Neonatal Abstinence Syndrome (NAS) /Neonatal Opioid Withdrawal Syndrome (NOWS), Clinical Pathway, Inpatient

Modified Finnegan Scoring: Scoring Tool

Modified Finnegan Score
  • 24 Rule:
    • 3 consecutive scores ≥ 8 or
    • 2 consecutive scores ≥ 12
  • Scoring:
    • Begin when infant symptomatic or
    • by 24 hours of life
  • Perform 30 - 60 minutes after feed
  • Assess every 3 - 4 hours
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  • Short Half-Life
  • Long Half-Life
  • Observe for at least 72 hours
  • Discharge if scores are stable
  • Observe for 5 - 7 days
  • Consider earlier discharge if:
    • Finnegan Scores stable
    • Home situation stable
    • Appropriate follow up arranged
 
 
 
 
 
 
 
 
  • Observe infant at least 48 hours after last dose of pharmacologic treatment
  • Ensure scores remain < 8
 
 
  • Discharge Recommendations
  • Ensure that a follow-up appointment is scheduled with the PCP by parent prior to discharge
  • Notify PCP prior to infant’s discharge
  • Refer to Early Intervention
  • If mother is Hepatitis C positive, recommend ID follow up and testing
  • Encourage postnatal support for mother/family