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Updated: May 25, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Implementing practice guidelines and education to improve care of infants with neonatal abstinence syndrome
Katherine Lucas1, Robin B Knobel
1Department of Nursing, Cape Fear Valley Health System, Fayetteville, North Carolina, USA.
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.
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