This system is the Finnegan Neonatal Abstinence Scoring Tool (D’Apolito, 2014). Dr. Finnegan
and colleagues tested and published the Finnegan Neonatal Abstinence Scoring System (FNASS)
in the 1970’s. This scoring system was created to have a systematic approach to evaluating
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NEONATAL ABSTINENCE SYNDROME
neonates born in the heroin epidemic in Philadelphia. Finnegan and his colleagues had created
this to assess a patient’s various body systems, which include assessments of autonomic nervous
system, neurological, and gastrointestinal, which required a nurse to evaluate the patient every
two to six hours based off of the signs of withdrawal (Verklan, 2019, pg. 267-277).
The
assessment of the mother and how much information is obtained about drug or alcohol use while
pregnant is vital for nurses to get an idea about how much exposure the infant received,
especially if the mother did not see a health care professional prior to the birth of her newborn.
The scoring system contains 31 items that are assessed, which are also weighted numerically
from 1-5, an infant who scores greater than eight is recommended receive pharmacologic therapy
(Jansson, 2019). Once the infant has been diagnosed a care plan will be put in place for the
infants treatment, if the newborn is born preterm additional care may be needed depending on
developmental aspects of the neonates organ system.
Developing a care plan for a NAS patient will be based off of the evaluation the infant
goes through, most hospitals use a scoring system, which determine the severity of NAS. Having
the mother as part of treatment can benefit the newborns recovery period such as having skin-to-
skin contact and breastfeeding as long as the mother is not opioid dependent and no HIV
infections are present (Hill, 2018). The nurses and staff showing support to the new mother and
father can greatly influence the infant, the new parents may feel that they are in a vulnerable state
and judged based off of the interaction they receive from the nurses. The new parents will need
to learn, practice, and strategize specialized care for their infant. In one study that observed
mothers and infants who resided together in the same room it was 63 percent less likely for the
newborn to need pharmacological treatment and was sent home in less than ten days (Hill, 2018).
The new mother may also be evaluated and case management will set up a care plan for both the
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NEONATAL ABSTINENCE SYNDROME
newborn and the mother to ensure that ongoing services such as mental health evaluations and
treatment options for mother are available and for the awareness that the NAS infant will be
going through continuous changes as they grow older. The infant may for see challenges such a


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- Fall '19