NAS photo

Substance Exposed Newborn (SEN)/Neonatal Abstinence Syndrome (NAS)

The incidence of Neonatal Abstinence Syndrome (NAS) increased from 11.9 NAS cases per 1,000 live births in 2019 to 14.0 in 2020. At that time, nearly 91% of newborns with NAS remained in the hospital for 4 to 7 days or longer. Additionally, NICU admissions were significantly higher for newborns with substance exposure.

Recent studies and practices such as the Eat-Sleep-Console methodm, as well as other non-pharmacological interventions, have demonstrated that pharmacological interventions can be reduced while giving parents skills and confidence to care for their baby before leaving the hospital. Since 78% of newborns with NAS are discharged with their parents, this is especially important.

This also highlights the importance of referral and discharge planning, such as Plans of Safe Care. The PA PQC Substance-Exposed Newborn initiative is designed to support these recommendations. (PA DOH, 2022)

Neonatal abstinence syndrome by county

Source: Pennsylvania Department of Health, 2020

Successes

%
Increase in standards
22% increase in the percentage of hospitals using a standard definition for NAS.

2023-2024 Goals

Increase the percentage of newborn care teams educated on post-discharge services from 70% to 80% of participating hospitals

Increase the percentage of newborn care teams educated on the criteria for Plans of Safe Care from 70% to 80% of participating hospitals

Maintain at least 75% of newborns with NAS receiving non-pharmacotherapy bundled treatments (impacting at least 350 newborns per year)

Increase the percentage of newborns with NAS who were were referred to appropriate follow-up services at discharge from 85% to 95% (impacting at least 350 newborns per year)

Increase the percentage of hospitals with a protocol to close the loop on the referral status with the post-discharge services and supports from 30% to 50%

Key Interventions

Educate staff about maternal/infant screening, prenatal education, and support

Standardize non-pharmacological treatment bundles as the first line of treatment for SEN

Connect families to appropriate follow-up services prior to discharge and close the loop on those referrals

Establish family care plans prior to discharge