Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Leslie Scott

Clinical Mentor

Dr. Nicole Garritano

Committee Member

Kara Smith


Neonatal Abstinence Syndrome (NAS) is a condition in which an infant experiences withdrawal from uterine exposure to various substances such as caffeine, nicotine, amphetamines, THC, opioids, benzodiazepines, and other types of substances. Depending on the severity of the symptoms, these infants may experience a longer hospital stay and may need treatment and monitoring in the neonatal intensive care unit (NICU), resulting in an increase in healthcare costs. The objective of this project was to determine if targeted drug screening of newborns was effective in determining infants at risk of NAS based on a positive screening result. This study utilized a retrospective, cross-sectional electronic health record (EHR) review of infants born between September 1st, 2015 and September 1st, 2016 who met criteria for umbilical cord drug screening. Rates of umbilical cord drug screening and screening results were compared to risk factors associated with targeted drug screening criteria to determine which risk factor criteria were predictive of a positive umbilical cord drug screening result. The EHR records of 340 infants met criteria. Risk factors associated with targeted drug screening criteria were not significantly sensitive nor specific in predicting infants at risk of NAS based on positive drug screen results. In order to truly identify all infants at risk for withdrawal, universal screening is recommended.