49 Rooming-In to Treat Neonatal Abstinence Syndrome

Abstract

Abstract Background Ontario has been facing a steady rise in the number of individuals abusing narcotics. Newly implemented rooming-in programs in Ontario have allowed infants of opioid-dependent mothers to stay in the same room as their mother while the infant continues to be monitored for signs of neonatal abstinence syndrome (NAS). Objectives To retroactively review the impact of a rooming-in program for babies at risk of NAS on the need for pharmacologic treatment and length of stay in one community hospital site in Belleville, Ontario. Design/Methods Belleville General Hospital developed a rooming-in program for newborns at risk of NAS in July 2015. Prior to its inception, the standard of care was to admit these infants to the special care nursery for monitoring and treatment. Charts were reviewed to collect data on infants born to mothers using opioids in the 24 months prior to (July 2013 – June 2015) and after (July 2015 – June 2017) the implementation of our program. The two groups were compared for the primary outcomes studied, including the number of babies started on morphine and length of stay in hospital. Secondary outcomes were also examined, including breast feeding rates, resource intensity weight, and total hospital cost. Results Rooming-in is associated with a reduction in the need for treatment with morphine, shorter length of stay in hospital, improved breast feeding rates, and lower total hospital cost. Conclusion Our study demonstrates that rooming-in programs for babies born to mothers using opioids have benefits in terms of quality of care and health care resource utilization. These findings add to the existing literature on NAS that rooming-in can be successfully implemented in a community hospital.