Evaluation of a Neonatal Abstinence Syndrome Training Program on Correct Use of the Finnegan Scoring Tool and Nurse Confidence

Angela Clark, Eastern Kentucky University


Maternal substance abuse during pregnancy is a growing perinatal problem. Drug-exposed infants are at risk of Neonatal Abstinence Syndrome (NAS) as a result of withdrawal symptoms. The Finnegan Scoring Tool (FST) can be used to identify infants showing withdrawal symptoms but must be used correctly. Educational programs that demonstrate correct use of the FST have been shown to improve accuracy and nurse confidence. A voluntary, convenience sample of nurses from three units participated in a project to evaluate the impact of a NAS training program on correct use of the FST and nurse confidence. Using a pre/post-test design, participants improved accuracy by 29.4% at post-training. The accuracy goal of at least 90% inter-observer reliability for NAS scoring was achieved post-training, but the benchmark was not retained at follow-up. However, identification of correct total NAS score did not always correlate to accurate symptom identification. There was a statistically significant increase in confidence from pre-training to post-training. Participants reported positive project feedback and need for additional training. Nurses need advanced NAS training in order to improve symptom detection that will in turn impact patient outcomes.