What is the PICOT question?

Among infants diagnosed with Neonatal Abstinence Syndrome (NAS), does the use of supportive, nonpharmacological care decrease their length of stay when compared to the pharmacological use of methadone & morphine?

Define each element of the question below:

P– (Patient, population, or problem): Infants born diagnosed with NAS (withdrawing)

I– (Intervention): use of nonpharmacological, supportive measures (swaddling, skin-to-skin, cuddling, donor breast milk, aromatherapy, weighted blankets, vibrotactile stimulation crib mattress, rocking, etc.)

C– (Comparison with other treatment/current practice): pharmacological use of methadone & morphine

O– (Desired outcome): decreased length of stay by any amount of time

T-(Time Frame):n/a

Neonatal Abstinence Syndrome (NAS) is a group of conditions caused when babies are exposed to certain drugs such as opiates, heroin, benzodiazepines, antidepressants, or methadone/suboxone/Subutex in utero prior to birth that leads the infant to withdraw after birth. The prevalence & incidence of NAS continue to increase as the levels of opiate & IV drug use continue to significantly increase each day in the U.S. Some sources say that every hour an infant is born with NAS in the United States. NAS has many symptoms & complications for babies including body shakes, seizures, overactive reflexes, hypertonia, excessive crying, high-pitched cries, poor feeding, breathing problems, weight loss, fever, sweatiness, stuffy nose, sneezing, diarrhea, throwing up, trouble sleeping, jaundice, & low birth weight, or preterm delivery. Typically, these infants are scored using Finnegan’s Scoring Tool & too often, are being prescribed methadone & morphine for their withdrawal symptoms. To deal with this more effectively & provide patients with the best quality care possible, Neonatal Intensive Care Units (ICUs) should be doing everything possible to alleviate these symptoms without the unnecessary implementation & exposure to more drugs like methadone & morphine. The education of staff & parents is a much-needed implementation along with the use of nonpharmacological, supportive measures.

What is the practice area?

(Check all that apply.)                                                               Administration

✓  Clinical                                                                                   Other

✓  Education

all that apply)                                                                          Difference between hospital & community practice

✓  Safety/risk management concerns                                Clinical practice issue is a concern

✓Unsatisfactory patient outcomes (lengthy