Neonatal abstinence syndrome occurs when babies withdraw from drugs they were exposed to in the womb.
At Christus St. Vincent, Jennifer Castaneda-Lovato, RN, and pediatrician Jennifer Achilles, MD, worked together in the hospital’s Clinician-Directed Performance Improvement program, which encourages staff to improve hospital safety and patient outcomes.
Their project is one of 33 since 2015 that has reduced the time infants with neonatal abstinence syndrome were in the hospital by almost half. They also decreased medication to wean the infants off drugs.
The treatment involved giving the infants methadone to relieve withdrawal symptoms and then weaning them from the drug and tracking their condition according to a 21-point scoring system nurses use. The scoring system was “very complex, time-consuming and variable between nurses,” Dr. Achilles said.
The protocol cut the average hospital stay for babies experiencing withdrawal from 18 to 9.8 days. The percentage of infants treated with morphine or methadone dropped from 31 percent to 22 percent.
Dr. Achilles credited Ms. Castaneda-Lovato with the idea. Their colleagues were initially skeptical, Dr. Achilles said.
“It’s very hard to get doctors to change anything, even if it’s a doctor trying to convince them,” she said. “Now it’s the accepted protocol. It’s exciting to be in a small community hospital … doing innovative treatment for babies withdrawing from opioids. Really, in a few years, it will be the standard of care.”
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