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Background: Neonatal abstinence syndrome (NAS) is the combination of physiologic and neurobehavioral withdrawal symptoms exhibited by infants following the abrupt halt of intrauterine exposure to addictive drugs at the time of delivery. The Finnegan Scoring Tool (FST) is a clinical assessment tool used to determine the severity of withdrawal. Scores generated by the FST are used to regulate opioid therapy. An infant’s duration of drug therapy and hospital length of stay is directly correlated to accurate and consistent administration of the FST in association with stringent weaning protocols. Purpose: The purpose of this paper is to propose best practice recommendations for the administration of the FST respective to infant feeding schedules. Findings: Research suggests that evidence-based clinical practice guideline (CPG) supported by proper application of the FST and rigid adherence to weaning protocols is of paramount importance for the successful treatment of NAS. A thorough review of the literature revealed no evidence for best practice regarding the timing of FST scoring of infants relative to their feeding schedules. Implication for Practice: Developing guidelines for feeding based administration of the FST, may facilitate NAS treatment and decrease hospital length of stay and healthcare costs. Implications for Research: Further investigation is needed to evaluate CPGs and launch quality initiatives focused upon quality, safety and costs associated with inpatient management of NAS.

Pairing Best Practices to Reduce Length of Stay with Neonatal Abstinence Syndrome: The Finnegan Scoring Tool and Cue-Based Feedings