Standardizing care for infants born with drug withdrawal

Standardizing hospital care policies across institutions for infants diagnosed with drug withdrawal symptoms at birth reduces their length of treatment and hospitalization, according to collaborative research led by Vermont Oxford Network, Vanderbilt and the University of Michigan Health System.

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome experienced by infants exposed to opioids, or narcotic drugs like oxycodone, while in utero. NAS has been linked to both illicit drug use as well as prescription opioids—narcotic pain relievers such as hydrocodone—by pregnant women. Infants born with NAS are more likely to have respiratory complications, feeding difficulty, low birthweights and extended hospital stays.

Vanderbilt and University of Michigan research previously found that the number of infants diagnosed with NAS grew nearly fivefold from 2000 to 2012.

Vermont Oxford Network, Vanderbilt and the University of Michigan published their most recent findings April 15 in the journal Pediatrics, looking at the impact of standardizing care for infants born with NAS.

The data from the 199 participating centers, located in the United States, Canada and the United Kingdom, revealed that following a standardized protocol led to an overall reduction of one day in median length of treatment—from 17 to 16 days—and length of hospitalization was reduced by two days—from 21 to 19 days.

An NAS toolkit served as a blueprint to guide centers through the process, which included developing and implementing a standard process for identification, evaluation, treatment and discharge of infants with NAS, as well as measuring and reporting rates of NAS and drug exposure. Data was collected from each center from 2012 to 2014. During that period 199 centers audited 3,458 infants with NAS.

Along with implementing evidence-based potentially better practices at the 199 participating institutions, the collaborative supported participants with interactive webinars, real-time feedback of outcomes and sharing of improvement practices through electronic forums.

– by Christina Echegaray