Infants in Drug Withdrawal: A National Description of Nurse Workload, Infant Acuity, and Parental Needs

In the Journal of Perinatal and Neonatal Nursing, Jessica Smith and colleagues, including Jeannette Rogowski and Eileen Lake, investigate how infants in drug withdrawal compare with nondrug withdrawal infants to inform proper nurse assignments based on infant acuity and parental needs. Though not commonly recognized, a troubling aspect of the opioid epidemic is increased drug use among pregnant women, which has led to an increase in infants who are exposed to licit or illicit drugs during pregnancy through the placenta. Infants in drug withdrawal have complex physiological and behavioral states, requiring intensive nursing care. 

The authors analyzed nurse survey data from 6,045 staff nurses from a national sample of 104 neonatal intensive care units. Nurses reported the care of 15,233 infants, 361 (2.4%) of whom were in drug withdrawal. Three-fourths of hospitals had at least one infant in drug withdrawal. In these hospitals, the mean number of infants in drug withdrawal was 4.7.

The authors had three main findings: (1) nurses caring for infants in drug withdrawal have higher workloads, (2) infants in drug withdrawal are higher acuity, and (3) parents of infants in drug withdrawal require more time and require significantly more care to address complex social needs. The authors conclude that managers and charge nurses should consider the demands of caring for infants in drug withdrawal in assignment decisions and provide necessary support and education.