{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:46:41Z","timestamp":1792176401249,"version":"4.4.0"},"reference-count":25,"publisher":"American Academy of Pediatrics (AAP)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"\n OBJECTIVES:<\/jats:title>\n The incidence of infants born exposed to opioids continues to rise. Historically, newborns with neonatal abstinence syndrome have been treated with medication-weaning protocols, leading to costly and prolonged hospital stays. We aimed to reduce the proportion of newborns with neonatal abstinence syndrome who receive opioid medications for treatment of withdrawal symptoms through a quality improvement program.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n In 2016, we formed a multidisciplinary team and used quality improvement methodology to conduct plan-do-study-act cycles. Interventions included prenatal education, family engagement, nonpharmacologic treatments, morphine as needed, and the eat, sleep, console assessment tool. Primary metrics were the proportion of newborns exposed to opioids requiring pharmacologic treatment and the cumulative dose of opioids per exposed newborn requiring pharmacologic treatment.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n There were 81 infants in the baseline period (January 2015\u2013September 2016) and 100 infants in the postintervention group (October 2016\u2013August 2018). For infants who required medication for treatment, the postintervention group had significantly lower total cumulative dose in methadone equivalents (1.3 mg vs 6.6 mg), shorter length of stay (10.9 days vs 18.7 days), and nonsignificant lower direct costs ($11\u2009936 vs $15\u2009039).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n The described intervention effectively replaced the Finnegan Neonatal Abstinence Scoring System and had improved outcomes in more exposed infants receiving no opioid treatment, and when medication was required, the total cumulative dose of opioids was lower. The postintervention group had shorter average length of stay and lower costs.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/hpeds.2019-0144","type":"journal-article","created":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T09:25:21Z","timestamp":1564651521000},"page":"624-631","source":"Crossref","is-referenced-by-count":51,"title":["A Quality Improvement Initiative to Improve the Care of Infants Born Exposed to Opioids by Implementing the Eat, Sleep, Console Assessment Tool"],"prefix":"10.1542","volume":"9","author":[{"given":"Jennifer S.","family":"Achilles","sequence":"first","affiliation":[{"name":"CHRISTUS St. Vincent Regional Medical Center, Santa Fe, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Castaneda-Lovato","sequence":"additional","affiliation":[{"name":"CHRISTUS St. Vincent Regional Medical Center, Santa Fe, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2019,8,1]]},"reference":[{"issue":"3","key":"2021120817093252700_B1","doi-asserted-by":"crossref","first-page":"e20183801","DOI":"10.1542\/peds.2018-3801","article-title":"Public health surveillance of prenatal opioid exposure in mothers and infants","volume":"143","author":"Honein","year":"2019","journal-title":"Pediatrics"},{"issue":"4","key":"2021120817093252700_B2","doi-asserted-by":"crossref","first-page":"e20173520","DOI":"10.1542\/peds.2017-3520","article-title":"Incidence and costs of neonatal abstinence syndrome among infants with medicaid: 2004\u20132014","volume":"141","author":"Winkelman","year":"2018","journal-title":"Pediatrics"},{"issue":"31","key":"2021120817093252700_B3","doi-asserted-by":"crossref","first-page":"845","DOI":"10.15585\/mmwr.mm6731a1","article-title":"Opioid use disorder documented at delivery hospitalization \u2014 United States, 1999\u20132014","volume":"67","author":"Haight","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"10","key":"2021120817093252700_B4","article-title":"Neonatal abstinence syndrome surveillance in New Mexico","volume":"2018","author":"Saavedra","year":"2018","journal-title":"The New Mexico Epidemiology Report"},{"issue":"4","key":"2021120817093252700_B5","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1542\/hpeds.2012-0079","article-title":"Neonatal abstinence syndrome management from prenatal counseling to postdischarge follow-up care: results of a national survey","volume":"3","author":"Mehta","year":"2013","journal-title":"Hosp Pediatr"},{"issue":"4","key":"2021120817093252700_B6","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.acap.2016.10.003","article-title":"Wide variation found in care of opioid-exposed newborns","volume":"17","author":"Bogen","year":"2017","journal-title":"Acad Pediatr"},{"issue":"1","key":"2021120817093252700_B7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1542\/hpeds.2017-0077","article-title":"Ozonoff. 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