The interaction of neonatal abstinence syndrome and opioid use disorder treatment availability for women insured by medicaid.

OBJECTIVE: This paper will discuss the process of mapping opioid use disorder (OUD) treatment resources for pregnant women and discuss the intersection between treatment resources and rates of neonatal abstinence syndrome (NAS). DESIGN: A resource manual was developed through a systematic process with stakeholders across Illinois. Resources were mapped by county and overlaid with county rates of NAS, using hospital discharge data. RESULTS: Across Illinois, 89 treatment resources were identified for pregnant women insured by Medicaid. Resources were concentrated in 36% of Illinois' counties. Counties with limited treatment resources generally had high rates of NAS. Sixty-six percent of NAS cases among rural Illinois residents had no OUD treatment resources in their county. Rural counties had less access to medication-assisted treatment (MAT), the standard of care for treatment of OUD, compared with other counties across the state. CONCLUSIONS: Efforts to increase OUD treatment options for pregnant women insured by Medicaid should concentrate on geographic areas with limited access and high need.

Using Youth Risk Behavior Survey Data to Create Change: A Guide for 21st-Century School Nurses.

To meet the diverse and complex needs of school-age children, school nurses must practice student-centered, evidence-based, and quality care. As school nurses look to increase the use of data within their practice, the Youth Risk Behavior Survey (YRBS) is an essential source of information about adolescent behaviors that contribute to leading causes of morbidity and mortality. Results from the YRBS are available at the national, state and, in some cases, school district and county level. In addition to providing an overview of the YRBS survey, this article will guide readers on how to implement the survey, access results, and apply the findings within their student population. The use of these data aids nurses who act as leaders within the school community.

Care and Treatment Recommendations for Pregnant Women with Opioid Use Disorder.

BACKGROUND: Recent data suggest a significant increase in use of opioids among pregnant women. In the United States, reported rates of neonatal abstinence syndrome increased from 1.5 per 1,000 to 6.0 per 1,000 live births from 2000 to 2013. Use of opioids, both pharmacologic and nonpharmacologic, during pregnancy exposes women and babies to increased risks of adverse health outcomes. Professional organizations recommend addressing the complex needs of women who use opioids during pregnancy. OBJECTIVE: The purpose is to review the role of nurses in the prenatal setting caring for pregnant women with opioid use disorder. METHODS: We conducted a literature search using the CINAHL, PubMed, and PsycInfo electronic databases through January 2018 to identify best practices for referring women to treatment from the prenatal care office. Search terms included "substance use disorder," "pregnancy," "prenatal care," "referral," and "referral pathway." RESULTS: From our search, 68 abstracts were identified as relevant for review. Eight articles were selected for the analysis based on our focus. The findings assisted in development of our recommendations for nurses. CLINICAL IMPLICATIONS: During prenatal care, nurses can screen for opioid use disorder, develop positive relationships, and refer to treatment. This care should be based on values-neutral strategies to promote healthy outcomes for pregnant women and their babies.

What Is a Nurse?

Traditional images of the profession don't reflect the myriad roles we now play.