Audra is the key facilitator for our community Neonatal Abstinence Syndrome collaborative which was first brought to us through the Vermont Oxford Network. Audra joined the collaborative in 2013, assisting our Neonatal medical director and our lead Neonatal Nurse Practitioner. The main purpose of the collaborative was to provide a family centered approach for parents and their infant when an infant is withdrawing from opiate exposure. Audra led this team as the RN representing the Women's and Children's division. The team tactics were very successful, including:
• Placing the family with their infant in a family centered area where they can receive full support while caring for their baby to include: comfortable rooms, meals, showers, and the support of nursing staff teaching the family how to comfort and care for their withdrawing infant.
• Providing education and coping skills to families and to the infant during their withdrawal stages. The focus was to keep the infant comfortable and decrease the amount of medicinal comforts that some infants do not need if comforted by their caregivers.
• The collaborative started providing neonatal consults to these families prior to delivery in collaboration with Marion County Public Health. This consult provides a direct link to the hospital and introduces the family to what they can expect once their baby is born.
Audra was a key player in this change in practice at Salem Health. She facilitated the planning and follow up meetings throughout the process with the hospital and community players. She met with staff in Mother/Baby, NICU, and Pediatrics to listen to concerns and provide ideas and solutions between nursing staff and the collaborative group. She facilitated nursing education and nursing standards by building electronic tools and teaching those tools to staff in both group and individual settings. The collaborative from 2013-2015 made great progress.
We now have a strong NAS program within our Women's and Children's division that supports both baby and family during this difficult time of withdrawal. This program has identified a large number of NAS infants that we would not have identified prior to consultations. The program has also significantly decreased total length of stay and decreased or completely eliminated the need for opiate intervention when treating these infants.
Audra initiated and co-wrote our current March of Dimes grant. The funds were utilized to provide education to Marion and Polk county healthcare providers who are prescribing opiates to women of child bearing age. Education focuses on the key aspects of prescribing these meds and the risks passed onto the mother's fetus if she were to become pregnant. Audra once again stepped up to not only assist with the grant proposal, but she helped provide the education to the providers in the community. 75% of healthcare providers, including physicians, NP's, dentists, and pharmacists have received this education to help decrease Neonatal Abstinence Syndrome in infants. The education is also provided to public health nurses, WIC certifiers, and nontraditional health care workers in Marion and Polk counties. This education has increased NAS consults and the identification of NAS infants who may be born at risk for withdrawal.
It is impressive the amount of time and energy Audra has put into this collaborative. Her leadership and hard work is making a true difference in a very vulnerable population. We could not have been successful in this arena without her facilitation and passion.