This is a pivotal study that shows using the Eat Sleep Console approach, including the ESC Care Tool, is a safe and effective way to care for babies with prenatal opioid exposure.
Bonny Whalen, MDA groundbreaking multi-centered clinical trial in which pediatricians, neonatologists, 十大网赌平台推荐希区柯克医疗中心十大网赌平台推荐健康儿童医院(CHaD)和新英格兰北部围产期质量改善网络(NNEPQIN)的护士教育工作者发挥了关键作用，证明了安全护理新生儿阿片类药物戒断综合征(NOWS)婴儿的有效方法，大大减少了新生儿产后对阿片类药物的接触，减少了他们的住院时间.
“Eating, Sleeping and Consoling for Neonatal Opioid Withdrawal,” recently published in the New England Journal of Medicine is 这是第一个比较饮食睡眠控制台(ESC)护理工具©与使用21项正式评分方法的传统医院护理模式的大型多中心试验 Finnegan Neonatal Abstinence Scoring System. The ESC Care Tool was developed in 2016 by pediatricians Bonny Whalen, MD and Kate MacMillan, MD, MPH at CHaD, Matthew Grossman, MD at Yale-New Haven Children’s Hospital, Susan Minear, MD and neonatologist Elisha Wachman, MD at Boston Medical Center.
“This is a pivotal study that shows using the Eat Sleep Console approach, including the ESC Care Tool, is a safe and effective way to care for babies with prenatal opioid exposure,” said Whalen. “这将有助于改变美国和国际上对婴儿及其家庭的护理，鼓励并授权父母成为孩子的一线治疗。, 在他们自己的房间里用爱和关注照顾他们，只有在婴儿需要更多帮助时才给他们药物. This approach promotes bonding and attachment, factors known to improve neurodevelopment and long-term outcomes in children. 限制婴儿接触阿片类药物的总量也可能改善发育结果.”
The ESC Care Tool is a structured, standardized, baby- and family-centered care tool based on the innovative Eat, Sleep, Console approach developed by Grossman at Yale, 哪个医疗决策的重点是这三个主要的新生儿功能，而不是阿片类药物戒断的婴儿可能会经历的无数症状，比如 tremors, excessive crying and irritability. 开发该工具是为了帮助支持医院对接触阿片类药物的新生儿进行正式评估和标准化护理, 同时促进父母作为新生儿的主要照顾者，并鼓励使用皮肤对皮肤等非药物护理干预措施, rooming-in of parents with their infants, holding, swaddling, breastfeeding, and a calm environment as effective methods to improve withdrawal symptoms.
Boston Medical Center first piloted the ESC Care Tool 2016年，十大网赌平台推荐希区柯克医疗中心儿童医院成为下一家正式将ESC护理工具应用于阿片类药物暴露新生儿临床护理的新英格兰医院，并根据提供者和家庭反馈进行了改进. To date, 超过55家医院参加了新英格兰北部的正式质量改进倡议, including all 17 New Hampshire birthing hospitals, 是否在新生儿护理中实施了ESC护理工具，提供者和家庭对这种新的护理模式总体上感到满意.
Using this preliminary work, principal investigators of the ESC-NOW trial - Leslie Young, 佛蒙特大学(UVM)儿童医院的医学博士和路易斯维尔大学的洛里·德夫林博士, 与Whalen和MacMillan合作，在他们的临床试验中使用ESC护理工具，目的是调查ESC方法与全国“常规”医院护理相比的临床疗效和安全性. 该试验由IDeA国家儿科临床试验网络(十大网赌平台推荐希区柯克医学中心是18个参与站点之一)和NICHD新生儿研究网络的合作伙伴进行.
26家美国医院接受了由专家教师以高度可靠的方式使用ESC护理工具的正式培训, including Whalen, MacMillan, neonatologist Adrienne Pahl, MD from UVM, 以及来自温特沃斯道格拉斯医院和法拉的护士教育家/领导者凯蒂·怀特 Sheehan, MSN, RN, IBCLC from the Geisel School of Medicine at Dartmouth.
In the ESC-NOW clinical trial, which included more than 1300 infants, 研究人员发现，采用ESC方法护理的婴儿在医学上约为出院做好了准备.7 days earlier (8.2 vs 14.9 days) and were 63% less likely to receive opioid medication treatment (19.5% vs 52%)，与使用传统的基于finnegan的评分方法护理的新生儿相比.
正在对一部分婴儿进行为期两年的随访研究，以监测包括婴儿神经发育在内的其他婴儿和家庭福利措施, 并将进一步告知ESC护理方法在新英格兰北部和全国范围内护理阿片类药物暴露新生儿的安全性. 该试验由帮助结束成瘾长期倡议或NIH HEAL倡议资助®这是一个跨机构的努力，旨在加快科学解决方案，遏制全国阿片类药物危机.
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十大网赌平台推荐健康儿童医院是该地区唯一的综合性儿科医疗保健系统. Fully integrated in Dartmouth Health 在黎巴嫩十大网赌平台推荐希区柯克医疗中心(CHaD)儿童医院工作了30多年, NH—Dartmouth Health Children's promotes health, advances knowledge, and delivers the best patient and family-centered care for infants, children, and adolescents across New Hampshire and Vermont. 十大网赌平台推荐健康儿童医院作为十大网赌平台推荐盖泽尔医学院的主要儿科合作伙伴，进行开创性的研究并教育下一代的卫生专业人员. 高技能和协作性的儿童保健专业人员在整个区域的多种环境中提供护理. 十大网赌平台推荐希区柯克医疗中心(CHaD)的儿童医院和曼彻斯特十大网赌平台推荐希区柯克诊所提供专科门诊和当日手术服务. 普通儿科的初级保健预约在贝德福德的十大网赌平台推荐希区柯克诊所提供, Concord, Lebanon, Manchester and Nashua, NH and Bennington, VT; as well as at Dartmouth Health members: Alice Peck Day Memorial Hospital, Cheshire Medical Center, New London Hospital and Mt. Ascutney Hospital and Health Center.