• NAS;
  • individualized teaching;
  • maternal narcotic pain medication

Poster Presentation

  1. Top of page
  2. Poster Presentation

Purpose for the Program

We have seen a sharp increase in the number of women who have given birth to infants at Saint Joseph's Children's Hospital and have taken either methadone or subutex but have not received any information during their pregnancies about the possible adverse effects that these medications may have on their infants. Within a 6-month period we had six infants in the neonatal intensive care unit (NICU) at the same time with neonatal abstinence syndrome (NAS) because they were born to mothers who were taking methadone during their pregnancies. A microsystem analysis confirmed a gap in the education that was relayed to pregnant women who were taking methadone or subutex about infant withdrawal. The first step of the Maternal Education and Neonatal Program was to address this gap.

Proposed Change

Women who were taking subutex or methadone were identified through the obstetrics (OB) clinic or the alcohol and other drug abuse clinic and were offered individualized time with a nurse from the NICU. This time was used to review a booklet that was developed to explain NAS and what the patient, her significant other, and family could expect from an infant with NAS.

Implementation, Outcomes, and Evaluation

Initial meetings were held. The project went to the Institutional Review Boards (IRB) of both facilities, but because the project involved hospital and clinic personnel it did not require IRB approval. The booklet was developed and printed. Since the implementation of the project, the physicians from the clinic have had the NICU nurses meet with women who were taking narcotic pain medications (and two women who were taking subutex) throughout their pregnancies and whose infants were at risk of NAS.

Of the women that have been through the education program, three have given birth. The evaluations from the women at the time of the education session was positive and no improvement was needed; the evaluation after birth was that they felt more prepared to cope with their infant and no improvement was needed.

Implications for Nursing Practice

We had not anticipated the physicians from the OB clinic to use this program for the education of women on long-term narcotic pain medication, but a definite need was identified. Another need identified was an educational need for the staff to learn the signs and symptoms of NAS related to the medications the mother is taking.