Assessing the Effects of Auricular Acupressure on Newborns With NAS
| Status: | Not yet recruiting |
|---|---|
| Healthy: | No |
| Age Range: | Any |
| Updated: | 3/28/2019 |
| Start Date: | April 1, 2019 |
| End Date: | September 30, 2020 |
| Contact: | Lindy Edwards, MSN, RN |
| Email: | ledwards6@mymail.vcu.edu |
| Phone: | 804-337-3114 |
Assessing the Effects of Auricular Acupressure on Newborn Behaviors and Withdrawal Signs in Newborns With Neonatal Abstinence Syndrome: A Pilot Study
This study will determine the feasibility of using auricular acupressure as an intervention
in newborns with neonatal abstinence syndrome(NAS). Auricular acupuncture has been used as an
intervention in adults in withdrawal by the National Acupuncture Detoxification Association
with good results. The same points on the ear used by National Acupuncture Detoxification
Association (NADA) will be used in this intervention using a spring-loaded microprobe to
apply minimal pressure instead of needles.
The purpose of this study is to identify barriers to recruiting newborns with NAS; to
identify newborn behaviors during the intervention that determine tolerance of the
intervention, and to compare results of vitals signs and withdrawal scores prior to
intervention and post-intervention.
in newborns with neonatal abstinence syndrome(NAS). Auricular acupuncture has been used as an
intervention in adults in withdrawal by the National Acupuncture Detoxification Association
with good results. The same points on the ear used by National Acupuncture Detoxification
Association (NADA) will be used in this intervention using a spring-loaded microprobe to
apply minimal pressure instead of needles.
The purpose of this study is to identify barriers to recruiting newborns with NAS; to
identify newborn behaviors during the intervention that determine tolerance of the
intervention, and to compare results of vitals signs and withdrawal scores prior to
intervention and post-intervention.
After Institutional Review Board (IRB) approval, the Primary Investigator (PI) will make
daily calls to the units to ascertain whether any newborns have been admitted with a positive
drug screen. The researcher will go to the mother's private room after delivery to explain
the study. Consents and demographic data will be acquired. The PI will make daily calls to
the units to ascertain whether the consented newborns have started on treatment for signs of
withdrawal. Before each intervention visit, the PI will call the unit to confirm the newborns
feeding schedule with the assigned nurse and arrange for a convenient time to perform the
intervention. The intervention will begin on day 1 of pharmacological treatment for
withdrawal signs of NAS by the medical staff. The intervention will be provided six times
over a 2-week period on day 1,3,5,7,9, and 11 of treatment as recommended by the consulting
acupuncturist.
On the day of the intervention the PI will arrive 45 minutes prior to the feeding to perform
the following (1) scrub in, (2) set up the secluded area for treatment if infant is not in a
private room, (3) transport the newborn to the private/secluded area in the nursery/Neonatal
Intensive Care Unit (NICU) if with the mother or in one of the nurseries, (4) perform vital
signs (about 3 minutes) and assess ears for any signs of redness or bruising, (5) implement
the intervention (approximately 5 minutes), and (6) perform vital signs 5 minutes'
post-intervention with post-assessment of ears for any signs of redness or bruising.
Acupressure will be implemented by the PI, using a stainless steel spring-loaded probe to
apply small amounts of pressure to the 5 points on the newborn's inner earlobe. The
stainless-steel probe will be thoroughly cleaned with alcohol between each newborn. Pressure
is given over a 30 second period for each site on the ear and then repeated on the opposite
ear. The proposed study will include a fixed intervention as the same intervention will be
given to all participants in the treatment group.
The behaviors exhibited by the newborn during intervention will be recorded. Distress signs
will be monitored. If they continue for greater than a minute or impede the successful
implementation of the intervention, then the intervention will be stopped. The newborn will
be soothed and comforted for no greater than ten minutes. If calm after soothing, then
intervention will proceed. If the same distress signs are exhibited again, then the
intervention will be stopped for the day.
Five minutes' post-intervention the PI will reassess vital signs. The Modified Finnegan
Scoring Scale (MFSS) will be taken from the chart for the assessment prior to the
intervention and scores immediately post-intervention. Infants who were removed from the
mother's room will be returned. Total time for intervention infants should be approximately
35-40 minutes.
daily calls to the units to ascertain whether any newborns have been admitted with a positive
drug screen. The researcher will go to the mother's private room after delivery to explain
the study. Consents and demographic data will be acquired. The PI will make daily calls to
the units to ascertain whether the consented newborns have started on treatment for signs of
withdrawal. Before each intervention visit, the PI will call the unit to confirm the newborns
feeding schedule with the assigned nurse and arrange for a convenient time to perform the
intervention. The intervention will begin on day 1 of pharmacological treatment for
withdrawal signs of NAS by the medical staff. The intervention will be provided six times
over a 2-week period on day 1,3,5,7,9, and 11 of treatment as recommended by the consulting
acupuncturist.
On the day of the intervention the PI will arrive 45 minutes prior to the feeding to perform
the following (1) scrub in, (2) set up the secluded area for treatment if infant is not in a
private room, (3) transport the newborn to the private/secluded area in the nursery/Neonatal
Intensive Care Unit (NICU) if with the mother or in one of the nurseries, (4) perform vital
signs (about 3 minutes) and assess ears for any signs of redness or bruising, (5) implement
the intervention (approximately 5 minutes), and (6) perform vital signs 5 minutes'
post-intervention with post-assessment of ears for any signs of redness or bruising.
Acupressure will be implemented by the PI, using a stainless steel spring-loaded probe to
apply small amounts of pressure to the 5 points on the newborn's inner earlobe. The
stainless-steel probe will be thoroughly cleaned with alcohol between each newborn. Pressure
is given over a 30 second period for each site on the ear and then repeated on the opposite
ear. The proposed study will include a fixed intervention as the same intervention will be
given to all participants in the treatment group.
The behaviors exhibited by the newborn during intervention will be recorded. Distress signs
will be monitored. If they continue for greater than a minute or impede the successful
implementation of the intervention, then the intervention will be stopped. The newborn will
be soothed and comforted for no greater than ten minutes. If calm after soothing, then
intervention will proceed. If the same distress signs are exhibited again, then the
intervention will be stopped for the day.
Five minutes' post-intervention the PI will reassess vital signs. The Modified Finnegan
Scoring Scale (MFSS) will be taken from the chart for the assessment prior to the
intervention and scores immediately post-intervention. Infants who were removed from the
mother's room will be returned. Total time for intervention infants should be approximately
35-40 minutes.
Inclusion Criteria:
- Greater than 36 weeks gestation
- Newborns with positive drug screen and initiation of treatment for withdrawal
Exclusion Criteria:
- Prematurity (< 36 weeks' gestation)
- Any major disease/ illness at birth (e.g. sepsis, necrotizing enterocolitis,
gastroenteritis, respiratory disease, cardiac anomalies, anatomical malformation of
ears) that could potentially confound the withdrawal symptoms
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