Presentation Title

Increasing Support for Opioid Exposed Newborns: A Quality Improvement Project

Presenter's Name(s)

Maeve G. Higgins, UVM CNHSFollow

Project Collaborators

Dr. Molly Rideout (Collaborating Mentor)

Abstract

Problem Statement

Opioid exposed newborns, who may develop neonatal abstinence syndrome, benefit from non-pharmacological care, such as holding or “cuddling”. It is difficult for parents and staff at University of Vermont Children’s Hospital to provide adequate cuddling to fulfill all opioid exposed newborns’ needs. This project aimed to increase access to cuddling for opioid exposed newborns in the newborn nursery of University of Vermont Children’s Hospital so that 50% of newborns assessed to benefit from cuddling were cuddled by March 1st, 2020.

Methods

Quality improvement methodology was employed - including identifying aims, measures, and ideas for change - by conducting stakeholder interviews and creating a process map and key driver diagram. Ideas for change were implemented through “plan do study act” cycles. A mixed methods approach was used to analyze quantitative and qualitative data from the pre-intervention and post-intervention period. Descriptive data will be provided for each outcome, process, and balancing measure.

Results

Baseline nurse survey estimates indicated only 8.7% of opioid exposed newborns assessed to benefit from cuddling accessed cuddling in the pre-intervention period. Less than one quarter of nurses reported ever using cuddlers, most needs were overnight, and most nurses predicted using cuddlers would decrease their workload. At one month, there were 53 cuddling sessions reported and 11 volunteers cuddled in the newborn nursery. Results of follow up survey are pending.

Conclusion

As a result of this project, initial data may indicate increased access to cuddling for the opioid exposed infants. Most volunteers report neutral or satisfied with the program, although there are often no newborns to cuddle in the nursery during current shifts. Over the coming months, we anticipate expanding the hours to match unit needs, branching out to inpatient pediatrics to help with cuddling and decrease overlap, and training more volunteers.

Primary Faculty Mentor Name

Marianne (Molly) Rideout

Secondary Mentor NetID

skasser

Secondary Mentor Name

Susan Kasser

Status

Undergraduate

Student College

College of Nursing and Health Sciences

Program/Major

Nursing

Primary Research Category

Health Sciences

Second College (optional)

Honors College

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Increasing Support for Opioid Exposed Newborns: A Quality Improvement Project

Problem Statement

Opioid exposed newborns, who may develop neonatal abstinence syndrome, benefit from non-pharmacological care, such as holding or “cuddling”. It is difficult for parents and staff at University of Vermont Children’s Hospital to provide adequate cuddling to fulfill all opioid exposed newborns’ needs. This project aimed to increase access to cuddling for opioid exposed newborns in the newborn nursery of University of Vermont Children’s Hospital so that 50% of newborns assessed to benefit from cuddling were cuddled by March 1st, 2020.

Methods

Quality improvement methodology was employed - including identifying aims, measures, and ideas for change - by conducting stakeholder interviews and creating a process map and key driver diagram. Ideas for change were implemented through “plan do study act” cycles. A mixed methods approach was used to analyze quantitative and qualitative data from the pre-intervention and post-intervention period. Descriptive data will be provided for each outcome, process, and balancing measure.

Results

Baseline nurse survey estimates indicated only 8.7% of opioid exposed newborns assessed to benefit from cuddling accessed cuddling in the pre-intervention period. Less than one quarter of nurses reported ever using cuddlers, most needs were overnight, and most nurses predicted using cuddlers would decrease their workload. At one month, there were 53 cuddling sessions reported and 11 volunteers cuddled in the newborn nursery. Results of follow up survey are pending.

Conclusion

As a result of this project, initial data may indicate increased access to cuddling for the opioid exposed infants. Most volunteers report neutral or satisfied with the program, although there are often no newborns to cuddle in the nursery during current shifts. Over the coming months, we anticipate expanding the hours to match unit needs, branching out to inpatient pediatrics to help with cuddling and decrease overlap, and training more volunteers.