Maternal, Child Health and Neonatal Nursing Commons^™

Utilization Of Care By Infants With Neonatal Abstinence Syndrome In Delaware, Michele K. Savin, Dnp, Aprn, Nnp-Bc

College of Nursing Posters

Introduction: There is little information regarding use of expected well care by infants diagnosed with neonatal abstinence syndrome (NAS) post initial discharge. We describe expected and unexpected utilization of care by infants with NAS in the first year of life.

Methods: A de-identified State of Delaware Medicaid data set was obtained. Included were all infants with an ICD-9 code for NAS from 01/01/2012-12/31/2014. All associated medical claims were extracted for one year after birth. Utilization rates of primary care, immunizations, urgent or emergency care, and re-hospitalization were quantified.

Results: 499 of 522 babies were able to be fully analyzed. The …

Utilization Of Care By Infants With Neonatal Abstinence Syndrome In Delaware, Michele K. Savin, Msn, Nnp-Bc

College of Nursing Faculty Papers & Presentations

From 1999-2013, the nationwide incidence of neonatal abstinence syndrome (NAS) due to maternal drug use rose from 1.5/1000 to 6/1000 hospital births. There is a dearth of information regarding what happens to these children when they are discharged. The purpose of this Practice Inquiry Project is to utilize existing Delaware Medicaid data to retrospectively explore the utilization of services and gaps in care for the infant with NAS in the first year of life. Key findings include less than expected well child visits and immunizations along with higher hospital re-admission rates. This represents missed opportunities for care, also demonstrating the …

Neonatal Implications Of Substance Use Treatment During Pregnancy, Michele K. Savin, Msn, Nnp-Bc

College of Nursing Faculty Papers & Presentations

I am writing in response to “Pharmacologic Treatment of Opioid Addiction During Pregnancy” by Keough and Fantasia (2017). The article nicely compares and summarizes the use of methadone and buprenorphine to treat substance use in pregnant women. I was dismayed, however, by the sections regarding neonatal considerations and breastfeeding, which contained some problematic assertions and some inaccurate conclusions.

Opioid Exposed Mothers And Infants In Delaware: Clinical And Legal Considerations, Michele K. Savin, Msn, Nnp-Bc, David A. Paul, Md

College of Nursing Faculty Papers & Presentations

Drug use is on the rise in Delaware, as demonstrated by the continued increase in infants born with neonatal abstinence syndrome. Thoughful, evidence based, and coordinated approaches are necessary to impact this problem. There is solid evidence that mothers and infants who remain together have improved outcomes. Professional medical and nursing societies are unanimous in support of non-punitive approaches to care. Medical Professionals, legislators, and society in general would benefit from ongoing education on the addiction disease process in order to best care for the increasing number of mother/baby dyads with neonatal abstinence syndrome.

We Can Do Better: An Argument For Improved Care Of The Opioid Addicted Mother-Infant Dyad, Michele K. Savin, Msn, Nnp-Bc

College of Nursing Faculty Papers & Presentations

As the number of addicted maternal-infant dyads increases, so does the need for nursing to expand its understanding of the addiction process and the evidencebased interventions that best serve mothers and infants. Nursing attitudes toward the opioid-addicted mother and infant dyad are influenced by knowledge deficits and communication difficulties. Care required encompasses medical, legal, social, and economic perspectives. Professionals and society at large have disagreements regarding whether to approach the phenomenon from a punitive or supportive strategy. Facilities to care for the mother-infant dyad with addiction are limited. Increasing knowledge has great potential for active understanding and ability to impact …