008–“Hush Little Baby” Comprehensive Care for the Treatment of Neonatal Abstinence Syndrome.

Abstract

As health care professionals we are committed to providing an environment that promotes patient safety and healing. Patient safety involves nurses acquiring skills and utilizing critical thinking to assure that the least restrictive measures are implemented to meet the patient's needs. These skills require an understanding of the relationship between patient safety and protective measures, the continuum of protective measures from least restrictive to physical restraint, and ways to collocate and promote the use of least restrictive measures. In addition, for those times when restraints are necessary for patient safety, this presentation will include strategies to increase awareness of when to safely “let go” and remove restraints. 008–“Hush Little Baby” Comprehensive Care for the Treatment of Neonatal Abstinence Syndrome. Marybeth Koehler, BSN, RN, C, New Hanover Regional Medical Center, Wilmington, NC Target Audience: Staff Nurses, Clinical Educators, Neonatal Nurse Practitioners Background: Nurses identified four core issues that hindered the care of patients and families affected by neonatal abstinence syndrome (NAS). These included variability of medication concentration and administration, subjectivity in the use of the standardized withdrawal-scoring tool, gaps in staff and family education, and accurate acuity assessment for inpatient placement. Problem: As the number of women in methadone treatment programs rises, there is a corresponding increase in the numbers of neonates that experience withdrawal symptoms. NAS presents the practitioner with an array of difficult issues surrounding successful treatment of these complex families. This presentation will outline the comprehensive, multidisciplinary approach developed by one Magnet designated hospital in southeastern North Carolina. Method: A core team of nurses, social workers, physicians, pharmacists and case managers was recruited to analyze current practice and develop a comprehensive plan. The new plan includes standardized level of care resulting in appropriate inpatient placement, a protocol for medication administration, and the valid and objective use of the scoring tool. Results and Implication for Practice: Strengths of this project are numerous and can be applicable in any practice setting. For example, our comprehensive approach has now expanded to include the expertise of lactation consultants and the mother's health care team. The key outcome, however, has been accurate scoring which results in appropriate dosing of medication leading to an easier weaning process. 009–A Bereavement Program. Nina Lee-Pittman, MS, RN, CPN, Beth StoudenmireBurney, RN, Greenville Memorial Hospital, Greenville, SC Children are not supposed to die. Sadly, sometimes they do die so as caregivers we need to respond appropriately. Therefore, we formed an interdisciplinary team to look at our bereavement process. We gathered data from all areas within our hospital which may experience a child's death and found varied approaches. Our team developed a plan for the upcoming year based on a review of best practices. A variety of education opportunities were held for all RNs, licensed practical nurses, child life specialists, patient care technicians, social workers, and nursing assistants within the identified areas. A computer-based program was completed for baseline knowledge development. Bereavement manuals for labor and delivery areas and pediatric areas were developed. Quarterly programs were held to accomplish the hands-on training related to keepsakes, communication with families, siblings, and each other. The perspective of the parent and self-care were addressed. A checklist was developed to ensure all aspects of care were completed. The following goals were accomplished: (a) development of a comprehensive plan for when a death occurs, (b) institution of a consistent process for the care of the infant, child, or adolescent and their family members, (c) support for families and health care providers through the grief process, and (d) availability of resources for all staff members when of a death occurs or is expected. Implications for practice are to ease the uncomfortable and difficult situations associated with death using consistent and concrete methods to facilitate an effective grief process for all. 010–Choose Wisely*: A Vascular Access Device Selection Algorithm for Pediatric Patients. Michelle Niewinski, BSN, RN, CPN, Ann Marie Frey, BSN, RN, CRNI, Deborah Atkins, RN, The Children's Hospital of Philadelphia, Philadelphia, PA According to Intravenous Nurses Society (INS) Standards of Practice, RNs are the most qualified to select vascular access devices (VADs) for their patients. Assuming the patient advocate role, we developed a pediatric VAD selection algorithm. Because it is the prescribing clinician's responsibility to order the VAD, we felt this algorithm would provide a tool to select the appropriate device. Key considerations included in the algorithm were therapy duration, infusate characteristics, vascular integrity, and the therapy administration setting. Our goal is to provide availability of this tool for use by multiple disciplines involved in ordering or inserting