Interobserver Reliability of the Finnegan Neonatal Abstinence Scoring Tool in an Acute Care Setting

Interobserver reliability was established for total score. Interobserver reliability was not established for single measures with the majority of the discrepancies found within the central nervous system portion of the FNAST. If clinical decisions are made based on the reliability of these scores, values should be a minimum of 0.90. Going forward, education in Finnegan scoring should have an increased focus on the central nervous system portion of the scoring tool. We also recommend that interobserver reliability of the FNAST should be part of annual competencies and included in orientation for new nurses on the NICU, mother/baby unit, and PEDS/PICU due to the epidemiology of NAS.