Karen D’Apolito, PhD, APRN, NNP-BC

Dr. Karen D’Apolito is the developer and narrator of the Inter-Observer Reliability Program. The program was first developed in 1993 as a part of my dissertation research. This research examined the use of a mechanical rocking bed to examine whether it would decrease signs and symptoms of withdrawal in opioid-exposed infants. While working with these babies and the staff it became apparent that each staff nurse was interpreting the signs and symptoms of withdrawal listed on the Finnegan Scoring Tool differently. Therefore, there was no consistency with scoring. This led to the development of the item definitions and the establishment of the inter-observer reliability program. The program was used to educate the staff to reliability in the use of the tool. The program was easy to use and the staff maintained a 90% inter-observer reliability when implementing the tool in the clinical area. Since completing of her PhD, Dr. D’Apolito has worked in education as the Co-Director and now Director of a Neonatal Nurse Practitioner Program. While visiting students during their clinical rotations Dr. D’Apolito noticed many more drug-affected infants being admitted into nurseries throughout the US. Typically, the Finnegan Scoring Tool is used to assess the severity of withdrawal in these babies; however, an inconsistency in scoring still exists today.  This led to the update of the inter-observer reliability program that was developed in 1993. Dr. Loretta Finnegan and Dr. Karol Kaltenbach were consultants during the revision process. Dr. D’Apolito is very appreciative for their input and suggestions.

Dr. D’Apolito has published in the area of neonatal abstinence syndrome and infant adaptation. She has presented many workshops to health care professionals regarding the establishment of inter-observer reliability using the Finnegan Scoring Tool. Dr. D’Apolito is working with the Regional Manager for Methadone Treatment Centers in Tennessee to develop a comprehensive treatment program for pregnant women in recovery for drug-addiction. She served as Co-Investigator on a 5 year NIDA funded grant focusing on the treatment of pregnant opioid-dependent women with methadone and buprenorphine. In 2008, she received the National Perinatal Association’s Individual Contribution to Maternal Child Health Award for her work with neonates exposed to drugs in utero.

Dr. Loretta Finnegan, MD

Dr. Loretta P. Finnegan is President of Finnegan Consulting which addresses education, research, and treatment in issues relating to women’s health and perinatal addiction. She is recognized nationally and internationally as an expert in these fields and credited with the development of an assessment tool for neonatal opioid abstinence which is used widely in neonatal intensive care units in this country and abroad. Dr. Finnegan was the founder and Director of a landmark program called Family Center, a comprehensive, multidisciplinary program for pregnant addicted women and their children at Jefferson Medical College and Hospital in Philadelphia. She has given nearly 1000 presentations throughout the United States and in many international settings to disseminate her clinical and research knowledge in women’s health and perinatal addiction. She has participated in international symposia, conferences and technical consultations or has been a visiting professor in 24 countries. Dr. Finnegan has authored or co-authored 170 scientific publications. . In 1990, Dr. Finnegan joined the National Institutes of Health and was appointed to several positions during her tenure including the Senior Advisor on Women’s Issues, National Institute on Drug Abuse; Director, Women’s Health Initiative, Office of the Director; and Medical Advisor to the Director, Office of Research on Women’s Health, Office of the Director, a position that she held until early 2006. Dr. Finnegan has been the recipient of numerous treatment and research grants from the National Institutes of Health, state and local governments and foundations.

Dr. Finnegan is available for consultation. You can email her at Finnegal337@aol.com

Authors