AKPQC Substance-Exposed Newborns Initiative
AKPQC Substance-Exposed Newborns Initiative (SENI)
The Alaska Perinatal Quality Collaborative is developing a neonatal initiative to improve care for substance-exposed newborns and their families. As a first step in this initiative, the AKPQC is partnering with the State of Alaska Substance-Exposed Newborns Initiative (SENI) to promote universal verbal prenatal screening utilizing a validated screening tool. The SENI tool relies on the 4P’s Plus©, the only screening instrument for tobacco, drugs, and alcohol that is specifically validated for pregnant people.
SENI is pleased to announce a new partnership with the Alaska Center for Substance Use in Pregnancy and the Newborn, Inc. (ACSUPN). The fundamental mission of ACSUPN is “to help mothers have the healthiest possible pregnancy, to spare their newborn the pain and trauma of substance withdrawal, and to advance their collective futures as a family.” William (Bill) Trawick, NNP-BC, ACSUPN Executive Director, will be collaborating with SENI staff to develop and implement trainings focused on universal screening utilizing the SENI tool and appropriate management of newborns with substance exposure. Bill has been practicing within the neonatal intensive care environment for 35 years, and he has been an integral partner throughout the development and implementation of SENI.
SENI is expanding to offer the screening tool and support to additional hospitals, outpatient facilities, birth centers, and midwifery practices. If your facility or practice is interested in screening childbearing people for substances utilizing the validated SENI tool, please email [email protected].
The 4Ps Plus© is a copyrighted instrument with a licensing fee paid for by the State of Alaska. The SENI Screening Tool many not be used, reproduced, or distributed without the written consent of the SENI Program.
Please note that most patients will only require completion of the top half of the tool. The bottom of the tool is completed when a person indicates that they had “any” tobacco, alcohol, or marijuana in the month before they were pregnant.
In 2016, the Alaska Department of Health and Social Services (DHSS) Divisions of Behavioral (DBH) and Public Health (DPH), Office of Substance Misuse and Addiction Prevention (OSMAP), and hospitals in Anchorage, Fairbanks, Juneau, and Palmer launched a project to screen childbearing people being admitted for childbirth for harmful substances, domestic violence, depression, and desire for subsequent pregnancy. The goal of the project was to support clinicians to provide evidence-based care for pregnant woman and their infants. By early 2017, the project evolved into the Alaska Prenatal Screening Program (APSP).
In February 2017, Alaska’s Governor issued a disaster declaration for Alaska’s opioid epidemic. The magnitude of the epidemic’s impact among Medicaid-covered childbearing people and infants born during 2007-2016, was astounding, with their rate of Neonatal Abstinence Syndrome increasing from 4.4 to 16.9 cases per 1,000 live births.
By July 2019, the APSP had screened 2,298 childbearing people. Later that year the program re-branded and became the Substance Exposed Newborns Initiative (SENI) as the focus of the program expanded into inclusion of promoting screening in outpatient prenatal care settings.
In January 2020, the AKPQC began supporting SENI with a goal to include recommendations and resources for infant toxicology testing, optimizing non-pharmacologic management, standards for pharmacologic management, as well as Plans of Safe Care and full spectrum community support services for infants and families with substance exposure.
Background and Foundational Resources
- A Public Health Response to Opioid Use in Pregnancy
- ACOG Committee Opinion Number 711: Opioid Use and Opioid Use Disorder in Pregnancy
- ACOG Committee Opinion Number 736: Optimizing Postpartum Care
- Neonatal Abstinence Syndrome and Ethical Approaches to the Identification of Pregnant Women Who Use Drugs
- SAMHSA Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
- The 4P’s Plus© Screening Instrument
SENI has a limited supply of Nourishing Connections: A Guide for Healthy Breastfeeding by Ira Chasnoff, MD. This is a helpful guide for health care workers to use to educate and counsel patients who are breastfeeding and using substances. If you would like to order a copy of this guide at no cost for your hospital, birth center, or midwifery practice, please email [email protected]
Stay tuned to this webpage for more information and initiative resources.
Contact the SENI Program at [email protected] or 907-269-3426.