Hello!

I need help filling out the sections underneath the bold headings (below) for a nursing statistics class. The answers must come from an article. I cannot upload a PDF of the article, but I references it (and the DOI is listed), so you can easily access it. Most of the chart is complete....I just need to make sure I'm on the right track and it's correct!!

Please keep my PICOT in mind, as it talks about non-pharmacological interventions. So I cannot focus on morphine or other meds given.

PICOT -How does non-pharmacological intervention affect the length of hospital stay for infants exposed to maternal opioid use in utero?

Population/Sample

Data for infants 35 weeks' gestation with confirmed in utero opioid exposure and worsening symptoms of NAS requiring transfer to the inpatient floor.

Control Group

389 infants (baselinen= 203;

Interventionn= 186) that had 1 FNASS score during newborn hospitalization. 76 infants (baselinen= 40; interventionn= 36) with escalating NAS symptoms requiring transfer to the inpatient floor met criteria for inclusion in the final analysis.

Exclusion Criteria

Infants with conditions requiring nothing by mouth for >12 hours or morphine initiation in the ICU.

Intervention/Independent Variable

A collaborative approach to care, maintaining the maternal-infant dyad by rooming in, and increased nonpharmacologic interventions including skin-to-skin placement, swaddling, and limiting stimulation.

Emphasizing of non-pharmacological interventions such as reducing stimuli, pacifier use, swaddling, and increased calorie density.

Comparison

Number of morphine doses and the cumulative dose of morphine received per infant with NAS on the inpatient floor

Outcome/Dependent Variable

The ALOS for infants with NAS transferred to the inpatient floor decreased from a baseline of 10.3 days to 4.9 days during the intervention period, when non pharmacological methods were used.

Type of Research Evidence

Qualitative Data Analysis

Statistics

Data monitoredusing statistical process control charts to assess improvement over time in key aims. Standard Shewhart rules were used for the interpretation and determination of special cause variation (primarily 8 consecutive points on the same side of the centerline)

Results

FNASS scores for assessment, emphasized maintaining the maternal-infant dyad during treatment, and incorporated nonpharmacologic treatments for withdrawal. These improvements successfully reduced our ALOS to below the national average of 16 days

Attrition- None

Adverse Events - None

Theory -

??

Recommendation-

Changing the approach to non-pharm management first can decrease length of stay. It can lead to near elimination of pharmacotherapy use and resultin greater than 50% reduction in length of stay. No increase in readmission rates or adverse events.

Reference

Blount T, Painter A, Freeman E, Grossman M, Sutton AG. (2019). Reduction in length of stay and morphine use for NAS with the "eat, sleep, console" method.Hosp Pediatr 9(8),615-623. doi: 10.1542/hpeds.2018-0238.Epub 2019 Jul 8. PMID: 31285356.