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Journal article
Standardized Scoring Tool and Weaning Guideline to Reduce Opioids in Critically Ill Neonates
Pediatric quality & safety, v 7(3), pp e562-e562
01 May 2022
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
IntroductionPain impacts brain development for neonates, causing deleterious neurodevelopmental outcomes. Prescription opioids for analgesia or sedation are common; however, prolonged opioid exposure in neonates is associated with neurodevelopmental impairment. Balancing the impact of inadequate pain control against prolonged opioid exposure in neonates is a clinical paradox. Therefore, we sought to decrease the average days of opioids used for analgesia or sedation in critically ill neonates at a level IV Neonatal Intensive Care Unit by 10% within 1 year. MethodsA multidisciplinary quality improvement team used the model for improvement, beginning with a Pareto analysis, and identified a lack of consistent approach to weaning opioids as a primary driver for prolonged exposure. The team utilized 2 main interventions: (1) a standardized withdrawal assessment tool-1 and (2) a risk-stratified opioid weaning guideline. ResultsWe demonstrated a reduction in mean opioid duration from 34.3 to 14.1 days, an increase in nursing withdrawal assessment tool-1 documentation from 20% to 90%, and an increase in the documented rationale for daily opioid dose in provider notes from 20% to 70%. Benzodiazepine use did not change. ConclusionStandardized withdrawal assessments combined with risk-stratified weaning guidelines can decrease opioid use in critically ill neonates.
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Details
- Title
- Standardized Scoring Tool and Weaning Guideline to Reduce Opioids in Critically Ill Neonates
- Creators
- Dipen VyasVilmaris Quinones CardonaAmanda CarrollCatherine MarkelMegan YoungRachel Fleishman
- Publication Details
- Pediatric quality & safety, v 7(3), pp e562-e562
- Publisher
- Lippincott
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000810124200014
- Scopus ID
- 2-s2.0-85139025860
- Other Identifier
- 991019167800904721
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- Web of Science research areas
- Pediatrics