Mothers and Newborns Affected by Opioids – OB
10x
The increase in pregnancy-associated deaths from opioid poisonings in IL between 2008 and 2017.
100
37.5%
65%
New Angel’s Story Naloxne Video for Providers and Nurses
Transforming Care to Save Mothers from Overdose Death
Objectives:
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1.Screen every pregnant patient for OUD with a validated screening tool
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2.Assess readiness for and starting Medication-Assisted Treatment (MAT) and linking to Recovery Treatment Programs
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3.Complete an OUD Clinical Care Checklist, which includes providing Naloxone (Narcan) counsling and prescription
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4.Reduce stigma and bias across the clinical team
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5.Empower mothers through education to use non-pharmacologic care for their newborns exposed to opioids
MNO – OB Clinical Leadership
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Barb Parilla
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Jaye Shyken
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David Ouyang
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Ann Borders
Webinars
- Upcoming Webinars
- 2023 Sustainability Webinars
- 2021 Sustainability Webinars
- 2020 Webinars
- 2019 Webinars
- 2018 Webinars
- 2017 Webinars
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Upcoming Webinars
MNO-OB Teams Call
The ILPQC MNO-OB teams call meets monthly on the 4th Monday of the month.
Please see the main page of ilpqc.org for all meeting dates and times.
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2023 Sustainability Webinars
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2021 Sustainability Webinars
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2020 Webinars
January 2020: Key Strategies for Success
and Creating a Crossing the Finish Line PlanFebruary 2020: Strategies to Cross the Finish Line-Round Robin Part 1:Screening, MNO Folders, OB Education, Missed Opp. Review
June 2020: MNO-OB Strategies to Cross the Finish Line
July 2020: MNO-OB Strategies to Cross the Finish Line
August 2020: MNO-OB Strategies to Cross the Finish Line
September 2020: MNO-OB Strategies to Cross the Finish Line
November 2020: MNO-OB Strategies to Cross the Finish Line
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2019 Webinars
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2018 Webinars
January 2018: MNO Wave 1 Team Launch Call
February 2018: MNO OB Wave 1 Teams Call
March 2018: MNO OB Wave 1 Teams Call
June 2018: MNO-OB Teams Call: Screening and Linkage to Care: Part One Screening
October 2018: MNO-OB Teams Call: Addressing Stigma & Bias Education for Providers, Nurses, and Staff
November 2018: MNO-OB Teams Call: Standardizing Education for Mothers with OUD Prenatally and on L&D
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2017 Webinars
Toolkit
- MNO-OB Sustainability (2021+)
- Initiative QI & Data Resources
- National Resources
- Universal Screening tools
- OUD/SBIRT Clinical Algorithm Implementation
- OUD Protocol
- Mapping Local Treatment & Services for OUD
- OUD Clinical Care Checklist & Protocols
- Narcan Counseling and Prescribing
- MNO-OB Folder
- Provider/Staff & Patient Education
- Prevention
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MNO-OB Sustainability (2021+)
IL MAR-NOW:
Callers can access MAR NOW 24 hours a day, 7 days a week. Care Managers help callers determine their best treatment options and connect them to a provider for an immediate telephone appointment and medication prescription. Care Managers can also facilitate a same- or next-day, in-person appointment. All callers are connected to ongoing treatment with a community provider that best meets their needs.
New Narcan Resources!
- Example Free Narcan and Test Trip Access Protocol from UCMC (March 2023)
- IDHS IDHS/SUPR Drug Overdose Prevention Program (DOPP)
- Narcan Education:
Sustainability Information:
- MNO-OB Sustainability Plan (complete with QI team and share with ILPQC & your perinatal network administrator)
LPQC Data System Sustainability Data Forms:
- MNO-OB Monthly Patients with OUD Data Collection form (Updated 2.19.2021)
- Combined MNO-OB & Neonatal Monthly Patients with OUD Data Collection form (Updated 2.19.2021)
- MNO OB Monthly Documentation of Screening for Maternal Opioid Use Disorder *UPDATED*
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Initiative QI & Data Resources
MNO-OB Getting Started
MNO-OB Data Forms and Measures
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- Mothers and Newborns affected by Opioids OB Data Form *UPDATED*
- Mothers and Newborns affected by Opioids OB-Neo Combined Data Form *UPDATED*
- Mothers and Newborns affected by Opioids Monthly Structure Measures Data Form *UPDATED*
- MNO OB Monthly Documentation of Screening for Maternal Opioid Use Disorder *UPDATED*
MNO-OB QI Resources
- Mothers and Newborns Affected by Opioids Initiative Slide Set adapted from ACOG District II Slide Deck and Resources*
- MNO 6 Key Opportunities for Improvement
- Mothers and Newborns affected by Opioids Key Drivers Diagram
- Mothers and Newborns affected by Opioids OB Readiness Survey (Survey Closed, email info@ilpqc.org for survey form)
- Plan-Do-Study-Act Worksheet
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National Resources
Obstetric Care for Women with Opioid Use Disorder Bundle and Resource Listing, by the Alliance for Innovation on Maternal Health (AIM) and Council on Patient Safety in Women’s Healthcare*
ACOG Committee Opinions*
- ACOG Committee Opinion #711: Opioid Use and Opioid Use Disorder in Pregnancy*
- ACOG Committee Opinion #742: Postpartum Pain Management*
- ACOG Committee Opinion #633: Alcohol Abuse and Other Substance Use Disorders
- ACOG Committee Opinion #473: Substance Abuse Reporting and Pregnancy – the Role of the OBGYN
SMFM Resources
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Universal Screening tools
- NEW: Example OUD Screening Worksheet for affiliated prenatal sites
- NEW: Example OB Chair Letter to MNO Teams
- Example screening tools (These tools screen for increased risk of substance abuse. Screen positive patients should be assessed for OUD with follow-up questions and SBIRT protocol)
Additional Screening tools
Comparison and validation of screening tools for substance use in pregnancy: a cross-sectional study conducted in Maryland prenatal clinics
Mothers and Newborns affected by Opioids: Universal Screening for OUD with a Validated Tool Strategies: Workshop presented at the National Academies of Science / Medicine
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OUD/SBIRT Clinical Algorithm Implementation
Key OUT/SBIRT Clinical Algorithm Resources:
- OUD/SBIRT Clinical Algorithm
- MNO-OB Nursing Workflow
- MNO-OB Missed Opportunities Review / Debrief Form – tool to review monthly OUD cases to provide feedback to clinical teams
- ILPQC SBIRT Pocket Card
Additional SBIRT Resources:
- ILPQC MNO-OB Provider / Prenatal Site Letter*
- MA Perinatal SBIRT Pocket Card
- Example IHR Integrated Screening & SBIRT 1-Pager
- Helping women get Treatment: Screening and diagnosis of OUD overview*
- Screening for Substance Use using an SBIRT Framework (step-by-step how to develop a screening protocol)*
- Example Process Flow Map for SBIRT at Initial OB Visit*
- Example Protocol for Women who Endorse or Screen Positive for OUD to Link to Substance Use Care Services*
- Example Algorithm/Process Flow for Substance Use Screening in Pregnancy (Prenatal and Labor and Delivery)*
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OUD Protocol
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Mapping Local Treatment & Services for OUD
Mapping Local Resources for Addiction / Behavioral Health Care for pregnant /postpartum women with OUD
- ILPQC Mapping Tool to map local resources* (Should share document with all units at your hospital that care for pregnant women and affiliated prenatal outpatient sites)
- IDPH Opioid Use Treatment Resources for Pregnant Women with Medicaid in Illinois
- Illinois Department of Children & Family Services (DCFS) Service Provider Identification & Exploration Resource (SPIDER)
- AIM “Questions for States to Consider” Outpatient Engagement Strategies *New*
Buprenorphine Training for OB providers
- SAMHSA MAT Website
- ASAM Treatment of OUD Trainings
- Providers Clinical Support System (PCSS) MAT Education, Mentoring, and Resources
- Providers Clinical Support System (PCSS) MAT Training Courses
- Providers Clinical Support System (PCSS) MAT Clinical Mentoring
- Providers Clinical Support System (PCSS) MAT Resources
- Treatment Improvement Protocol: TIP 40: Clinical Guidelines for the use of Buprenorphine in the Treatment of Opioid Addiction
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OUD Clinical Care Checklist & Protocols
- ILPQC OUD Clinical Care Checklist*
- Example Checklist for Providers for Prenatal/Intrapartum/Postpartum Care of Pregnant Women with Substance Use Disorders*
- Example Checklist to Optimize Prenatal Care for Women with OUD, Chart Template*
- AIM Opioid Use Disorder Chart Checklist *New**
- Example Best Practice Recommendations for Prenatal/Intrapartum/Postpartum Care Complicated by Substance Use Disorders*
- SMFM Consult Series #56, Hepatitis C in pregnancy—updated guidelines
Additional Checklist Resources to Optimize Care for Women with OUD
- Breastfeeding Guidelines for Women with a Substance Use Disorder*
- NNEPQIN – Helping Women Address Behavioral Health and Psychiatric Needs
- NNEPQIN – Strategies for Treating Concurrent Tobacco Use Disorder
- NNEPQIN – Federal Legislation Regarding Infant Plan of Safe Care
- SAMHSA – Clinical Guidance for Treating Pregnant Women and Parenting Women with Opioid Use Disorder and their Infants – Section III: Maternal Postnatal Care (Section III: Maternal Postnatal Care, Factsheets 14-16)
- Prescribing Guidelines from Pennsylvania: Use of Addiction Treatment Medications (MAT) in the Treatment of Pregnant Patients with Opioid Use Disorder
- SAMHSA Clinical Guidance for Treating Pregnant and Parenting Women with Opioid Use Disorder and their Infants: Planning Prior to L&D, Peripartum Pain Relief: SAMHSA – Clinical Guidance for Treating Pregnant Women and Parenting Women with Opioid Use Disorder and their Infants – Section I: Pernatal Care (Section I: Prenatal Care, Factsheets 7 & 8)
- Ohio MOMS Maternal Opiate Medical Support Care Coordination Model
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Narcan Counseling and Prescribing
New Narcan Resources!
- IDHS IDHS/SUPR Drug Overdose Prevention Program (DOPP)
- Narcan Education:
Narcan Resources
- Narcan- Save a Life Poster
- AMA: Help save lives: co-prescribe naloxone to patients at risk of overdose*
- Naloxone Rescue Kit Consultation Checklist*
- Quick Start Guide: Narcan Education for Family Members*
- Narcan Prescription Aid– Bring to Pharmacy to Purchase Narcan Nasal Spray
- IDHS IDHS/SUPR Drug Overdose Prevention Program (DOPP)
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MNO-OB Folder
All MNO-OB Folder Materials (Download all here)
Patient Education Materials (Give to and review with moms)
- Prescription Pain Medicines and Pregnant Women
- NAS- You are the Treatment
- NAS: What you Need to Know
- Contraception Counseling for Women with OUD
Clinical Team Resources (Give to OB & Nurse to complete)
- OUD/SBIRT Clinical Algorithm
- OUD Clinical Care Checklist
- Narcan- Quick start guide & Narcan- Save a Life Poster for OB to review and prescribe to patient
- OUD Protocol
- Nurse Workflow
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Provider/Staff & Patient Education
General Information for Women with OUD
- General patient education: Pain medications, opioids and pregnancy
- Pregnancy and MAT one-pager
- Are you in Treatment or Recovery? Contraception Counseling for Women with OUD, from OPQC
Increase maternal participation in the care of opioid exposed newborns
MNO-OB Provider Education Campaign
- NEW ILPQC MNO-OB eModules for Providers and Nurses
- ACOG’s Newest eModule on Obstetric Care of Patients with Opioid Use Disorder– Earn a maximum of 7 AMA PRA Category 1 Credits!
- Set up an MNO-OB Grand Rounds / OB Provider Meeting by contacting us at info@ilpqc.org
- SBIRT Simulation Guide– includes 4 case studies with sample screening tools and participant assessments.
- Provider Poster (Mom & Baby)
- Provider Poster (Provider & Woman)
- Narcan- Save a Life Poster
- MNO OB Office Flyers
- SBIRT eModules
- Reducing Stigma & Bias Resources
- Words Matter (filmed at ILPQC 5th Annual Conference- 2018) – eModule for Providers, Nurses, and Staff about OUD as a chronic illness, stigma and bias*
- Beyond Labels: Do Your Part to Reduce Stigma (March of Dimes)
Provider/Nursing/Staff Education on OUD
- Free Online CME Courses from UIC College of Medicine (For MD, NP, PAs) including MAT Induction and Follow-up; Trauma Informed Care, NAS and More!
- SBIRT Implementation eModule (90 min)
- Pause Before You Prescribe – ILPQC hand out for all providers / nurses focused on safe prescribing for pregnant women*
- Words Matter: How Language Choice Can Reduce Stigma – Provider / Nurse education
- CDC Guideline for Prescribing Opioids for Chronic Pain – hand out for providers/nurses
- Provider Training with CDC e-modules: Applying CDC Guidelines for Prescribing Opioids
- SMFM Consult Series #56, Hepatitis C in pregnancy—updated guidelines
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Prevention
- Avoid overprescribing at delivery graphic
- A Shared Decision-Making Intervention to Guide Opioid Prescribing After Cesarean Delivery – article and powerpoint tool*
- Example Enhanced Recovery After Surgery (ERAS) Pathway for Cesarean Section*
- Example SBAR: removing opioids from order sets to reduce opioid over prescribing at delivery
- Overview of State Law for ILPMP Lookup and Documentation*
- ILPMP Registration webpage
- ILPMP example script for documentation
**Key Resource
The following material is an example only and not meant to be prescriptive. The resources provided in this toolkit are for informational purposes only. The exclusion of a resource, program, or website does not reflect the quality of that resource, program or website. Note: websites and URLs are subject to change.
Clinical Quick Start Resources
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1. ILPQC SBIRT Pocket Card – resource for OB Provider to provide brief intervention, with SBIRT documentation and billing guidance
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2. OUD/SBIRT Clinical Algorithm – for pregnant/postpartum patients identified with Opioid Use Disorder
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3. Missed Opportunity Review / Debrief – tool to review monthly OUD cases to provide feedback to clinical teams
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4. ILPQC OUD Clinical Care Checklist – tool for OB providers to complete prenatally or by delivery for patients with OUD including Narcan counseling and prescription offer, Hepatitis C screening, peds/neonatal prenatal consult, etc.
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5. Provider Poster (Mom & Baby) – key messaging for OB providers to link pregnant and postpartum women with OUD to MAT, provide Narcan Coulsening, and link to recovery treatment programs
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6. Provider Poster (Provider & Patient) – key messaging every OB provider needs to know to save a mother’s life
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7. Education Poster #1 – Importance of screening all pregnant patients for OUD with a validated screening tool
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8. Education Poster #2 – Key strategies for caring for pregnant/postpartum patients with OUD