Abstract
Context: A high alert medication (HAM) is a medication that causes serious harm if it is used in error. Neonatal nurses are responsible for administering HAMs; incorrect administration can significantly affect clinical outcomes.
 Aim: The study aimed to evaluate the effectiveness of nursing guidelines on nurses' performance regarding HAMs at neonatal intensive care units (NICUs).
 Methods: A quasi-experimental design (pre/post-test) was utilized. The study was conducted at NICUs in Children's Hospital and Maternity and Gynecological Hospital affiliated to Ain Shams University. A convenience sample of 80 nurses caring for high-risk neonates was included in the current study from the previous setting for six months. Two tools were used to collect data. They are a structured interview questionnaire and nurses’ performance observational checklist.
 Results: The nurse's mean age was 27.79±6.83. 35% of them have worked part-time jobs. A highly statistically significant improvement was shown post-test compared to the pre-test regarding the nurses' knowledge and practices about HAMs at 0.001.
 Conclusion: The present study concludes that applying nursing guidelines interventions improved the neonatal nurses' knowledge and practice related to HAMs. The study recommended emphasizing the importance of using nursing guidelines of HAMs interventions for improving neonatal nurses' knowledge and practices at NICUs.
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