Purpose for the Program
The number of newborn infants treated every year at the Western Pennsylvania Hospital for neonatal abstinence syndrome (NAS) has increased more than 150% since 2004. Nurses conduct the Finnegan Neonatal Abstinence Scoring Tool every 2 hours to analyze the infant's withdrawal symptoms and determine if pharmacologic intervention is necessary and/or effective. Up to 30% of infants may be managed without medication. Interventions for treatment of these infants include medication and supportive care. The purpose of the program, as a unit evidence-based practice project, was to learn if the addition of baby cuddlers as caregivers could affect the length of stay required for treatment of these infants.
A baby cuddler is a trained baby holder who can fill the gaps when parents are not able to be present. The cuddler provides an important component of the developmental care for the hospitalized infant. The importance of human contact and touch in the well being of all hospitalized infants has been well documented. Baby cuddlers on a daily basis held, rocked, and comforted the infants suffering from drug withdrawal.
Implementation, Outcomes, and Evaluation
Seventy-five infants were admitted to the department with the diagnosis of NAS in the 1-year study period from May 2009 to May 2010. Length of stay was compared from the first 6 months without the baby cuddler program to the last 6 months after the initiation of the program. From May 2009 to October 2009, the average length of stay for infants with NAS was 26.2 days without the baby cuddler program. From November 2009 to May 2010, the average length of stay for infants with NAS was 22.4 days, a decrease in length of stay of 3.8 days. After the official evidence-based project ended, from May 2010 to April 30, 2011, the pediatric unit cared for an additional 75 NAS patients. The length of stay average was 23.9 days, a decrease in length of stay of 2.3 days compared with the initial noncuddler group. Baby cuddlers completed an orientation to their role and received education on hand washing and Health Insurance Portability and Accountability Act regulations. From initiation of the project on October 1, 2009, to February 28, 2011, baby cuddlers have contributed 2,855 hours of cuddling to patients suffering from NAS.
Implications for Nursing Practice
Nurses have implemented a low-cost intervention that decreases length of stay and, thus, affects hospital finances and provides quality patient care to a vulnerable population.