Sleep

Training and Integration of Eat, Sleep, Console Model for Infants and Families at an Urban Academic Health Center.

TL;DR

ESC education enhanced preparedness of birthing staff and clinicians to implement the nonpharmacologic ESC tool for management of neonatal opioid withdrawal syndrome, with coordinated, multidisciplinary education and collaboration supporting successful implementation in clinical settings.

Key Findings

Training 254 participants in the Eat, Sleep, Console (ESC) approach resulted in statistically significant improvement in self-rated preparedness to use nonpharmacologic interventions.

  • Mean preparedness score improved from 3.91 (pretraining) to 4.64 (posttraining) on a 5-point scale where 1 = strongly disagree and 5 = strongly agree
  • Improvement was statistically significant (p = .03) based on paired pre- and posttraining surveys
  • Only 11 participants completed both pre- and posttraining surveys, forming the paired survey group
  • 88 total participants completed pre- or posttraining surveys out of 254 trained

Pre/posttraining unpaired survey results indicated high levels of preparedness implementing ESC concepts among participants.

  • 88 participants completed pre- or posttraining surveys
  • Unpaired survey analysis was used given the low number of participants completing both surveys (n = 11)
  • High levels of preparedness were reported in implementing ESC concepts across the unpaired survey group

A multidisciplinary group of 254 perinatal and neonatal staff and clinicians were trained in the ESC approach across an urban academic health center.

  • Participants included nurses, OB/GYN and family medicine attending physicians and residents, neonatal advanced practice clinicians, midwives, and social workers
  • Training took place on labor and delivery and neonatal intensive care units
  • Training sessions were 30 to 60 minutes in length and delivered virtually
  • The knowledge-to-action framework was used to guide project design and implementation

The ESC training program was developed as an alternative to the Finnegan Neonatal Abstinence Scoring System (FNASS) for managing neonatal opioid withdrawal syndrome (NOWS).

  • The current standard FNASS requires waking neonates to assess NOWS and prioritizes pharmacotherapy treatment
  • ESC focuses on infants' abilities to function and cope with opioid withdrawal and prioritizes nonpharmacologic interventions
  • ESC emphasizes the crucial role of the parent-infant relationship
  • The training program included an ESC algorithm for care in addition to didactic sessions and surveys

What This Means

This research describes the development and delivery of a training program to teach hospital staff a newer, more family-centered approach to caring for newborns experiencing opioid withdrawal, known as neonatal opioid withdrawal syndrome (NOWS). The Eat, Sleep, Console (ESC) method evaluates whether a baby can eat, sleep, and be comforted, and prioritizes non-medication strategies and parental involvement rather than relying primarily on scoring systems and drug treatment. The program trained 254 staff members — including nurses, doctors, midwives, and social workers — through virtual sessions of 30 to 60 minutes across labor/delivery and neonatal intensive care settings at one urban academic hospital. This research suggests that the training meaningfully improved staff confidence in using non-medication approaches to help babies through withdrawal. Among the small group of 11 participants who completed surveys both before and after training, self-rated preparedness scores rose significantly, from an average of 3.91 to 4.64 out of 5 (p = .03). A broader group of 88 survey respondents also showed high levels of preparedness in implementing ESC concepts after training, though the overall survey completion rate was relatively low compared to the number trained. The practical implication of this work is that a structured, multidisciplinary educational program can prepare diverse hospital teams to shift toward a more humane, family-centered model of newborn withdrawal care. By training staff from multiple disciplines together and providing a clear clinical algorithm, hospitals may be better positioned to reduce unnecessary medication use and strengthen the bond between parents and their newborns during a vulnerable period.

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Citation

Conti S, Chin J, Kemble K, Witham B, Yoder K, Pattison A, et al.. (2026). Training and Integration of Eat, Sleep, Console Model for Infants and Families at an Urban Academic Health Center.. MedEdPORTAL : the journal of teaching and learning resources. https://doi.org/10.15766/mep_2374-8265.11583