Quality & Safety

Commitment to Excellence in Quality and Safety

As the stewards of care for children hospitalized at UF Health Shands Children’s Hospital, our faculty and staff believe there is nothing more important than the health and well being of your child. Pediatric hospitalists are dedicated to making the inpatient environment safe and will work with you and your family to ensure your child receives the highest quality of care.

Current and Ongoing Programs

Gloved hand checking the heart beat of infant

Neonatal Abstinence Syndrome (NAS)

Neonatal Abstinence Syndrome (NAS) is a condition that results from the sudden discontinuation of chronic fetal opioid exposure. Currently, the most widely used NAS scoring tool is the Finnegan Neonatal Abstinence Scoring System (FNASS). FNASS assigns a score from 0-3 for a catalog of 21 symptoms associated with withdrawal; elevated total scores represent higher severity of NAS.

Traditionally, the initiation of pharmacotherapy for elevated FNASS scores requires gradual tapering of medication; this results in significantly extend hospital stay for these infants. A newer approach, the “Eat, Sleep, and Console” (ESC) method, emphasizes infants’ function and comfort, rather than reducing signs and symptoms of severe withdrawal with pharmacotherapy. The results of these studies appear promising with decreased length of stay (LOS), utilization of morphine, and hospital cost.

At UF Health Shands Children’s Hospital, a revised treatment strategy was proposed in Oct 2017 for NAS management to maximize non-pharmacological intervention and assess infant’s ability to function with ESC to determine the initiation of morphine. Next, in Jan 2019, a formalized treatment algorithm was developed; it merges Finnegan scoring and the ESC method to determine the need for pharmacological intervention based on infant function and comfort. This innovative treatment method improved the quality of patient care by decreasing LOS and minimizing morphine exposure.