PQCNC NAS Learning Session 2 May 2015

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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• *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 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$% +%can do #o uc$.

PQCNC NAS Learning Session 2 May 2015

Documents