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Updated: Apr 26, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Evidence-based nurse-driven interventions for the care of newborns with neonatal abstinence syndrome

Tammy Casper1, Megan Arbour

  • 1Cincinnati Children's Hospital Medical Center (Dr Casper) and College of Nursing, University of Cincinnati (Drs Casper and Arbour), Ohio.

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|July 29, 2014
PubMed

Insights

Neonatal abstinence syndrome (NAS) is increasing, affecting newborns with withdrawal symptoms. This study outlines essential nursing interventions for managing NAS in the NICU, focusing on symptom monitoring and bedside care.

Area of Science:

  • Neonatology
  • Pediatric Nursing
  • Pharmacology

Background:

  • Neonatal abstinence syndrome (NAS) is a significant and growing concern in the US, linked to rising maternal substance use.
  • Infants with NAS experience withdrawal symptoms affecting multiple systems and often require extended neonatal intensive care unit (NICU) stays.
  • Existing research heavily focuses on pharmacologic and physician-led interventions, leaving a gap in evidence-based nursing practices.

Purpose of the Study:

  • To develop a comprehensive nursing clinical practice guideline for the management of NAS in a level IV NICU.
  • To address the lack of specific nursing recommendations for infants experiencing NAS.
  • To provide evidence-based, nursing-driven interventions for NAS care.

Main Methods:

  • A thorough review and analysis of existing literature on NAS management.
  • Interviews with neonatal experts to gather clinical insights and best practices.
  • Development of a clinical practice guideline based on literature review and expert consensus.

Main Results:

  • The guideline incorporates methods for identifying maternal substance use.
  • It specifies the initiation and timing of the Finnegan Scoring System for symptom assessment.
  • It details bedside nursing interventions aimed at reducing withdrawal symptoms in newborns with NAS.

Conclusions:

  • Evidence-based nursing interventions are crucial for effectively managing NAS.
  • Standardized nursing guidelines can improve the care and outcomes for infants with NAS.
  • This guideline provides a framework for nurses to implement targeted interventions for NAS management.

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