Background: The incidence of Neonatal Abstinence Syndrome (NAS) has increased nationally; however, only 55% of NICUs indicated having a written NAS treatment plan as recommended by the American Association of Pediatrics. Current practice included symptom management via morphine only; however, non-pharmacological interventions were not routinely delivered.

Purpose: The purpose of this project was to standardize and improve the care provided to patients with NAS.

Methods: A systematic search was conducted using keywords and subject headings from the PICOT question. Retrieved synthesized evidence suggested that adding breastfeeding and rooming-in as first-line treatment options reduced the length of hospital stay and medication treatment. An interprofessional council developed and implemented a comprehensive treatment guideline featuring education on addiction, trauma-informed care, evidence-based NAS treatment options, and Finnegan scoring.

Results: Post-education knowledge assessment scores were 100 percent. Hospital length of stay was reduced from 27 (2017) to 17 days (2019) and the length of morphine treatment was reduced from 34 (2017) to 20 days (2019). Associated hospital all NAS cases costs dropped from $499,709 pre-intervention to $192,573 post-intervention. The guideline is now the standard plan of care to ensure that all NAS patients receive best practice.

Date of publication

Spring 5-2-2020

Document Type

DNP Scholarly Project



Persistent identifier


Committee members

Ellen Fineout-Overholt, PhD., RN, FNAP, FAAN, Christina Chan, MD, Venkat Kakkilaya, MD, Sandra Petersen, DNP, APRN, FNP/GNP-BC, PMHNP, Barbara Haas, Ph.D., RN, Yong Tai Wang, PhD, FACSM


Doctor of Nursing Practice