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Neonatal Abstinence Syndrome

Exploring Nurses' Attitudes, Knowledge, and Practice

Romisher, Rachael, BSN; Hill, Deanna, BSN, RNC-NIC; Cong, Xiaomei, PhD, RN

Section Editor(s): Dowling, Donna PhD, RN; ; Thibeau, Shelley PhD, RNC-NIC;

doi: 10.1097/ANC.0000000000000462
Original Research

Background: As opioid abuse increases in the United States, the rate of neonatal abstinence syndrome (NAS) rises dramatically. Caring for infants with NAS and their families is a significant challenge to neonatal nurses.

Purpose: The purpose of this survey study was to explore attitudes and practice trends among nurses caring for infants with NAS. The study also aimed to identify any gaps in knowledge about NAS.

Method: An anonymous, cross-sectional survey study was conducted using a researcher-developed questionnaire. The survey questionnaire included 20 Likert-scale questions regarding nurses' attitudes, knowledge, and practice in care of infants with NAS, 1 case study with 3 questions, and 2 open-ended questions. Nurses, including advanced practice nurses and nurse leaders, were invited to participate at a regional neonatal nursing conference in the New England area.

Results: A total of 54 participants responded, the majority being white, female, non-Hispanic, and bachelor's prepared. Many nurses shared concerns regarding the setting in which infants with NAS are cared for. Nurses expressed varying attitudes regarding interacting with the mothers but generally wanted to build a partnership with them. Nurses also reported a lack of standardized and consistent practice in care for infants with NAS. Three major themes were identified from open-ended questions, including environmental issues, relationship with the mother, and inconsistency in care.

Implications for Practice: Further research is needed for nurses providing care to infants with NAS. Specific education programs are needed for nurses who are caring for infants with NAS.

Implications for Research: Further research is needed regarding the effects of NAS on nurses and other healthcare providers.

University of Connecticut, School of Nursing, Storrs (Ms Romisher and Dr Cong); and Connecticut Children's Medical Center, Neonatal Intensive Care Unit, Hartford (Ms Hill).

Correspondence: Xiaomei Cong, PhD, RN, University of Connecticut, School of Nursing, Center for Advancement in Managing Pain (CAMP), 231 Glenbrook Rd, Unit 4026, Storrs, CT (

The authors declare no conflicts of interest.

This work was conducted at the University of Connecticut School of Nursing.

© 2018 by The National Association of Neonatal Nurses