1.1, 2.51]) was observed for participants receiving the ESC intervention (4.53, SD = 1.94), compared to the MFNASSS control (7.45, SD = 6.35). Although the ESC group appeared to have a greater proportion of neonates administered morphine (42.5% ESC vs. 26.7% MFNASSS), the relative risk was not statistically significant (RR = 1.28, 95% confidence interval [0.95, 1.72]). Morphine doses per day were reduced in the ESC group (0.37, SD = 1.50) compared to the MFNASSS group (5.16, SD = 1.02). Overall, the nurses had a positive perspective on the policy change.
Conclusion
ESC was successfully implemented in a Northwestern Ontario hospital. The overall LOS of neonates with NAS decreased. Nurses found the policy change to be safe and attainable.
期刊介绍：
Nursing for Women"s Health publishes the most recent and compelling health care information on women"s health, newborn care and professional nursing issues. As a refereed, clinical practice journal, it provides professionals involved in providing optimum nursing care for women and their newborns with health care trends and everyday issues in a concise, practical, and easy-to-read format.
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