Other Titles
Specialty Sleeper Impacts on Neonatal Intensive Care Unit Admission for Neonatal Abstinence: Average Length of Stay and Eat, Sleep, Console Sleep Score [Title Slide]
Abstract
During the COVID-19 pandemic, operational modifications resulted in an increased average length of stay (ALOS) for Neonatal Intensive Care Unit (NICU) infants with Neonatal Abstinence Syndrome (NAS), from 10 days to 30 days, and additional workload for nursing staff. In response an innovative responsive bassinet (SNOO) was introduced into existing Eat, Sleep, Console (ESC) care model with goal to improve sleep while maintaining American Academy of Pediatrics (AAP) Safe Sleep positioning.
A retrospective chart review was conducted on neonates admitted to NICU who received scheduled methadone dosing for NAS from December 2020 to September 2022. Study inclusion criteria was primary diagnosis of NAS, birth gestational age ≥35 weeks, and no co-diagnosis which would contribute to length of stay. SNOO was introduced in November 2021. Neonates were grouped in pre-SNOO (baseline) and post-SNOO (intervention) periods. Outcome measures included ALOS and the number of sleep-related “yes” scores on our ESC Care Tool (indicating poor sleep related to NAS). All statistical analyses were conducted on IBM SPSS Statistics 28. Mann-Whitney analysis completed based on sample size. Satisfaction surveys evaluated nurse satisfaction and time savings at 1-month and 6-months post-SNOO.
A total of 109 infant charts were reviewed. 13 infants (n=11%) fulfilled all inclusion criteria (baseline N=6, intervention N=7). ALOS declined by 17.38% (31.30 baseline; 25.86 intervention, p=0.57), and yes-scores for poor sleep decreased by 41.72% (28.67 baseline; 16.71 intervention, p=0.52). No significant differences based on gender, post-natal age, birth gestational age, length of stay, poor sleep scores, pharmacotherapy days, or “just in time” dosing were found. No other modalities of our preexisting ESC model of care were altered between groups. Satisfaction survey data demonstrated 84% of nurses surveyed at 6-months post-SNOO identified a timesaving’s of 1 to 2 hours per shift or more.
Conclusions: While observed reductions in ALOS and yes-scores were not powered for statistical significance, the addition of SNOO as a non-pharmacologic intervention within ESC care models may lead to improved outcomes. Further, impact of SNOO on nursing workload has the potential to improve care, efficiency, and satisfaction. Future studies should explore SNOO’s impact on NICU NAS admissions when utilized in the Newborn Nursery setting or implications of modeling safe sleep practices for this at-risk population.
Notes
References:
Adrian, A., Newman, S., Mueller, M. and Phillips, S. (2020) 'A Mixed-Methods Study to Investigate Barriers and Enablers to Nurses' Implementation of Nonpharmacological Interventions for Infants With Neonatal Abstinence Syndrome', Adv Neonatal Care, 20(6), pp. 450-463.
Grisham, Lisa M. NNP-BC; Stephen, Meryl M. CCRN; Coykendall, Mary R. RNC-NIC; Kane, Maureen F. NNP-BC; Maurer, Jocelyn A. RNC-NIC; Bader, Mohammed Y. MD. Eat, Sleep, Console Approach: A Family-Centered Model for the Treatment of Neonatal Abstinence Syndrome. Advances in Neonatal Care: April 2019 - Volume 19 - Issue 2 - p138-144 doi: 10.1097/ANC.0000000000000581
Grossman, M. R., Lipshaw, M. J., Osborn, R. R., & Berkwitt, A. K. (2018). A novel approach to assessing infants with neonatal abstinence syndrome. Hospital Pediatrics, 8(1), 1–6. https://doi.org/10.1542/hpeds.2017-0128
Kocherlakota, P. (2014). Neonatal abstinence syndrome. Pediatrics, 134(2).
https://doi.org/10.1542/peds.2013-3524
Sublett, Juli MSN, RN. Neonatal Abstinence Syndrome: Therapeutic Interventions. MCN, The American Journal of Maternal/Child Nursing: March/April 2013 - Volume 38 - Issue 2 – p102-107 doi: 10.1097/NMC.0b013e31826e978e
Sigma Membership
Omega Mu, Kappa Tau
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Quality Improvement
Research Approach
Mixed/Multi Method Research
Keywords:
Acute Care, Emerging Technologies, Neonatal Intensive Care Unit, NICU, Neonatal Abstinence Syndrome, NAS, Eat Sleep Console
Recommended Citation
Pariser-Schmidt, Melinda, "Impact of a Responsive Bassinet on Neonatal Abstinence Syndrome in the NICU" (2025). Biennial Convention (CONV). 54.
https://www.sigmarepository.org/convention/2025/presentations_2025/54
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-19
Impact of a Responsive Bassinet on Neonatal Abstinence Syndrome in the NICU
Indianapolis, Indiana, USA
During the COVID-19 pandemic, operational modifications resulted in an increased average length of stay (ALOS) for Neonatal Intensive Care Unit (NICU) infants with Neonatal Abstinence Syndrome (NAS), from 10 days to 30 days, and additional workload for nursing staff. In response an innovative responsive bassinet (SNOO) was introduced into existing Eat, Sleep, Console (ESC) care model with goal to improve sleep while maintaining American Academy of Pediatrics (AAP) Safe Sleep positioning.
A retrospective chart review was conducted on neonates admitted to NICU who received scheduled methadone dosing for NAS from December 2020 to September 2022. Study inclusion criteria was primary diagnosis of NAS, birth gestational age ≥35 weeks, and no co-diagnosis which would contribute to length of stay. SNOO was introduced in November 2021. Neonates were grouped in pre-SNOO (baseline) and post-SNOO (intervention) periods. Outcome measures included ALOS and the number of sleep-related “yes” scores on our ESC Care Tool (indicating poor sleep related to NAS). All statistical analyses were conducted on IBM SPSS Statistics 28. Mann-Whitney analysis completed based on sample size. Satisfaction surveys evaluated nurse satisfaction and time savings at 1-month and 6-months post-SNOO.
A total of 109 infant charts were reviewed. 13 infants (n=11%) fulfilled all inclusion criteria (baseline N=6, intervention N=7). ALOS declined by 17.38% (31.30 baseline; 25.86 intervention, p=0.57), and yes-scores for poor sleep decreased by 41.72% (28.67 baseline; 16.71 intervention, p=0.52). No significant differences based on gender, post-natal age, birth gestational age, length of stay, poor sleep scores, pharmacotherapy days, or “just in time” dosing were found. No other modalities of our preexisting ESC model of care were altered between groups. Satisfaction survey data demonstrated 84% of nurses surveyed at 6-months post-SNOO identified a timesaving’s of 1 to 2 hours per shift or more.
Conclusions: While observed reductions in ALOS and yes-scores were not powered for statistical significance, the addition of SNOO as a non-pharmacologic intervention within ESC care models may lead to improved outcomes. Further, impact of SNOO on nursing workload has the potential to improve care, efficiency, and satisfaction. Future studies should explore SNOO’s impact on NICU NAS admissions when utilized in the Newborn Nursery setting or implications of modeling safe sleep practices for this at-risk population.
Description
Participants will be able to identify symptoms of Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS) as evaluated using the Eat, Sleep, Console tool. Participants will be able to identify variations in NAS/NOWS treatment practices. Participants will be able to identify integration of novel technologies into the NICU setting to support NAS/NOWS treatment.