437 - The impact of the implementation of Eat, Sleep, Console for the management of infants with Neonatal Opioid Withdrawal Syndrome on the morphine dose and length of stay

Publication Number: 437.6890

Ana TFS. Leslie, McMaster University Michael G. DeGroote School of Medicine, Dundas, ON, Canada; Saaraniya Sooriyakumar-Suresh, McMaster University Michael G. DeGroote School of Medicine, Hamilton, ON, Canada; Samara G. Chitayat, McMaster University Michael G. DeGroote School of Medicine, Burlington, ON, Canada; Maame Plaumann, McMaster University Michael G. DeGroote School of Medicine, Hamilton, ON, Canada; Sarah Simpson, St. Joseph's Healthcare, Hamilton, Hamilton, ON, Canada; Milena Kudus, McMaster University Michael G. DeGroote School of Medicine, hamilton, ON, Canada; Sandra Anne. Seigel, McMaster University, Hamilton, ON, Canada

Background: The opioid overuse crisis has increased tremendously the incidence of neonatal opioid withdrawal syndrome (NOWS) for the past 15 years. Traditionally, Finnegan Neonatal Abstinence Scoring System (FNASS) was used for assessing babies with NOWS. Eat Sleep Console (ESC) represents a new approach based on intensification of non-pharmacological interventions and family involvement in the care of the newborn.

Objective: To assess the differences in the total morphine use and hospital length of stay in infants with NOWS managed by ESC compared to FNASS.

Design/Methods: In this retrospective chart review study, we evaluated infants with NOWS born at 35 weeks’ gestation or more. Data was collected from infants born between June 2022 to June 2024 and divided into 2 periods. During Period 1, FNASS was used for NOWS assessment (June 2022 to May 2023). In Period 2, ESC was implemented (June 2023 to May 2024). Infants were identified through keyword search diagnoses of “Neonatal Abstinence Syndrome” contained within our EPIC electronic medical record system. The primary outcomes were length of stay (LOS) in days and cumulative dose of morphine administration (mg/kg/admission).

Results: A total of 21 neonates in Period 1 and 30 neonates during Period 2 were included. There were no statistical differences between Periods 1 vs 2 for the cumulative morphine administration (1.527 mg/kg/admission vs 1.096 mg/kg/admission, p = 0.43) or LOS (10.4 days vs 13.5 days, p = 0.13).

Conclusion(s): Contrary to the existing evidence in the literature, implementing the ESC model in our study did not significantly decrease the total cumulative dose of morphine administration or the number of days in hospital compared to FNASS. Our main limitation was the small sample size.