Neonatal Opioid Withdrawal Syndrome (NOWS), formerly known as Neonatal Abstinence Syndrome (NAS), refers to the collection of signs and symptoms that may occur in opioid-exposed newborns shortly after birth. Between 2010 and 2013, the number of infants with NOWS doubled with a total cost exceeding $23 million in Alabama.
The ALPQC aims to reduce variation in treatment and optimize the care of infants with NOWS, with the goal of optimizing nonpharmacologic management, pharmacologic management, and providing a safe discharge for these infants and mothers.
To that end, we’ve developed a toolkit that utilizes evidence-based and standard practices used by other perinatal quality collaboratives. We recognize that each hospital is unique and not all of these factors need to be addressed in every facility. Therefore, it is important to use this toolkit to determine what may be relevant to your facility.
REDCap Data Portal Submission Schedule
| Monthly Data Measures* | Due Date | Quarterly Data Measures | Due Date |
| September 2022 | November 30, 2022 | July – September 2022 | November 30, 2022 |
| October 2022 | November 30, 2022 | ||
| November 2022 | December 31, 2022 | ||
| December 2022 | January 31, 2023 | October – December 2022 | January 31, 2023 |
| January 2023 | February 28, 2023 | ||
| February 2023 | March 31, 2023 | ||
| March 2023 | April 30, 2023 | January – March 2023 | April 30, 2023 |
| April 2023 | May 31, 2023 | ||
| May 2023 | June 30, 2023 | ||
| June 2023 | July 31, 2023 | April – June 2023 | July 31, 2023 |
| July 2023 | August 31, 2023 | ||
| August 2023 | September 30, 2023 | ||
| September 2023 | October 31, 2023 | July – September 2023 | October 31, 2023 |
| October 2023 | November 30, 2023 | ||
| November 2023 | December 31, 2023 | ||
| December 2023 | January 31, 2024 | October – December 2023 | January 31, 2024 |
*Links for monthly data collection will be shared with data entry designees on the first of each month.
Data Resources
Key Documents
- NOWS Charter (June 2022)
- NOWS Getting Started Kit (June 2022)
- NOWS Toolkit & Checklist
- NOWS Driver Diagram
- NOWS Team Roster
- Worksheets
- PDSA
Care Team Education
- Increase Use of Patient-Centered Language
- Beyond Labels: Do Your Part to Reduce Stigma
- Disrupting Stigma: How understanding, empathy, and connection can improve outcomes for families affected by substance use and mental disorders (NEW)
- Say This Not That – Language Matters
- Stop Judging, Start Healing Campaign (ADPH, ADMH)
- SAMHSA Words Matter: How Language Choice Can Reduce Stigma
- OPQC Substance Abuse 101: MythBusters
- Reducing Stigma Education Tools (ReSET) Modules – PCSS
- Stigma and Opioid Use Disorder Webinar: What Pediatricians Need to know in Caring for Mothers and Children (AAP)
- General Resources
- Maternal-Infant Health and Opioid Use: Education and Professional Development (AAP)
- Recovery-Friendly Family-centered Pediatrics (AAP)
- PCSS Resources for Health Professionals, Patients and Community
- IHI Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care
- SAMHSA: Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants
- Provider Education Resources, FPQC
- Partner with Mothers to Seek and Support Recovery Post Prenatal Opioid Exposure
- National Clinician Consultation Center: Substance Use Management
- Peer Support in the Neonatal OB Department
- Naloxone
- Safe Sleep
Withdrawal Scoring Consistency
Nonpharmacologic Care & Keeping Mother-Baby Dyad Together
- ALPQC NOWS Toolkit Nonpharmacologic Management
- Non-Pharmacologic Care Definition
- How to Care for a Baby with NAS Infographics
- Eat, Sleep, Console: a family-centered approach to manage NAS (OPQIC)
- Eat Sleep Console Simulation & Debrief Video (ILPQC)
- Engaging Mom in Nonpharmacologic Care Simulation & Debrief Video (ILPQC)
- Sample Rooming-In policy for mother-infant dyad impacted by in-utero opiod exposure (Baystate Children’s Hospital, IL)
- Improve Infant Nutrition and Breastfeeding
Pharmacologic Care Consistency
Collaborative Discharge Plan & Patient Education
- ALPQC NOWS Toolkit: Creating a Collaborative Discharge Plan
- NOWS: Planning the Mother-Infant Dyad Discharge (AAP)
- Collaborative Discharge Tools
- Peer Support
- Naloxone education
- Family Education
- Other resources:
- Virtual Recovery Resources – SAMHSA (NEW)
- Medication-Assisted Treatment – SAMHSA
- Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and Their Infants – SAMHSA
- ACOG District II OUD in Pregnancy Resource
- Obstetric Care for Women with Opioid Use Disorder, AIM Bundle
- Prenatal Consultation Guidelines, ILPQC
- NNEPQIN: Federal Legislation Regarding Infant Plan of Safe Care
Additional Resources
- ALPQC NOWS Toolkit Additional Resources
- Illinois Perinatal Quality Collaborative – Mothers and Newborns Affected by Opioids (MNO), Neonatal Initiative
- Florida Perinatal Quality Collaborative – NAS Initiative
- Ohio Perinatal Quality Collaborative – NAS Project
- Northern New England Perinatal Quality Improvement Network – Toolkit for the Care of Substance Exposed Newborns
- AAP Clinical Report: Neonatal Opioid Withdrawal Syndrome
- AAP Policy Statement: A Public Health Response to Opioid Use in Pregnancy
- AAP Clinical Report: Promoting Optimal Development: Identifying Infants and Young Children with Developmental Disorders Through Developmental Surveillance and Screening
- ILPQC MNO Prenatal Consultation Guidelines
Webinar Slides
- Action Period Call: Addressing Implicit Bias and Health Disparities in a Level IV NICU – January 2023 | Slides| Recording
- Action Period Call: Hospital Team Share & PDSA Cycles Review – December 2022 | Slides
- Action Period Call: Reviewing Baseline Data & Benchmarks – October 2022 | Slides
- Action Period Call: Do Less Harm – September 2022 | Slides | Recording
- Action Period Call: NOWS Call to Action – August 2022 | Slides
- 2022 Learning Session 1.2 : QI and Data – July 2022 | Slides | Recording
- 2022 Learning Session 1: NOWS Overview – July 2022 | Slides | Recordings:
- Withdrawal Scoring – July 2021
- Non-Pharmalogic Management – June 2021
- Baseline Data & Infant Discharge – May 2021
- Supportive Maternal Discharge – April 2021
- Baseline Data Collection Review & PDSA Cycles – March 2021
- Collecting and Entering Data – February 2021
- Learning Session 1 – January 2021
- ALPQC 2020 Summit
