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Implementing Practice Guidelines and Education to Improve Care of Infants With Neonatal Abstinence Syndrome

Lucas, Katherine DNP, APRN, NNP-BC; Knobel, Robin B. PhD, RN

Section Editor(s): Dowling, Donna

doi: 10.1097/ANC.0b013e318241bd73
Original Research

PURPOSE: To develop and implement a program for the management of neonatal abstinence syndrome (NAS) and the use of the Finnegan Neonatal Abstinence Scoring Tool (FNAST). We evaluated knowledge gain in nurses as a result of implementation of the practice guidelines and education.

SUBJECTS: Participants included 68 nurses employed in a neonatal intensive care unit (NICU) at a single facility.

DESIGN: A nonexperimental, pretest/posttest study evaluated change in nursing knowledge about NAS and the use of the FNAST after implementation of evidence-based clinical practice guidelines and an educational project.

METHODS: Nurses were tested before and after participation in education about NAS. A subset of 10 nurses was evaluated using the FNAST with videos of infants having NAS.

RESULTS: Volunteer participation in the NAS educational project occurred in 81% of the NICU nurses. All nurses showed some improvement in scores on the posttest, with 2% to 44% improvement. All 10 nurses who participated in the interactive DVD test scored 90% or more against the FNAST criterion 1 week after participation in the educational project.

CONCLUSION: Evidence-based clinical practice guidelines and education around NAS and the FNAST equip caregivers with the necessary tools to consistently and accurately assess an infant with NAS when using the FNAST.

Department of Nursing, Cape Fear Valley Health System, Fayetteville, North Carolina (Dr Lucas); and Duke University School of Nursing, Durham, North Carolina (Drs Lucas and Knobel).

Correspondence: Katherine Lucas, DNP, APRN, NNP-BC, 3937 Nikita D, Hope Mills, NC 28348 (

The work occurred at the Cape Fear Valley Health System Neonatal Intensive Care Unit, Fayetteville, North Carolina.

The authors declare no conflict of interest.

© 2012 National Association of Neonatal Nurses