5 Neonatal A & P pre-course workbook Biosciences … ?Complete prior to course start, within the workbookUse a biology textbook that suits learning needsBlackburn – essential, more neonatal specific textHand in on first day for feedbackContinue to use for review prior to formal teaching sessions
6 Achieving the GCNC Theory modules: Practice module: The Special Care Baby (20 credits)The Neonate in Intensive Care (20 credits)AssessmentPractice module:Clinical practice based learning (20 credits)Core Clinical Skills set:Demonstration of practiceElective placementWritten evidence to support transfer of knowledge to practice.
7 GCNC 2011-12 Course structure Semester 1 (Sept – Jan)Assessment:January submissionSemester 2a (Jan – May)May submissionThe Special Care BabyTeaching Dates:September 27th, 28th & 29th .November 8th, 9th & 10thDecember 6th & 7th.Formative submission:Plan of essay and essay draft for feedback midway through modulePractice examSubmission of 2,500 word critical analysis essay+2 hour examThe Neonate in Intensive CareJanuary 24th - 26thFebruary 28th & 29th, March 1stApril 17th & 18thPresentation topic and plan midway through moduleMock MCQ paper MarchPractice presentations April1 ½ hour MCQ paper30 minute presentationWork based Learning (Semester 1 + 2a)Teaching dates:September 6th – preparation day (1)September 23rd - preparation day (2)Topic chosen by mid OctoberSubmission of Learning contract by early November.Plan and draft of essay by end March.Portfolio submission5,000 word essayClinical skills acquisition:Special Care Baby – skills set + 8 evidence of achievement records completed by January 2010Neonate Intensive Care – skills set + 8 evidence of achievement records completed by May 2010Elective placement
8 Theory modules Special Care Baby eg: Altered physiology of neonatal systems & appropriate interventions (eg respiration, nutrition, thermoregulation)Introduction to blood gas analysisNeonatal abstinence syndromePharmacokineticsFamily assessment models, family nursing, attachment theoryDischarge planningEvidence based policyExam techniques
9 Theory modules … Neonate in Intensive Care eg: Pathological basis of neonatal conditionsSupporting families in crisisEnd of life careMulti-systems approach & response to physiological parametersStabilisation & TransferHealth outcomes of NICPresentation skills
10 Work Based Learning module PortfolioProject supported by identified mentor;Learning contract , objectives and learning journal;Records of 4 x mentor meetings and 2 x tripartite meetings;Reflection on practiceEssay
11 Skills acquisitionNMC clinical mentor (+ associate) who holds neonatal QIS qualificationAssessment of competency in practice (knowledge +skill)Core Clinical Skills Set - 12 pieces of evidencePractice development shown with student utilising knowledge in practice.
12 Core skills setRequirement to complete alongside the Certificate as part of WBL.Allow consistency of learning skills to appropriate standardDocumented and agreed by Trusts.Originally based on Scottish Neonatal Nurses Group, 2005; now forms part of QIS national definition (BAPM, 2012) and RCN neonatal career framework (RCN, 2012)
13 YNN Core Clinical Skills Set 6 core skills:Respiratory and Cardiovascular ManagementFluid, Electrolyte, Nutrition and Elimination ManagementNeurological and Pain ManagementSkin, Hygiene, and infection prevention managementTemperature ManagementManaging and supporting the family
14 Range: Gestational ages of neonates from 24 – post term; Birthweight ranges: ELBW, VLBW, LBW, Normal BW, IUGR, LGA;Physical conditions, abilities and continuing improvement or deterioration;Surgical infants of differing conditions;Infants with congenital abnormalities;Infants preparing to be discharged home.
15 Record of achievement For both Special Care and Intensive Care: Completion of individual skills achievement records
16 Core Skill 1: Respiratory and cardiovascular management: Neonatal nurse QIS performance criteriaObserved but not performedPerformed with direct supervisionIndependent practice1aRecognise deviations from normal respiratory and cardiovascular functionInterpret trends in the results of blood gas analysis1bIntervene to restore/maintain homeostasis1cRecognise need for and request assistance in relation to basic life supportPerform basic life support*Assist with advanced resuscitation and stabilisation1dInitiate oxygen therapy via head box, nasal cannulae and faciallyInitiate respiratory support via the use of nasal continuous positive airways pressure (CPAP) or high-flow oxygen systemsSafely care for the baby with a supported airway*Safely care for the baby requiring all methods of mechanical ventilation and respiratory support1eAssess the need for suction of respiratory secretionsUse safe and effective oral and nasal suction techniques*Use safe and effective endotracheal tube/tracheostomy suction techniques*Perform chest physiotherapy techniques utilising an agreed plan of care1fRecognise the need for intubation/extubation*Assist with elective / emergency intubation*Perform extubation1g*Assist with the insertion/removal of chest drainProvide care for baby with chest drain in situ
17 Stages of progression in skills acquisition. Observed but not performed (identifies gaps in experience)Performed with direct supervisionQuestioning the basis for practice - EVIDENCE BASED PRACTICERationale for decision making - WHY ARE YOU DOING WHAT YOU ARE DOING? WHAT ARE THE RISKS AND BENEFITS TO THE BABY/FAMILY?Options for practice & individualised pathways of careIndependent practiceIndependent skills & decision making
18 Record of achievement For both Special Care and Intensive Care: Completion of individual skills achievement records6 pieces of written evidence (one for each skill - 12 in total)
19 Evidence of practice devlopment Each skill must have written evidence to support the rationale behind practice.Each piece of evidence must include:Witness testimony (demonstration of skill development) plus1 or 2 of the following eg:Annotated bibliography (showing how evidence will be utilised in practice)Reflective account (using a reflective model)Q & A session (eg work sheets, study day, critical incident)Integration of a teaching session (in University or practice)
20 EXAMPLE: Evidence of achievement Core skill: Element: bSC/IC (circle relevant): IC Record number: 5Scenario: 31 week twins were being delivered by elective caesarian section for maternal PIH during my shift. Having previously observed a delivery in theatre I asked to assist the senior nurse who would be caring for one of the twins. My role prior to the delivery was to set up an IC space. At the delivery I was able to be part of the team, prioritising the babies immediate needs for temperature control, respiration and stability.Type of evidence supporting practice development: (attached in portfolio)Witness testimony2. Reflective account utilising John’s structured model of reflectionIdentified Learning:Key principles and priorities for resuscitation (resus council UK)Impact of early care guidelines on outcomes for premature babiesRelevance of team working, roles, communication and planning in ‘at risk’ deliveriesMethods for reducing heat losses in delivery situationsAssessing respiratory and cardiovascular stability in the premature newborn at deliveryMentor: (name/signature) Date:
21 Record of achievement For both Special Care and Intensive Care: Completion of individual skills achievement records6 collections of written evidence (12 in total)Completion of final achievement list
22 Final achievement of skills throughout complete range Core SkillStudent signatureMentor signatureDate achievedRespiratory and cardiovascular managementNeurological and Pain managementFluid, electrolyte, nutrition and elimination managementSkin and hygiene managementThermal control managementManaging and supporting the familySignature of Mentor: I accept responsibility for the assessment of competency for…………………………………………………………………………………………… Date ………………………………..
23 Record of achievement (final portfolio for qualification) For both Special Care and Intensive Care:Completion of individual skills achievement records6 pieces of written evidence (16 in total)Completion of final achievement listCompleted programme achievement documentationNetwork Lead Nurse agrees final qualification based on completion of skills/WBL & theory modules
24 Using evidence?What types of evidence show development of knowledge and practice?How can you be sure that knowledge is translated to practice?
25 Mentor responsibilities…? Attendance at WBL workshops!!Active on mentor registerUnderstanding of module and programme requirementsTime working with student …?Support student in accessing learning opportunities throughout project development and skills acquisitionOverall achievement of skillsUnderstanding of process of achievement of skills set and requirements for evidence.
26 Student responsibilities Arrange regular meetings with mentorAgree outcomes and short term goalsCompletion of skills assessment portfolioAttendanceGroup dynamics & group work (ground rules)Time management for studyReading!Pre study day directed workSeek advice & supportRevision using a timetable; planning assessment workStudy skills?
27 Student support Academic supervisor Choosing topicsWriting at level 3Drafts of essays for advice and comment – in person or viaUniversity skills centre; librarianUniversity website - VLERegional Educator/Lead NurseMentorchallenging, committed2nd mentor
28 Mentor supportProgramme/module managerNetwork lead nurse –Regional Network EducatorUnit Practice educatorsPrevious GCNC mentorsRegional Neonatal Mentor/education Group