Presented by

Pam Fisher and Tamara Dowless

Carolinas Medical Center - Pineville
Teaching parents to recognize key signs and
symptoms of narcotic abstinence can lead to
shorter hospital stays, promote more effective
and successful care of these babies at home,
and minimize readmissions.
! Establish trust with the parents and enlist them
as partners; Trust is essential for collaboration
! Empower the parents with knowledge and
confidence; they are an extension of the care the
baby receives in the hospital
! Teach the parents how to respond to their babys
special needs and minimize symptoms
! Ensure that educational tools are easy to use and
appropriate for their level of Health Literacy
! Recognize the parents journey
! Encourage breastfeeding / skin to skin care
! Facilitate visitation
! Share information
! Encourage longer periods of visitation rather
than frequent short visits
! Establish goals for the visits
! What are the parents expectations?
! What are the healthcare teams expectations?
! Coordinate departmental consultations
during the extended visitation times
! Develop a Care Contract
! Encourage parents to call for phone updates
when they are unable to visit

Sample Medical Contract
To be printed on hospital letterhead




Care Contract for Parents of ___________________________
(insert infant name here)

Visitation Schedule (check all that apply)
Between the dates of _____________ the following should be completed:

_____ full days of visitation in NICU (at least 6 hours at the bedside)
(list possible dates here ________________)

_____ overnight stays (depending on unit census)
(list overnight dates here _______________)

Discharge teaching will be complete prior to your baby going home. This will include infant CPR and basic infant care.
These sessions can take place during your visitation as listed above, but before any overnight stays outside of your babys
room.

Skills Required for Discharge (Check all that apply)
Demonstrate effective comfort measures and caring taking techniques.
Demonstrate knowledge of medication needs and ability to give medication properly, including appropriate dosing.
Verbalize and recognition signs and symptoms of withdrawal.
Verbalize when to call pediatrician.
Verbalize when to call 911.

Discharge Referrals
**This section is to be individualized to each infants needs. See example below.**
Home Health RN and PT visits will begin the day after discharge.
Babynet referral is in place for long term developmental follow. They will also make home visits.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________

Barriers / Concerns
Please list any concerns or barriers to completing this contract (for example, work schedule or transportation). Our team will
work with you to connect you with the appropriate resources.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________

_______________________________________ _______________________________________ ________________
Parent Name Parent Signature Date

_______________________________________ _______________________________________ _______________
Hospital team member name (MD, MSW, NNP) Hospital team member signature Date




Patient Sticker
! Basic Knowledge how is their baby different
! Measuring behaviors simple tools for
tracking and treating
! Prevention techniques to minimize
symptoms
! Intervention when to get help
! Typical newborn care
! Basic principles of using the Finnegan
Neonatal Abstinence Scoring Tool (FNAST)
! Identifying common symptoms their baby
displays
! Help parents to identify typical newborn
behavior (i.e. Purple Crying)
! Discuss the babys score as determined with
the Finnegan Neonatal Abstinence Scoring
Tool
! Highlight NAS symptoms that are most
common for each individual baby
! Common measures used include:
! Sleep
! Crying
! Shaking
! Diarrhea
! Sneezing
! Yawning
! Sucking / Feeding
! Spitting
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! Low lights
! Sound control - avoid loud noises, TV, loud
conversations, banging doors, etc.
! Hold/gently rock baby
! Skin to skin/kangaroo care
! Swaddling

! Facilitate a rooming in experience; a
minimum of 2-3 days is optimal
! Utilize the rooming in time to ensure
understanding of teaching using Teach Back
! Encourage and praise their efforts; provide
them with specific feedback
! Reinforce what to watch for at home

! Ask Me 3:
1) What is my babys main problem?
____I understand ____ I need more guidance
2) What do I need to do about it?
____I understand ____I need more guidance
3) Why is it important for me to do this?
____I understand ____I need more guidance
! Teach Back:
____Able to verbalize/demonstrate ____Needs more guidance
! The care of these children requires a
complete team of healthcare providers
INCLUDING THE PARENTS and extensive
education for families.
! When successful, these children go home
sooner and parents can perform more
confidently in their roles.