Doctor of Nursing Practice
Psychiatric Mental Health Nurse Practitioner (PMHNP)
Year Degree Awarded
Month Degree Awarded
stigma, therapeutic communication, Facilitating Attuned Interactions, substance use disorder, neonatal intensive care, neonatal abstinence syndrome
Background: The number of newborns exposed to opiates quadrupled in the United States from 1999 to 2014, from 1.5 per 1,000 hospital deliveries to 6.5 per 1,000. Many of these babies are admitted to the neonatal intensive care unit for neonatal abstinence withdrawal syndrome. While neonatal nurses are trained to care for babies exposed to substances in utero, they often struggle to meet the unique psychosocial needs of the babies’ parents. Negative attitudes and strained interactions between neonatal nurses and families with substance use disorders (SUDs) result in subtherapeutic alliances and suboptimal outcomes in neonatal nurseries. Purpose: Educational quality improvement (QI) interventions aimed at reducing stigma and improving therapeutic communication skills and SUD knowledge help neonatal nurses develop a therapeutic alliance with parents with SUDs, thereby improving outcomes. Methods: An educational quality improvement project was designed to meet these objectives based on Facilitating Attuned Interactions (FAN), a conceptual framework and practice model for therapeutic interactions. Results: Stigmatizing attitudes, SUD knowledge, and comfort with FAN processes were measured before and after the class to determine if there were improvements. One-sample t-tests on outcome measures revealed statistically significant improvements with moderate to large effect sizes in stigma (p .021, d-.46), SUD knowledge (p d 2.86), and FAN processes (p d 1.38). Conclusion: This QI project represents an effective, novel intervention that reduces stigma and improves the therapeutic alliance between neonatal nurses and families with SUDs.
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