Morgan J Hartgrove1, Laurie L Meschke2, Terry L King3, Carla Saunders4. 1. University of Tennessee, Knoxville, TN, 37996, USA. 2. Department of Public Health, University of Tennessee, Knoxville, TN, 37996, USA. LLMeschke@utk.edu. 3. Clinical Pharmacy, East Tennessee Children's Hospital, Knoxville, TN, 37916, USA. 4. Pediatrix Medical Group & East TN Children's Hospital, Knoxville, TN, 37916, USA.
Abstract
OBJECTIVE: Describe the characteristics of infants with NAS and determine if treatment outcomes varied between three protocols. STUDY DESIGN: Based on medical record data, infant treatment for NAS-related withdrawal reflected one of three protocols: (1) No rescue dose (n = 836, 52.7%): Prescriber ordered initiation and escalation doses and determined when infants were eligible for weaning, (2) Rescue dose (n = 233, 14.7%): No rescue dose with the addition of a prescriber-ordered rescue dose, (3) Rescue dose by order set (n = 516, 32.6%): Rescue dose with addition of nurse-assisted order of morphine during escalation. RESULTS: The no rescue dose group had longer length of stay, days to wean, and inpatient days, and greater initial morphine dose than the two rescue dose groups (p < 0.001). Treatment outcomes between the two rescue dose protocols did not differ. CONCLUSIONS: The benefits related to rescue dosing further inform the development of a standardized NAS treatment protocol.
OBJECTIVE: Describe the characteristics of infants with NAS and determine if treatment outcomes varied between three protocols. STUDY DESIGN: Based on medical record data, infant treatment for NAS-related withdrawal reflected one of three protocols: (1) No rescue dose (n = 836, 52.7%): Prescriber ordered initiation and escalation doses and determined when infants were eligible for weaning, (2) Rescue dose (n = 233, 14.7%): No rescue dose with the addition of a prescriber-ordered rescue dose, (3) Rescue dose by order set (n = 516, 32.6%): Rescue dose with addition of nurse-assisted order of morphine during escalation. RESULTS: The no rescue dose group had longer length of stay, days to wean, and inpatient days, and greater initial morphine dose than the two rescue dose groups (p < 0.001). Treatment outcomes between the two rescue dose protocols did not differ. CONCLUSIONS: The benefits related to rescue dosing further inform the development of a standardized NAS treatment protocol.