WIP 04 - Evaluating the Transition from Finnegan Scoring to Eat, Sleep, Console Across Nursery and NICU Settings for Neonatal Opioid Withdrawal Syndrome

Publication Number: WIP 04.7440

Robert J. Nadler, Nationwide Children's Hospital, Pickerington, OH, United States; Kristen L. Benninger, Nationwide Children's Hospital, Columbus, OH, United States; Rakhi Gupta Basuray, Nationwide Children's Hospital, Columbus, OH, United States; Sara Conroy, Nationwide Children's Hospital, Columbus, OH, United States

Background: The Eat, Sleep, Console (ESC) care approach simplifies the assessment of infants with neonatal opioid withdrawal syndrome (NOWS), focusing on non-pharmacologic management with decreased length of stay and receipt of pharmacologic treatment in a recent large, multi-center trial. However, current research does not address the continuum of care from newborn nursery (NBN) to NICU settings. At our large, academic delivery hospital, infants are cared for in the NBN with NICU transfer for a higher level of care and/or pharmacologic treatment. Until now, only infants admitted to the NICU at our site have been eligible to participate in multi-center research studies, missing a large proportion of infants with NOWS at our site and providing an incomplete picture of the true impact of ESC. This is largely driven by difficulty obtaining data across the care settings with two different electronic medical records (EMR) and IRB systems despite their physical proximity in the same hospital.

Objective: In infants with NOWS, compare the rate of NICU transfer and pharmacologic treatment before and after transition from Finnegan to ESC across the continuum of care including NBN and NICU care settings.

Design/Methods: This is a retrospective cohort study of infants born from 2016 to 2024 at a large, academic delivery hospital. The NBN and NICU at our site transitioned from Finnegan to ESC in September 2023. Working closely with each care setting’s data informatics team, we developed a coordinated data extraction and abstraction plan from each respective EMR: 1) NBN and 2) NICU, with subsequent data validation and combination into a single dataset. We will compare rate of NICU transfer and pharmacologic treatment pre- and post-transition using chi-square or Fisher’s exact test, adjusting models for sociodemographic and background variables and other relevant covariates. This study was approved by both IRB systems (6/18/24; 7/5/24). Data extraction and abstraction are currently in progress with estimated completion 12/31/24. Data analysis will be completed with working results by March 2025.