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8/9/2019 PQCNC NAS Learning Session 2 May 2015
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PQCNC NASLearning Session
May 14 2015
MJ McCafrey, MD, CAPT USN (e!"
Direc!or PQCNC
Pro#essor o# Pe$ia!rics
UNC Sc%oo& o# Me$icine
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T%e Pe$ia!ri' ')erience
• *ro+ 2004201-, ./4,45 in#an!s#ro+ 2 c&inica& cen!ers eree&igi3&e #or inc&sion in or s!$y
• 10,-2/ in#an!s (2" +e! or cri!eria#or NAS
• Co%or! $iagnos!ic )%rases6 7neona!a&a3s!inence syn$ro+e,8 7$rgi!%$raa&,8 or 7$rg i!%$raa&syn$ro+e98
• 'c&$e$ any in#an!s i!% congeni!a&Tolia VN et al. N Engl J Med 2015. DOI:10.1056/NEJMsa1500439
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T%e Pe$ia!ri' ')erience
• *ro+ 2004 !%rog% 201-, NASincrease$ #ro+ />1000 a$+issions !o2/>1000
• T%e ra!e o# increase as signi
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T%e Pe$ia!ri' ')erience
• T%e N:CU $ays a!!ri3!e$ !oin#an!s i!% !%e neona!a& a3s!inencesyn$ro+e increase$ #ro+ 09. in
2004 !o 490 in 201-
• :n 2004, on&y 1 cen!er %a$ +ore !%an10 o# N:CU $ays a!!ri3!e$ !o
in#an!s i!% !%e neona!a& a3s!inencesyn$ro+e9 ?y 201-, in#an!s i!%NAS accon!e$ #or +ore !%an 10 o#
N:CU $ays a! 2- cen!ers, #or +oreolia VN et al. N Engl J Med 2015. DOI:
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Annualized NICU Admission Rates for the Neonatal Abstinence Syndrome and Median Length ofStay, According to Year
!olia "N et al N #ngl $ Med %&'( )*I+
'&'&(-N#$Msa'(&&./0
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1ro2ortion of !otal NICU )ays Attributed to Infants 3ith the Neonatal Abstinence SyndromeAccording to Year, and the Yearly 1ro2ortion of !otal NICU )ays According to Center
!olia "N et al N #ngl $ Med %&'( )*I+
'&'&(-N#$Msa'(&&./0
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1erinatal 4uality Collaborati5e ofNorth Carolina
SURVIVAL! (An Activity.)May 13, 2015
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You and you co"anion# $av% &u#t
#uviv%d t$% ca#$ o' a #a "an%. ot$
t$% "iot and co*"iot +%% i%d in t$% ca#$.It i# id*-anuay and you a% in ot$%n
/anada. $% daiy t%"%atu% i# 25 %o+
%o, and t$% ni$t ti% t%"%atu% i# 40%o+ %o. $%% i# #no+ on t$% ound,
and t$% county#id% i# +ood%d +it$ #%v%a
c%%# ci##co##in t$% a%a. $% n%a%#t
to+n i# 20 i%# a+ay. You a% a d%##%d
in city cot$%# a""o"iat% 'o a u#in%##
%%tin.
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You ou" o' #uvivo# ana%d to #ava% t$% 'oo+in
it%#
• A a o' #t%% +oo
• A #a a6• A oad%d .45*cai% "i#to
• /an o' /i#co #$ot%nin
• %+#"a"%# (on% "% "%#on)
• /ia%tt% i$t% (+it$out 'uid)
• 76ta #$it and "ant# 'o %ac$ #uvivo
• 20 6 20 't. "i%c% o' $%avy*duty canva#
•
A #%ctiona ai a" ad% o' "a#tic• 8n% 'i't$ o' 100*"oo' +$i#%y
• A co"a##
• 9aiy*#i% c$ocoat% a# (on% "% "%#on)
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You ta# a# a ou" i# to i#t t$%#% 12 it%#
in od% o' i"otanc% 'o you #uviva and
"ovid% t$% ationa% 'o t$% u#%# 'o %ac$.
You MUS co% to a%%%nt a# a ou".You $av% 12 inut%# to co"%t% t$% ta#.
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Sr;i;a& Q:
• Tea+or=
• Lea$ers%i)
• Ai+ S!a!e+en! @i!% Me!ric
: • Bey Dri;ers
:
• S!ra!egies :
• Ac!ions :
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Ranin#;
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NAS@%ere @e a;e?een@%ere @e AreEoing
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Ma!erna& Narco!ic Use
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Loca!ion o# Care
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$ca!ion
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Pri+ary Me$ Use$
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Secon$ary Me$ Use$
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*ee$ing
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A;erage N+3er o# @eans
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A;erage sca&a!ions
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Disc%arge$ o+e on Me$s
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Payor
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P%ar+a LFS
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To!a& Leng!% o# S!ay
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C%ec=&is!
• Tea+ i!% a +ission
• Ai+ an$ +ission
• e)or! an$ re;ie yor $a!a
• :$en!i#y s)eci
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C%oose Gor Tea++a!es@ise&y
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Srron$ yorse i!% !%ose on !%esa+e +ission
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Areas #or :n!er;en!ion
• S!an$ar$iHe$ !rea!+en! an$ eaninggi$e&ines
• Pro+o!e %osing in Iie!es! roo+)ossi3&e
• :n!erra!or re&ia3i&i!y : Do3&e score a! or 12
• S!an$ar$iHe +e$ica!ions
• Par!ner i!% )aren!s in scoring
• *ocs on 3reas!#ee$ing
TAM@FB
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TAM@FB
Aon% +% can do
#o itt%, to%t$% +%can do #o uc$.