P0056 - Reduction of Need for Treatment and Length of Hospital Stay Following Institution of a Neonatal Abstinence Syndrome Rooming-in Program

Background: To assess the impact of a rooming-in program for babies at risk of Neonatal Abstinence Syndrome (NAS) in one community hospital center, in Belleville, Ontario. The primary outcomes of interest were the need for pharmacologic treatment for NAS and length of stay in hospital. Secondary outcomes of interest included the following: healthcare resource utilization (resource intensity weight and hospital cost), and feeding patterns of the maternal-infant dyad.

Methods: This pretest post-test designed study was conducted at one community hospital site, Belleville General Hospital. The hospital developed a rooming-in program for newborns at risk of NAS in July 2015. Prior to its inception, the standard of care was to admit these infants to the special care nursery for monitoring and treatment. Charts on infants born to mothers using opioids in the 24 months prior to (July 2013 – June 2015) and after (July 2015 – June 2017) the implementation of our program were examined. The two groups were compared for the primary outcomes studied, including the number of babies started on morphine and length of stay in hospital. Secondary outcomes examined breast feeding rates, resource intensity weight, and total hospital cost.

Results: Rooming-in is associated with a reduction in the need for treatment with morphine, shorter length of stay in hospital, improved breast-feeding rates, and lower total hospital cost.

Conclusion: Our study demonstrates that rooming-in programs for babies born to mothers using opioids has benefits in terms of quality of care and health care resource utilization. These findings add to the existing literature on NAS that rooming-in can be successfully implemented in a community hospital.