Date of this Version


Document Type

DNP Project


The purpose of this quality improvement project is to implement an educational program and bedside guide about the Finnegan Neonatal Abstinence Scoring Tool (FNAST) to increase accuracy, inter-rater reliability, and confidence when assessing infants with neonatal abstinence syndrome. The project is based on a Plan-To-Do-Study-Act framework involving a pre-assessment and post-assessment. It took place in a 70-bed neonatal intensive care unit in a hospital in South Florida that frequently cares for infants with neonatal abstinence syndrome but lacks an established training program within the organization. A convenience sample of 24 registered nurses from the neonatal intensive care unit participated in the project with varying degrees of experience. The participants watched a video of a newborn with neonatal abstinence syndrome while scoring the infant using the FNAST and rating their confidence level while scoring each item within the scoring tool. Then, they participated in an educational session and were provided a bedside reference guide before completing a post-assessment where they watched the same video from the pre-assessment, scored the infant using the FNAST, and rated their confidence level after receiving the education. Participants improved their inter-rater reliability from 46% in pre-training to 71% in post-training. Average confidence levels while using the FNAST also increased from the pre-training session to the post-training session. Advanced training in neonatal abstinence syndrome scoring can result in improved health outcomes by decreasing length of hospital stay and time on pharmacological therapy.