Wombmates to Roommates: Rooming-In to Manage Infant Withdrawal

In recent years, opioid use during pregnancy has grown as fast as that in the general population. The state of Utah's rate of Neonatal Opioid Withdrawal Syndrome (NOWS) has increased from 2.5/1000 births in 2009 to 6.4/1000 births in 2017. Nationally, the average length of stay for a NOWS newborn is 23 days at a cost of $94,000 in the Neonatal Intensive Care Unit compared to a healthy newborn's stay of 2 days at $1900. The purpose of this project was to implement "rooming-in" which is keeping the newborn with the mother to provide comprehensive NOWS care for the newborn. In this quality improvement initiative, rooming-in was implemented for 24 newborns with NOWS meeting specific criteria. Their length of stay and medications administered were evaluated and compared to 20 newborns with NOWS cared for in the Intermediate Care Unit (ICN). Parent satisfaction surveys were collected for those that participated in rooming-in and nurse surveys were collected for those that cared for the rooming-in newborns. Rooming-in newborns were admitted for an average of 7 days and received an average of 10 doses of medications. Newborns cared for in the ICN were admitted for an average of 11 days and received an average of 32 doses of medications. The ICN stay was 1.93-6.52 days longer than the rooming-in stay. The average cost per patient stay for the rooming-in newborn was $9552 compared to $21,014 for ICN care. The average cost savings per patient was $11,462. The nurses and parents who participated in rooming-in expressed overall high satisfaction with the process.