Download or read book Do Neonatal Nurses Caring for Newborns with Neonatal Abstinence Syndrome nas Whose Mothers Used Illicit Substances During Pregnancy Experience Moral Distress a Pilot Study written by Valarie Artigas and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Maternal substance misuse/abuse during pregnancy may lead to adverse neonatal outcomes, including neonatal abstinence syndrome (NAS). NAS is a constellation of withdrawal symptoms exhibited in newborns in response to the discontinuance of in-utero exposure to licit and illicit substances. The incidence of NAS is directly related to the increasing rates of maternal substance use/abuse. The United States has experienced a five-fold increase of newborns born with NAS. The care of the newborn with NAS is one of the most challenging conditions for the neonatal nurse. Management of newborns with NAS requires knowledge that has not been traditionally partnered within care of the neonatal intensive care unit (NICU) but rather more often in the newborn nursery. And thus, understanding addiction, addictive behaviors and the psychological needs of substance misusing/abusing parents have not been common place in all NICU settings. Caring for the newborn with NAS and interacting with the addicted parent and parents may present ethical and moral dilemmas for the neonatal nurse. This pilot study explored the presence of moral distress among neonatal nurse caring for the newborn with NAS whose mothers used illicit substances during pregnancy. A descriptive study engaged neonatal nurses from a Level III NICU in completing the Moral Distress Scale Pediatric version. Frequency and intensity of moral distress among the sample assisted in determining the presence and levels of moral distress. Neonatal nurses caring for newborns with NAS whose mothers used illicit substances during pregnancy experienced varying degrees moral distress.The results of this research study revealed that indeed, neonatal nurses experience moral distress to varying degrees within the NICU setting. Caring for newborns with NAS within this sample participant group produced moral distress especially when these nurses interacted with substance misusing mothers and care givers. Although not all neonatal nurses caring for newborns with NAS and/or interacting with substance misusing care givers experienced moral distress the review of the data is imperative for identifying strategies to support nurses universally to prevent/address moral distress in the NICU.
Download or read book Family Resilience and Recovery from Opioids and Other Addictions written by Julie M. Croff and published by Springer Nature. This book was released on 2021-01-22 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: The book examines the relationship between family resilience and recovery from substance use disorders. It presents information on etiology of substance use disorders within the family system as well as new research on resilience in addiction recovery. The book facilitates the development of evidence-based resilience practices, programs, and policies for those working or dealing with families and addiction. Key topics addressed include: Protecting workers from opioid misuse and addiction. Neuroscience-informed psychoeducation and training for opioid use disorder. New models for training health care providers. Role of families in recovery capital. Family Resilience and Recovery from Opioids and Other Addictions is a must-have resource for researchers, professors, and graduate students as well as clinicians and related professionals in family studies, public health, and clinical psychology and all interrelated disciplines, including behavioral health, social work, and psychiatry.
Download or read book Nursing Care of Newborn Infants with Neonatal Abstinence Syndrome Increasing Knowledge Through Education written by Jeanne Franza and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Neonatal Abstinence Syndrome (NAS) is a multisystem disorder that occurs in newborns after birth when the mother has been taking addictive drugs, usually opiates, during pregnancy. These infants experience withdrawal symptoms and require prolonged hospital stays. When and infant with NAS requires treatment with medication, the length of stay is greatly prolonged due to the need to slowly taper the medication before discharge. Patrick et al. (2012) found that the incidence of NAS increased from 1.2 per 1000 live births in 2000 to 3.39 per 1000 live births in 2009, and the mean hospital cost for an infant with NAS increased from $39,400 in 2000 to $53,4000 in 2009. NAS has become a costly epidemic. Nurses who care for these infants require specialized knowledge. The RNs and APRNs in a community hospital expressed uncertainty regarding assigning Finnegan scores, which indicate the level of withdrawal symptoms. Many of these nurses were very experienced but had not had recent education focused on NAS or addiction, or experience in addiction medicine or behavioral health. The nurses required tools to be able to establish a therapeutic relationship with mothers who have addiction issues. A recently updated clinical practice guideline was in place, but education had not been provided to the RNs and APRNs regarding the updated guideline for the care of these infants, achieving accuracy in Finnegan scoring, or the establishment of a therapeutic relationship with the mother. The purpose of this evidence-based practice change was to increase nurses' knowledge in the care of these infants and their mothers. The plan included an educational program consisting of three parts; a PPT presentation on NAS, an interactive DVD session to achieve reliability in Finnegan scoring, and journal club style discussions focused on establishing a therapeutic relationship with mothers who have addiction issues. A pre/post test survey was done to measure increase in knowledge. All participants showed an increase in knowledge, with a change in score of 36.21%, well over the 10% increase benchmark. This change represents 71.92% growth. This outcome is statistically significant. The RNs and APRNs also overwhelmingly agreed in the program evaluations that they had increased confidence in their ability to care for infants and communicate effectively with their mothers, as a result of the educational program. The outcome of this project supports the provision of education focused on NAS for RNs and APRNs who care for these infants and their mothers. " -- Abstract.
Download or read book Nursery and NICU Nurses Early Recognition of Neonatal Abstinence Syndrome written by Dora E. Martin and published by . This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Neonatal abstinence syndrome (NAS) is defined as the result of when a pregnant, substance-abusing woman gives birth to her infant. Once delivered, the infant is abruptly removed from the source of the addictive substance(s). NAS is an increasing health problem among infants born to drug-addicted mothers, and in one year alone, the United States had roughly 225,000 infants who were exposed to illicit substances. The nursery nurses who care for the NAS infants require very specific and unique set of skills. Therefore, it is imperative for nursery nurses to become skilled in the use the Finnegan Neonatal Abstinence Scoring Tool (FNAST) to identify and direct treatment of NAS. The target population included the nursery nurses at a Level-I hospital located in Southeast Texas, who had no formal assessment tools or guidelines to diagnose or treat infants with NAS. The intervention involved a pre/post-test, distribution of NAS/FNAST educational materials, and the implementation of standardized clinical guidelines, in which to start the treatment process on the infants. Post implementation, the nurses rated FNAST as useful, and it improved communication between nurses and doctors by using consistent identifying criteria from which to evaluate the infant with NAS. The purpose of this project was to evaluate the effectiveness of implementing clinical practice guidelines to help increase the identification of infants with NAS, by providing the nursery nurses with the FNAST, as a proven instrument. The outcome of this data exceeded the goal of 80%, with an actual increase of 92% in the levels of NAS recognition by neonatal nurses, and showed a gain of 100% compliance in using the new protocol. Key Words: Nursery nurses; Neonatal Abstinence Syndrome (NAS); Substance abusing pregnant women Finnegan Neonatal Abstinence Scoring Tool (FNAST);" -- Abstract.
Download or read book Neonatal Abstinence Syndrome written by Cynthia Woods and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Neonatal Abstinence Syndrome (NAS) is a condition affecting neonates who have been exposed to illicit or prescription drugs while in the womb. NAS, also known as newborn withdrawal syndrome, is a serious concern as the incidence of drug abuse in pregnancy is increasing, with a corresponding rise in infant withdrawal cases. The symptoms of NAS range from excessive crying and irritability to seizures and death; the average hospital stay is from one week to several months, depending upon the gravity of the symptoms. There is a lack of evidence-based practices and standardized protocols to guide the management of care for these babies. Nonpharmacological nursing interventions, in addition to pharmacological treatments, are vital in the care of these infants. Non-pharmacological nursing interventions have been shown to decrease the severity of neonatal abstinence syndrome and reduce the amount of days in the hospital. Non-pharmacological treatments include: providing a quiet, dimly lit environment; swaddling; the use of pacifiers; holding the infant vertically when rocking; rubbing the baby instead of patting; kangaroo mother care; breastfeeding; and encouraging the rooming in of mother and child whenever feasibly possible. Establishing standardized nursing intervention protocols and providing appropriate training for the nursing staff are effective ways to treat NAS infants resulting in the positive outcome of decreased days in the hospital.
Download or read book Implications of Early Education of Mothers with Infants Born with Neonatal Abstinence Syndrome NAS written by Noreen Kearney Beckett and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The number of infants being admitted to neonatal intensive care units (NICU) for treatment for Neonatal Abstinence Syndrome (NAS) has increased over the last 10 years(Alcoholism and Drug Abuse Weekly, 2012). There is evidence to support maternal involvement in the infants care, improves outcomes during the NICU admissions. Current models used in NICU's miss opportunities to improve the care of NAS infants. The purpose of this intervention is to improve the care of NAS infants (Jones, 2012) in NICU's, by educating at risk mothers early in pregnancy and supporting their involvement during the NICU admission (Armstrong, 2012). Development and dissemination of educational material would initiate the process. Evaluation of this intervention would look at length of stay to make predictions, whether early education of mothers decreased length of stay (Pritham, 2012). Next NICU's would have to consider the ability to change current practice models and environments and look for ways to increase mothers' involvement during the infants' admission (Mundy, 2010) (Young, 2013). The circumstances creating the NAS admission are often complicated, with many variables to consider in determining the success of the intervention. Having a child is a life changing moment, and may provide an opportunity to improve not only the life of the infants but also the life of the infant's opiate dependent mother. Changing current model could provide and environment that will increase attachment between mother and infant, decreasing days of treatment, and improving longer-term outcome for child (Marie-Mitchell, 2013).
Download or read book Neonatal Abstinence Syndrome written by Russell Bailey and published by Nova Science Publishers. This book was released on 2015 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The prenatal use of opioids, including heroin and opioids prescribed for pain management, can produce a withdrawal condition in newborns known as Neonatal abstinence syndrome (NAS). These and other substances pass through the placenta that connects the baby to its mother in the womb. The baby becomes addicted along with the mother. A recent study found that cases of NAS have tripled over the last decade and that treatment costs for newborns with NASmost of which are paid by Medicaidare more than five times the cost of treating other newborns at birth. This book examines federally funded research, federal programs, and other federal agency efforts related to prenatal opioid use or NAS; gaps identified by federal agency officials and experts in efforts to address prenatal opioid use or NAS; and how federal efforts to address prenatal opioid use or NAS are planned and coordinated. It also discusses symptoms and characteristics of NAS.
Download or read book Significance of Non Pharmacologic Treatment on Infants with Neonatal Abstinence Syndrome written by Kristin Klutz and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The incidence of Neonatal Abstinence Syndrome (NAS) is increasing across the United States (Davidson and Schub, 2014). Researchers who performed a retrospective analysis of national hospital discharge data found that the annual rate of maternal opioid use increased nearly fivefold, and the incidence of NAS increased nearly threefold during the period 2000 to 2009 (Davidson and Schub, 2014). The onset of withdrawal symptoms in infants is dependent on what substances the infant was exposed to in utero as well as the amount. Infants that experience Neonatal Abstinence Syndrome require specialized care that includes pharmacologic and nonpharmacologic management. The current practice at Winchester Medical Center is to care for these infants on the post- partum unit while they room in with their mothers. Once the infant scores high enough to be started on pharmacologic treatment, they are then moved into the newborn nursery. This standard of practice is not beneficial to the infant because of the negative effects it has on the infant. Current research shows that non- pharmacologic management is just as important in the recovery of infants with Neonatal Abstinence Syndrome as pharmacologic management. Davidson and Schub (2014) discussed the importance of reducing sensory stimulation, which included dimming the lights, swaddling, and prone positioning. Their study showed that breastfeeding for at least 72 hours after birth reduces the severity of Neonatal Abstinence Syndrome symptoms and decreases the need for pharmacologic treatment (Davidson and Schub, 2014). This project will attempt to determine the effects of pharmacologic versus nonpharmacologic treatment on infants with Neonatal Abstinence Syndrome. The implementation will begin by educating patients and all staff affected by this change. Regular meetings will be held with management and staff, as well as the implementation team in order to ensure all questions are answered. Doing so will ensure that all questions are addressed and suggestions are able to be made. The practice change of improving the environment of infants with Neonatal Abstinence Syndrome will then take effect with constant monitoring and evaluation by the implementation team. Results will be evaluated each month and changes will be made as necessary to guarantee that the unit is following best- practice.
Download or read book Developing Training to Address Neonatal Nurse Knowledge Practice and Perceived Attitude for Neonatal Abstinence Syndrome written by and published by . This book was released on 2020 with total page 60 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract Background: Neonatal abstinence syndrome (NAS) is increasing in the United States as a result of increased opioid-use disorder among women of childbearing age. NAS affects three out of four babies who are exposed to chronic use of opioids during the mother's pregnancy. Caring for infants with NAS is challenging. Researchers have identified a deficit of knowledge and skills, and have discovered judgmental attitude of nurses caring for babies with NAS. Globally, nurses caring for infants with NAS need education on current evidence-based practice to improve quality of care. The purpose of this project was to create an educational intervention based on assessed, localized, educational needs for NICU staff nurses caring for babies experiencing NAS. Methods: This project used the design thinking implementation framework and IHI Psychology of Change framework to assess the needs of NICU nurses caring for infants experiencing NAS and develop related education. A baseline survey of the nurses' knowledge, attitudes, and practices was done. Similarly, nurse stakeholder interviews were completed and themes were analyzed using thematic content analysis to further specify localized needs. Educational materials were prototyped in subsequent interviews with the nurses until the materials were found useful. Findings/Results: RNs correctly identified symptoms and treatment for NAS. RNs overall felt empathy for infants with NAS, but less empathetic towards the infant's mothers and blamed them for the infant's health problems. The RNs were confident in their knowledge to provide adequate care for the infants but self-identified a need for improvement in knowledge, care, and documentation. RNs appropriately use nonpharmacological treatment, but desire more education in the interventions. Other areas for needed improvement were medication treatment, in-home and outpatient care, and parameters for breastfeeding. RNs identified educational needs through interviews and provided feedback on the two prototypes created using empathy mapping. Conclusions: The proposed next step is to implement the designed educational intervention and study related outcomes. The IHI Psychology of Change Framework and the design thinking process, when combined, offer a strong method for participant engagement. The design thinking process may be important to timely and effective care in-so-much that it allows flexibility to change as the context changes.
Download or read book Treatment of Neonatal Abstinence Syndrome Due to Crystal Methamphetamine written by Charlotte Wells (Clinical reviewer) and published by . This book was released on 2019 with total page 9 pages. Available in PDF, EPUB and Kindle. Book excerpt: Neonatal abstinence syndrome (NAS) is defined as drug withdrawal symptoms experienced by a neonate upon birth due to maternal drug use during pregnancy. Symptoms can include irritability, poor sucking, hypertonia, low birth weight and seizures. NAS occurs most commonly with maternal opioid use, but can occur with other substances such as cocaine, cannabis, and amphetamines (including crystal methamphetamine). Maternal drug abuse, both licit and illicit, has been growing in Canada. Mothers who use methamphetamines in pregnancy tend to be younger, have lower levels of education, lower socioeconomic status, are more likely to drink and smoke during pregnancy, and have less prenatal care prior to child birth. Pregnant persons who abuse drugs and their children are often a vulnerable group and require extra care and treatment. Care for NAS due to opioids usually includes non-pharmacological treatment and pharmacological treatments, but standardization of care is difficult as symptoms of withdrawal may differ between neonates. The purpose of this report is to examine recent literature regarding diagnosis and treatment of NAS due to crystal methamphetamine.
Download or read book The Experiences of Nurses Engaging in Therapeutic Relationships with Mothers of Newborns Diagnosed with Neonatal Abstinence Syndrome written by Brett Aston and published by . This book was released on 2021 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The therapeutic nurse-client relationship is at the core of nursing practice and is meant to benefit the health and wellbeing of clients (CNA, 2017; CNO, 2006; RNAO 2002). Mothers of newborns diagnosed with neonatal abstinence syndrome (NAS), however, have reported negative relationships with their newborns' nurses (Cleveland & Gill, 2013; Cleveland & Bonugli, 2014). Likewise, neonatal nurses have also discussed their challenges working with this population of mothers (Demirci et al., 2015; Murphy-Oikonen et al., 2010; Raeside, 2003; Romisher et al., 2018). The purpose of this study was to explore neonatal nurses' experiences of engaging in therapeutic relationships with mothers of newborns diagnosed with NAS. This qualitative study follows the methods of interpretive description (Thorne, 2016). Eligible participants were recruited using purposeful and convenience sampling. Data was collected by semi-structured telephone interviews. Interviews were audio-recorded and transcribed verbatim, and a thematic analysis was conducted following Thorne's (2016) alternative sorting technique. Two major themes were identified by researchers. The first theme, building the relationship, is broken down into subthemes assessing the mother and choosing an approach, caring for and involving the mother, making a connection, and getting to know mom and her needs. The second theme, the competing pressures of working with NAS, is further categorized into the subthemes working with baby and mother, collaborating with the Children's Aid Society, and struggling with stigma. The findings from this study have implications for nursing practice, education, policy, and research that promotes the success of establishing therapeutic relationships with mothers of newborns diagnosed with NAS.
Download or read book Factors Associated with the Incidence and Severity of Neonatal Abstinence Syndrome in Infants Born to Opioid Dependent Mothers written by Lisa Anne Scott and published by . This book was released on 2018 with total page 348 pages. Available in PDF, EPUB and Kindle. Book excerpt: Neonatal abstinence syndrome (NAS), the constellation of withdrawal symptoms experienced by neonates exposed to opioids prenatally, is an epidemic affecting an estimated 23,580 infants each year with an annual cost of $720 million. The purpose of this study was to examine factors associated with the incidence and severity of NAS as measured by the need for initiation of neonatal medication, peak medication dose, hospital length of stay (LOS), and hospital costs among newborns born to opioiddependent mothers. A retrospective review of medical records was conducted with two convenience samples: 204 infants born to mothers who used opioids during pregnancy; and 121 of these infants who required treatment with morphine to control symptoms of NAS. Data from April 2011 to September 2017 were collected from medical records of a large Midwestern hospital. Exploratory analysis and descriptive statistics were performed. Associations between independent variables and outcomes were examined using correlations, chi-square, t-tests, analyses of variance, and linear regression. Of the 204 neonates who were exposed to opioids prenatally, 121 (59%) developed symptoms of NAS requiring treatment with morphine. Neonates requiring morphine had significantly higher gestational ages than those who did not (37.7 vs 36.4 weeks; p =
Download or read book Breastfeeding Neonatal Abstinence Syndrome Newborns Improves Infant Outcomes written by Amber Barry and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Neonatal Abstinence Syndrome (NAS) is a current and increasing problem many neonatal intensive care units (NICU) are facing. Controversial to NAS is whether the opioid dependent mother should breastfeed. Research proves that breastfeeding the NAS infant is very beneficial and safe. Breastfeeding provides a decrease in the severity of symptoms caused by NAS, is linked to a decreased hospitalization, and aids in health and bonding. The proposal for research is to allow for breastfeeding as an option at Banner Good Samaritan Medical Center where the current policy in place does not support it. As infants are admitted to the NICU for NAS, breast milk along with pharmacotherapy treatment is shown through evidence-based practice that the infant's length of stay is shorter compared to infants that receive formula. Family-centered care theory is greatly affected when opioid dependent mothers are denied support services and education regarding breastfeeding and their withdrawing infant. To gauge for change and effectiveness nursing staff, neonatologist, neonatal nurse practitioners, LAMB committee, and policyholders will be given new researched information on the benefits of breastfeeding NAS babies and their outcomes.
Download or read book Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy written by World Health Organization and published by . This book was released on 2015-04-20 with total page 37 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines have been developed to enable professionals to assist women who are pregnant, or have recently had a child, and who use alcohol or drugs or who have a substance use disorder, to achieve healthy outcomes for themselves and their fetus or infant. They have been developed in response to requests from organizations, institutions and individuals for technical guidance on the identification and management of alcohol, and other substance use and substance use disorders in pregnant women. They were developed in tandem with the WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy.
Download or read book An Evidence based Approach to Managing Neonatal Abstinence Syndrome written by Kimberly Larsen Kusak and published by . This book was released on 2008 with total page 58 pages. Available in PDF, EPUB and Kindle. Book excerpt: Neonates born to mothers addicted to opiates may develop neonatal abstinence syndrome (NAS). An infant exposed to opiates in-utero causes the neonate to withdraw from the substance after birth. Neonates with NAS are at risk for adverse outcomes including seizures and death along with many adverse symptoms related to neurological excitability and gastrointestinal dysfunction as described by the American Academy of Pediatrics (1998). As mentioned by Hunt et al. (2008), neonates exposed to opiates are at higher risk for prematurity, low birth weight and adverse neurodevelopment. These risk factors are directly related to increased death and adverse outcomes for this population. Variability exists regarding the treatment of NAS. The project intention is to propose an evidence-based practice recommendation for the treatment of neonates with NAS, thus providing consistency in care. A thorough literature search was done using several search engines including Medline, Pubmed, Cochran Library, CINAHL, National Guidelines Clearinghouse, Medline via First Search, and individual journal searches. The evidence was compiled and reviewed for strong research technique including type of randomization, inclusion and exclusion criteria, population representation, bias, confounding variables, and loss to follow-up. Protocol recommendations include evidence based recommendations for the care of NAS including medication treatment protocols. The protocol's focus is on increased positive patient outcomes and safety. Specifically, the goal is to avoid adverse outcomes such as seizures and death along with decreased duration of treatment, hospital stay, and nursing care. Overall, the practice recommendations raise multidisciplinary team awareness, increases care consistency, and provides a method for early intervention.
Download or read book How to Create a Neonatal Withdrawal Center written by Mary Brown and published by CreateSpace. This book was released on 2015-08-07 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt: When a baby is born with neonatal abstinence syndrome (NAS) as a result of drug exposure while in the womb, finding an appropriate setting for the newborn is essential to its survival. Lily's Place, a recovery center serving the Huntington, West Virginia, area, focuses on working with both child and mother to help heal the family from chemical dependence. Offering the highest level of care in a nurturing, home-like atmosphere, Lily's Place also operates at a fraction of the cost of a hospital stay. In How to Create an NAS Center: A New Model of Care for Neonatal Abstinence Syndrome, the cofounders of Lily's Place provide a comprehensive set of guidelines for creating a low-stimulus, medically appropriate environment for the care and treatment of infants born with NAS. Including detailed information on setting up nonprofit status, bylaws, articles of incorporation, and staffing, this book details the entire process of creating a nuturing residential treatment facility for babies experiencing withdrawal. Full of wisdom and insight from a team of specialists with over sixty years of experience in the NICU arena, this book is an essential resource for anyone hoping to establish a thriving NAS center in their community.
Download or read book Drug Dependence in Pregnancy written by National Institute on Drug Abuse. Services Research Branch and published by . This book was released on 1978 with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt:
