Association of medication-assisted treatment and short acting opioids with newborn head circumference and birth weight.

Objective: We compared the association of methadone, buprenorphine, and short-acting opioid exposure with newborn head circumference (HC) and birth weight (BW), and evaluated gestational age (GA) as a mediator.

Study Design: We included newborns born 2013-2018 identified by neonatal abstinence syndrome diagnosis code (N = 572) and birthday-matched unexposed controls (N = 571). Linear regressions of opioid exposure with HC and BW controlled for tobacco, marijuana, cocaine, gabapentin, cesarean section, Medicaid, and newborn sex, with mediation analysis by GA.

Decreasing Unplanned Extubations in the Neonatal ICU.

Background: Unplanned extubation (UE) is a preventable adverse event and may lead to additional complications such as cardiovascular resuscitation or respiratory compromise in a critically ill neonate during an emergent re-intubation. A quality improvement project to reduce unplanned endotracheal tube dislodgement would reduce these morbidities. We aimed to reduce UEs in the NICU to 1 UE/100 ventilator days by October 2018.

Introduction to quality improvement tools for the clinician.

As physicians continue search for ways to deliver high quality care to their patients and families, newer tools and methods are being introduced. Initially developed by manufacturing, quality improvement methods have been slowly adopted by healthcare and are now standard curriculum in medical schools. The IHI Model for Improvement allows for teams to create.

Using Quality Improvement Tools to Reduce Chronic Lung Disease.

Rates of chronic lung disease (CLD) in very low birthweight infants have not decreased at the same pace as other neonatal morbidities over the past 20 years. Multifactorial causes of CLD make this common morbidity difficult to reduce, although there have been several successful quality improvement (QI) projects in individual neonatal intensive care units. QI projects have become a mainstay of neonatal care over the past decade, with an increasing number of publications devoted to this topic.

Improving Care for Neonatal Abstinence Syndrome.

Background And Objective: Care for neonatal abstinence syndrome (NAS), a postnatal drug withdrawal syndrome, remains variable. We designed and implemented a multicenter quality improvement collaborative for infants with NAS. Our objective was to determine if the collaborative was effective in standardizing hospital policies and improving patient outcomes.