Implementing the eat, sleep, console method into a tertiary care delivery center

Background

Infants experiencing Neonatal Opioid Withdrawal Syndrome (NOWS) after birth has been a significant public health issue since the opioid crisis began in the U.S. Traditional assessment tools for symptom management have historically resulted in prolonged hospitalization and continued exposure to opioids after birth to treat them.

Purpose

Eat, Sleep, Console (ESC) was implemented to replace a popular NOWS assessment tool in a neonatal intensive care unit at a large urban children's hospital's maternity center. The aim was to determine whether using ESC would decrease length of hospitalization, use of morphine for treatment, as well as increase the number of direct discharges from the postpartum unit.

Results

ALOS decreased from 9.2 days to 6.2 days, a 33% reduction. Morphine treatment initiation decreased from 21.7% to 3.8%, an 82.4% reduction. Neither group included infants treated with a second line medication. Finally, the discharge rate improved by 47% directly from the postpartum unit.

Conclusions

Using ESC, all identified outcomes regarding management of infants with NOWS improved. Wide-scale use of ESC could have multiple benefits for this patient population including a reduction in healthcare costs and prolonged exposure to opioids after birth, as well as preservation of the mother-infant dyad in the immediate postpartum period. Further research is needed to study the long-term impact of the ESC method.