Preferred Name

Rebekah Draper

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.


Date of Graduation


Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing


Erica Lewis

Milena Staykova

Jennifer Martin



Background: Neonatal abstinence syndrome (NAS) is increasing in the United States as a result of increased opioid-use disorder among women of childbearing age. NAS affects three out of four babies who are exposed to chronic use of opioids during the mother’s pregnancy. Caring for infants with NAS is challenging. Researchers have identified a deficit of knowledge and skills, and have discovered judgmental attitude of nurses caring for babies with NAS. Globally, nurses caring for infants with NAS need education on current evidence-based practice to improve quality of care. The purpose of this project was to create an educational intervention based on assessed, localized, educational needs for NICU staff nurses caring for babies experiencing NAS. Methods: This project used the design thinking implementation framework and IHI Psychology of Change framework to assess the needs of NICU nurses caring for infants experiencing NAS and develop related education. A baseline survey of the nurses’ knowledge, attitudes, and practices was done. Similarly, nurse stakeholder interviews were completed and themes were analyzed using thematic content analysis to further specify localized needs. Educational materials were prototyped in subsequent interviews with the nurses until the materials were found useful. Findings/Results: RNs correctly identified symptoms and treatment for NAS. RNs overall felt empathy for infants with NAS, but less empathetic towards the infant’s mothers and blamed them for the infant’s health problems. The RNs were confident in their knowledge to provide adequate care for the infants but self-identified a need for improvement in knowledge, care, and documentation. RNs appropriately use nonpharmacological treatment, but desire more education in the interventions. Other areas for needed improvement were medication treatment, in-home and outpatient care, and parameters for breastfeeding. RNs identified educational needs through interviews and provided feedback on the two prototypes created using empathy mapping. Conclusions: The proposed next step is to implement the designed educational intervention and study related outcomes. The IHI Psychology of Change Framework and the design thinking process, when combined, offer a strong method for participant engagement. The design thinking process may be important to timely and effective care in-so-much that it allows flexibility to change as the context changes.



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