Florida Perinatal Quality Collaborative
NAS Initiative
Neonatal Abstinence Syndrome Initiative
The United States is battling an opioid epidemic, which has resulted in increasing illicit use and misuse of prescription opioids among pregnant women. Neonatal abstinence syndrome (NAS), in which infants exhibit postnatal withdrawal symptoms most commonly due to chronic in utero exposure to opioids, is one unfortunate sequelae of the opioid epidemic. It manifests as a combination of central nervous system irritability, autonomic nervous system hyperactivity, respiratory difficulties, and gastrointestinal dysfunction. The majority of pregnant women taking illicit drugs, using prescribed opioids, or receiving opioid replacement therapy will deliver an infant having withdrawal symptoms, and many of these infants will develop NAS and require pharmacologic management. NAS infants are more likely to have a diagnosis of prematurity, low birth weight, respiratory complications, seizures, and feeding difficulty. Beyond the neonatal period, they are at risk for behavioral problems, learning problems, visual disorders, and psychosocial difficulties (for example, risk for child abuse, foster placement).
Despite awareness of a rising NAS incidence, there is a scarcity of evidence-based management for NAS, lack of improvement in length of inpatient stay, and a rise in health care costs, which highlight the considerable variations in its management by pediatricians and neonatologists. The FPQC hopes to address variability in NAS management.
News & Announcements
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The NAS Initiative Tool Box contains tool kit documents, example hospital guidelines and helpful websites, screening tools, plan of safe care and discharge materials, patient education materials, and more. This resource is updated regularly throughout the project.
Online Tool Box for NAS Hospitals
Newly Added Tool Box Resources:
- Provider Education video modules
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NAS End of Initiative Celebration - June 2, 2020
NAS Data Collection: Definitions, Procedures, and Tools - December 4, 2018
Pharmacologic Management - January 15, 2019
Eat, Sleep, Console: The Colorado Experience - February 19, 2019
Connecting to the World Outside - March 19, 2019
Inter-Rater Reliability - April 16, 2019
Non-Pharmacologic Management - May 2019
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Manatee Memorial Hospital
BayCare-Morton Plant Hospital
St. Vincent's Medical Center (Riverside)
Nemours Children's Hospital
Tradition Medical Center
Martin Medical Center
Tampa General Hospital
St. Joseph's Women's Hospital
Winter Haven Women's Hospital
Golisano Children's Hospital of Southwest Florida
AdventHealth Waterman
Winnie Palmer Hospital NICU
AdventHealth Tampa
Medical Center of Trinity
Winnie Palmer Hospital Newborn Nursery
University of Florida Health Jacksonville
Lakeland Regional Health
Sacred Heart Hospital Pensacola/Studer Family Children's Hospital
Mease Countryside Hospital
Sarasota Memorial Hospital
Fort Walton Beach Medical Center
Naples Community Hospital
University of Florida Health - Gainesville
Bayfront Health Spring Hill
AdventHealth Memorial Medical Center
Baptist Health South
Halifax Health Medical Center
Nicklaus Children’s Hospital
Plantation General Hospital
Holtz Children's/Jackson Memorial Hospital
Holmes Regional Medical Center
Gulf Coast Regional Medical Center (Panama City)
AdventHealth for Children