ArticleAdvances in neonatal care : official journal of the National Association of Neonatal Nurses2018
A Quality Improvement Initiative to Increase Scoring Consistency and Accuracy of the Finnegan Tool: Challenges in Obtaining Reliable Assessments of Drug Withdrawal in Neonatal Abstinence Syndrome.
Article in Advances in neonatal care : official journal of the National Association of Neonatal Nurses, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 39 citations in OpenAlex.
- Implicit Racial Bias in Evaluation of Neonatal Opioid Withdrawal Syndrome.Journal of racial and ethnic health disparities · 2025Trial
- Physiologic dysregulation in newborns with prenatal opioid exposure: Cardiac, respiratory and movement activity.Neurotoxicology and teratologyTrial
- Barriers to Maternal Presence at the Bedside of Infants With Neonatal Opioid Withdrawal Syndrome.Cureus · 2026Article
- Stochastic vibration and early weight growth in opioid-exposed newborns: a randomized trial.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Early pharmacotherapy versus no pharmacotherapy: difference in skin conductance response to physical stimuli in infants with neonatal opioid withdrawal syndrome.BMC pediatrics · 2026Observational
- A comparative study of two scoring systems for the assessment of neonatal abstinence syndrome.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- A Structural Examination of Racial Differences in Pharmacologic Treatment Among Opioid Exposed Infants.Journal of racial and ethnic health disparities · 2026Article
- The ultrasonic vocalization (USV) syllable profile during neonatal opioid withdrawal and a kappa opioid receptor component to increased USV emissions in female mice.Psychopharmacology · 2025Article
- Actigraphy: An Adjunctive Method to Measure Irritability in Opioid-Exposed Newborns.Journal of nursing measurement · 2024Article
- The ultrasonic vocalization (USV) syllable profile during neonatal opioid withdrawal and a kappa opioid receptor component to increased USV emissions in female mice.bioRxiv : the preprint server for biology · 2024Article
- A review of the genomics of neonatal abstinence syndrome.Frontiers in genetics · 2023Review
- Newborn Cry Acoustics in the Assessment of Neonatal Opioid Withdrawal Syndrome Using Machine Learning.JAMA network open · 2022Article
- Article
- Neonatal abstinence syndrome: Effectiveness of targeted umbilical cord drug screening.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Actigraphy: Metrics reveal it is not a valid tool for determining sleep in neonates.Journal of sleep research · 2022Article
- Comparison of Two Morphine Dosing Strategies in the Management of Neonatal Abstinence Syndrome.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- Integrated Review of the Assessment of Newborns With Neonatal Abstinence Syndrome.Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2021Review
- Improving the Assessment of Neonatal Abstinence Syndrome (NAS).Children (Basel, Switzerland) · 2021Article
- Study design and rationale for a randomized controlled trial to assess effectiveness of stochastic vibrotactile mattress stimulation versus standard non-oscillating crib mattress for treating hospitalized opioid-exposed newborns.Contemporary clinical trials communications · 2021Article
- Salivary cortisol levels as a biomarker for severity of withdrawal in opioid-exposed newborns.Pediatric research · 2020Observational
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundCurrent practice for diagnosing neonatal abstinence syndrome and guiding pharmacological management of neonatal drug withdrawal is dependent on nursing assessments and repeated evaluation of clinical signs. PURPOSE: This single-center quality improvement initiative was designed to improve accuracy and consistency of Finnegan scores among neonatal nurses.
methodsOne-hundred seventy neonatal nurses participated in a single-session withdrawal-assessment program that incorporated education, scoring guidelines, and a restructured Finnegan scale. Nurses scored a standardized video-recorded infant presenting with opioid withdrawal before and after training.
resultsNearly twice as many nurses scored at target (Finnegan score of 8) posttraining (34.7%; mean error = 0.559, SD = 1.4) compared with pretraining (18.8%; mean error = 1.31, SD = 1.95; Wilcoxon, P < .001). Finnegan scores were significantly higher than the target score pretraining (mean = 9.31, SD = 1.95) compared with posttraining (mean = 8.56, SD = 1.40, Wilcoxon P < .001); follow-up assessments reverted to pretraining levels (mean = 9.16, SD = 1.8). Score dispersion was greater pretraining (variance 3.80) compared with posttraining (variance 1.96; Kendall's Coefficient, P < .001) largely due to score disparity among central nervous system symptomology. IMPLICATIONS FOR PRACTICE: Education, clinical guidelines, and a restructured scoring tool increased consistency and accuracy of infant withdrawal-assessments among neonatal nurses. However, more than 60% of nurses did not assess withdrawal to the target score immediately following the training period and improvements did not persist over time. IMPLICATIONS FOR RESEARCH: This study highlights the need for more objective tools to quantify withdrawal severity given that assessments are the primary driver of pharmacological management in neonatal drug withdrawal.Video Abstract available at https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.