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. 2018 Jan/Mar;32(1):72-79.
doi: 10.1097/JPN.0000000000000309.

Infants in Drug Withdrawal: A National Description of Nurse Workload, Infant Acuity, and Parental Needs

Jessica G Smith  1 , Jeannette A Rogowski, Kathryn M Schoenauer, Eileen T Lake
Affiliations

Infants in Drug Withdrawal: A National Description of Nurse Workload, Infant Acuity, and Parental Needs

Jessica G Smith et al. J Perinat Neonatal Nurs. 2018 Jan/Mar.

Abstract

Infants in drug withdrawal have complex physiological and behavioral states, requiring intensive nursing care. The study objectives were to describe acuity, parental needs, and nurse workload of infants in drug withdrawal compared with other infants. The design was cross-sectional and involved secondary nurse survey data from 6045 staff nurses from a national sample of 104 neonatal intensive care units. Nurses reported the care of 15 233 infants, 361 (2.4%) of whom were in drug withdrawal. Three-fourths of hospitals had at least 1 infant in drug withdrawal. In these hospitals, the mean number of infants in drug withdrawal was 4.7. Infant acuity was significantly higher among infants in drug withdrawal. Parents of infants in drug withdrawal required significantly more care to address complex social situations (51% vs 12%). The number of infants assigned to nurses with at least 1 infant in withdrawal (mean = 2.69) was significantly higher than typical (mean = 2.51). Given infant acuity and parental needs, policies legislating patient-to-nurse ratios should permit professional discretion on the number of patients to assign nurses caring for infants in drug withdrawal. Managers and charge nurses should consider the demands of caring for infants in drug withdrawal in assignment decisions and provide support and education.

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Conflict of interest statement

Conflicts of Interest and Source of Funding: This study was conducted during the primary author’s postdoctoral fellowship, which was funded by the National Institute of Nursing Research of the National Institutes of Health award number T32NR007104 “Advanced Training in Nursing Outcomes Research” (Aiken, PI). The primary data set was funded through the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative grant “Acuity-Adjusted Staffing, Nurse Practice Environments and NICU Outcomes” (Lake, PI).

Figures

Figure 1
Figure 1
Blue markers indicate hospitals that had at least one infant in drug withdrawal. Yellow markers indicate hospitals with no infants in drug withdrawal.
Figure 2
Figure 2
Figure 2a. Needs of Parents Who Required Extra Nurse Time for Infants in Drug Withdrawal N = 165 infants Figure 2b. Needs of Parents Who Required Extra Nurse Time: Infants not in Drug Withdrawal N = 6,771 infants
Figure 2
Figure 2
Figure 2a. Needs of Parents Who Required Extra Nurse Time for Infants in Drug Withdrawal N = 165 infants Figure 2b. Needs of Parents Who Required Extra Nurse Time: Infants not in Drug Withdrawal N = 6,771 infants
See this image and copyright information in PMC

References

    1. Dart RC, Surratt HL, Cicero TJ, et al. Trends in Opioid Analgesic Abuse and Mortality in the United States. N Engl J Med. 2015;372(3):241–248. - PubMed
    1. Wang X, Zhu Y, Dave CV, Alrwisan AA, Voils SA, Winterstein AG. Trends of Neonatal Abstinence Syndrome Epidemic and Maternal Risk Factors in Florida. Pharmacotherapy. 2017 - PubMed
    1. Tolia VN, Patrick SW, Bennett MM, et al. Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs. N Engl J Med. 2015;372(22):2118–2126. - PubMed
    1. Corr TE, Hollenbeak CS. The economic burden of neonatal abstinence syndrome in the United States. Addiction. 2017 - PubMed
    1. Desai RJ, Hernandez-Diaz S, Bateman BT, Huybrechts KF. Increase in prescription opioid use during pregnancy among Medicaid-enrolled women. Obstet Gynecol. 2014;123(5):997–1002. - PMC - PubMed

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