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Objective <p>Infants in the NICU often require prolonged sedation, increasing risk for iatrogenic withdrawal. We aimed to reduce mean opioid exposure by 20% (26 to 21 days) by May 2023, with sustained improvement through May 2024.</p> Study design <p>A multidisciplinary team used the Model for Improvement with iterative Plan-Do-Study-Act cycles and EHR tools to implement a standardized sedation-weaning guideline. Applicable outcome, process, and balancing measures were analyzed using statistical process control charts.</p> Results <p>Among patients receiving &gt;4 days of opioids, mean exposure decreased from 26 to 17 days, length of stay from 70 to 50 days; and overall dexmedetomidine exposure from 18 to 12 days. Adherence to individualized weaning plans improved and feedback indicated effective withdrawal management.</p> Conclusions <p>Standardized weaning reduced opioid exposure, LOS, and sedative use, enhancing safety, care quality, and NICU capacity.</p>

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Tiny doses, big impact: Optimizing sedation weaning to reduce opioid use in a Level IV NICU

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月29日

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  • Tara Glenn,
  • Jeanne Carroll,
  • Amy Kimball,
  • Mark Speziale,
  • Gale Romanowski,
  • Nona Chamankhah,
  • Halli Helgeson,
  • Elaine Sim,
  • Jennifer Kimmel,
  • Jane Kang,
  • Amie Wong,
  • Peggy Grimm,
  • Michael Van Gorder,
  • Danielle Heath,
  • Laurel Moyer

摘要

Objective

Infants in the NICU often require prolonged sedation, increasing risk for iatrogenic withdrawal. We aimed to reduce mean opioid exposure by 20% (26 to 21 days) by May 2023, with sustained improvement through May 2024.

Study design

A multidisciplinary team used the Model for Improvement with iterative Plan-Do-Study-Act cycles and EHR tools to implement a standardized sedation-weaning guideline. Applicable outcome, process, and balancing measures were analyzed using statistical process control charts.

Results

Among patients receiving >4 days of opioids, mean exposure decreased from 26 to 17 days, length of stay from 70 to 50 days; and overall dexmedetomidine exposure from 18 to 12 days. Adherence to individualized weaning plans improved and feedback indicated effective withdrawal management.

Conclusions

Standardized weaning reduced opioid exposure, LOS, and sedative use, enhancing safety, care quality, and NICU capacity.