NAS, How do you score?

[luvmybabes]

I work in a 20 bed NICU and 25% of our babies suffer from NAS. How does your facility handle scoring these babies? We use the Finnegan scoring system and recently they decided they want us to check our score with a second RN if the score is 8 or >. I have been doing this since 2002 and i am insulted that my judgement is being questioned. Just wondering how other facilities handle this situation.

[NICUmiiki, DNP, NP]

We don't wake them up. That's crazy. We score them since the last score. If at any point since the last score they exhibited any of the behaviors, they get points for it.

[denicu]

We don't wake them up. That's crazy. We score them since the last score. If at any point since the last score they exhibited any of the behaviors, they get points for it.

I think its crazy too but as a traveler I have to go along with their plan of care.

[aerorunner80, ADN, BSN, MSN, APRN]

If I have a baby who I think is going to score high with my initial assessment, I will ask the provider to come to the bedside to watch me assess and we both discuss what we see. If we disagree or if I see something they don't (this happens a lot with residents) I will tell them why I feel it is a sign of withdrawal. I do this with babies who aren't currently being dosed with anything and are showing constant signs of withdrawal and also when I feel the baby may have been underscored by the previous nurse or may need an increase in their dose.

I prefer to do this because it really keeps the lines of communication open and helps build trust. I believe in constant communication with my providers at all times.

[Labmom1118]

We use the Finnegan Scoring System and didn't really get any training. Just the descriptions. I don't see how a second person can check you unless they have been with that patient the whole scoring period since it is dynamic. I use my judgment to consider other factors into my score. My baby slept less than 2 hours but woke up because of a dirty diaper? I'm not gonna penalize that. Someone else might. I wish we had better education on when to use it and how to use it.