A comparison of two neonatal withdrawal scales

A retrospective case note audit

Kahlia Fox, Phillip S. Kavanagh, Andrea L. Fielder

Research output: Contribution to journalArticle

Abstract

Aim: The aim of this study was to compare the Lipsitz Withdrawal Scale (LWS) and Modified Finnegan Withdrawal Scale (MFWS) with regard to their equivalent ability to guide therapeutic interventions for neonates withdrawing from opioids and non-opioid substances. Method: Medical records of 34 patients born between 2000 and 2001 and 28 patients born between 2010 and 2011 at the WCHN were audited, with data collected on neonates scored with either the LWS or MFWS, respectively. Additional information were collected from case notes and hospital databases about the identified neonates. Results: There was no difference in treatment initiation between the LWS and MFWS for opioid exposed neonates. Scoring was commenced significantly closer to time of birth for opioid exposed neonates, treated with morphine and assessed with the MFWS. Opioid exposed neonates, treated with both morphine and phenobarbitone were administered significantly higher doses of morphine when assessed with the LWS. Conclusion: These findings confirm that the same percentage of neonates are receiving pharmacological intervention irrespective of which scale they are assessed with. Findings also suggest that neonates are now being assessed for symptoms closer to time of birth, potentially leading to quicker treatment initiation, smaller doses of medication and shorter hospital stays. Future prospective studies should be undertaken to compare the two scales further.

Original languageEnglish
Pages (from-to)284-291
Number of pages8
JournalJournal of Neonatal Nursing
Volume22
Issue number6
DOIs
Publication statusPublished - Dec 2016
Externally publishedYes

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Newborn Infant
Opioid Analgesics
Morphine
Parturition
Phenobarbital
Medical Records
Length of Stay
Therapeutics
Databases
Prospective Studies
Pharmacology

Cite this

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title = "A comparison of two neonatal withdrawal scales: A retrospective case note audit",
abstract = "Aim: The aim of this study was to compare the Lipsitz Withdrawal Scale (LWS) and Modified Finnegan Withdrawal Scale (MFWS) with regard to their equivalent ability to guide therapeutic interventions for neonates withdrawing from opioids and non-opioid substances. Method: Medical records of 34 patients born between 2000 and 2001 and 28 patients born between 2010 and 2011 at the WCHN were audited, with data collected on neonates scored with either the LWS or MFWS, respectively. Additional information were collected from case notes and hospital databases about the identified neonates. Results: There was no difference in treatment initiation between the LWS and MFWS for opioid exposed neonates. Scoring was commenced significantly closer to time of birth for opioid exposed neonates, treated with morphine and assessed with the MFWS. Opioid exposed neonates, treated with both morphine and phenobarbitone were administered significantly higher doses of morphine when assessed with the LWS. Conclusion: These findings confirm that the same percentage of neonates are receiving pharmacological intervention irrespective of which scale they are assessed with. Findings also suggest that neonates are now being assessed for symptoms closer to time of birth, potentially leading to quicker treatment initiation, smaller doses of medication and shorter hospital stays. Future prospective studies should be undertaken to compare the two scales further.",
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A comparison of two neonatal withdrawal scales : A retrospective case note audit. / Fox, Kahlia; Kavanagh, Phillip S.; Fielder, Andrea L.

In: Journal of Neonatal Nursing, Vol. 22, No. 6, 12.2016, p. 284-291.

Research output: Contribution to journalArticle

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