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Graduate Certificate in Neonatal Care

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Presentation on theme: "Graduate Certificate in Neonatal Care"— Presentation transcript:

1 Graduate Certificate in Neonatal Care
Sue Turrill, University of Leeds Programme Manager.

2 Programme introduction
The GCNC programme Assessments Module content YNN core clinical skills set Support

3 Development of the GCNC
2007-8 Specialised Neonatal qualification Academic and skills based Developed by University and Network

4 Student preparation YNN 1-7 competencies (foundation learning)
Neonatal Anatomy & Physiology workbook Student introduction day Time management/time planning Course structure Study days/studying at home Assessments Core skills set Mentor Gwynn arranging elective placement - timing, experience, trust & network managed.

5 Neonatal A & P pre-course workbook
Biosciences … ? Complete prior to course start, within the workbook Use a biology textbook that suits learning needs Blackburn – essential, more neonatal specific text Hand in on first day for feedback Continue 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) Assessment Practice module: Clinical practice based learning (20 credits) Core Clinical Skills set: Demonstration of practice Elective placement Written evidence to support transfer of knowledge to practice.

7 GCNC 2011-12 Course structure
Semester 1 (Sept – Jan) Assessment: January submission Semester 2a (Jan – May) May submission The Special Care Baby Teaching Dates: September 27th, 28th & 29th . November 8th, 9th & 10th December 6th & 7th. Formative submission: Plan of essay and essay draft for feedback midway through module Practice exam Submission of 2,500 word critical analysis essay + 2 hour exam The Neonate in Intensive Care January 24th - 26th February 28th & 29th, March 1st April 17th & 18th Presentation topic and plan midway through module Mock MCQ paper March Practice presentations April 1 ½ hour MCQ paper 30 minute presentation Work based Learning (Semester 1 + 2a) Teaching dates: September 6th – preparation day (1) September 23rd - preparation day (2) Topic chosen by mid October Submission of Learning contract by early November. Plan and draft of essay by end March. Portfolio submission 5,000 word essay Clinical skills acquisition: Special Care Baby – skills set + 8 evidence of achievement records completed by January 2010 Neonate Intensive Care – skills set + 8 evidence of achievement records completed by May 2010 Elective placement

8 Theory modules Special Care Baby eg:
Altered physiology of neonatal systems & appropriate interventions (eg respiration, nutrition, thermoregulation) Introduction to blood gas analysis Neonatal abstinence syndrome Pharmacokinetics Family assessment models, family nursing, attachment theory Discharge planning Evidence based policy Exam techniques

9 Theory modules … Neonate in Intensive Care eg:
Pathological basis of neonatal conditions Supporting families in crisis End of life care Multi-systems approach & response to physiological parameters Stabilisation & Transfer Health outcomes of NIC Presentation skills

10 Work Based Learning module
Portfolio Project supported by identified mentor; Learning contract , objectives and learning journal; Records of 4 x mentor meetings and 2 x tripartite meetings; Reflection on practice Essay

11 Skills acquisition NMC clinical mentor (+ associate) who holds neonatal QIS qualification Assessment of competency in practice (knowledge +skill) Core Clinical Skills Set - 12 pieces of evidence Practice development shown with student utilising knowledge in practice.

12 Core skills set Requirement to complete alongside the Certificate as part of WBL. Allow consistency of learning skills to appropriate standard Documented 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 Management Fluid, Electrolyte, Nutrition and Elimination Management Neurological and Pain Management Skin, Hygiene, and infection prevention management Temperature Management Managing 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 criteria Observed but not performed Performed with direct supervision Independent practice 1a Recognise deviations from normal respiratory and cardiovascular function Interpret trends in the results of blood gas analysis 1b Intervene to restore/maintain homeostasis 1c Recognise need for and request assistance in relation to basic life support Perform basic life support *Assist with advanced resuscitation and stabilisation 1d Initiate oxygen therapy via head box, nasal cannulae and facially Initiate respiratory support via the use of nasal continuous positive airways pressure (CPAP) or high-flow oxygen systems Safely care for the baby with a supported airway *Safely care for the baby requiring all methods of mechanical ventilation and respiratory support 1e Assess the need for suction of respiratory secretions Use 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 care 1f Recognise the need for intubation/extubation *Assist with elective / emergency intubation *Perform extubation 1g *Assist with the insertion/removal of chest drain Provide 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 supervision Questioning the basis for practice - EVIDENCE BASED PRACTICE Rationale 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 care Independent practice Independent skills & decision making

18 Record of achievement For both Special Care and Intensive Care:
Completion of individual skills achievement records 6 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) plus 1 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: b SC/IC (circle relevant): IC Record number: 5 Scenario: 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 testimony 2. Reflective account utilising John’s structured model of reflection Identified Learning: Key principles and priorities for resuscitation (resus council UK) Impact of early care guidelines on outcomes for premature babies Relevance of team working, roles, communication and planning in ‘at risk’ deliveries Methods for reducing heat losses in delivery situations Assessing respiratory and cardiovascular stability in the premature newborn at delivery Mentor: (name/signature) Date:

21 Record of achievement For both Special Care and Intensive Care:
Completion of individual skills achievement records 6 collections of written evidence (12 in total) Completion of final achievement list

22 Final achievement of skills throughout complete range
Core Skill Student signature Mentor signature Date achieved Respiratory and cardiovascular management Neurological and Pain management Fluid, electrolyte, nutrition and elimination management Skin and hygiene management Thermal control management Managing and supporting the family Signature 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 records 6 pieces of written evidence (16 in total) Completion of final achievement list Completed programme achievement documentation Network 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 register Understanding of module and programme requirements Time working with student …? Support student in accessing learning opportunities throughout project development and skills acquisition Overall achievement of skills Understanding of process of achievement of skills set and requirements for evidence.

26 Student responsibilities
Arrange regular meetings with mentor Agree outcomes and short term goals Completion of skills assessment portfolio Attendance Group dynamics & group work (ground rules) Time management for study Reading! Pre study day directed work Seek advice & support Revision using a timetable; planning assessment work Study skills?

27 Student support Academic supervisor
Choosing topics Writing at level 3 Drafts of essays for advice and comment – in person or via University skills centre; librarian University website - VLE Regional Educator/Lead Nurse Mentor challenging, committed 2nd mentor

28 Mentor support Programme/module manager Network lead nurse – Regional Network Educator Unit Practice educators Previous GCNC mentors Regional Neonatal Mentor/education Group


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