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Career, education and competence framework for neonatal nursing in the UKRCN guidance

Acknowledgements

It is anticipated that this Royal College of Nursing (RCN) neonatal competency framework will be useful for all health care professionals working within neonatal nursing. The RCN and the working group would like to thank everyone involved with its development, particularly Fiona Smith, RCN Adviser in Children and Young People’s Nursing, for her strategic vision.

A number of people from a variety of organisations, including the British Association of Perinatal Medicine, the Neonatal Nursing Association and the Scottish Neonatal Nursing Group, gave willingly of their advice and time, notably Dr Bryan Gill, Sue Turill, Glenys Connolly and Róisín McKeon-Carter. Without their invaluable enthusiasm, passion, commitment and drive this task would have been much harder.

The working party volunteers who were involved in the development of this framework included representatives from all four UK countries.

Working party volunteers

Róisín McKeon-Carter, Senior ANNP and Service Line Director Neonatology, Plymouth Hospitals NHS Trust

Wendy Davies, Lead Nurse, Wales Neonatal Network

Yvonne Freers, Clinical Reader, Simpson Centre for Reproductive Health, Edinburgh

Rosie Kelly, Clinical Manager, Acute Paediatrics and Neonatology South Eastern Health and Social Care Trust

Alex Mancini, Lead Nurse for Neonatal Complex, Palliative and Bereavement Care, NICU Chelsea and Westminster Foundation Trust, London

Heather Nelson, Family Care Co-ordinator, Neonatal Service, Nottingham University Hospital Trust

Lynne Paterson, Neonatal Nurse Consultant, South Tees Hospitals NHS Foundation Trust and Nurse Lead, Northern Neonatal Network

Alison Wright, Senior Nurse Neonatal Services and ANNP, NICU Ninewells Hospital, Dundee

Sharon Nurse, Senior Teaching Fellow, School of Nursing and Midwifery, Queen’s University, Belfast

Project leads

Doreen Crawford, Current Chair of the RCN Children and Young People (CYP) Acute Care Forum (which includes the neonatal special interest community), Senior Lecturer Child Health, De Montfort University, Leicester and Consultant Nurse Editor of the Nursing Children and Young People Journal

Debra Teasdale, Head of Health, Wellbeing and the Family, Canterbury Christ Church University, Kent

This publication is due for review in November 2016. To provide feedback on its contents or on your experience of using the publication, please email [email protected]

RCN Legal Disclaimer

This publication contains information, advice and guidance to help members of the RCN. It is intended for use within the UK but readers are advised that practices may vary in each country and outside the UK.

The information in this publication has been compiled from professional sources, but its accuracy is not guaranteed. Whilst every effort has been made to ensure the RCN provides accurate and expert information and guidance, it is impossible to predict all the circumstances in which it may be used. Accordingly, to the extent permitted by law, the RCN shall not be liable to any person or entity with respect to any loss or damage caused or alleged to be caused directly or indirectly by what is contained in or left out of this information and guidance.

Published by the Royal College of Nursing, 20 Cavendish Square, London W1G 0RN © 2015 Royal College of Nursing. All rights reserved. Other than as permitted by law no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise, without prior permission of the Publishers or a licence permitting restricted copying issued by the Copyright Licensing Agency, Saffron House, 6-10 Kirby Street, London EC1N 8TS. This publication may not be lent, resold, hired out or otherwise disposed of by ways of trade in any form of binding or cover other than that in which it is published, without the prior consent of the Publishers.

Royal colleGe of nuRsinG

3

Introduction 4 Background 4 1. Competence and education framework to supportcareers in neonatal nursing in the UK 7Overview 7

The application of ‘levels of practice’ to the neonatal workforce 11

2. Core competences for neonatal practice 14Communication and interpersonal relationships 14

Personal, professional and people development 16

Health, safety and security 18

Service development 21

Quality 24

Equality, diversity and rights 26

Responsibility for patient care 28

3. Core clinical skills for the neonatal workforce 31

4. Curriculum/programme preparation and maintaining proficiency 49

References 106

Contents

Careers for neonatal nurses

RCN guidance for nursing staff

4

Career, eduCation and CompetenCe framework for neonatal nursing in the uk

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Introduction

Neonatal care has come a long way in a short time. Outcomes that could only have been dreamed of 10 to 15 years ago are, in many cases, now possible for infants of extremely low birth weight. Alongside advances in supportive technology and pharmacology there have been equally worthy care innovations, including a range of benchmarks, standards and competences developed and designed to ensure safe and enhanced quality care (SNNG, 2005; DH, 2009; BAPM, 2010; RCN, 2012b; Scottish Government, 2013).

The ethos of neonatal care emphasises close collaboration with families in all neonatal health care settings and we acknowledge the importance of family members in relation to the health and wellbeing of infants (IPFCC, 2013). We urge all neonatal units to action the BLISS Charter tool (BLISS, 2013) as findings from a recent national survey (Picker Institute, 2011) indicated the need for improvement on this point.

This document has been informed by numerous influential drivers, from a variety of sources, and it has been difficult to do justice to the breadth of information available. As neonatal care is in a state of constant evolution and transition, this document will be updated and developed in line with changes to the service and will include your feedback.

Background

England

Health Education England (HEE) has stated that it is the NHS engine responsible for delivering better health and a better health care workforce for England – including the education, training and personal development of every member of staff (HEE, 2013). Yet a search on the HEE website for neonatal care, education, pathway or programmes returns no results.

The Education outcomes framework (DH, 2013) was designed to help the integrated health and care workforce meet the outcomes set out in the NHS, public health and social care frameworks, and is central to the relationship between the Department of Health (DH) and the whole health care system. As yet, the indicators are not specific to neonatal nurse education, but elements from the domains are transferable, in particular those related to competence, capability, performance, values, behaviours and the application of NICE clinical guidelines.

Northern Ireland

For many years, neonatal services in Northern Ireland (NI)collaborated closely using an informal network model to ensure consistency of practice and training across the Province. In 2013, a managed clinical network became operational as a result of recommendations in the Troop Report (Independent review of incidents of pseudomonasaeruginosa infection in neonatal units, April 2012). The primary aim of the network is to enhance the future commissioning and delivery of safe, high-quality, sustainable neonatal services for all infants and their families within NI. This will include: advising on a review of cot capacity; implementation of clinical guidance; patient care pathways; communication pathways and user engagement. The network is supported by a regional transport team.

Nurse education has been delivered by a range of providers in Northern Ireland with Queen’s University providing neonatal modules, University of Ulster providing the non-medical prescribing course and the clinical education centre providing stand-alone training days. Some competency development has taken place through the introduction of the infection care audit tool for augmented care areas (Regional neonatal infection prevention and control audit tool, RQIA, Feb 2013) with a specific focus on


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Welsh mothers and infants receive appropriate care provided by skilled, trained staff. The network has published two reviews of capacity (cots and staffing available) in 2012 and 2013 and has made recommendations to address nurse shortages and improve staff skill levels. The network has a key role in monitoring nursing establishments, staff in post and QIS qualification status on a six-monthly basis.

Since 2011, nurse establishments have improved in Wales and in 2013 the Review of nurse training and education in Wales was published, along with the Education career framework. Nurse education is delivered by the University of South Wales and the University of Bangor. In South Wales the intensive care module is now available at Masters level. The non-registered workforce has been re-examined with a comprehensive assessment of their roles and responsibilities. Best practice guidance and educational development for this part of the workforce has been given to Health Boards. Neonatal competences have been developed for nurses working in local neonatal units who rotate to intensive care units for updating of skills and competences. In 2013, all units in Wales adopted a Neonatal Patient Acuity Tool which measures nurse numbers against the acuity of infants and helps to support safe levels of care.

National networks and workforce skills

Neonatal NHS services in England were first configured into networks in 2003. Following this there have been numerous changes and reconfigurations; in its review of neonatal services in England, the National Audit Office (2007) was unable to state whether or not networks had improved the overall value for money of the service. In 2010, Scotland followed suit with the establishment of three regional networks.

The RCN and Bliss continue to campaign for improved staffing levels (RCN, 2013b) and for an appropriate skills mix as outlined in the RCN toolkit (2009) and quality framework (2013). As the neonatal workforce is a diverse team, education to equip the practitioner – regardless of level – is important. Pockets of excellence have emerged such as the neonatal intensive care unit, transitional care ward nursery nurse and health care assistant preceptorship programmes developed by the South West Peninsula Neonatal Network.

The Cavendish Review (2013) recommended that HEE should introduce a Certificate of Fundamental Care and a Higher Certificate of Fundamental Care for all health care assistants (HCAs). To be meaningful to neonatal education,

neonatal units. Advanced neonatal nurse training is not currently provided in Northern Ireland, but work is underway to develop an advanced nurse practitioner course with specialist pathways in adults, paediatrics and neonates to be delivered in Northern Ireland. This work, it is hoped, will also provide a career pathway for all nurses from generalist through specialist to advanced practice and consultant nurse.

A neonatal service review is due to be undertaken during 2014 to consider staffing levels across the region. The focus will be on both medical and nursing establishments as well as cot capacity.

Scotland

Early on, Scotland led the way in designing neonatal nurse competency levels (SNNG, 2005). The competency document developed by the Scottish Neonatal Nurses’ Group put the focus on the registrant and made several pertinent recommendations, including the need to ring fence funding to support neonatal nurse education.

Scotland has developed a comprehensive career and development framework for health care support workers providing neonatal care in hospital settings which complements the existing career and development framework for neonatal nurses in Scotland (SNNG and NES, 2010; SNNG and NES, 2012).

The Scottish Government recognises that achieving and maintaining elements of its neonatal care quality framework requires a competent nursing workforce in sufficient numbers to comply with the quality statements. Work is ongoing within NHS Education Scotland (NES) to consider ways of ensuring a national approach to sustainable neonatal education at all levels. In line with the Scottish Government’s nursing and midwifery workload and workforce planning strategy, a national neonatal workload tool is completed by all neonatal units each day.

Wales

In Autumn 2010, a Wales Neonatal Network was established bringing together NHS health professionals and partners from other organisations to ensure equitable, high quality, clinically effective neonatal care is available to infants and their families in Wales.

A primary aim of the network is to co-ordinate the development of a sustainable neonatal service to ensure

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these would need to be tailored to the specialty and the level 2, 3 and 4 competences and the level 2, 3 and 4 recommended education and training in section 4 of this document could provide the basis for this.

Neonatal education requires strategic direction and leadership. The Council of Deans of Health is the representative voice of UK university health faculties which provide education and research for health care professionals.

With 85 member universities, the Council plays an influential leadership role (Council of Deans for Health, 2013a) and is clearly interested in health care support worker education and training needs (Council of Deans for Health, 2013b). National and UK-wide guidance on the education and career path for HCAs/assistant practitioners is important as recommendations for this workforce to be regulated are growing (The Law Commission, 2012; RCN, 2012c; Mid Staffordshire enquiry, 2013; The Cavendish Review, 2013). There is significant pressure on government to take action and the regulation of unregistered neonatal workforce would reduce safeguarding risks for this vulnerable cohort of patients.

This document goes beyond the minimum standards as defined by Skills for Health (2013) and although this document contains no specific section on safeguarding, the competences and curriculum have been developed in line with the current recommendations.

Preparing registrants and health care support workers

At the time of writing, several neonatal programmes and pathways for providing registrants and health care support workers with the knowledge and skills required in neonatal care has been suspended across the UK. In these times of financial austerity a number of higher education institutions have taken the difficult decision to withdraw neonatal courses that were not viable financially. This will have serious implications for the future development of the neonatal service, and in order to staff units and care for resident infants and families, managers are having to become ever more resourceful and creative.

The Centre for Workforce Intelligence is the English and Welsh authority for workforce planning and development, providing advice and information to the health and social care system. It has developed a set of metrics to help planning models (CfWI, 2013) which are being ignored.

One of the system dynamics models of GP supply and care pathways, including long-term conditions, maternity, and neonatal cited in Table 2, comes from an area which has suspended the neonatal education pathway. This has resulted in students having to travel long distances for places on surviving programmes.

Once qualified in the specialty, registrants should not stand still. Reflecting the RCN Children and Young People’s Nursing Philosophy (in press) and the NMC requirement for revalidation, the RCN supports the need for continuing professional development and specific post-registration education and training opportunities. The RCN has developed guidance for nurses who have extended and expanded their scope of practice (RCN, 2012b). Many of the elements contained within the guidance are transferable.

Values and resilience

Although the neonatal service has largely escaped the criticisms which other care services have been exposed to, recruitment to the specialty requires candidates to be compassionate and caring as reflected in the vision enshrined in Compassion in practice (DH, 2012), the RCN Principles of nursing (2010) and the quality ambitions of the Healthcare quality strategy for Scotland (Scottish Government, 2010). In Northern Ireland the following documents are proving very influential: Quality 2020 (DHSSPSNI, November 2011) and Maternity Strategy 2012-2018 (DHSSPSNI, July 2012).

Educating for resilience to protect against the risk of compassion fatigue that can arise as a consequence of the numbers of infants that die on a neonatal unit is easier said than done. Kain (2013) suggested that neonatal nurses may have inefficient grief management skills and has urged for the development of a framework to aid understanding of the nature of nurse grief.

Such a tool will take time to develop, but in the meantime this document contains educational strategies to support nurses who are caring for infants with palliative care. It also includes end-of-life care – see for example, Mancini et al (2014).



Competence and education framework to support careers in neonatal nursing in the UK

Overview

Table 1 overleaf provides a visual representation of how neonatal staff are able to develop and progress from entry at HCA level 2. For registered nurses/midwives, in keeping with the previous framework (RCN, 2009), the Benner model demonstrating progression within levels of practice has been retained. Career progressions through these levels of practice are achieved utilising the following elements:• knowledgeacquisitiondemonstratedthroughspecific

programmes of preparation or education either within or external to higher education

• relatingthisknowledgetothedemonstrationofcompetence which has been linked to the KSF (NHS, 2004; RCN, 2009; for links to the Welsh and Scottish competences see references).

The development of this framework reflects current good practice and the requirements for career progression within health care settings (Skills for Health, 2006; RCN, 2009). It aims to ensure equity in the career and educational opportunities available to meet the needs of neonatal nurses, the employing organisation and the wider neonatal community as a whole. As a result it is recommended that:• thisframeworkisusedthroughouttheUKtoinform

workforce development and educational plans in practice environments

• theassociatedcompetences,coreclinicalskillsetandmatched educational requirements should be used at practice level and by higher education institutes to underpin and benchmark local provision.

As such the competences in this document are described in more detail than the broad statements within the Department of Health’s Toolkit for high quality neonatal services (DH, 2009) and the Neonatal care in Scotland: a quality framework (Scottish Government, 2013), which will be beneficial during any audit of local neonatal services following the introduction of the specialist neonatal care quality standards (NICE, 2010).

The Benner’s level of practice entry point into the structure will vary depending on an individual’s prior experience, skill set and educational attainment. To ensure parity in recruitment and career development practices across the UK it is recommended that:• employersshouldbeencouragedtousetheknowledge,

level of educational achievement, and specified skill set to support the development of job descriptions and specifications

• theframeworkcanbeusedtomappriorexperienceandcompetence to determine individual development needs and potentially accelerate career progression.

The educational aspects reflect expected entry qualifications for each level of the framework, continuing professional education for contemporary practice, and the requirements for progression to allow transition to higher level of practice/competence. This is supported by narrative on the following pages.

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Tabl

e 1.

Ove

rvie

w o

f RCN

com

pete

nce

and

educ

atio

n fr

amew

ork

to s

uppo

rt c

aree

rs in

neo

nata

l nur

sing

Leve

l of

prac

tice

Min

imum

pro

fess

iona

l/ed

ucat

iona

l ent

ry

requ

irem

ents

Cont

inuo

us d

evel

opm

ent

Com

pete

nce

leve

l and

bro

ad

desc

ript

ion

of le

vel o

f pra

ctic

e/ro

leS

kill

s fo

r H

ealt

h (S

fH) c

aree

r fr

amew

ork*

Hea

lth

care

su

ppor

t w

orke

r (H

CSW

)

Nur

sery

nu

rse

Ass

esse

d at

inte

rvie

w/N

VQ

/SV

Q

leve

l 2 o

r eq

uiv

alen

t

Nu

rser

y n

urs

e ce

rtifi

cate

Acc

redi

tati

on p

rior

exp

erie

nce

Indu

ctio

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d pr

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pre

para

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men

sura

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serv

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sta

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d su

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as

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nga

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d ob

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kills

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m

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nu

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anda

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ates

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dem

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earn

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prac

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futu

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equ

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.

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d m

ain

tain

s co

mp

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nd

core

ski

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equ

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to

per

form

at

this

leve

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vel r

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agre

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ay e

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mat

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s w

ards

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part

men

ts.

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Sen

ior

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sup

port

w

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3 or

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plom

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of

the

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and

prev

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Men

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u

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re a

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En

gage

wit

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in le

vel 4

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ills

know

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d pr

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ld b

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side

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(RM

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ee

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gram

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ly q

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ff.

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ctio

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car

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rol

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wor

k to

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d de

gree

qu

alifi

cati

on (

if d

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2. o

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ved

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d m

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ew e

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ants

.

Init

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– a

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ires

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ic s

kills

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d kn

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tice

for

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tice

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ial c

are.

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ce p

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leve

l has

rea

ched

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sist

entl

y h

igh

sta

nda

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this

rol

e m

ay e

xten

d to

hig

h

dep

ende

ncy

car

e u

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r su

per

visi

on, p

rior

to

un

dert

akin

g p

ost

regi

stra

tion

qu

alifi

cati

on.

Leve

l 5P

ract

itio

ner

The

nur

se m

ay r

emai

n at

this

leve

l, m

aint

aini

ng c

ompe

tenc

e bu

t sho

uld

be e

ncou

rage

d an

d su

ppor

ted

to d

evel

op fu

rthe

r to

pre

pare

for

the

spec

ialis

t co

urse

. •

Und

erta

ke p

ost r

egis

trat

ion

qual

ifica

tion

in n

eona

tal n

ursi

ng (

spec

ial,

high

dep

ende

ncy

and

inte

nsiv

e ca

re)

to s

uppo

rt d

evel

opm

ent o

f com

pete

nce

and

core

ski

ll as

a n

eon

atal

nu

rse

qual

ified

in s

pec

ialt

y (Q

IS)

stat

us.

• W

orks

tow

ards

neo

nata

l nur

se (

QIS

) co

mpe

tenc

e an

d co

re s

kills

und

er d

irec

t sup

ervi

sion

of N

MC

-qua

lified

men

tor

in h

igh

depe

nden

cy a

nd in

tens

ive

care

env

iron

men

ts.

Com

pete

nt

RN

(C

hild

/Adu

lt)

or R

M

Post

reg

istr

atio

n n

eon

atal

qu

alifi

cati

on

En

gage

d w

ith

deg

ree

leve

l stu

dy

NM

C m

ento

r

To r

emai

n in

rol

e:

1. c

onso

lidat

es k

now

ledg

e an

d sk

ills

deve

lopm

ent

2. c

onti

nu

ous

upd

atin

g to

rem

ain

con

tem

por

ary

3. N

MC

app

rove

d si

gn-o

ff m

ento

rsh

ip p

rogr

amm

e.

Ach

ieve

s an

d m

ain

tain

s n

eon

atal

nu

rse

(QIS

) co

mp

eten

ce a

nd

core

ski

lls.

Th

e n

eon

atal

nu

rse

is q

ual

ified

to

prac

tice

w

ith

in a

ll ar

eas

of n

eon

atal

car

e.

Leve

l 6

Sen

ior

prac

titi

oner

The

neo

nata

l nur

se m

ay r

emai

n at

this

leve

l, m

aint

aini

ng c

ompe

tenc

e or

may

cho

ose

to d

evel

op fu

rthe

r.•

Und

erta

ke s

tudy

in n

eona

tal n

ursi

ng a

t hon

ours

deg

ree/

post

grad

uate

leve

l to

supp

ort d

evel

opm

ent o

f com

pete

nce

and

core

ski

ll at

exp

erie

nced

neo

nata

l nur

se s

tatu

s an

d po

tent

ial r

ole

deve

lopm

ent.

• W

orks

tow

ards

com

pete

nce

and

core

ski

lls fo

r ex

peri

ence

d ne

onat

al n

urse

s un

der

the

supe

rvis

ion

of a

n ex

peri

ence

d ex

pert

nur

se w

ith

sign

-off

men

tor

qual

ifica

tion

.

Pro

fici

ent

RN

(C

hild

/Adu

lt)

or R

M

Post

-reg

istr

atio

n n

eon

atal

qu

alifi

cati

on

NM

C s

ign

-off

men

tor

qual

ifica

tion

Hon

ours

deg

ree

qual

ifica

tion

or

reco

gnit

ion

of

prio

r ex

per

ien

tial

le

arn

ing

in c

linic

al, e

duca

tion

, le

ader

ship

or

man

agem

ent

role

s

To r

emai

n in

rol

e:1.

con

solid

ates

kn

owle

dge

and

skill

s de

velo

pmen

t

2. c

onti

nu

ous

upd

atin

g to

rem

ain

con

tem

por

ary

3. N

MC

-app

rove

d pr

acti

ce e

duca

tor/

lect

ure

r pr

ogra

mm

e fo

r th

ose

lead

ing

in-h

ouse

/HE

edu

cati

on.

Ach

ieve

s an

d m

ain

tain

s co

mp

eten

ce a

nd

core

clin

ical

ski

lls fo

r ex

per

ien

ced

neo

nat

al

nu

rses

. Con

side

rs e

nh

ance

d n

eon

atal

nu

rse

prac

titi

oner

pro

gram

mes

.

Rol

e de

velo

pmen

t ex

per

ien

ced

neo

nat

al

nu

rses

wor

k in

pre

scri

bed

nu

rsin

g ro

les

such

as

neo

nat

al t

ran

spor

tati

on, s

hif

t m

anag

emen

t ro

les

(for

exa

mpl

e, w

ard

char

ge n

urs

e/si

ster

), d

evel

opm

ent

care

lead

, la

ctat

ion

su

ppor

t, co

mm

un

ity

outr

each

pr

acti

tion

er, p

ract

ice

deve

lopm

ent/

clin

ical

ed

uca

tor.

Leve

l 6

Sen

ior

prac

titi

oner

Th

e n

eon

atal

nu

rse

may

rem

ain

at

this

leve

l, m

ain

tain

ing

com

pet

ence

or

may

ch

oose

to

deve

lop

furt

her

.•

Un

dert

ake

pos

tgra

duat

e st

udy

to

supp

ort

futu

re r

ole

deve

lopm

ent

and

the

deve

lopm

ent

of c

omp

eten

ce a

s an

exp

ert

neo

nat

al n

urs

e.

• Fo

r cl

inic

al p

ract

ice

role

dev

elop

men

t w

orks

tow

ards

cor

e sk

ills

for

exp

ert

neo

nat

al n

urs

es (

or lo

cally

det

erm

ined

equ

ival

ent)

un

der

sup

ervi

sion

(ex

per

t n

urs

e w

ith

an

NM

C

appr

oved

sig

n-o

ff m

ento

r qu

alifi

cati

on o

r an

app

ropr

iate

ly q

ual

ified

mem

ber

of t

he

med

ical

tea

m).

*It i

s im

port

ant t

o no

te th

at th

e ca

reer

fram

ewor

k le

vels

do

not e

quat

e di

rect

ly to

Age

nda

for C

hang

e pa

y ba

nds.

10


Return to contents

Tabl

e 1.

Ove

rvie

w o

f RCN

com

pete

nce

and

educ

atio

n fr

amew

ork

to s

uppo

rt c

aree

rs in

neo

nata

l nur

sing

Leve

l of

prac

tice

Min

imum

pro

fess

iona

l/ed

ucat

iona

l ent

ry

requ

irem

ents

Cont

inuo

us p

rofe

ssio

nal d

evel

opm

ent

Com

pete

nce

leve

l and

bro

ad

desc

ript

ion

of le

vel o

f pra

ctic

e/ro

leS

fH c

aree

r fr

amew

ork*

Expe

rt

RN

(C

hild

/Adu

lt)

or R

M

Post

-reg

istr

atio

n n

eon

atal

qu

alifi

cati

on

NM

C m

ento

r/pr

acti

ce e

duca

tor

qual

ifica

tion

En

han

ced

neo

nat

al n

urs

e pr

acti

tion

er

Edu

cate

d to

mas

ter’

s de

gree

leve

l or

equ

ival

ent

Rec

ogn

itio

n o

f pr

ior

exp

erie

nti

al

lear

nin

g in

clin

ical

, edu

cati

on,

lead

ersh

ip o

r m

anag

emen

t ro

les

To r

emai

n in

rol

e:1.

con

solid

ates

kn

owle

dge

and

skill

s de

velo

pmen

t

2. c

onti

nu

ous

upd

atin

g to

rem

ain

con

tem

por

ary

3. a

cces

s to

doc

tora

l an

d p

ost-

doct

oral

stu

dy t

o ad

van

ce n

eon

atal

nu

rsin

g in

th

e fu

ture

Ach

ieve

s an

d m

ain

tain

s co

mp

eten

ce fo

r ex

per

t n

eon

atal

nu

rses

.

For

thos

e in

clin

ical

pra

ctic

e ex

per

t ro

les,

ac

hie

ves

and

sust

ain

cor

e cl

inic

al s

kills

set

as

spec

ified

wit

hin

exp

ert

leve

l or

as lo

cally

de

term

ined

.

Exp

ert

neo

nat

al n

urs

e ro

les

incl

ude

n

eon

atal

un

it m

anag

er, n

eon

atal

pra

ctic

e de

velo

pmen

t, fa

cilit

ator

/fam

ily s

upp

ort/

safe

guar

din

g le

ad, r

esea

rch

er, e

stab

lish

ed

adva

nce

d n

eon

atal

nu

rse

prac

titi

oner

, n

eon

atal

nu

rse

con

sult

ant.

Leve

l 7-8

A

dvan

ced

prac

titi

oner

Leve

l 8 p

lus

C

onsu

ltan

t

Edu

cato

r

Res

earc

her

Exe

cuti

ve

Sen

ior

boar

d le

vel

*It i

s im

port

ant t

o no

te th

at th

e ca

reer

fram

ewor

k le

vels

do

not e

quat

e di

rect

ly to

Age

nda

for C

hang

e pa

y ba

nds.



SHCSWs working at this level would be expected to care for infants who require special care under the direct supervision of a registered practitioner or Level 4 assistant practitioner/nurse. At present not all UK countries use Level 3 health care support workers.

Assistant practitioner Level 4

For those who can provide evidence of previous experience and consolidation of practice as a SHCSW and who have the appropriate level of knowledge and skill and can demonstrate the depth of understanding and ability to care for infants requiring special care.

In addition to meeting national mandatory induction standards, participating in local induction and orientation programmes, and role-specific in-house education, all staff will have the opportunity to attain neonatal specific education at NVQ4/foundation degree or equivalent.

Within this role the assistant practitioner will have in-depth knowledge and understanding and a comprehensive skill base related to their practice. They will be expected to assess, plan, deliver and evaluate aspects of care of an infant requiring special and minimal high dependency care under direct or indirect supervision of a registered practitioner. The assistant practitioner will support and act as a mentor and role model for HCSWs and senior HCSWs and offer help and support to more senior colleagues.

Benner level – novice/advanced beginner: new entrant

If using the Benner model – the novice to advanced beginner would define the new entrant to neonatal nursing.

For those with no prior experience of the sick or compromised neonate following initial registration, this would be the point of entry into the RCN career and educational framework for registrants to support neonatal nursing across the UK.

All newly qualified entrants to neonatal nursing will require a period of preceptorship in order to make the transition from being a student to becoming an accountable practitioner (NMC circular 21/2006). Preceptorship programmes should be aligned with local induction programmes which facilitate familiarisation with local policies and procedures.

The application of ‘levels of practice’ to the neonatal workforce

Health care support worker (HCSW) Level 2

For those with no prior experience of working within the health care sector or with experience outside maternity and neonatal services, this would be the point of entry into the RCN career and educational framework to support neonatal nursing across the UK.

All staff will be required to meet national mandatory induction standards and participate in local induction and orientation programmes; for example, cleanliness champions, breastfeeding support training, child protection and basic life support training. HCSWs working at this level would be expected to care for the well infant, detect deterioration in the condition of the infant, support colleagues in diagnostic procedures and implement treatments as instructed under the direct supervision of a registered practitioner or Level 4 assistant practitioner. At present not all countries in the UK use Level 2 health care support workers.

Senior health care support worker (SHCSW) Level 3

For those who can evidence previous experience and/or consolidation of practice as HCSW or appropriate level of knowledge and skill to care for infants requiring special care, this would be the point of entry into the RCN career and educational framework to support neonatal nursing across the UK.

In addition to meeting national mandatory induction standards and participating in local induction and orientation programmes, all staff will participate in role-specific in-house education; for example, develop awareness of subtle cues/behavioral changes concerning infant/family wellbeing, carry out familiar tasks with minimal supervision and/or more specialised tasks and duties delegated to them, use specialist equipment, recognise risk in relation to care provision and utilise assessment tools as appropriate, show awareness of patient advocacy, act as a role model for HCSWs and offer help and support to more senior colleagues.

12


Return to contents

education (HE) sector, which is subject to rigorous quality control to ensure a standardised level of attainment. Such education and training programmes will be consistent with higher education undergraduate degree level, specifically focused on the neonate across all the care categories as defined nationally (BAPM, 2001). In England, neonatal modules of study within higher education at the present time are generally 30 and 60 HE credits at HE level 5 or 6. In Scotland, these courses are 20 and 40 credits at SCQF level 10. As registered nursing/midwifery is now an all graduate profession it is recommended that:• futureprovisionofspecialisteducationtosupportthe

‘neonatal nurse/midwife’ should be offered at postgraduate degree level, but with f lexibility of level to facilitate the attainment of degrees for those who have a diploma or equivalent qualification gained in the UK or abroad and this will support the progression towards an all graduate status for nurse/midwife. All staff who undertake this level of study and skill acquisition should be recognised nationally within the neonatal community as a neonatal nurses/midwives in line with previous recommendations (NES, 2002).

Career progression

The neonatal nurse/midwife may choose to remain within the competent level of practice, embedding education and continuing to demonstrate knowledge, competence and core clinical skills of the neonatal nurse/midwife QIS. Neonatal nurses and midwives will assume personal responsibility for continuing professional development to support contemporary practice (NMC, 2010). They will teach and supervise learners in the skills within their range of competence, so must work towards a recognised NMC mentorship qualification with sign-off responsibility – so reflecting the principles already evident within pre-registration assessment (NMC 2009a).

Progression can occur if the neonatal nurse/midwife engages in additional experience/education to develop the skills required to achieve the knowledge, competence and core clinical skill set for the experienced neonatal nurse who operates at the proficient level of practice. Typically this will require completion of a postgraduate programme of study.

Benner model – proficient: the experienced neonatal nurse/midwife

Experienced neonatal nurses/midwives function at this level of practice and will provide effective management of all levels of neonatal care. This level of nurse/midwife is

During preceptorship and beyond, these ‘novices’ would be supported to develop the competence and core clinical skill for new entrants to enable them to provide basic care within the special care situations. This practical development would be complemented by the acquisition of additional knowledge via in-house, network or higher education institute study sessions – so creating a foundation of knowledge to support initial and subsequent career development (DH, 2009; Scottish Government, 2013).

An established nurse or midwife at this career level (one-year post registration) would be expected to commence work towards a NMC-recognised mentorship qualification to facilitate the experience of student health care professionals during neonatal placements in their specified area of expertise (NMC, 2008a).

Nurses/midwives working at this level would not be expected to work routinely with complex neonates in any care category. Although they should have insight into high dependency/intensive care they would not be equipped to provide these levels of care without direct supervision.

Career progression

Those who aspire to advance their career should be encouraged to work towards the requirements for the competent level of practice by undertaking a post-registration specialist neonatal education and training programme. This will involve developing care knowledge and skills within high dependency and intensive care environments under direct supervision of a nurse who is qualified in specialty (QIS) and the attainment of competence and the core skill set of the neonatal nurse QIS.

Benner level – competent: the neonatal nurse/midwife (QIS)

Progression to neonatal nurse/midwife status can occur after successfully completing a post-registration education and training programme and demonstrating the competences and core clinical skills as a neonatal nurse/midwife qualified in specialty.

Although the term ‘neonatal nurse/midwife’ is not recordable on the professional register as yet, it is essential from a workforce perspective that the knowledge, skills and competences inferred by this status are transferable across the UK. Therefore, the theoretical component of the specialist education required for operation as a neonatal nurse/midwife should be based within the UK higher



national guidance, debate and policy. Roles at this level may include the following:• neonatalmanager–providingservicemanagementfora

defined area

• neonatalmatron–providingserviceandclinicalmanagement for a defined area

• neonatalpracticedevelopmentfacilitator/researcher– leading on and promoting best practice through patient safety and quality improvement initiatives, including and undertaking clinical audit and research

• advancedandspecialistroles–expertsinspecificareasof neonatal care

• accessingandcompletinganadvancedneonatalnursepractitioner programme (ANNP*); equipping the ANNP to provide total care for a caseload of infants. The ANNP programme should be achieved through a UK-wide accredited educational programme and the ANNP should work within a designated advanced neonatal nurse practitioner role; this should help eliminate variability between programmes and roles

• neonatalnurses/midwifeconsultants/educators and researchers – championing strategic policy development/equipping the neonatal work force of the future and performing studies to push the boundaries of care forward and making today’s dreams tomorrow’s reality.

All expert neonatal nurses/midwives will have undertaken postgraduate study to support and develop their roles. While all operate at expert level of competence, only clinical practice experts would be operating at the expert level of the core skills as this is not a requirement for those whose role has diverted from the direct provision of neonatal care.

Career progression

Experts will engage with appropriate CPD opportunities to remain contemporary within their role (NMC, 2010) and be able to successfully revalidate. They should assist in the education and development of the future workforce as determined locally (NMC, 2008a). The development of greater expertise to enhance neonatal care will involve the completion of a postgraduate higher education and training programme to master’s degree level and/or leading to a master’s degree qualification/doctoral study and post doctorial education where appropriate for the role.

sufficiently experienced to act independently within a multi-disciplinary/multi-agency context, and reflects roles such as:• clinicalspecialist

• neonataltransportation

• shiftmanagementroles(forexample,wardchargenurse/midwife/sister)

• developmentcarelead

• lactationsupport

• communityoutreachpractitioner

• practicedevelopment/clinicaleducator.

The experienced neonatal nurse/midwife has completed an academic degree that supports an individual’s higher level functioning in the neonatal unit. Such an award may give them eligibility to record a professional qualification of specialist practitioner.

In collaboration with medical staff and advanced neonatal nurse practitioners, the experienced neonatal nurse/midwife will assess, plan, implement and evaluate the overall management of infants requiring all levels of neonatal care; will assess and manage critical and clinical events to ensure safe and effective care, summoning appropriate assistance as necessary; and will facilitate learning by others in the neonatal unit (NMC, 2008a).

Career progression

Experienced nurses/midwives working at the proficient level of practice would, like all others, be required to maintain contemporary practice (NMC, 2008b) and will demonstrate competence and core clinical skills as an experienced neonatal nurse/midwife.

However, those who aspire to the expert practice level will engage with postgraduate higher education study leading towards a master’s degree qualification. Where future career development remains embedded within clinical practice, then the experienced nurse/midwife would also work towards developing the competence and core clinical skills associated with the expert roles in neonatal nursing.

Benner level – expert: this could include specific roles beyond neonatal nursing alone

Experienced neonatal nurses may choose to further develop their knowledge, skills and competence to this level to become an expert neonatal nurse who is able to function in an independent role. The expert nurse will engage in

* ANNP practitioners can also be midwives.

14


Return to contents

Communication and interpersonal relationships

Including data processing and management, production and communication of information and knowledge, and the design and production of visual records.

The neonatal practitioner will utilise a wide range of media to communicate effectively with infants, parents, carers and health care workers. The neonatal practitioner will demonstrate interpersonal behaviour and skills conducive to developing and maintaining therapeutic and professional relationships.

Elements• Communicateeffectivelywithinfants,family,relatives,

carers and other professional colleagues.

• Actastheinfant’sadvocate.

• Maintaineffectiveandsupportivecommunicationwithin the neonatal nursing team and with other professionals.

• Contributetocreatinganenvironmentthatfostersopencommunication and trust with families and colleagues.

• Liaisewithhealthcareprofessionalsandindividualsinother disciplines from within and outwith the organisation to support quality patient care.

Tools• Allformsofcommunication–oral,written,electronic,

body language, tone of voice.

• Activelistening.

• Facilitating.

• Advisingandcounselling.

• Influencingandpersuading.

Core competences for neonatal practice

The development of core competences can be seen as integral to the neonatal practitioner’s career development as seen in Section 1. In compliance with the NHS career structure and development, the competences were informed by the Knowledge and skills framework (NHS, 2004) which cites the dimensions outlined below. Aspects of family-centered and developmental care are embedded within the core dimensions which are presented under the following headings:• communicationandinterpersonalrelationships

• personal,professionalandpeopledevelopment

• health,safetyandsecurity

• servicedevelopment

• quality

• equality,diversityandrights

• responsibilityforpatientcare.

The competences included under each heading overlap with several of the specific dimensions of the NHS (2004) KSF, therefore these are included as subheadings throughout. It is recognised that each unit will have developed their own role profiles and that these may be more extensive or place different emphasis on certain aspects of the core competences.

2



Com

pete

nces

for

the

leve

ls o

f neo

nata

l pra

ctic

e

Lev

el 2

Lev

el 3

Lev

el 4

Com

mu

nic

ates

eff

ecti

vely

wit

h a

ran

ge o

f p

eopl

e on

a r

ange

of

mat

ters

.•

Nee

ds t

o be

abl

e to

com

mu

nic

ate

wit

h a

ran

ge o

f p

eopl

e on

a

ran

ge o

f m

atte

rs in

a fo

rm t

hat

is a

ppro

pria

te t

o th

em a

nd

the

situ

atio

n. T

hes

e m

ay b

e pa

ren

ts u

nde

r st

ress

an

d pa

ren

ts

wh

ose

lan

guag

e is

not

En

glis

h.

• M

anag

es b

arri

ers

to e

ffec

tive

com

mu

nic

atio

n.

• C

omm

un

icat

es in

su

ch a

way

as

to d

emon

stra

te c

ompa

ssio

n

and

empa

thy,

wit

h r

esp

ect,

and

pres

erve

th

e di

gnit

y of

th

e fa

mily

.•

Shou

ld b

e se

nsi

tive

as

to w

hen

com

mu

nic

atio

n is

not

goi

ng

wel

l an

d be

min

dfu

l of

thei

r sc

ope

in p

ract

ice

and

seek

ear

ly

supp

ort.

• K

eeps

acc

ura

te a

nd

com

plet

e re

cord

s co

nsi

sten

t w

ith

le

gisl

atio

n, p

olic

ies

and

proc

edu

res.

• A

ppre

ciat

es t

he

nee

d fo

r co

nfi

den

tial

ity

of in

form

atio

n a

nd

how

it is

mai

nta

ined

.•

Dem

onst

rate

s ac

cura

te v

erba

l han

dove

r in

eve

ry s

ecti

on.

Dev

elop

s an

d m

ain

tain

com

mu

nic

atio

n w

ith

peo

ple

abou

t di

fficu

lt m

atte

rs a

nd/

or in

dif

ficu

lt s

itu

atio

ns.

• Id

enti

fies

th

e ra

nge

of

peo

ple

likel

y to

be

invo

lved

in t

he

com

mu

nic

atio

n p

roce

ss a

nd

seek

to

iden

tify

pot

enti

al

com

mu

nic

atio

n d

iffe

ren

ces.

• P

rese

nts

info

rmat

ion

in t

he

rele

van

t co

nte

xt.

• C

omm

un

icat

es w

ith

peo

ple

in a

form

an

d m

ann

er t

hat

is

con

sist

ent

wit

h t

hei

r le

vel o

f u

nde

rsta

ndi

ng,

cu

ltu

re,

back

grou

nd

and

pref

erre

d w

ays

of c

omm

un

icat

ing.

• R

ecog

nis

es a

nd

refl

ects

on

bar

rier

s to

eff

ecti

ve

com

mu

nic

atio

n.

• Su

ppor

ts a

cu

ltu

re o

f co

mm

un

icat

ion

wh

ich

has

th

e in

fan

t an

d fa

mily

at

the

cen

tre

of t

he

proc

ess.

• M

odel

s st

yles

wh

ich

dem

onst

rate

car

ing,

com

pass

ion

an

d em

path

y.

• (W

ith

som

e re

spon

sibi

lity

to L

evel

2 c

olle

agu

es)

prov

ides

fe

edba

ck t

o ot

her

wor

kers

as

appr

opri

ate.

• K

eeps

acc

ura

te a

nd

com

plet

e re

cord

s of

act

ivit

ies

con

sist

ent

wit

h le

gisl

atio

n, p

olic

ies

and

proc

edu

res.

• U

nde

rsta

nds

th

e n

eed

for

con

fide

nti

alit

y of

info

rmat

ion

an

d h

ow it

is m

ain

tain

ed.

Shou

ld h

ave

the

com

pet

ence

to

faci

litat

e an

un

ders

tan

din

g of

th

e im

por

tan

ce o

f co

mm

un

icat

ion

an

d in

terp

erso

nal

re

lati

onsh

ips.

• D

iscu

sses

th

e im

por

tan

ce o

f co

mm

un

icat

ing

and

inte

ract

ing

in a

pro

fess

ion

al m

ann

er w

ith

par

ents

an

d m

embe

rs o

f th

e m

ult

idis

cipl

inar

y te

am.

• D

emon

stra

tes

in p

ract

ice

the

prin

cipl

es o

f ef

fect

ive

com

mu

nic

atio

n a

nd

appr

opri

ate

com

mu

nic

atio

n s

kills

wh

ich

ta

kes

into

con

side

rati

on t

he

wh

ole

fam

ily.

• St

ates

th

e im

por

tan

ce o

f fa

mily

-cen

tred

car

e an

d h

ow it

is

impl

emen

ted

on t

he

un

it.

• D

emon

stra

tes

the

abili

ty t

o de

liver

acc

ura

te v

erba

l han

dove

r at

th

e co

t si

de.

• D

emon

stra

tes

the

abili

ty t

o re

cord

acc

ura

te in

form

atio

n in

pa

tien

t re

cord

s, b

oth

wri

tten

an

d el

ectr

onic

ally

.•

Dem

onst

rate

s th

e ab

ility

to

inte

ract

wit

h p

aren

ts a

nd

fam

ilies

in

dif

fere

nt

and

diffi

cult

car

e se

ttin

g.•

Show

s em

path

y/co

mpa

ssio

n a

nd

cari

ng

atti

tude

to

pati

ents

, pa

ren

ts a

nd

fam

ilies

.•

Com

mu

nic

ates

in a

n a

ppro

ach

able

, cou

rteo

us

and

prof

essi

onal

man

ner

.•

Dem

onst

rate

s an

un

ders

tan

din

g of

th

e n

eed

for

con

fide

nti

alit

y of

info

rmat

ion

an

d h

ow it

is m

ain

tain

ed.

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

C

ompe

tent

neo

nata

l nur

se/m

idw

ife

(QIS

) P

rofi

cien

t ne

onat

al n

urse

/mid

wif

e E

xper

t ne

onat

al n

urse

/mid

wif

e

• U

nde

rsta

nds

th

e im

por

tan

ce o

f ef

fect

ive

com

mu

nic

atio

n.

• D

emon

stra

tes

the

abili

ty t

o co

mm

un

icat

e ef

fect

ivel

y an

d ef

fici

entl

y w

ith

col

leag

ues

.•

Com

mu

nic

ates

tac

tfu

lly, m

ain

tain

ing

tru

st,

inte

grit

y an

d co

nfi

den

ce.

• U

ses

effe

ctiv

e co

mm

un

icat

ion

str

ateg

ies

to

wor

k w

ith

infa

nts

an

d in

par

tner

ship

wit

h

pare

nts

/car

ers,

giv

ing

them

info

rmat

ion

n

eces

sary

to

faci

litat

e in

form

ed c

hoi

ce, t

o m

eet

the

nee

ds o

f th

e in

fan

t.•

Use

s co

mm

un

icat

ion

str

ateg

ies

to e

mpa

this

e th

e ca

rin

g en

viro

nm

ent.

• C

olle

cts,

col

late

s, r

ecor

ds, i

npu

ts a

nd

rep

orts

ro

uti

ne

and

sim

ple

data

an

d in

form

atio

n.

• M

ain

tain

s ac

cura

te a

nd

con

tem

por

aneo

us

reco

rds.

• D

evel

ops

a ra

ppor

t an

d co

mm

un

icat

es

effe

ctiv

ely

wit

hin

th

e n

eon

atal

tea

m a

nd

wit

h

oth

er h

ealt

h c

are

prof

essi

onal

s, a

bou

t ro

uti

ne

and

daily

act

ivit

ies,

ove

rcom

ing

diff

eren

ces

that

may

exi

st.

• P

rom

otes

eff

ecti

ve r

esp

ectf

ul c

omm

un

icat

ion

pr

oces

ses

wit

h in

fan

ts, f

amili

es a

nd

colle

agu

es.

• W

ith

in t

he

real

m o

f al

loca

ted

resp

onsi

bilit

y,

infl

uen

ces

and

teac

hes

oth

ers.

• H

as t

he

cou

rage

to

act

as t

he

infa

nt’s

adv

ocat

e w

hen

app

ropr

iate

.•

Has

th

e co

nfi

den

ce t

o co

mm

un

icat

e ba

d n

ews.

•

Stru

ctu

res,

an

alys

es, i

nte

rpre

ts a

nd

rep

orts

fa

ctu

al d

ata

and

info

rmat

ion

an

d su

per

vise

s ot

her

s in

th

e m

ain

ten

ance

of

accu

rate

an

d co

nte

mp

oran

eou

s re

cord

s.•

Ch

ecks

info

rmat

ion

, con

firm

s ac

cura

cy,

reco

gnis

es d

iscr

epan

cies

an

d ta

ke a

ppro

pria

te

acti

on.

• P

roce

sses

, mod

ifies

an

d m

anag

es d

ata

and

info

rmat

ion

.•

Wri

tes

com

plex

rep

orts

.•

Pre

pare

s an

d de

liver

s pr

esen

tati

ons.

• E

stab

lish

es a

nd

mai

nta

ins

com

mu

nic

atio

n

wit

h in

divi

dual

s an

d gr

oups

abo

ut

com

plex

an

d di

fficu

lt n

eon

atal

mat

ters

, ove

rcom

ing

any

prob

lem

s.•

Act

ivel

y su

ppor

ts a

nd

lead

s in

itia

tive

s to

en

sure

op

tim

al c

omm

un

icat

ion

of

loca

l an

d n

atio

nal

pol

icy

dire

ctiv

es a

nd

info

rmat

ion

p

erti

nen

t to

neo

nat

al c

are.

• Pe

rsu

ades

, mot

ivat

es, i

nfl

uen

ces

and

neg

otia

tes

wit

h a

wid

e ra

nge

of

peo

ple

to

assi

st w

ith

dec

isio

n-m

akin

g an

d ac

tion

as

requ

ired

.•

An

alys

es, i

nte

rpre

ts a

nd

rep

orts

info

rmat

ion

an

d kn

owle

dge

rela

ted

to id

eas

and

con

cep

ts.

• In

flu

ence

s st

rate

gic

pol

icy

mak

ing

at lo

cal a

nd

nat

ion

al le

vel.

• Le

ads

mee

tin

gs, g

ives

pre

sen

tati

ons

and

infl

uen

ces

a w

ide

ran

ge o

f in

divi

dual

s an

d gr

oups

at

stra

tegi

c le

vel t

o ta

ke a

ctio

n a

nd

mak

e ch

ange

s.•

Rec

eive

s an

d pr

oces

ses

com

plex

, sen

siti

ve a

nd

con

ten

tiou

s in

form

atio

n, i

nit

iati

ng

acti

ons

requ

ired

.•

Est

ablis

hes

an

d m

ain

tain

s co

mm

un

icat

ion

w

ith

var

iou

s in

divi

dual

s an

d gr

oups

on

co

mpl

ex, w

ide

ran

gin

g an

d p

oten

tial

ly

stre

ssfu

l top

ics

rela

ted

to n

eon

atal

ser

vice

s.•

En

able

s ef

fect

ive

com

mu

nic

atio

n t

o ov

erco

me

barr

iers

.•

Des

ign

s an

d de

velo

ps s

trat

egie

s to

pro

cess

an

d m

anag

e da

ta a

nd

info

rmat

ion

.•

An

alys

es, s

ynth

esis

es a

nd

pres

ents

kn

owle

dge

and

info

rmat

ion

abo

ut

com

plex

su

bjec

ts a

nd

con

cep

ts t

o in

flu

ence

key

dec

isio

ns.

16


Return to contents

Personal, professional and people development

The neonatal practitioner will assume responsibility for personal professional development, demonstrating a commitment to lifelong learning and activities that enhance knowledge, skills, values and attitudes required for safe and effective neonatal nursing practice.

Elements• Practiceatalltimeswithincurrentlegislation,

professional rules, codes and guidelines.

• Provideongoingevidenceofcompetencethroughmaintenance of a personal professional portfolio.

• Developselfandothers.

• Contributetopracticedevelopmentthroughactiveparticipation in clinical working groups.

• Contributetothedevelopmentofthephilosophyofshared governance within the neonatal team.

• Facilitateandactivelyparticipateinclinicalsupportactivities and orientation of colleagues and learners.

Tools• Formallearning.

• On-the-jobtrainingopportunities.

• E-learning.

• Accesstospecifictrainingandawards.

• Networking.

• Clinicalsupervision.



Com

pete

nces

for

the

leve

ls o

f neo

nata

l pra

ctic

e

Lev

el 2

Lev

el 3

Lev

el 4

Dev

elop

s ow

n k

now

ledg

e an

d sk

ills

and

prov

ide

info

rmat

ion

to

oth

ers

to h

elp

thei

r de

velo

pmen

t.•

Res

pon

ds p

osit

ivel

y to

th

e co

nst

ruct

ive

feed

back

from

oth

ers

and

is p

roac

tive

in s

eeki

ng

area

s to

dev

elop

an

d en

han

ce t

hei

r ow

n s

kills

an

d in

tere

sts

in t

he

deve

lopm

ent

of t

he

serv

ice

wit

hin

th

eir

curr

ent

pos

t.•

Refl

ects

on

wh

at h

as b

een

hel

pfu

l in

th

eir

lear

nin

g an

d de

velo

pmen

t to

dat

e.•

Take

s an

act

ive

part

in t

he

ann

ual

dev

elop

men

tal r

evie

w o

f ow

n w

ork

agai

nst

th

eir

role

des

crip

tors

/ou

tlin

e fo

r th

e p

ost

wit

h t

hei

r re

view

er a

nd

proa

ctiv

ely

sugg

ests

are

as fo

r le

arn

ing

and

deve

lopm

ent

in t

he

com

ing

year

.•

Take

s an

act

ive

part

in le

arn

ing

opp

ortu

nit

ies

of p

aren

ts a

nd

oth

ers.

•

Eval

uat

es t

he

effe

ctiv

enes

s of

lear

nin

g op

por

tun

itie

s an

d al

erts

ot

her

s to

ben

efits

an

d pr

oble

ms.

• K

eeps

an

up-

to-d

ate

reco

rd/p

ortf

olio

of

thei

r ow

n

deve

lopm

enta

l pro

gres

s.

Dev

elop

s on

esel

f an

d co

ntr

ibu

tes

to t

he

deve

lopm

ent

of o

ther

s.•

Can

refl

ect

con

stru

ctiv

ely

on t

he

feed

back

from

oth

ers

and

can

ev

alu

ate

how

wel

l th

ey a

re a

pply

ing

thei

r kn

owle

dge

and

skill

s to

mee

t th

eir

curr

ent

wor

k.•

Mee

ts t

he

dem

ands

an

d th

e re

quir

emen

ts o

f th

eir

pos

t.•

Iden

tifi

es o

wn

dev

elop

men

t n

eeds

an

d se

ts o

wn

per

son

al

deve

lopm

ent

obje

ctiv

es in

dis

cuss

ion

wit

h t

hei

r re

view

er.

• Ta

kes

resp

onsi

bilit

y fo

r ow

n p

erso

nal

dev

elop

men

t an

d m

ain

tain

s ow

n p

erso

nal

dev

elop

men

t p

ortf

olio

.•

Mak

es e

ffec

tive

use

of

lear

nin

g op

por

tun

itie

s w

ith

in a

nd

outs

ide

the

wor

kpla

ce, e

valu

atin

g th

eir

effe

ctiv

enes

s an

d fe

edin

g ba

ck r

elev

ant

info

rmat

ion

.•

En

able

s ot

her

s to

dev

elop

an

d ap

ply

thei

r kn

owle

dge

and

skill

s in

pra

ctic

e.•

Teac

hes

an

d su

ppor

ts p

aren

ts a

nd

mor

e ju

nio

r co

lleag

ues

. •

Con

trib

ute

s to

th

e de

velo

pmen

t of

oth

ers

in a

man

ner

th

at is

co

nsi

sten

t w

ith

legi

slat

ion

, pol

icie

s an

d pr

oced

ure

s.•

Con

trib

ute

s to

th

e op

por

tun

itie

s in

th

e w

orkp

lace

to

supp

ort

oth

ers

to s

ee it

as

a le

arn

ing

envi

ron

men

t.

Dev

elop

s th

e co

mp

eten

ce t

o fa

cilit

ate

an u

nde

rsta

ndi

ng

of t

he

imp

orta

nce

of

per

son

al, p

rofe

ssio

nal

an

d p

eopl

e de

velo

pmen

t.•

Dem

onst

rate

s th

ey r

ecog

nis

e th

eir

own

lim

itat

ion

s an

d le

vel o

f ab

ility

an

d de

velo

ps le

arn

ing

plan

s to

mee

t p

erso

nal

lear

nin

g n

eeds

.•

Show

s an

un

ders

tan

din

g of

all

asp

ects

of

con

fide

nti

alit

y.•

Dem

onst

rate

s an

insi

ght

into

th

e le

vel o

f sk

ills

and

exp

erie

nce

an

d ar

eas

wh

ere

they

nee

d to

impr

ove.

•

Is a

ble

to id

enti

fy t

hei

r lim

itat

ion

in p

ract

ice

and

can

iden

tify

th

eir

lear

nin

g n

eeds

via

th

eir

per

son

al d

evel

opm

ent

plan

(P

DP

).•

Dem

onst

rate

s th

e u

se o

f re

flec

tive

pra

ctic

e to

dev

elop

th

eir

skill

s.•

Dem

onst

rate

s th

ey a

re a

war

e of

th

e kn

owle

dge

and

skill

for

thei

r gr

ade.

• D

emon

stra

tes

that

wh

erev

er p

ossi

ble

they

hav

e ac

tive

ly

part

icip

ated

in le

arn

ing

opp

ortu

nit

ies

to d

evel

op k

now

ledg

e an

d sk

ills.

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

/mid

wif

e (Q

IS)

Pro

fici

ent

neon

atal

nur

se/m

idw

ife

Exp

ert

neon

atal

nur

se/m

idw

ife

• C

ontr

ibu

tes

to o

wn

per

son

al d

evel

opm

ent.

• Is

aw

are

of li

mit

atio

ns

of s

kills

an

d sc

ope

of

prof

essi

onal

pra

ctic

e in

neo

nat

al n

urs

ing,

ex

erci

ses

acco

un

tabi

lity

and

seek

s ad

vice

an

d su

ppor

t ac

cord

ingl

y.•

Dem

onst

rate

s a

com

mit

men

t to

con

tin

uou

s pr

ofes

sion

al d

evel

opm

ent

and

acti

vely

pa

rtic

ipat

e in

th

e ap

prai

sal p

roce

ss.

• A

ctiv

ely

part

icip

ates

in t

each

ing

prog

ram

mes

an

d fa

cilit

ates

lear

nin

g.

• R

ecog

nis

es s

ign

s of

ow

n n

egat

ive

stre

ss a

nd

seek

s ap

prop

riat

e su

ppor

t.

• D

evel

ops

own

kn

owle

dge,

ski

lls a

nd

prac

tice

an

d co

ntr

ibu

tes

to t

he

deve

lopm

ent

of o

ther

s.•

Act

s as

a r

esou

rce

of s

pec

ialis

t kn

owle

dge

and

clin

ical

pra

ctic

e.•

Fost

ers

an e

nvir

onm

ent

that

en

cou

rage

s st

aff

deve

lopm

ent,

supp

orti

ng

and

cou

nse

llin

g st

aff

as n

eces

sary

.•

Dev

elop

s, d

eliv

ers

and

eval

uat

es s

taff

de

velo

pmen

t pr

ogra

mm

es t

hat

su

ppor

t th

e ac

hie

vem

ent

of c

linic

al s

kills

, lea

ders

hip

an

d be

st p

ract

ice

in n

eon

atal

nu

rsin

g.

• D

evel

ops

own

kn

owle

dge

and

skill

s to

rem

ain

cu

rren

t in

pra

ctic

e, d

isse

min

atin

g n

ew

know

ledg

e an

d sk

ills

for

wid

er b

enefi

t.•

Iden

tifi

es o

wn

lim

itat

ion

s an

d/or

kn

owle

dge

and

skill

defi

cits

, for

mu

late

s a

plan

of

acti

on

and

orga

nis

es d

evel

opm

ent

opp

ortu

nit

ies

to

enh

ance

con

tin

uou

s pr

ofes

sion

al

deve

lopm

ent.

•

Rec

ogn

ises

th

e lim

itat

ion

s of

oth

ers;

pro

vide

s su

ppor

t/in

form

atio

n/t

each

ing

to o

ther

s to

h

elp

thei

r de

velo

pmen

t.•

Rec

ogn

ise

sign

s of

neg

ativ

e st

ress

in o

ther

s,

offe

rs s

upp

ort

and

wor

k to

war

ds a

llevi

atio

n

of t

ensi

on.

• D

emon

stra

tes

know

ledg

e of

pu

blic

pol

icie

s an

d pa

rtic

ipat

es in

pro

fess

ion

al a

ctiv

itie

s th

at

rela

te t

o th

e ad

van

cem

ent

of n

eon

atal

nu

rsin

g pr

acti

ce.

• D

evel

ops

and

eval

uat

es o

wn

an

d ot

her

s’

know

ledg

e an

d pr

acti

ce a

cros

s pr

ofes

sion

al

and

orga

nis

atio

nal

bou

nda

ries

.•

Iden

tifi

es a

nd

deliv

ers

stra

tegi

es t

o en

sure

th

e pr

ovis

ion

of

edu

cati

on a

nd

deve

lopm

ent

prog

ram

mes

to

mee

t th

e n

eeds

of

the

neo

nat

al s

ervi

ce.

• Su

ppor

ts t

he

deve

lopm

ent

of a

cu

ltu

re in

w

hic

h p

rofe

ssio

nal

s le

arn

tog

eth

er.

• Su

ppor

ts t

he

deve

lopm

ent

of a

cu

ltu

re in

w

hic

h in

divi

dual

s ar

e va

lued

an

d in

ter-

prof

essi

onal

lear

nin

g is

en

cou

rage

d.

18


Return to contents

Health, safety and security

The neonatal practitioner will utilise a range of policies, procedures and protocols that optimise a safe and secure environment that supports neonatal practice.

Elements• Maintainandpromotehealth,safetyandsecurity.

• Demonstrateknowledgeofandcomplywithlocalandnational health and safety legislation, infection control policies, and clinical governance and risk management regulations.

• Contributetomaintainingasafeandsecureenvironment.

Tools• Healthandsafetylegislationandpolicies.

• Infectioncontrolpolicies.

• Clinicalgovernance.

• Riskmanagement.

• Movingandhandling.

• Staffgovernance.

• Training/mandatoryupdatesasdefinedinemployer’shealth and safety policies and procedures.



Com

pete

nces

for

the

leve

ls o

f neo

nata

l pra

ctic

e

Lev

el 2

Lev

el 3

Lev

el 4

Mon

itor

s an

d m

ain

tain

s h

ealt

h, s

afet

y an

d se

curi

ty o

f se

lf a

nd

oth

ers.

• A

tten

ds a

nd

com

plet

es t

he

in-h

ouse

man

dato

ry a

nd

stat

uto

ry

trai

nin

g in

clu

din

g th

e ch

ild s

afeg

uar

din

g, h

ealt

h, s

afet

y an

d se

curi

ty s

essi

ons.

• C

an d

emon

stra

te w

ays

to m

inim

ise

risk

to

hea

lth

, saf

ety

and

se

curi

ty w

hic

h m

ay in

clu

de:

1. s

afe

han

d hy

gien

e pr

acti

ces

and

use

of

per

son

al p

rote

ctio

n

equ

ipm

ent

2. m

ovin

g an

d h

and

ling

infa

nts

/equ

ipm

ent

3. a

larm

sys

tem

s4.

mon

itor

ing

pare

nti

ng

skill

s5.

cle

anin

g eq

uip

men

t an

d eq

uip

men

t u

se6.

saf

e h

and

ling

of E

BM

an

d in

fan

t fo

rmu

la7.

per

son

al h

ealt

h m

ain

ten

ance

. •

Rec

ogn

ises

th

e n

eed

for

‘dev

elop

men

tal c

are’

an

d ‘q

uie

t ti

me’

on

th

e n

eon

atal

un

it.

• A

ssis

ts a

nd

supp

orts

th

e n

eon

atal

mu

ltid

isci

plin

ary

team

in

the

asse

ssm

ent

of a

ctu

al a

nd

pot

enti

al r

isks

in t

he

wor

kpla

ce

for

self

an

d ot

her

s.•

Can

acc

ess

and

use

ris

k as

sess

men

t to

ols

and

supp

ort

the

neo

nat

al t

eam

in u

sin

g va

lidat

ed r

isk

asse

ssm

ent

tool

s.•

Mon

itor

s th

e sa

fety

of

the

envi

ron

men

t fo

r in

fan

ts a

nd

thei

r fa

mili

es.

• Id

enti

fies

an

d as

sess

es t

he

pot

enti

al r

isks

invo

lved

in t

hei

r w

ork

acti

viti

es a

nd

proc

esse

s fo

r se

lf a

nd

oth

ers.

• Id

enti

fies

how

bes

t to

man

age

the

risk

s.•

Wor

ks in

su

ch a

way

to

be c

ompl

ian

t w

ith

legi

slat

ion

, pol

icie

s an

d pr

oced

ure

s.•

Can

init

iate

th

e ac

tion

s re

quir

ed in

th

e m

anag

emen

t of

an

em

erge

ncy

sit

uat

ion

.•

Sum

mon

s as

sist

ance

imm

edia

tely

wh

en t

his

is n

eces

sary

.•

Is v

igila

nt

in r

epor

tin

g ac

tual

or

pot

enti

al p

robl

ems

that

may

pu

t h

ealt

h, s

afet

y an

d se

curi

ty a

t ri

sk a

nd

sugg

ests

how

th

ey

mig

ht

be a

ddre

ssed

.•

Supp

orts

oth

ers

in m

ain

tain

ing

hea

lth

, saf

ety

and

secu

rity

.

Pro

mot

es, m

onit

ors

and

mai

nta

ins

best

pra

ctic

e in

hea

lth

, saf

ety

and

secu

rity

.•

Part

icip

ates

in t

he

man

dato

ry a

nd

stat

uar

y tr

ain

ing

incl

udi

ng

the

child

saf

egu

ardi

ng,

hea

lth

, saf

ety

and

secu

rity

ses

sion

s.

May

lead

som

e se

ssio

ns.

•

Dem

onst

rate

s w

ays

to m

inim

ise

risk

to

hea

lth

, saf

ety

and

secu

rity

wh

ich

may

incl

ude

:1.

saf

e h

and

hygi

ene

prac

tice

s an

d u

se o

f p

erso

nal

pro

tect

ion

eq

uip

men

t2.

mov

ing

and

han

dlin

g in

fan

ts/e

quip

men

t3.

ala

rm s

yste

ms

4. m

onit

orin

g pa

ren

tin

g sk

ills

5. c

lean

ing

equ

ipm

ent

and

equ

ipm

ent

use

.6.

saf

e h

and

ling

of E

BM

an

d in

fan

t fo

rmu

la7.

per

son

al h

ealt

h m

ain

ten

ance

8. r

ole

mod

ellin

g be

hav

iou

rs d

esig

ned

to

min

imis

e ri

sks

to

infa

nt

and

fam

ilies

. •

Supp

orts

an

d en

forc

es t

he

un

its

deve

lopm

enta

l car

e st

rate

gies

an

d m

onit

ors

the

adh

eren

ce t

o th

e n

urs

ery

quie

t ti

me.

• Id

enti

fies

th

e ri

sks

invo

lved

in w

ork

acti

viti

es a

nd

proc

esse

s an

d su

ppor

t st

rate

gies

on

how

bes

t to

man

age

the

risk

s.•

Mon

itor

s w

ork

area

s an

d pr

acti

ces

and

ensu

res

they

are

saf

e an

d fr

ee fr

om h

azar

ds, t

hat

th

ey c

onfo

rm t

o h

ealt

h, s

afet

y an

d se

curi

ty le

gisl

atio

n, p

olic

ies,

pro

cedu

res

and

guid

elin

es.

• Ta

kes

the

nec

essa

ry a

ctio

n in

rel

atio

n t

o ri

sks,

iden

tifi

es h

ow

hea

lth

, saf

ety

and

secu

rity

can

be

impr

oved

an

d ta

kes

acti

on t

o pu

t th

is in

to e

ffec

t.

Com

pet

ence

to

faci

litat

e a

grea

ter

un

ders

tan

din

g of

th

e kn

owle

dge

and

skill

s re

quir

ed e

nsu

rin

g th

e h

ealt

h, s

afet

y an

d w

ellb

ein

g of

th

e in

fan

t, st

aff

and

visi

tors

.•

Dem

onst

rate

s th

at t

hey

hav

e co

mpl

eted

in-h

ouse

man

dato

ry

and

stat

uto

ry t

rain

ing,

incl

udi

ng

hea

lth

, saf

ety

and

secu

rity

.•

Dem

onst

rate

s th

e ab

ility

to

supp

ort

the

neo

nat

al n

urs

ing

team

in

th

e as

sess

men

t of

act

ual

an

d p

oten

tial

ris

ks in

th

e w

orkp

lace

for

self

an

d ot

her

s.•

Kn

ows

wh

ere

to a

cces

s ri

sk a

sses

smen

t to

ols

and

supp

ort

the

neo

nat

al t

eam

in u

sin

g va

lidat

ed r

isk

asse

ssm

ent

tool

s.•

Pro

mot

es a

nd

assi

sts

in m

ain

tain

ing

a h

ealt

hy, s

afe

and

secu

re

wor

kin

g en

viro

nm

ent

– ch

ecki

ng

fixt

ure

s an

d fi

ttin

gs in

th

e lo

w d

epen

den

cy n

urs

ery,

mai

nta

inin

g le

vels

of

hea

tin

g,

ligh

tin

g an

d ve

nti

lati

on.

• D

emon

stra

tes

safe

sys

tem

s of

wor

kin

g in

th

eir

day-

to-d

ay

prac

tice

for

self

an

d ot

her

s im

plem

ente

d as

a r

esu

lt o

f u

nde

rtak

ing

rele

van

t ri

sk a

sses

smen

ts; f

or e

xam

ple,

th

e co

rrec

t di

spos

able

of

clin

ical

an

d n

on-c

linic

al w

aste

.•

Dem

onst

rate

s ap

prop

riat

e u

se o

f se

curi

ty s

yste

ms

and

alar

ms,

th

e m

onit

orin

g of

par

ents

, vis

itor

s an

d ot

her

mem

bers

of

the

mu

ltid

isci

plin

ary

team

to

the

neo

nat

al u

nit

; for

exa

mpl

e,

chal

len

gin

g vi

sito

rs.

• Sh

ould

be

awar

e of

clin

ical

neg

ligen

ce, c

onfi

den

tial

ity

and

child

saf

egu

ardi

ng

issu

es.

• D

emon

stra

tes

know

ledg

e of

how

to

rep

ort

acci

den

ts a

nd

inci

den

ces.

• D

emon

stra

tes

know

ledg

e of

how

to

refe

r to

th

e n

eon

atal

tea

m

wh

en c

once

rned

abo

ut

actu

al o

r p

oten

tial

ris

ks.

• D

emon

stra

tes

way

s to

min

imis

e ri

sk t

o h

ealt

h, s

afet

y an

d se

curi

ty w

hic

h m

ay in

clu

de:

1. s

afe

han

d hy

gien

e pr

acti

ces

2. m

ovin

g an

d h

and

ling

infa

nt’s

/equ

ipm

ent

3. a

larm

sys

tem

s4.

mon

itor

ing

pare

nti

ng

skill

s5.

cle

anin

g eq

uip

men

t an

d eq

uip

men

t u

se.

• R

ecog

nis

es t

he

nee

d fo

r de

velo

pmen

tal c

are

and

quie

t ti

me

on

the

neo

nat

al u

nit

. •

Is a

war

e of

wh

at a

ctio

n t

o ta

ke t

o ev

acu

ate

the

neo

nat

al u

nit

sh

ould

th

e n

eed

aris

e.•

Dem

onst

rate

s w

hat

act

ion

s to

tak

e w

ith

reg

ard

to p

rote

ctin

g se

lf a

nd

oth

ers

from

vio

len

t an

d ag

gres

sive

sit

uat

ion

s.

20


Return to contents

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

/mid

wif

e (Q

IS)

Pro

fici

ent

neon

atal

nur

se/m

idw

ife

Exp

ert

neon

atal

nur

se/m

idw

ife

• Is

aw

are

of, a

nd

com

plie

s w

ith

, loc

al a

nd

nat

ion

al h

ealt

h a

nd

safe

ty le

gisl

atio

n,

infe

ctio

n c

ontr

ol p

olic

ies,

an

d cl

inic

al

gove

rnan

ce a

nd

risk

man

agem

ent

regu

lati

ons.

• A

ssis

ts in

mai

nta

inin

g a

safe

an

d se

cure

en

viro

nm

ent.

• Id

enti

fies

pot

enti

al r

isks

in t

he

wor

kpla

ce a

nd

take

s ap

prop

riat

e ac

tion

to

min

imis

e th

e ri

sk.

• Pa

rtic

ipat

es in

th

e pr

epar

atio

n a

nd

mai

nte

nan

ce o

f n

eon

atal

equ

ipm

ent.

• Id

enti

fies

em

erge

ncy

sit

uat

ion

s, s

um

mon

s h

elp

and

acts

wit

hin

ow

n le

vel o

f ex

per

tise

.

• A

ctiv

ely

impl

emen

ts lo

cal a

nd

nat

ion

al h

ealt

h

and

safe

ty le

gisl

atio

n, i

nfe

ctio

n c

ontr

ol

pol

icie

s, c

linic

al g

over

nan

ce a

nd

ris

k m

anag

emen

t re

gula

tion

s, a

nd

inte

grat

es t

hes

e in

to p

ract

ice.

• M

anag

es e

mer

gen

cy s

itu

atio

ns,

su

mm

ons

appr

opri

ate

hel

p, a

nd

acts

wit

hin

ow

n le

vel o

f pr

ofes

sion

al c

omp

eten

ce.

• M

onit

ors

and

mai

nta

ins

the

hea

lth

, saf

ety

and

secu

rity

of

self

an

d ot

her

s in

th

e n

eon

atal

u

nit

.•

Pre

pare

s an

d m

ain

tain

s eq

uip

men

t.

• Su

ppor

ts o

ther

s to

dea

l wit

h e

mer

gen

cy

situ

atio

ns.

• C

arri

es o

ut

risk

ass

essm

ents

rel

ated

to

neo

nat

al c

are

and

man

ages

th

ose

risk

s ap

prop

riat

ely.

• E

nsu

res

all a

ppro

pria

te m

easu

res

are

take

n in

re

lati

on t

o in

fect

ion

con

trol

.•

Act

s as

a r

ole

mod

el a

nd

prom

otes

bes

t pr

acti

ce in

hea

lth

, saf

ety

and

secu

rity

.•

Pre

pare

s an

d m

ain

tain

s eq

uip

men

t an

d

ensu

re s

taff

tra

inin

g is

cu

rren

t an

d u

p-to

-dat

e.•

Con

trib

ute

s to

sta

ff t

rain

ing.

• E

nsu

res

the

wor

kin

g en

viro

nm

ent

com

plie

s w

ith

org

anis

atio

nal

, pro

fess

ion

al a

nd

lega

l re

quir

emen

ts a

nd

guid

elin

es.

• M

onit

ors

safe

wor

k pr

acti

ces.

• A

ssu

mes

lin

e m

anag

emen

t re

spon

sibi

lity

for

acci

den

t/in

cide

nt

rep

orti

ng

and

mon

itor

ing.

• D

evel

ops

a cu

ltu

re t

hat

act

ivel

y im

prov

es

hea

lth

, saf

ety

and

secu

rity

.•

Pro

mot

es r

isk

man

agem

ent

stra

tegi

es in

th

e n

eon

atal

un

it.

• A

ckn

owle

dges

an

d id

enti

fies

tra

inin

g n

eeds

of

staf

f, n

egot

iate

s re

sou

rces

, fac

ilita

tes

trai

nin

g to

mee

t n

eeds

.•

En

sure

s be

st p

ract

ice

in h

ealt

h, s

afet

y an

d se

curi

ty, i

ncl

udi

ng

adeq

uat

e tr

ain

ing

for

staf

f.•

Dev

elop

s an

d pr

ovid

es a

ppro

pria

te t

rain

ing

opp

ortu

nit

ies.

• A

sses

ses

the

nee

d fo

r an

d m

anag

es t

he

purc

has

e of

equ

ipm

ent

to s

upp

ort

neo

nat

al

care

.



Service development

Including logistics, facilities maintenance and management, partnership, leadership, management of people, and management of physical and/or financial resources.

The neonatal practitioner will demonstrate knowledge of effective inter-professional working practices that respect and utilise the contribution of all members of the health care team. The neonatal practitioner will contribute effectively to the planning and organisation of neonatal care services to maximise the provision of a high quality service to infants, parents, families and carers.

Elements• Demonstrateabilitytoco-ordinate,organiseand

prioritise workload.

• Demonstrateleadershipskillswithintheneonatalnursing practice.

• Maintaincollaborativeworkingrelationshipswiththemultidisciplinary team, the general public and external agencies.

• Manageresourceseffectively.

• Bereceptivetonewdevelopmentsintheprovisionofneonatal care.

• Participateinclinicalgovernanceinitiatives.

Tools• Settinggoalsandobjectives.

• Supervisingandfacilitating.

• Delegating.

• Equipment.

• Operationalplanning.

• Budgeting.

• Controllingandmonitoring.

• Administration.

• Leading,managinganddevelopingstaff.

• Coachingandmentoring.

• Visioning.

• Resources.

• Timemanagement.

• Prioritising.

• Projectplanning.

• Peoplemanagement.

22


Return to contents

Com

pete

nces

for

the

leve

ls o

f neo

nata

l pra

ctic

e

Lev

el 2

Lev

el 3

Lev

el 4

Con

trib

ute

s to

th

e im

prov

emen

t of

ser

vice

s.•

Dis

cuss

es a

nd

agre

es w

ith

th

e w

ork

team

th

e im

plic

atio

ns

the

dire

ctio

n, p

olic

ies

and

stra

tegi

es h

ave

on t

hei

r cu

rren

t pr

acti

ce.

• V

oice

s ‘br

igh

t id

eas’

an

d n

egot

iate

s th

e ch

ange

s th

at t

hey

can

m

ake

as a

tea

m t

o de

velo

p th

e n

eon

atal

ser

vice

. •

Supp

orts

oth

ers

in u

nde

rsta

ndi

ng

the

nee

d fo

r an

d in

mak

ing

agre

ed c

han

ges.

• Ev

alu

ates

ow

n a

nd

oth

ers

wor

k w

hen

req

uir

ed t

o do

so,

p

erh

aps

usi

ng

ben

chm

arki

ng

to e

valu

ate

the

effe

ctiv

enes

s of

ch

ange

.•

Feel

s ab

le t

o di

scu

ss e

lem

ents

of

good

pra

ctic

e el

sew

her

e.•

Has

th

e co

nfi

den

ce t

o ra

ise

an a

lert

if t

her

e ar

e sy

stem

s in

pla

ce

wh

ich

are

det

rim

enta

l to

the

deliv

ery

of t

he

serv

ice.

App

rais

es, i

nte

rpre

ts a

nd

appl

ies

sugg

esti

ons,

rec

omm

enda

tion

s an

d di

rect

ives

to

impr

ove

serv

ices

.•

Iden

tifi

es a

nd

eval

uat

es a

reas

for

pot

enti

al s

ervi

ce

impr

ovem

ent.

Dis

cuss

es t

hes

e w

ith

oth

ers

and

agre

es h

ow t

he

serv

ice

cou

ld b

e im

prov

ed a

s a

resu

lt.

• Su

ppor

ts o

ther

tea

m m

embe

rs d

uri

ng

tim

es o

f ch

ange

an

d w

ork

wit

h o

ther

s to

ove

rcom

e pr

oble

ms

and

ten

sion

s th

at

cou

ld p

rese

nt.

• Sh

ares

th

e vi

sion

to

mai

nta

in a

nd

sust

ain

s di

rect

ion

, pol

icie

s an

d st

rate

gies

un

til t

hey

are

firm

ly e

mbe

dded

.•

Has

su

ffici

ent

flex

ibili

ty t

o al

ter

thei

r pr

acti

ce in

lin

e w

ith

ag

reed

impr

ovem

ents

an

d ch

alle

nge

tra

diti

on w

hic

h is

on

lo

nge

r of

use

. •

Eval

uat

es w

ith

oth

ers

the

effe

ctiv

enes

s of

ser

vice

im

prov

emen

ts.

• Su

ppor

ts o

ther

s in

mak

ing

an a

ppra

isal

of

draf

t p

olic

ies

and

mak

es r

ecom

men

dati

ons

for

impr

ovem

ent.

Com

pet

ence

to

faci

litat

e a

grea

ter

un

ders

tan

din

g of

ser

vice

de

velo

pmen

t.•

Show

s a

will

ingn

ess

and

un

ders

tan

din

g of

th

e n

eed

to id

enti

fy

any

area

s th

at w

ill im

prov

e th

e ef

fect

iven

ess

of t

he

serv

ice

and

thei

r ow

n p

ract

ice

wit

hin

th

e n

eon

atal

tea

m.

• E

nco

ura

ges

pare

nts

/fam

ilies

to

com

men

t on

ser

vice

s pr

ovid

ed

thro

ugh

par

ents

qu

esti

onn

aire

/com

men

ts b

ox/o

nlin

e fe

edba

ck/p

aren

t fo

rum

s an

d so

fort

h.

• W

orks

wit

hin

th

e sc

ope

of t

hei

r pr

acti

ce a

nd

com

pet

ence

an

d se

eks

supp

ort

from

th

e n

urs

ing

team

to

impr

ove

up

on w

ork

prac

tice

s an

d th

e se

rvic

es.

• D

emon

stra

tes

a p

osit

ive

and

con

stru

ctiv

e ap

proa

ch t

o se

rvic

e im

prov

emen

t. •

Rai

ses

con

cern

s to

sen

ior

mem

bers

of

neo

nat

al s

taff

wh

en it

is

per

ceiv

ed t

hat

asp

ects

of

the

serv

ice

are

adve

rsel

y af

fect

ing

pati

ents

, par

ents

, fam

ilies

, car

ers

and

oth

er m

embe

rs o

f st

aff

– fo

r ex

ampl

e, in

fect

ion

con

trol

issu

es a

nd

so fo

rth

.

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

/mid

wif

e (Q

IS)

Pro

fici

ent

neon

atal

nur

se/m

idw

ife

Exp

ert

neon

atal

nur

se/m

idw

ife

• A

ssis

ts in

mai

nte

nan

ce a

nd

deve

lopm

ent

of

the

neo

nat

al s

ervi

ce.

• A

cts

as a

rol

e m

odel

for

jun

ior

colle

agu

es a

nd

lear

ner

s an

d su

per

vise

s le

arn

ers

as

appr

opri

ate

wit

hin

pre

dete

rmin

ed p

aram

eter

s an

d pr

ovid

es fe

edba

ck.

• C

omm

ents

on

pol

icie

s, p

roce

dure

s or

p

ossi

ble

deve

lopm

ents

.•

Part

icip

ates

in p

artn

ersh

ip w

orki

ng

wit

hin

th

e n

eon

atal

un

it.

• A

ssis

ts w

ith

th

e lo

gist

ics

of m

ovin

g in

fan

ts

and

equ

ipm

ent

wit

hin

th

e se

rvic

e.•

Rec

ogn

ises

th

e n

eed

to o

rgan

ise

and

prio

riti

se

wor

kloa

d as

par

t of

a t

eam

, tak

ing

cogn

isan

ce

of a

ctiv

itie

s w

ith

in t

he

neo

nat

al u

nit

.•

Is a

war

e of

an

d m

ain

tain

s th

e ph

ysic

al

reso

urc

es in

th

e n

eon

atal

un

it.

• Is

aw

are

of a

nd

effi

cien

tly

use

s th

e fi

nan

cial

re

sou

rces

in t

he

neo

nat

al u

nit

.

• Su

per

vise

s ju

nio

r st

aff

wit

hin

pre

dete

rmin

ed

para

met

ers

and

prov

ides

feed

back

.•

Dev

elop

s le

ader

ship

pot

enti

al w

ith

in t

he

clin

ical

env

iron

men

t, ac

tin

g as

a r

ole

mod

el

for

staf

f an

d p

eers

.•

Part

icip

ates

in p

artn

ersh

ip, w

orki

ng

wit

h

indi

vidu

als,

gro

ups

an

d ot

her

s w

ith

in t

he

neo

nat

al u

nit

.•

(Wit

hin

th

e re

alm

of

allo

cate

d re

spon

sibi

lity)

, ef

fect

ivel

y m

anag

es r

esou

rces

in t

he

neo

nat

al

un

it.

• (W

ith

in t

he

real

m o

f de

lega

ted

resp

onsi

bilit

y), c

ontr

ibu

tes

to t

he

deve

lopm

ent

of n

eon

atal

car

e.•

Pla

ns

own

tim

e an

d pr

iori

tise

s ov

er a

dai

ly

and

wee

kly

tim

e-sc

ale.

• O

rgan

ises

th

e lo

gist

ics

to m

ove

infa

nts

an

d eq

uip

men

t.

• A

ctiv

ely

con

trib

ute

s an

d pa

rtic

ipat

es in

th

e de

velo

pmen

t of

neo

nat

al s

ervi

ces.

• P

rovi

des

effe

ctiv

e pr

ofes

sion

al le

ader

ship

, fa

cilit

atin

g ch

ange

an

d de

velo

pin

g th

e se

rvic

e in

res

pon

se t

o ch

angi

ng

hea

lth

car

e n

eeds

.•

Pro

acti

vely

faci

litat

es a

nd

part

icip

ates

in

reso

urc

e an

d n

eon

atal

un

it m

anag

emen

t, m

axim

isin

g re

sou

rces

an

d co

ntr

ibu

tin

g to

th

e m

anag

emen

t an

d de

velo

pmen

t of

sta

ff.

• H

igh

ligh

ts a

nd

inst

igat

es a

ctio

n p

lan

s to

m

anag

e de

fici

ts in

res

ourc

es.

• D

epu

tise

s fo

r th

e lin

e m

anag

er.

• Is

invo

lved

in t

he

recr

uit

men

t an

d se

lect

ion

an

d p

erso

nal

pro

fess

ion

al d

evel

opm

ent

of

staf

f.•

Dev

elop

s an

d su

stai

ns

wor

kin

g w

ith

in

divi

dual

s, g

rou

ps, a

gen

cies

an

d ot

her

s in

volv

ed in

neo

nat

al c

are.

• P

rop

oses

pol

icy/

serv

ice

chan

ges.

• A

lloca

tes,

del

egat

es, c

o-or

din

ates

, mon

itor

s an

d as

sess

es w

ork

of t

he

team

an

d in

divi

dual

s.

• D

evel

ops

stra

tegi

es a

nd

pol

icie

s fo

r n

eon

atal

se

rvic

e de

velo

pmen

t at

loca

l an

d n

atio

nal

le

vel.

• M

onit

ors

staf

f de

velo

pmen

t.•

Lead

s a

team

wit

h c

ompl

ex w

ork

acti

viti

es b

y es

tabl

ish

ing

obje

ctiv

es a

nd

stan

dard

s.•

Dev

elop

s, s

ust

ain

s an

d ev

alu

ates

par

tner

ship

w

orki

ng

wit

h in

divi

dual

s, g

rou

ps, a

gen

cies

an

d ot

her

s in

volv

ed in

th

e pr

ovis

ion

of

neo

nat

al c

are.

• D

evel

ops,

impl

emen

ts a

nd

eval

uat

es p

olic

ies

and

stra

tegi

es fo

r re

cru

itin

g, d

eplo

yin

g,

deve

lopi

ng

and

reta

inin

g st

aff.

• D

emon

stra

tes

a cr

itic

ally

an

alyt

ical

app

roac

h

to s

trat

egic

dec

isio

n m

akin

g an

d ju

dgem

ents

re

late

d to

neo

nat

al c

are.

• P

rovi

des

lead

ersh

ip a

nd

man

agem

ent

in

neo

nat

al n

urs

ing

thro

ugh

eff

ecti

ve r

ole

mod

ellin

g, o

ffer

ing

visi

on fo

r th

e ad

van

cem

ent

of n

eon

atal

nu

rsin

g.•

Em

pow

ers

neo

nat

al n

urs

es in

pra

ctic

e an

d st

imu

late

s co

-op

erat

ion

an

d en

thu

sias

m

wit

hin

th

e n

eon

atal

nu

rsin

g te

am.



• P

lan

s an

d or

gan

ises

sev

eral

com

plex

neo

nat

al

care

act

ivit

ies.

•

Org

anis

es a

nd

prio

riti

ses

con

flic

tin

g w

orkl

oad

dem

ands

.•

Pri

orit

ises

th

e m

ovem

ent

of in

fan

ts a

nd

eq

uip

men

t.

• P

repa

res,

dev

elop

s an

d m

onit

ors

fin

anci

al a

nd

mat

eria

l res

ourc

e fo

r a

ran

ge o

f co

mpl

ex

neo

nat

al c

are

acti

viti

es.

• Id

enti

fies

su

cces

s cr

iter

ia a

nd

esta

blis

hes

m

onit

orin

g sy

stem

s fo

r n

eon

atal

nu

rsin

g pr

acti

ce.

• P

lan

s an

d m

anag

es p

roje

cts

rela

ted

to s

ervi

ce

deve

lopm

ent

stra

tegi

es t

o en

sure

saf

e an

d ef

fici

ent

mov

emen

t of

infa

nts

an

d eq

uip

men

t.•

Secu

res

phys

ical

an

d fi

nan

cial

res

ourc

es a

nd

esta

blis

h s

trat

egie

s fo

r th

eir

use

.

24


Return to contents

Quality

Including research and development.

The neonatal practitioner will demonstrate commitment to evidence-based practice, utilising research, quality standards and clinical audit tools. The neonatal practitioner will demonstrate a critical thinking approach to problem solving to enhance neonatal care.

Elements• Activelyuseaproblemsolvingapproachtocaredelivery

and the needs of the infant.

• Utiliseresearchskills,criticallyappraiseandevaluateneonatal practice.

• Contributetothemaintenanceofanenvironmentwithinthe neonatal unit where research, quality and clinical audit are valued.

• Incollaborationwiththemulti-professionalteam,auditstandards of care delivery.

• Usedecision-makingskills.

Tools• Creativethinking.

• Decisionmaking.

• Research.

• Audit.

• Evaluation.

• Makingrecommendations.

• Reflectivepractice.



Com

pete

nces

for

the

leve

ls o

f neo

nata

l pra

ctic

e

Lev

el 2

Lev

el 3

Lev

el 4

Mai

nta

ins

qual

ity

in o

wn

wor

k an

d en

cou

rage

oth

ers

to d

o so

.•

Act

s co

nsi

sten

tly

wit

h le

gisl

atio

n, p

olic

ies,

pro

cedu

res

and

oth

er q

ual

ity

appr

oach

es a

nd

enco

ura

ges

oth

ers

to d

o so

.•

Wor

ks w

ith

in t

he

limit

s of

th

eir

own

com

pet

ence

an

d w

ith

in

thei

r ow

n le

vel o

f re

spon

sibi

lity

and

acco

un

tabi

lity

in t

he

mu

ltid

isci

plin

ary

team

an

d or

gan

isat

ion

.•

Wor

ks a

s an

eff

ecti

ve a

nd

resp

onsi

ble

team

mem

ber.

• Se

eks

to p

rior

itis

e th

eir

own

wor

kloa

d an

d or

gan

ises

ow

n

wor

k to

red

uce

ris

ks t

o qu

alit

y ca

re.

• Se

eks

to u

se a

nd

mai

nta

in t

he

hea

lth

car

e se

ttin

g’s

reso

urc

es

effi

cien

tly

and

effe

ctiv

ely

and

supp

orts

oth

ers

to d

o so

.•

Seek

s to

mon

itor

th

e qu

alit

y of

wor

k in

th

eir

own

are

a an

d al

erts

oth

ers

to q

ual

ity

issu

es.

Th

e Le

vel 3

neo

nat

al p

ract

itio

ner

has

a r

ole

in c

ontr

ibu

tion

to

the

impr

ovem

ent

of q

ual

ity.

• A

cts

con

sist

entl

y w

ith

legi

slat

ion

, pol

icie

s, p

roce

dure

s an

d ot

her

qu

alit

y ap

proa

ches

an

d pr

omot

es t

he

valu

e of

qu

alit

y ap

proa

ches

to

oth

ers.

•

Un

ders

tan

ds t

hei

r ow

n r

ole

wit

hin

th

e m

ult

idis

cipl

inar

y te

am

and

wor

ks w

ith

in t

hei

r ow

n s

cop

e. T

he

Leve

l 3 p

ract

itio

ner

se

eks

to d

evel

op t

hei

r sk

ill b

ase

over

tim

e.

• W

orks

as

an e

ffec

tive

an

d re

spon

sibl

e te

am m

embe

r an

d su

ppor

ts o

ther

s to

do

so.

• P

rior

itis

es t

hei

r ow

n w

orkl

oad,

org

anis

es a

nd

per

form

s ow

n

resp

onsi

bilit

ies

in a

man

ner

th

at m

ain

tain

s an

d pr

omot

es

qual

ity.

• Ev

alu

ates

th

e qu

alit

y of

ow

n a

nd

oth

ers

wor

k an

d ra

ises

qu

alit

y is

sues

an

d re

late

d ri

sks

wit

h t

he

rele

van

t p

eopl

e.•

Supp

orts

th

e in

trod

uct

ion

an

d m

ain

ten

ance

of

qual

ity

syst

ems

and

proc

esse

s in

ow

n w

ork

area

an

d ta

ke t

he

appr

opri

ate

acti

on w

hen

th

ere

are

per

sist

ent

qual

ity

prob

lem

s.

Com

pet

enci

es t

o fa

cilit

ate

a gr

eate

r u

nde

rsta

ndi

ng

of q

ual

ity.

• D

emon

stra

tes

an a

war

enes

s of

qu

alit

y in

th

e h

ealt

h c

are

sett

ing

and

mak

es r

ecom

men

dati

ons

and

sugg

esti

ons

duri

ng

team

mee

tin

gs w

hic

h c

ould

en

han

ce t

he

qual

ity

of c

are.

• D

emon

stra

tes

an u

nde

rsta

ndi

ng

as t

o th

e n

eed

to m

ain

tain

st

anda

rds

of c

are

and

supp

ort

Leve

l 2 a

nd

3 in

th

eir

own

qu

ests

to

sust

ain

qu

alit

y fa

mily

-cen

tred

car

e.•

Mon

itor

s th

e w

orkl

oad

of L

evel

2 a

nd

3 st

aff

and

refe

rs a

ny

con

cern

s to

a s

enio

r m

embe

r of

th

e n

eon

atal

tea

m.

• M

onit

ors

pare

nt

sati

sfac

tion

an

d re

fer

any

sugg

esti

on o

f co

mpl

ain

t to

a s

enio

r m

embe

r of

th

e te

am.

• D

emon

stra

tes

that

th

ey k

now

how

to

be s

afe

wit

hin

th

eir

sph

ere

of a

bilit

y an

d co

mp

eten

ce.

• K

now

s h

ow t

o re

fer

qual

ity

issu

es p

rom

ptl

y to

a s

enio

r m

embe

r of

sta

ff.

• Is

aw

are

of h

ow t

o u

se a

nd

mai

nta

in r

esou

rces

effi

cien

tly

and

effe

ctiv

ely,

su

ch a

s co

nsu

mab

les

and

sun

drie

s.

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

/mid

wif

e (Q

IS)

Pro

fici

ent

neon

atal

nur

se/m

idw

ife

Exp

ert

neon

atal

nur

se/m

idw

ife

• A

dop

ts a

qu

esti

onin

g/re

flec

tive

att

itu

de

tow

ards

clin

ical

pra

ctic

e, s

eeki

ng

and

uti

lisin

g be

st e

vide

nce

/gu

idel

ines

in t

he

prov

isio

n o

f ca

re t

o th

e in

fan

ts a

nd

thei

r fa

mili

es.

• A

ssis

ts w

ith

au

dit,

rese

arch

an

d de

velo

pmen

t pr

ojec

ts.

• A

dop

ts a

cri

tica

l app

roac

h t

o cl

inic

al p

ract

ice

and

enco

ura

ges

ques

tion

ing/

refl

ecti

on in

ot

her

s to

pro

mot

e a

cult

ure

of

best

pra

ctic

e in

n

eon

atal

car

e.•

Iden

tifi

es a

reas

for

prac

tice

dev

elop

men

t, su

gges

ts im

prov

emen

ts u

tilis

ing

loca

l m

ech

anis

ms

and

assi

sts

wh

ere

appr

opri

ate

wit

h t

he

chan

ge p

roce

ss.

• D

emon

stra

tes

skill

s an

d u

nde

rsta

ndi

ng

of

audi

t m

eth

odol

ogy,

pri

nci

ples

an

d ev

iden

ce

base

d pr

acti

ce.

• A

sses

ses

and

anal

yses

info

rmat

ion

to

solv

e pr

oble

ms.

• M

akes

rec

omm

enda

tion

s th

at h

ave

a p

osit

ive

impa

ct o

n n

eon

atal

car

e.•

Inst

igat

es, a

nd

faci

litat

es a

nd

proa

ctiv

ely

fost

ers

a cu

ltu

re o

f en

quir

y an

d fa

cilit

ate

chan

ge t

o in

tegr

ate

best

evi

den

ce in

to

neo

nat

al c

are,

by

usi

ng

stra

tegi

es o

f re

sear

ch

and

audi

t.

• M

akes

dec

isio

ns

and

deve

lops

sol

uti

ons

to

prob

lem

s th

at in

volv

e cl

ear

risk

an

d m

ay h

ave

no

clea

r an

swer

.•

Mak

es s

ign

ifica

nt

deci

sion

s th

at h

ave

a di

rect

im

pact

on

th

e m

ediu

m o

r lo

ng-

term

p

erfo

rman

ce o

f th

e n

eon

atal

un

it.

• A

nal

yses

an

d de

velo

p so

luti

ons

for

com

plex

pr

ofes

sion

al, c

linic

al o

r m

anag

eria

l pro

blem

s.•

Iden

tifi

es a

reas

for

rese

arch

in c

linic

al

prac

tice

.•

Part

icip

ates

in a

nd/

or le

ads

rese

arch

pro

ject

s in

col

labo

rati

on w

ith

oth

ers.

• Pa

rtic

ipat

es in

th

e sy

stem

atic

rev

iew

of

prot

ocol

s, t

reat

men

t pl

ans

and

outc

omes

to

dete

rmin

e th

eir

effe

ctiv

enes

s in

mee

tin

g es

tabl

ish

ed s

tan

dard

s of

car

e.

26


Return to contents

Equality, diversity and rights

The neonatal practitioner will practice within a legal, professional and ethical framework that includes employer’s and local guidance, policies and procedures, ensuring that own actions support and promote equality, diversity and rights.

Elements

Know, understand, use and integrate into practice all current legislation, rules and codes that are relevant to neonatal nursing practice, including:

• CodeofProfessionalPractice

• Midwives’RulesandStandards

• theChildrenAct2004,SafeguardingFrameworkandlocal procedures

• InternationalConventiononHumanRights/TheRightsof the Child.

Tools • Creativethinking.

• Decisionmaking.

• Research.

• Audit.

• Evaluation.

• Makingrecommendations.

• Reflectivepractice.

• Mandatorytrainingandupdates.



Com

pete

nces

for

the

leve

ls o

f neo

nata

l pra

ctic

e

Lev

el 2

Lev

el 3

Lev

el 4

Wor

ks in

su

ch a

way

th

at s

upp

orts

equ

alit

y an

d va

lues

div

ersi

ty.

• R

ecog

nis

es t

he

imp

orta

nce

of

the

infa

nt

and

fam

ily’s

rig

hts

an

d ac

ts in

acc

orda

nce

wit

h le

gisl

atio

n, p

olic

ies

and

proc

edu

res.

• A

cts

in a

way

th

at a

ckn

owle

dges

an

d re

cogn

ises

a p

erso

n’s

expr

esse

d be

liefs

, pre

fere

nce

s an

d ch

oice

s.•

Res

pec

ts d

iver

sity

an

d va

lues

peo

ple

as in

divi

dual

s.•

Seek

s to

pro

mot

e th

e ri

ghts

of

the

infa

nt

to b

e n

ouri

shed

wit

h

thei

r ow

n m

oth

er’s

bre

ast

milk

.•

Seek

s to

en

han

ce t

he

qual

ity

of c

are

by p

rovi

din

g ca

re w

hic

h is

re

spec

tfu

lly fa

mily

-cen

tred

. •

Take

s ac

cou

nt

of t

hei

r ow

n b

ehav

iou

r an

d co

mm

un

icat

ion

st

yle

and

the

nee

d to

be

awar

e on

th

e ef

fect

th

ese

may

hav

e on

ot

her

s.•

Dev

elop

s sk

ills

to id

enti

fy s

itu

atio

ns

wh

ich

may

hav

e a

neg

ativ

e im

pact

on

an

infa

nt

or t

hei

r fa

mily

’s r

igh

ts a

nd

take

ac

tion

to

see

the

situ

atio

n r

esol

ved.

Wor

ks in

su

ch a

way

th

at p

rom

otes

equ

alit

y an

d va

lues

div

ersi

ty.

• In

terp

rets

an

d tr

ansf

ers

the

eth

os o

f eq

ual

ity,

div

ersi

ty a

nd

righ

ts in

acc

orda

nce

wit

h le

gisl

atio

n, p

olic

ies,

pro

cedu

res

and

rele

van

t st

anda

rds

into

th

eir

wor

k et

hic

an

d su

ppor

t th

e de

liver

y of

car

e w

hic

h is

sen

siti

ve t

o th

is r

equ

irem

ent.

•

Seek

s to

iden

tify

pat

tern

s of

dis

crim

inat

ion

an

d ta

kes

acti

on t

o ov

erco

me

disc

rim

inat

ion

an

d pr

omot

e di

vers

ity

and

equ

alit

y of

opp

ortu

nit

y fo

r al

l.•

En

able

s ot

her

s to

pro

mot

e eq

ual

ity

and

dive

rsit

y an

d a

non

-dis

crim

inat

ory

cult

ure

.•

Supp

orts

peo

ple

wh

o n

eed

assi

stan

ce in

exe

rcis

ing

thei

r ri

ghts

.•

Seek

s to

en

cou

rage

th

e ri

ghts

of

the

infa

nt

to b

e n

ouri

shed

w

ith

th

eir

own

mot

her

’s b

reas

t m

ilk.

• Ta

kes

step

s to

en

sure

th

e qu

alit

y of

car

e is

res

pec

tfu

l, ca

rin

g,

and

com

pass

ion

ate

and

fam

ily-c

entr

ed.

Com

pet

ence

s to

faci

litat

e a

grea

ter

un

ders

tan

din

g of

equ

alit

y,

dive

rsit

y an

d ri

ghts

.•

Is a

ble

to d

emon

stra

te a

n a

war

enes

s of

rel

evan

t st

anda

rds,

le

gisl

atio

n, p

olic

ies

and

proc

edu

res

wh

ich

aff

ect

the

key

asp

ects

of

the

Ban

d 4

role

wh

ich

may

rel

ate

to: d

isab

ility

, di

gnit

y at

wor

k, m

enta

l cap

acit

y, r

elig

iou

s be

liefs

, hu

man

ri

ghts

, lan

guag

e, c

ompl

ain

ts a

nd

issu

e re

solu

tion

.•

Dem

onst

rate

s th

at t

hey

kn

ow h

ow t

o en

sure

pri

vacy

an

d di

gnit

y, fo

r ex

ampl

e, w

hen

bre

astf

eedi

ng

or e

xpre

ssin

g br

east

m

ilk, k

anga

roo

care

, cu

ltu

ral b

elie

fs.

• D

emon

stra

tes

that

th

ey a

re a

war

e th

at fa

mili

es w

ill h

ave

diff

erin

g p

ersp

ecti

ves

and

beh

avio

ur

such

as

cult

ura

l, re

ligio

us

and

eth

nic

dif

fere

nce

s.

• D

emon

stra

tes

in t

hei

r da

y-to

-day

pra

ctic

e an

abi

lity

to t

reat

p

eopl

e eq

ual

ly a

nd

fair

ly a

nd

be a

ble

to id

enti

fy d

iscr

imin

ator

y pr

acti

ces.

• D

emon

stra

tes

in t

hei

r da

y-to

-day

pra

ctic

e an

abi

lity

to id

enti

fy

disc

rim

inat

ion

tow

ards

neo

nat

es, p

aren

ts, f

amili

es a

nd

care

rs.

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

/mid

wif

e (Q

IS)

Pro

fici

ent

neon

atal

nur

se/m

idw

ife

Exp

ert

neon

atal

nur

se/m

idw

ife

• A

ssis

ts in

mai

nta

inin

g an

env

iron

men

t in

w

hic

h e

very

one

– in

clu

din

g in

fan

ts, p

aren

ts/

care

rs, f

amili

es a

nd

colle

agu

es –

is t

reat

ed

equ

itab

ly a

nd

wit

h r

esp

ect.

• A

cts

in a

man

ner

th

at s

upp

ort

equ

alit

y,

dive

rsit

y an

d ri

ghts

of

all i

ndi

vidu

als

• A

cts

as a

n a

dvoc

ate

for

infa

nts

rig

hts

.•

Rec

ogn

ises

an

d re

spec

ts t

he

pref

eren

ces

and

belie

fs o

f th

e fa

mily

/car

ers.

• R

eflec

ts o

n a

nd

chal

len

ges

per

son

al

assu

mp

tion

s an

d w

ays

of w

orki

ng.

• (I

n r

elat

ion

to

child

saf

egu

ardi

ng)

is a

war

e of

ro

le a

nd

resp

onsi

bilit

ies

and

acti

vate

sa

fegu

ardi

ng

proc

edu

res

wh

en n

eces

sary

, se

ekin

g su

ppor

t as

req

uir

ed.

• R

eflec

ts o

n a

nd

chal

len

ges

assu

mp

tion

s an

d w

ays

of w

orki

ng

of o

ther

s.•

Supp

orts

an

env

iron

men

t in

wh

ich

eve

ryon

e,

incl

udi

ng

infa

nts

, par

ents

/car

ers,

fam

ilies

an

d co

lleag

ues

– is

tre

ated

equ

itab

ly a

nd

wit

h

resp

ect.

• P

rovi

des

pare

nts

wit

h t

he

info

rmat

ion

re

quir

ed fo

r th

em t

o m

ake

info

rmed

de

cisi

ons

rega

rdin

g th

eir

infa

nt.

• P

rom

otes

an

env

iron

men

t in

wh

ich

eve

ryon

e is

tre

ated

equ

itab

ly a

nd

wit

h r

esp

ect.

• E

nab

les

pare

nts

to

mak

e in

form

ed d

ecis

ion

s re

gard

ing

thei

r in

fan

t an

d su

ppor

ts t

hem

in

thei

r de

cisi

ons.

• Id

enti

fies

th

e p

oten

tial

for

and

take

act

ion

to

prev

ent

or r

ecti

fy d

iscr

imin

atio

n a

nd

com

prom

ise

of r

igh

ts.

• In

terp

rets

an

d ch

alle

nge

s w

ays

of w

orki

ng

and

deve

lop

appr

opri

ate

solu

tion

s.•

Act

s as

an

adv

ocat

e on

beh

alf

of t

hos

e w

hos

e ri

ghts

hav

e be

en c

ompr

omis

ed.

• A

ctiv

ely

deve

lops

an

d pr

omot

es a

n

envi

ron

men

t in

wh

ich

eve

ryon

e is

tre

ated

eq

uit

ably

an

d w

ith

res

pec

t.•

Dev

elop

s an

ti-d

iscr

imin

ator

y p

olic

ies/

proc

edu

res

and

prov

ides

app

ropr

iate

su

ppor

t se

rvic

es fo

r in

fan

ts, p

aren

ts, c

arer

s an

d st

aff

that

com

ply

wit

h le

gisl

atio

n, p

rofe

ssio

nal

re

gula

tion

s an

d be

st p

ract

ice.

• M

onit

ors

effe

ctiv

enes

s of

equ

alit

y, d

iver

sity

an

d ri

ghts

pol

icie

s an

d pr

oced

ure

s th

rou

ghou

t th

e n

eon

atal

un

it.

• R

egu

larl

y re

view

s im

plem

enta

tion

, ef

fect

iven

ess

and

com

plia

nce

wit

h e

qual

ity

and

dive

rsit

y le

gisl

atio

n.

28


Return to contents

Tools • Educationandtraining.

• Healthpromotion.

• Guidelines,protocols,policiesandstandards.

• Biomedicalinvestigationsandreporting.

• Neonatalcareassessmenttools.

• Qualitystandards.

• Legislation.

• Specifictechnologies.

Responsibility for patient care

Including assessment of addressing individuals, improvement of protection of health and wellbeing needs, biomedical investigation and reporting, and measuring, monitoring and treating physiological conditions through the application of specific technologies.

The neonatal practitioner will, within agreed parameters, apply knowledge, clinical judgement, and a range of skills to provide safe, effective care to infants and their families/carers.

Elements• Developandmaintainasoundknowledgebaserelevant

to neonatal care.

• Developandmaintainownclinicalcompetence.

• Criticallyappraiseownlevelofcompetence,identifyingareas for further development.

• Incollaborationwiththefamilyandthemultidisciplinary team, assess, plan, deliver and evaluate neonatal care that reflects individual physical, social, cultural and spiritual needs.

• Ensurethatthemostappropriate,individualisedclinically effective neonatal care is achieved within the confines of available resources.

• Implementcareunderthedirectionofcurrentunitandprofessional policies, procedures and guidelines, and the law.

• Demonstrateeffectivedecisionmakinginthecontextofcurrent role.

• Usehealthpromotionstrategiestosupport/adviseparents and families.

• Ensurecareistakentosafeguardinfantsandtheirfamilies/carers at all times.

• Ensurewrittendocumentationisclear,concise,timelyand complies with professional and local guidelines and standards.

• Demonstrateanawarenessofcurrentdevelopmentsinneonatal practice.

• Demonstratethatneonatalpracticeisembeddedinevidence/best practice.

• Maintainandimprovequalityinallareasofneonatalpractice.



Com

pete

nces

for

the

leve

ls o

f neo

nata

l pra

ctic

e

Lev

el 2

Lev

el 3

Lev

el 4

Wit

h g

uid

ance

, su

per

visi

on a

nd

supp

ort

the

prac

titi

oner

will

u

nde

rtak

e ca

re a

ctiv

itie

s to

mee

t th

e h

ealt

h a

nd

wel

lbei

ng

nee

ds

of t

he

infa

nt

and

thei

r fa

mily

.•

Un

dert

akes

car

e to

su

ppor

t th

e in

fan

t an

d fa

mily

’s e

mot

ion

al

hea

lth

an

d w

ellb

ein

g n

eeds

.•

Un

dert

akes

car

e to

su

ppor

t th

e in

fan

t an

d fa

mily

’s p

hysi

cal

hea

lth

an

d w

ellb

ein

g n

eeds

.•

Un

dert

akes

car

e de

sign

ed t

o su

ppor

t th

e pr

ovis

ion

of

spir

itu

al

hea

lth

an

d w

ellb

ein

g of

th

e fa

mily

an

d w

her

e ap

prop

riat

e as

sist

s w

ith

pal

liati

ve c

are.

•

Rep

orts

any

hea

lth

an

d w

ellb

ein

g w

hic

h m

igh

t ar

ise

from

a

safe

guar

din

g is

sue.

• U

nde

rtak

es c

are

desi

gned

to

limit

th

e ex

pos

ure

to

risk

of

inci

den

ts/a

ccid

ents

.•

Ale

rts

colle

agu

es to

any

det

erio

rati

on o

f co

ndi

tion

or

situ

atio

n.

• U

nde

rtak

es p

lan

ned

car

e de

sign

ed t

o as

sist

wit

h t

he

neo

nat

e’s

care

in t

he

spec

ialis

t en

viro

nm

ent.

• U

nde

rtak

es c

are

desi

gned

to

com

ply

wit

h t

he

rele

van

t le

gisl

atio

n, p

olic

ies

and

proc

edu

res

wh

eth

er n

atio

nal

or

loca

l.

Wit

h s

up

ervi

sion

an

d su

ppor

t, pl

an, d

eliv

er a

nd

eval

uat

e ca

re t

o m

eet

the

infa

nt

wh

o is

in s

pec

ial c

are

hea

lth

an

d w

ellb

ein

g n

eeds

an

d th

ose

of t

hei

r fa

mily

.•

Ass

ists

wit

h t

he

infa

nt

and

fam

ily’s

em

otio

nal

hea

lth

an

d w

ellb

ein

g n

eeds

.•

Ass

ists

wit

h t

he

infa

nt

and

fam

ily’s

phy

sica

l hea

lth

an

d w

ellb

ein

g n

eeds

.•

Hel

ps p

rovi

de fo

r th

e sp

irit

ual

hea

lth

an

d w

ellb

ein

g n

eeds

an

d th

e n

eeds

of

the

infa

nt

and

fam

ily a

nd

wh

ere

appr

opri

ate

assi

sts

wit

h p

allia

tive

car

e.•

Ris

ks t

o h

ealt

h a

nd

wel

lbei

ng

mig

ht

aris

e fr

om s

afeg

uar

din

g is

sues

. •

Red

uce

s ex

pos

ure

to

risk

of

inci

den

ts/a

ccid

ents

.•

Aid

s th

e pr

even

tion

of

neg

lect

.•

Res

pon

ds t

o ra

pid

dete

rior

atio

n o

f co

ndi

tion

or

situ

atio

n.

• A

ssis

ts w

ith

th

e re

quir

emen

t fo

r ca

re in

a n

eon

atal

sp

ecia

list

envi

ron

men

t.•

Follo

ws

guid

ance

to

per

mit

cor

rect

adh

eren

ce t

o th

e re

leva

nt

legi

slat

ion

, pol

icie

s an

d pr

oced

ure

s m

ay b

e n

atio

nal

or

loca

l.

Pla

ns,

del

iver

s an

d ev

alu

ates

car

e to

add

ress

th

e in

fan

t an

d th

eir

fam

ily’s

com

plex

hea

lth

an

d w

ellb

ein

g n

eeds

. Th

ese

may

incl

ude

h

ealt

h a

nd

wel

lbei

ng

nee

ds w

hic

h a

re e

labo

rate

d in

th

e cl

inic

al

com

pet

ence

s.•

Th

e in

fan

t an

d fa

mily

’s e

mot

ion

al h

ealt

h a

nd

wel

lbei

ng

nee

ds.

• T

he

infa

nt

and

fam

ily’s

phy

sica

l hea

lth

an

d w

ellb

ein

g n

eeds

.•

Spir

itu

al h

ealt

h a

nd

wel

lbei

ng

nee

ds a

nd

the

nee

d fo

r, w

hen

ap

prop

riat

e, p

allia

tive

car

e.•

Ris

ks t

o h

ealt

h a

nd

wel

lbei

ng

mig

ht

aris

e fr

om s

afeg

uar

din

g is

sues

. •

Exp

osu

re t

o ri

sk o

f in

cide

nts

/acc

iden

ts.

• T

he

prev

enti

on o

f n

egle

ct.

• R

esp

onds

to

rapi

d de

teri

orat

ion

of

con

diti

on o

r si

tuat

ion

.•

A r

equ

irem

ent

for

care

in a

neo

nat

al s

pec

ialis

t en

viro

nm

ent.

• A

dher

es t

o re

leva

nt

legi

slat

ion

, pol

icie

s an

d pr

oced

ure

s m

ay b

e n

atio

nal

or

loca

l.

30


Return to contents

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

/mid

wif

e (Q

IS)

Pro

fici

ent

neon

atal

nur

se/m

idw

ife

Exp

ert

neon

atal

nur

se/m

idw

ife

• D

evel

ops

a so

un

d kn

owle

dge

base

re

leva

nt

to n

eon

atal

nu

rsin

g.•

Pro

vide

s qu

alit

y, e

ssen

tial

rou

tin

e n

eon

atal

car

e w

ith

in c

lear

ly d

efin

ed

guid

elin

es.

• R

esp

onds

to

the

nee

ds o

f th

e in

fan

t an

d th

e fa

mily

, pro

vidi

ng

qual

ity

care

usi

ng

curr

ent

info

rmat

ion

an

d kn

owle

dge.

• U

nde

rtak

es r

outi

ne

asse

ssm

ent

task

s re

late

d to

th

e h

ealt

h a

nd

wel

lbei

ng

of t

he

infa

nt.

• A

ssis

ts in

del

iver

ing

prog

ram

mes

of

neo

nat

al c

are

to s

upp

ort

futu

re h

ealt

h

and

wel

lbei

ng,

incl

udi

ng

deliv

ery

of

spec

ific

hea

lth

pro

mot

ion

info

rmat

ion

/te

ach

ing.

• Pe

rfor

ms

rou

tin

e te

sts

and

task

s re

late

d to

neo

nat

al in

vest

igat

ion

s an

d re

por

tin

g.•

Ass

esse

s, in

terv

enes

, eva

luat

es a

nd

rep

orts

th

e ou

tcom

es o

f pl

ann

ed c

are.

• E

nsu

res

acti

ons

assi

st t

he

mai

nte

nan

ce o

f h

igh

-qu

alit

y n

eon

atal

car

e.

• P

lan

s, im

plem

ents

an

d ev

alu

ates

nu

rsin

g ca

re t

o m

eet

the

hea

lth

an

d w

ellb

ein

g n

eeds

of

the

infa

nt

wh

en t

he

infa

nt’s

con

diti

on is

sta

ble.

• A

ssis

ts in

th

e ca

re o

f th

e in

fan

t w

hos

e n

eeds

are

co

mpl

ex a

nd

ever

ch

angi

ng.

• U

ses

crit

ical

judg

emen

t an

d re

ason

ing

to fa

cilit

ate

and

deliv

er c

are

to in

fan

ts in

par

tner

ship

wit

h p

aren

ts/

care

rs a

nd

the

mu

lti p

rofe

ssio

nal

tea

m.

• R

ecog

nis

es a

nd

take

s ap

prop

riat

e ac

tion

wh

en t

he

infa

nt’s

con

diti

on is

bec

omin

g u

nst

able

or

is

dete

rior

atin

g, in

clu

din

g re

ferr

al a

nd

init

iati

on o

f em

erge

ncy

inte

rven

tion

s.•

App

lies

tech

nol

ogy

for

mea

sure

men

t, m

onit

orin

g an

d tr

eatm

ent,

inte

rpre

t an

d re

spon

d to

th

e n

eeds

of

fam

ilies

/par

ents

/car

ers.

• A

ssis

ts p

aren

ts/c

arer

s an

d ot

her

sta

ff t

o as

sess

infa

nt’s

h

ealt

h, w

ellb

ein

g an

d re

late

d n

eeds

.•

Mai

nta

ins

a co

mpr

ehen

sive

kn

owle

dge

and

skill

s ba

se

rela

ted

to n

eon

atal

nu

rsin

g.•

Act

s as

a r

esou

rce

to c

olle

agu

es.

• Su

per

vise

s ca

re d

eliv

ery

of ju

nio

r co

lleag

ues

.•

En

sure

s ac

tion

s pr

omot

e qu

alit

y an

d al

ert

oth

ers

to

rele

van

t qu

alit

y is

sues

. •

Use

s co

re c

linic

al s

kills

an

d de

velo

ps c

riti

cal r

easo

nin

g sk

ills

to p

rovi

de s

afe

and

effe

ctiv

e ca

re t

o in

fan

ts in

pa

rtn

ersh

ip w

ith

par

ents

/car

ers

and

the

mu

lti

prof

essi

onal

tea

m.

• C

ontr

ibu

tes

to p

ract

ice

deve

lopm

ent.

• Is

acc

oun

tabl

e fo

r ow

n p

ract

ice.

• Is

res

pon

sibl

e an

d ac

cou

nta

ble

for

over

all c

are

deliv

ery

for

a de

fin

ed g

rou

p of

infa

nts

wit

h in

dire

ct

sup

ervi

sion

.•

An

tici

pate

s th

e n

eed

for,

plan

s an

d pa

rtic

ipat

es in

pr

ogra

mm

es o

f ca

re t

o su

ppor

t fu

ture

hea

lth

an

d w

ellb

ein

g in

clu

din

g: a

udi

olog

y an

d op

hth

alm

ic

scre

enin

g, v

acci

nat

ion

, dis

char

ge p

lan

nin

g an

d de

liver

ing

spec

ific

hea

lth

pro

mot

ion

info

rmat

ion

/te

ach

ing.

• E

nsu

res

acti

ons

prom

ote

qual

ity

and

aler

t ot

her

s to

re

leva

nt

qual

ity

issu

es.

• Su

per

vise

s ca

re d

eliv

ery

of ju

nio

r co

lleag

ues

.•

App

lies

tech

nol

ogy

for

mea

sure

men

t, m

onit

orin

g an

d tr

eatm

ent.

• M

anag

es t

he

impl

emen

tati

on o

f qu

alit

y ca

re/s

ervi

ce•

Act

s as

a r

ole

mod

el, p

rovi

din

g su

ppor

t an

d gu

idan

ce t

o ot

her

s in

impl

emen

tin

g ca

re.

• A

sses

ses,

pla

ns,

del

iver

s an

d ev

alu

ates

n

eon

atal

car

e to

add

ress

nee

ds t

hat

are

co

mpl

ex a

nd

ever

ch

angi

ng.

• P

lan

s, a

nal

yses

, in

terp

rets

an

d re

por

ts

biom

edic

al in

vest

igat

ion

s w

ith

in o

wn

leve

l of

pra

ctic

e.•

Pla

ns,

mon

itor

s an

d qu

alit

y as

sure

s th

e ap

plic

atio

n o

f te

chn

olog

y fo

r m

easu

rem

ent,

mon

itor

ing

and

trea

tmen

t.•

Con

trib

ute

s to

qu

alit

y im

prov

emen

t.•

In p

artn

ersh

ip w

ith

par

ents

/car

ers

and

the

mu

lti-

prof

essi

onal

tea

m, u

se h

igh

ly

deve

lop

ed/s

pec

ialis

t kn

owle

dge

and

clin

ical

sk

ills

in t

he

neo

nat

al u

nit

to

crea

te a

cu

ltu

re

and

clim

ate

that

is p

roac

tive

an

d re

spon

sive

to

mee

t th

e h

ealt

h c

are

nee

ds o

f in

fan

ts.

• Su

per

vise

s th

e ca

re g

iven

by

jun

ior

colle

agu

es.

• D

evel

ops

and

mai

nta

ins

know

ledg

e, s

kills

an

d co

mp

eten

ce t

o th

e le

vel o

f th

e ex

per

t w

ho

is a

ble

to fu

nct

ion

in a

n in

dep

ende

nt

role

.•

Dev

elop

s pr

acti

ce in

app

lyin

g te

chn

olog

y fo

r m

easu

rem

ent,

mon

itor

ing

and

trea

tmen

t.•

Dev

elop

s pr

acti

ce in

bio

med

ical

in

vest

igat

ion

an

d re

por

tin

g.•

Dem

onst

rate

s a

crit

ical

ly a

nal

ytic

app

roac

h

to s

trat

egic

dec

isio

n m

akin

g an

d ju

dgem

ents

rel

ated

to

neo

nat

al c

are.

• C

onti

nu

ousl

y m

onit

ors

acti

viti

es a

gain

st

qual

ity

stan

dard

s, a

nti

cipa

tes

fact

ors

that

m

ay r

edu

ce q

ual

ity

and

take

s ef

fect

ive

acti

on t

o ad

dres

s th

em.

• D

evel

ops,

impl

emen

ts a

nd

eval

uat

es

init

iati

ves

and

stra

tegi

es t

o im

prov

e th

e qu

alit

y of

neo

nat

al c

are.

• Im

prov

es q

ual

ity

of n

eon

atal

car

e th

rou

gh

prac

tice

rev

iew

.•

Dev

elop

s an

d im

plem

ents

str

ateg

ies

for

neo

nat

al c

are,

incl

ude

sta

nda

rds,

pol

icie

s an

d gu

idel

ines

for

care

del

iver

y.•

Dev

elop

s p

olic

ies

and

stra

tegi

es t

o im

prov

e th

e h

ealt

h a

nd

wel

lbei

ng

of in

fan

ts.

• Fo

ster

s a

proa

ctiv

e ca

re c

ult

ure

.•

Seek

s op

por

tun

itie

s to

add

val

ue

to c

are

prov

isio

n.

• A

cts

as a

rol

e m

odel

for

effe

ctiv

e le

ader

ship

in

neo

nat

al n

urs

ing

and

con

trib

ute

s to

cr

eati

ng

a vi

sion

for

the

adva

nce

men

t of

n

eon

atal

nu

rsin

g so

sti

mu

lati

ng

co-

oper

atio

n a

nd

enth

usi

asm

in n

eon

atal

n

urs

ing.

• E

mp

ower

s n

eon

atal

nu

rsin

g pr

acti

ce b

y pu

blis

hin

g lo

cally

, nat

ion

ally

an

d in

tern

atio

nal

ly.



The neonatal workforce must have the knowledge and ability to rationalise the strategy chosen in the application of all clinical skills.

Nurse consultant, clinical nurse specialist, lead nurse, advanced neonatal nurse practitioner.

In addition to the above core clinical skills, nurse consultants, clinical nurse specialists, lead nurses and advanced nurse practitioners will be required to demonstrate elements from the following (RCN, 2012):• provideexpertprofessionaladvicetopatients,carers

and colleagues

• undertakeresearchinaspecialistarea

• provideeducationandtrainingtootherstaff,students

• ensurethemaintenanceofclinicalexcellence.

Core clinical skills for the neonatal workforce

To achieve the competences expected for each of the levels of neonatal nursing practice from unregistered new entrant to expert and advanced, the neonatal workforce must develop specific skills (see Section 4 for example curriculum to enable these to be met). The skills required are diverse (DH, 2010, p.53). Some are transferable across several competences and the skills required are likely to change over time. Therefore the working group has restricted competence clarification to core clinical skills. Scotland has developed more detailed frameworks for Levels 2-4 reflecting the RCN’s position of the Level 2-4 knowledge and skills frameworks. These are reproduced in the addendum which can be found at the end of this section.

This document focuses on the key competences required for those who have responsibility for infant care and uses the modified categories of skills previously selected by the RCN in its 2009 publication, Integrated core career and competence framework for registered nurses.

Categories are as follows:• f luid,electrolyte,nutritionandeliminationmanagement

• neurological,developmentalcareandpainmanagement

• respiratoryandcardiovascularmanagement

• skin,hygieneandinfectioncontrolmanagement

• infanttemperaturemanagement

• palliativecare,end-of-lifecareandbereavementmanagement

• investigationsandprocedures

• equipmentandmonitoring.

3

32


Return to contents

Flui

d, e

lect

roly

te, n

utri

tion

and

eli

min

atio

n m

anag

emen

t

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Rec

ogn

ises

nor

mal

ch

arac

teri

stic

s of

th

e in

fan

t’s s

tool

an

d u

rin

e.

Invo

lves

th

e fa

mily

in t

he

care

of

thei

r in

fan

ts.

Rec

ogn

ises

nor

mal

an

d ab

nor

mal

ga

stro

inte

stin

al fu

nct

ion

, uri

nar

y tr

act

fun

ctio

n a

nd

bilir

ubi

n

elim

inat

ion

, rep

orti

ng

devi

atio

ns.

Impl

emen

ts in

terv

enti

ons

to s

ust

ain

h

omeo

stas

is a

ccor

din

g to

un

it

guid

elin

es.

Invo

lves

th

e fa

mily

in t

he

care

of

thei

r in

fan

ts.

Rec

ogn

ises

th

e m

ore

subt

le

devi

atio

ns

from

th

e n

orm

al

gast

roin

test

inal

fun

ctio

n a

nd

uri

nar

y tr

act

fun

ctio

n.

Man

ages

hig

h b

iliru

bin

leve

ls.

Impl

emen

ts in

terv

enti

ons

to s

ust

ain

h

omeo

stas

is a

ccor

din

g to

un

it

guid

elin

es.

Teac

hes

an

d su

ppor

ts t

he

fam

ily s

o th

at t

hey

can

be

invo

lved

in t

he

care

of

th

eir

infa

nts

.

Init

iate

s m

anag

emen

t an

d fo

llow

s gu

idel

ines

in t

he

care

an

d m

anag

emen

t of

infa

nts

wh

o h

ave

devi

atio

n fr

om t

he

nor

mal

el

imin

ator

y pa

thw

ays.

Teac

hes

, men

tors

an

d su

per

vise

s ot

her

sta

ff t

o lo

ok a

fter

th

e in

fan

t w

ho

hav

e a

ran

ge o

f ca

re

requ

irem

ents

.

Supp

orts

th

e de

velo

pmen

t of

fam

ily

edu

cati

on p

rogr

amm

es s

o th

at

pare

nts

can

feel

incl

ude

d an

d va

lued

as

par

tner

s in

th

e ca

re o

f th

eir

infa

nts

.

Inve

stig

ates

, pre

scri

bes

and

man

ages

tr

eatm

ents

for

any

GI

prob

lem

s, a

nd

prob

lem

s w

ith

uri

nar

y tr

act

fun

ctio

n

and

bilir

ubi

n e

limin

atio

n.

Dev

ises

fam

ily e

duca

tion

pr

ogra

mm

es s

o th

at p

aren

ts c

an fe

el

incl

ude

d an

d va

lued

as

part

ner

s in

th

e ca

re o

f th

eir

infa

nts

.

Mon

itor

s, a

udi

ts a

nd

upd

ates

un

it

pol

icie

s w

hic

h r

elat

e to

th

e ca

re o

f in

fan

ts w

ho

hav

e G

I pr

oble

ms,

pr

oble

ms

wit

h u

rin

ary

trac

t fu

nct

ion

an

d bi

liru

bin

elim

inat

ion

.

Adv

ises

an

d su

ppor

ts m

oth

ers

in

man

ual

/mec

han

ical

exp

ress

ion

of

brea

st m

ilk a

nd

the

han

dlin

g an

d st

orag

e of

sam

e.

Ass

ists

th

e m

oth

er t

o br

east

feed

ac

cord

ing

to e

vide

nce

-bas

ed/u

nit

gu

idel

ines

.

Init

iate

s an

d su

ppor

ts la

ctat

ion

.

Supp

orts

mot

her

s in

man

ual

/m

ech

anic

al e

xpre

ssio

n o

f br

east

milk

.

Ass

ists

th

e m

oth

er t

o br

east

feed

ac

cord

ing

to e

vide

nce

-bas

e/u

nit

gu

idel

ines

.

Info

rms

and

advi

ses

on s

tora

ge o

f br

east

milk

, bre

astf

eedi

ng,

han

d an

d m

ech

anic

al e

xpre

ssio

n a

nd

supp

lem

enta

ry m

eth

ods

of fe

edin

g.

En

cou

rage

s an

d as

sist

s th

e m

oth

er t

o br

east

feed

acc

ordi

ng

to e

vide

nce

-ba

se/u

nit

gu

idel

ines

.

Supp

orts

un

it s

taff

in t

he

man

agem

ent

of t

he

brea

stfe

edin

g dy

ad.

Supp

orts

th

e de

velo

pmen

t of

un

it

pol

icie

s re

late

d to

bre

astf

eedi

ng.

Supp

orts

th

e de

velo

pmen

t of

un

it

pol

icie

s re

late

d to

bre

astf

eedi

ng.

Teac

hes

, men

tors

an

d s

up

ervi

ses

oth

er s

taff

th

e im

por

tan

ce o

f n

atu

ral

feed

ing.

Part

icip

ates

an

d in

volv

es o

ther

s in

re

sear

ch a

nd

deve

lopm

ent

of p

ract

ice

to p

rom

ote

brea

stfe

edin

g.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.

May

un

dert

ake

con

sult

ant

nu

rse

role

s in

neo

nat

al n

utr

itio

n a

nd

as la

ctat

ion

sp

ecia

lists

.



Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Adv

ises

an

d de

mon

stra

tes

ster

ilisa

tion

pro

cedu

res

of fe

edin

g eq

uip

men

t an

d st

orag

e.

Adv

ises

on

saf

ety

issu

es a

rou

nd

prep

ared

form

ula

milk

.

Ass

ists

par

ents

/car

ers

in b

ottl

e fe

edin

g te

chn

iqu

es.

Adv

ises

an

d de

mon

stra

tes

ster

ilisa

tion

pro

cedu

res

of fe

edin

g eq

uip

men

t, st

orag

e of

ste

rilis

ed

equ

ipm

ent.

Edu

cate

s an

d de

mon

stra

tes

to t

he

pare

nts

an

d ju

nio

r st

aff

on t

he

reco

nst

itu

tion

of

feed

s an

d th

e m

anag

emen

t of

th

ese

feed

s.

Ass

ists

par

ents

/car

ers

in e

nte

ral

feed

ing

tech

niq

ues

.

Info

rms

and

advi

ses

on a

ll as

pec

ts o

f ot

her

en

tera

l fee

din

g m

eth

ods.

Use

s ev

iden

ce-b

ased

pra

ctic

e fo

r en

tera

l fee

din

g.D

evis

es, a

udi

ts a

nd

revi

ews

guid

elin

es

for

best

pra

ctic

e in

par

tner

ship

wit

h

med

ical

sta

ff.

Perf

orm

s sa

fe b

ottl

e fe

edin

g te

chn

iqu

es.

Safe

ly c

arri

es o

ut

all f

orm

s of

tu

be

and

bott

le fe

edin

g ac

cord

ing

to

evid

ence

-bas

e/u

nit

gu

idel

ines

.

Ass

esse

s en

tera

l fee

din

g n

eeds

, de

vise

s pl

an in

par

tner

ship

wit

h t

he

pare

nts

an

d re

view

s ap

prop

riat

ely.

Dev

ises

pro

cedu

res/

guid

elin

es fo

r en

tera

l fee

din

g.

Mon

itor

s an

d ev

alu

ates

, au

dits

an

d re

view

s im

plem

enta

tion

.

Teac

hes

sta

ff h

ow t

o id

enti

fy w

her

e th

ere

are

diffi

cult

ies

wit

h t

he

infa

nts

fe

edin

g (s

ee b

elow

) an

d m

akes

re

ferr

als

to s

pee

ch a

nd

lan

guag

e sp

ecia

lists

.

Adm

inis

ters

nu

trit

ion

al s

upp

lem

ents

ac

cord

ing

to p

resc

rip

tion

an

d u

nde

r th

e di

rect

ion

of

the

nu

rsin

g te

am.

Adm

inis

ters

nu

trit

ion

al s

upp

lem

ents

ac

cord

ing

to p

resc

rip

tion

an

d in

ac

cord

ance

to

guid

elin

es.

En

sure

s th

e re

quir

ed n

utr

itio

nal

su

pple

men

ts a

re p

resc

ribe

d.M

onit

ors

the

nee

d fo

r n

utr

itio

nal

su

pple

men

ts a

nd

ensu

res

com

plia

nce

.A

sses

ses

the

infa

nt’s

gro

wth

tra

ject

ory

and

pres

crib

es n

utr

itio

nal

su

pple

men

ts a

s re

quir

ed.

Rev

iew

s th

e n

eed

for

nu

trit

ion

al

supp

lem

ents

.

Rec

ogn

ises

typ

ical

an

d at

ypic

al o

ral

feed

ing

beh

avio

ur;

rec

ords

an

d re

por

ts fi

ndi

ngs

.

Safe

ly a

dmin

iste

rs in

trav

enou

s th

erap

y ac

cord

ing

to u

nit

gu

idel

ines

, re

cogn

isin

g an

d re

por

tin

g de

viat

ion

s an

d co

mpl

icat

ion

s.

Iden

tifi

es t

ypic

al a

nd

atyp

ical

ora

l fe

edin

g be

hav

iou

r; r

ecor

ds a

nd

rep

orts

fin

din

gs.

Sets

up,

mai

nta

ins

and

disc

onti

nu

es

intr

aven

ous/

intr

a-ar

teri

al t

her

apy,

ac

cord

ing

to u

nit

gu

idel

ines

.

Mai

nta

ins

cen

tral

lin

es a

nd

infu

sion

s su

ch a

s tr

ansp

aren

tal n

utr

itio

n

(TP

N).

Inte

rven

es a

ppro

pria

tely

to

redu

ce/

avoi

d de

viat

ion

s/co

mpl

icat

ion

s.

Man

age

feed

ing

diffi

cult

ies

acco

rdin

g to

car

e pl

an t

o re

assu

re a

nd

supp

ort

the

fam

ily.

In s

pec

ific

situ

atio

ns,

inse

rts

per

iph

eral

intr

aven

ous

lines

. Su

per

vise

s in

sert

ion

of

intr

aven

ous

lines

by

oth

ers.

Man

ages

app

ropr

iate

tre

atm

ent

for

devi

atio

ns/

com

plic

atio

ns.

In p

artn

ersh

ip w

ith

th

e fa

mily

de

sign

s an

d in

stit

ute

s a

plan

of

indi

vidu

alis

ed c

are

in o

rder

to

mee

t th

e in

fan

t’s n

eeds

.

Edu

cate

s, m

ento

rs a

nd

sup

ervi

ses

staf

f to

en

sure

saf

e ca

re.

Est

ablis

hes

intr

aven

ous

and

intr

a-ar

teri

al a

cces

s, u

mbi

lical

lin

es,

etc.

Inse

rts

and

rem

oves

cen

tral

lin

es.

Inst

igat

es a

nd

pres

crib

es t

reat

men

t.

Sele

cts

and

pres

crib

es a

ppro

pria

te

flu

id m

anag

emen

t.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.

34


Return to contents

Flui

d, e

lect

roly

te, n

utri

tion

and

eli

min

atio

n m

anag

emen

t (c

onti

nued

)

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Mon

itor

s in

put

and

outp

ut,

reco

rds

and

rep

orts

fin

din

gs.

Mon

itor

s in

put

and

outp

ut.

Cal

cula

tes

inta

ke r

equ

irem

ents

ac

cord

ing

to g

uid

elin

es. M

easu

res

outp

ut.

Cal

cula

tes

inta

ke a

nd

ou

tpu

t ac

cord

ing

to c

linic

al c

ondi

tion

an

d en

viro

nm

ent

wit

hin

set

gu

idel

ines

.

Edu

cate

s, m

ento

rs a

nd

sup

ervi

ses

staf

f to

en

sure

saf

e ca

re.

Cal

cula

tes

and

pres

crib

es fl

uid

inta

ke

acco

rdin

g to

clin

ical

con

diti

on a

nd

envi

ron

men

t.

Mea

sure

s an

d w

eigh

s in

fan

ts, r

ecor

ds

and

rep

orts

fin

din

gs.

Mea

sure

s w

eigh

t an

d le

ngt

h.

Mon

itor

s gr

owth

an

d de

velo

pmen

t th

rou

gh m

easu

rem

ent

of w

eigh

t an

d le

ngt

h, r

epor

tin

g of

dev

iati

ons.

Act

s on

dev

iati

ons

from

nor

mal

gr

owth

an

d de

velo

pmen

t an

d re

fers

ap

prop

riat

ely.

Inve

stig

ates

, pre

scri

bes

and

man

ages

tr

eatm

ents

for

prob

lem

s w

ith

wei

ght

or le

ngt

h.

Supp

orts

th

e in

fan

t an

d fa

mily

du

rin

g bl

ood

sam

plin

g. F

ollo

ws

un

it

guid

elin

es.

Obt

ain

s ca

pilla

ry b

lood

sam

ple

to

mea

sure

an

d m

onit

ors

bloo

d gl

uco

se

leve

ls, r

epor

tin

g de

viat

ion

s. F

ollo

ws

un

it g

uid

elin

es.

Impl

emen

ts in

terv

enti

ons

acco

rdin

g to

un

it g

uid

elin

es fo

r bl

ood

glu

cose

re

gula

tion

.

En

sure

s im

plem

enta

tion

of

evid

ence

-bas

ed g

uid

elin

es.

Edu

cate

s, m

ento

rs a

nd

sup

ervi

ses

staf

f to

en

sure

saf

e sa

mpl

ing

tech

niq

ues

.

Inte

rpre

ts a

nd

inst

igat

es a

ppro

pria

te

man

agem

ent

and

furt

her

in

vest

igat

ion

.

Dev

ises

, au

dits

an

d re

view

s u

nit

gu

idel

ines

for

best

pra

ctic

e in

pa

rtn

ersh

ip w

ith

med

ical

sta

ff.

Pro

vide

s ca

re t

o an

oth

erw

ise

wel

l in

fan

t w

ho

is r

ecei

vin

g ph

otot

her

apy

acco

rdin

g to

loca

l gu

idan

ce.

Supp

orts

th

e fa

mily

to

enga

ge in

th

eir

infa

nts

car

e.

Car

es fo

r th

e in

fan

t w

ho

requ

ires

ph

otot

her

apy

acco

rdin

g to

loca

l gu

idan

ce.

En

cou

rage

s an

d su

ppor

ts t

he

fam

ily

to e

nga

ge in

th

eir

infa

nt’s

car

e.

Init

iate

s ph

otot

her

apy

acco

rdin

g to

pr

edet

erm

ined

cri

teri

a an

d su

ppor

ts

and

sup

ervi

ses

staf

f w

ho

are

cari

ng

for

thes

e in

fan

ts.

En

sure

s th

e fa

mily

hav

e re

ceiv

ed a

n

expl

anat

ion

for

the

trea

tmen

t an

d m

anag

emen

t of

th

eir

infa

nt.

Edu

cate

s, m

ento

rs a

nd

sup

ervi

ses

staf

f to

en

sure

saf

e ca

re.

Supp

orts

th

e de

velo

pmen

t of

par

ent

info

rmat

ion

mat

eria

ls s

o th

at p

aren

ts

can

hav

e w

ritt

en in

form

atio

n

rega

rdin

g th

e tr

eatm

ent

and

man

agem

ent

of t

hei

r in

fan

t.

Pre

scri

bes

phot

oth

erap

y ac

cord

ing

to

clin

ical

nee

d.

Inve

stig

ates

cau

se o

f pa

thol

ogic

al

hyp

erbi

liru

bin

aem

ia.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.



Neu

rolo

gica

l, d

evel

opm

enta

l car

e an

d pa

in m

anag

emen

t

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Car

ing

for

the

wel

l in

fan

t.

Rec

ogn

ises

typ

ical

sle

ep/w

ake

stat

es,

usu

al p

ostu

re a

nd

mov

emen

t in

th

e n

ewbo

rn.

Rep

orts

dev

iati

ons

from

nor

mal

.

Supp

orts

th

e fa

mily

to

follo

w t

he

infa

nt’s

nee

d fo

r st

imu

lati

on a

nd

slee

p p

erio

ds.

Rec

ogn

ises

nor

mal

beh

avio

ur

in

infa

nts

of

diff

eren

t ge

stat

ion

s,

incl

udi

ng

slee

p/aw

ake

stat

es.

Rec

ogn

ises

nor

mal

ton

e, p

ostu

re a

nd

mov

emen

t.

Rep

orts

dev

iati

ons

from

nor

mal

Su

ppor

ts t

he

fam

ily t

o fo

llow

th

e in

fan

t’s n

eed

for

stim

ula

tion

an

d sl

eep

per

iods

.

Rec

ogn

ises

phy

siol

ogic

al a

nd

beh

avio

ura

l dif

fere

nce

s be

twee

n

stre

ss, d

istr

ess,

dis

com

fort

, pai

n,

conv

uls

ion

s an

d dr

ug

wit

hdr

awal

.

Alle

viat

es in

fan

t’s d

isco

mfo

rt/p

ain

u

sin

g st

anda

rd n

urs

ing

stra

tegi

es.

(In

par

tner

ship

wit

h t

he

fam

ily)

devi

ses

a ca

re p

lan

tak

ing

into

ac

cou

nt

the

infa

nt’s

nee

d fo

r st

imu

lati

on a

nd

slee

p p

erio

ds.

Pro

vide

s ed

uca

tion

, gu

idan

ce a

nd

supp

ort

for

staf

f to

en

able

th

em t

o re

cogn

ise

the

infa

nt’s

phy

siol

ogic

al

and

beh

avio

ura

l dif

fere

nce

s.

Init

iate

s re

ferr

als

base

d on

nee

d.

Mai

nta

ins

ongo

ing

use

of

rele

van

t as

sess

men

t to

ols

and

rep

ort

fin

din

gs.

Com

plet

es a

vaila

ble/

appr

opri

ate

asse

ssm

ent

tool

s an

d re

por

t fi

ndi

ngs

.In

terp

rets

ou

tcom

es o

f as

sess

men

t an

d im

plem

ents

str

ateg

ies

acco

rdin

g to

loca

l gu

idel

ines

.

Pro

vide

exp

lan

atio

n t

o th

e fa

mily

on

th

e u

se o

f as

sess

men

t to

ols.

Edu

cate

s st

aff

on t

he

use

of

rele

van

t as

sess

men

t to

ols.

Mon

itor

s an

d su

per

vise

s st

aff

wh

o u

se t

hes

e to

ols

to e

nsu

re c

onsi

sten

cy

in t

he

use

of

such

inst

rum

ents

.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.

Init

iate

s ap

prop

riat

e tr

eatm

ent.

Iden

tifi

es p

oten

tial

ly a

dver

se e

ven

ts

and

refe

rs o

n t

o m

inim

ise

any

impa

ct

shou

ld t

hey

occ

ur.

An

tici

pate

s p

oten

tial

ly a

dver

se e

ven

ts

and

refe

rs o

n t

o m

inim

ise

thei

r im

pact

sh

ould

th

ey o

ccu

r.

Pla

ns,

impl

emen

ts a

nd

eval

uat

es c

are

to a

void

/min

imis

e th

e im

pact

of

adve

rse

even

ts.

Doc

um

ents

an

d re

fers

iden

tifi

ed

adve

rse

even

ts.

Rev

iew

s ca

re a

nd

man

agem

ent

stra

tegi

es t

o av

oid/

min

imis

e th

e im

pact

of

adve

rse

even

ts.

Pro

vide

s ex

plan

atio

n t

o th

e fa

mily

w

her

e ‘m

inor

’ eve

nts

hav

e oc

curr

ed.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

. (I

n p

artn

ersh

ip w

ith

th

e m

edic

al

staf

f) in

form

s an

d pr

ovid

es

expl

anat

ion

to

the

fam

ily w

her

e ad

vers

e ev

ents

hav

e oc

curr

ed.

An

tici

pate

s an

d re

cogn

ises

sig

ns

of

dist

ress

/pai

n in

th

e n

ewbo

rn a

nd

take

s st

eps

to p

rovi

de c

omfo

rt fo

llow

s u

nit

gu

idel

ines

.

Supp

orts

th

e fa

mily

to

prov

ide

non

-ph

arm

aceu

tica

l mea

sure

s of

pr

omot

ing

com

fort

.

Rec

ogn

ises

an

d re

por

ts s

ign

s of

pai

n.

Pro

vide

s ro

uti

ne

nu

rsin

g ca

re t

o al

levi

ate

pain

an

d st

ress

to

the

infa

nt

acco

rdin

g to

un

it g

uid

elin

es.

Pro

vide

s ph

arm

aceu

tica

l age

nts

to

min

imis

e pa

in a

nd

disc

omfo

rt a

s pr

escr

ibed

. E

nco

ura

ges

and

supp

orts

th

e fa

mily

to

pro

vide

non

-ph

arm

aceu

tica

l m

easu

res

of p

rom

otin

g co

mfo

rt.

Rec

ogn

ises

an

d re

por

ts s

ubt

le s

ign

s of

pa

in.

Impl

emen

ts s

trat

egie

s th

at m

inim

ise

pain

ful e

xper

ien

ces.

En

sure

s th

at p

har

mac

euti

cal a

gen

ts

to m

inim

ise

pain

an

d di

scom

fort

are

pr

escr

ibed

wh

en r

equ

ired

.

Supp

orts

an

d su

per

vise

s st

aff

to

ensu

re t

hat

infa

nts

are

pro

vide

d co

mfo

rt w

hen

nec

essa

ry.

Dev

ises

pro

toco

ls t

o re

duce

str

ess

and

relie

ve p

ain

.A

udi

ts s

tres

s re

lief

and

pain

red

uct

ion

pr

otoc

ols.

36


Return to contents

Neu

rolo

gica

l, d

evel

opm

enta

l car

e an

d pa

in m

anag

emen

t (c

onti

nued

)

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Rec

ogn

ises

beh

avio

ur

asso

ciat

ed w

ith

n

eon

atal

abs

tin

ence

syn

drom

e (N

AS)

.

Supp

orts

th

e fa

mily

to

prov

ide

non

-ph

arm

aceu

tica

l mea

sure

s of

pr

omot

ing

com

fort

an

d co

nso

lati

on

to t

hei

r in

fan

t w

ho

has

NA

S.

Rec

ogn

ises

beh

avio

ur

asso

ciat

ed w

ith

N

AS.

Pro

vide

s ro

uti

ne

nu

rsin

g ca

re t

o al

levi

ate

effe

cts

of N

AS;

ad

min

istr

atio

n o

f m

edic

atio

ns

to

man

age

thes

e in

fan

ts.

Impl

emen

ts s

trat

egie

s th

at m

inim

ise

the

effe

cts

of N

AS.

Pro

vide

s su

ppor

t an

d gu

idan

ce fo

r st

aff

invo

lved

in t

he

care

ass

ocia

ted

wit

h m

ater

nal

dru

g de

pen

den

cy a

nd

NA

S.

Dev

elop

s st

rate

gies

for

staf

f re

gard

ing

mat

ern

al d

rug

dep

ende

ncy

an

d N

AS

invo

lvin

g m

ult

i-di

scip

linar

y/ag

ency

gr

oups

.

Init

iate

s re

ferr

als

base

d on

nee

d.

Follo

ws

indi

vidu

alis

ed d

evel

opm

enta

l ca

re p

lan

s su

ppor

t th

e fa

mily

to

be

invo

lved

in t

hei

r in

fan

t’s c

are.

Use

s de

velo

pmen

tal c

are

stra

tegi

es

incl

udi

ng

envi

ron

men

tal a

spec

ts,

pos

itio

nin

g an

d h

and

ling

acco

rdin

g to

th

e ca

re p

lan

an

d ac

cord

ing

to u

nit

p

olic

ies.

En

cou

rage

s th

e in

volv

emen

t of

fa

mili

es.

(In

par

tner

ship

wit

h t

he

fam

ily)

plan

s th

e in

fan

t’s c

are

and

adap

ts

nu

rsin

g st

rate

gies

to

mee

t th

e n

eeds

of

sp

ecifi

c in

fan

ts.

Invo

lves

th

e fa

mili

es in

th

e ca

re o

f th

eir

infa

nts

.

Edu

cate

s an

d su

ppor

ts s

taff

in t

he

use

of

deve

lopm

enta

l car

e st

rate

gies

.

Pro

vide

s ex

plan

atio

ns

to t

he

fam

ily

wh

en a

ddit

ion

al m

easu

res

are

requ

ired

.

Init

iate

s re

ferr

als

base

d on

nee

d.

Res

pira

tory

and

car

diov

ascu

lar

man

agem

ent

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Ass

esse

s an

infa

nt’s

wel

lbei

ng.

R

epor

ts d

evia

tion

s fr

om n

orm

al

brea

thin

g an

d de

viat

ion

s fr

om t

he

nor

mal

pu

lse.

Rec

ogn

ises

nor

mal

an

d ab

nor

mal

re

spir

ator

y/ca

rdio

vasc

ula

r fu

nct

ion

.

Rep

orts

dev

iati

ons

from

nor

mal

.

Inte

rven

es t

o re

stor

e/m

ain

tain

h

omeo

stas

is a

ccor

din

g to

loca

l gu

idel

ines

.

Men

tors

, su

per

vise

s an

d su

ppor

ts

staf

f in

ass

essi

ng

the

infa

nt’s

vit

al

sign

s.

Inte

rpre

ts t

ren

ds a

nd

eva

luat

es

man

agem

ent,

incl

ud

ing

bloo

d ga

s an

alys

is.

Edu

cate

s, m

ento

rs a

nd

sup

ervi

ses

staf

f in

th

e ac

cura

te a

sses

smen

t of

th

e in

fan

t’s v

ital

sig

ns.

Rec

ogn

ises

dev

iati

ons

from

nor

mal

re

spir

ator

y an

d ca

rdio

vasc

ula

r fu

nct

ion

.

Inte

rpre

ts a

nd

resp

onds

to

tren

ds in

th

e re

sult

s of

blo

od g

as a

nal

ysis

.

Dia

gnos

es r

espi

rato

ry p

ath

olog

y in

terp

reta

tion

of

ches

t ra

diog

raph

y.

Pre

scri

bes

and

inst

igat

es s

upp

orti

ve

inte

rven

tion

s an

d th

erap

ies

follo

win

g in

fan

t as

sess

men

t.



An

tici

pate

s an

d re

cogn

ises

de

teri

orat

ion

in t

he

new

born

an

d ta

kes

step

s to

req

ues

t as

sist

ance

an

d in

itia

tes

basi

c lif

e su

ppor

t m

easu

res

in a

n e

mer

gen

cy.

Supp

orts

an

d co

mfo

rts

pare

nts

.

Rec

ogn

ises

th

e n

eed

for,

and

requ

ests

, as

sist

ance

.

Obs

erve

s an

d pa

rtic

ipat

es in

th

e re

susc

itat

ion

of

the

infa

nt.

Init

iate

s ba

sic

life

supp

ort

mea

sure

s in

an

em

erge

ncy

.

Supp

orts

an

d co

mfo

rts

pare

nts

.

Perf

orm

s ba

sic

life

supp

ort.

Rec

ogn

ises

nee

d fo

r an

d re

ques

ts

assi

stan

ce.

Ass

ists

wit

h a

dvan

ced

resu

scit

atio

n

and

stab

ilisa

tion

.

Pro

vide

s ex

plan

atio

n t

o pa

ren

ts

duri

ng

the

resu

scit

ativ

e ev

ent

if t

he

pare

nts

wis

h t

o be

pre

sen

t.

Lead

s in

bas

ic li

fe s

upp

ort

situ

atio

n

and

stab

ilisa

tion

.

(In

som

e si

tuat

ion

s) p

erfo

rms

the

role

of

an a

dvan

ced

resu

scit

ator

.

Pro

vide

s te

am d

ebri

efs

wh

en

requ

ired

.

Perf

orm

s an

d le

ads

adva

nce

d re

susc

itat

ion

an

d st

abili

sati

on.

Teac

hes

sta

ff t

he

asse

ssm

ent

skill

s an

d th

e ba

sic

life

supp

ort

chro

nic

lun

g di

seas

e (C

LD

) ac

tion

s re

quir

ed t

o re

spon

d to

dev

iati

ons.

Perf

orm

s to

neo

nat

al a

dvan

ced

life

supp

ort

(NA

LS)

sta

nda

rds.

(In

par

tner

ship

wit

h t

he

med

ical

te

am)

info

rms

fam

ilies

of

the

outc

omes

of

resu

scit

atio

n.

Pro

vide

s on

goin

g ca

re o

f in

fan

ts w

ho

are

oxyg

en d

epen

den

t an

d w

ho

are

oth

erw

ise

stab

le.

Supp

orts

fam

ilies

to

part

icip

ate

in t

he

care

of

thei

r in

fan

t.

Safe

ly a

dmin

iste

rs o

xyge

n t

her

apy

via

the

incu

bato

r, h

ead

box,

nas

al

can

nu

lae

and

faci

ally

, in

clu

din

g ad

equ

ate

hum

idifi

cati

on a

s pr

escr

ibed

.

En

cou

rage

s fa

mili

es t

o be

com

e in

volv

ed in

th

e ca

re o

f th

eir

infa

nt

wh

o h

as a

n o

xyge

n r

equ

irem

ent.

Safe

ly c

ares

for

the

infa

nt

requ

irin

g m

ech

anic

al v

enti

lati

on/c

onti

nu

ous

pos

itiv

e ai

rway

s pr

essu

re.

Pro

vide

s ex

plan

atio

n a

nd

reas

sura

nce

fo

r th

e fa

mily

wh

o h

ave

an in

fan

t w

ith

th

is c

are

requ

irem

ent.

Wh

ere

pos

sibl

e, in

volv

e th

em in

pla

nn

ing

and

part

icip

atin

g in

th

eir

infa

nts

car

e.

Adj

ust

s re

spir

ator

y su

ppor

t ac

cord

ing

to n

eed

wit

hin

th

e lo

cal

guid

elin

es.

Edu

cate

s, s

up

ervi

ses,

men

tors

an

d su

ppor

ts s

taff

wh

o ar

e ca

rin

g fo

r in

fan

ts w

ith

a n

eed

for

resp

irat

ory

supp

ort.

Init

iate

s an

d m

anag

es lo

ng-

term

re

spir

ator

y su

ppor

t fo

r in

fan

ts w

ith

ch

ron

ic lu

ng

dise

ase

(CL

D),

pr

escr

ibes

med

icat

ion

to

man

age

CL

D.

Inst

igat

es a

nd

co-o

rdin

ates

dis

char

ge

plan

nin

g fo

r fa

mili

es o

f in

fan

ts w

ith

C

LD

.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.

Rec

ogn

ises

wh

en in

fan

ts h

ave

a bu

ild

up

of s

ecre

tion

s an

d ta

kes

acti

on t

o en

sure

a c

lear

air

way

.

Use

s sa

fe a

nd

effe

ctiv

e or

al a

nd

nas

al

suct

ion

tec

hn

iqu

es.

Ass

esse

s th

e n

eed

for

suct

ion

of

resp

irat

ory

secr

etio

ns.

Use

s sa

fe a

nd

effe

ctiv

e en

dotr

ach

eal

tube

/tra

cheo

stom

y su

ctio

n

tech

niq

ues

.

Perf

orm

s ch

est

phys

ioth

erap

y te

chn

iqu

es a

s pr

escr

ibed

.

Rev

iew

s an

d ev

alu

ates

th

e ef

fect

iven

ess

of p

hysi

oth

erap

y an

d su

ctio

n in

terv

enti

ons.

Edu

cate

s, s

up

ervi

ses

and

men

tors

st

aff

wh

o n

eed

to a

sses

s an

infa

nt

for

the

nee

d fo

r su

ctio

nin

g an

d in

how

to

safe

ly p

erfo

rm t

he

proc

edu

re.

Pre

scri

bes

ches

t ph

ysio

ther

apy.

Init

iate

s re

ferr

als

base

d on

nee

d.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.

38


Return to contents

Res

pira

tory

and

car

diov

ascu

lar

man

agem

ent

(con

tinu

ed)

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Ass

ists

wit

h e

lect

ive/

emer

gen

cy

intu

bati

on.

Car

es fo

r in

fan

ts w

ho

requ

ire

ven

tila

tion

.

Supp

orts

ext

uba

tion

.

Rec

ogn

ises

th

e n

eed

for

intu

bati

on/

extu

bati

on.

Car

es fo

r in

fan

ts r

equ

irin

g a

ran

ge o

f ve

nti

lati

on s

trat

egie

s an

d ad

jun

ctiv

e su

ppor

t (s

ee e

xam

ples

pro

vide

d in

th

e A

NN

P c

olu

mn

).

Perf

orm

s ex

tuba

tion

.

Edu

cate

s, m

ento

rs a

nd

supp

orts

sta

ff

to c

are

for

infa

nts

wh

o re

quir

e ve

nti

lato

ry s

upp

ort.

Perf

orm

s in

tuba

tion

.

Ass

esse

s an

d pr

escr

ibes

a r

ange

of

ven

tila

tion

mod

alit

ies;

for

exam

ple,

sy

nch

ron

ised

inte

rmit

ten

t m

anda

tory

ve

nti

lati

on (

SIM

V),

tid

al v

olu

me

ven

tila

tion

(T

V),

pat

ien

t-tr

igge

red

ven

tila

tion

(P

TV

), p

ress

ure

su

ppor

t ve

nti

lati

on (

PSV

), h

igh

freq

uen

cy

osci

llati

on v

enti

lati

on (

HFO

V).

Pre

scri

bes

seda

tion

/an

alge

sia

and

mu

scle

rel

axat

ion

to

mai

nta

in in

fan

t co

mfo

rt a

nd

com

plie

s w

ith

su

ppor

tive

ven

tila

tion

.

Pre

scri

bes

adju

nct

ive

resp

irat

ory

supp

ort;

for

exam

ple,

nit

ric

oxid

e in

hal

atio

n (

iNO

), s

yste

mic

pu

lmon

ary

vaso

dila

tors

.

Mon

itor

s sk

in in

tegr

ity

wh

ere

infa

nts

h

ave

had

ch

est

drai

ns.

Obs

erve

s th

e sk

in in

tegr

ity

of t

he

site

.

Obs

erve

s th

e h

ealin

g of

th

e ch

est

drai

n w

oun

d, r

epor

ts a

ny c

once

rns.

Ass

ists

wit

h t

he

inse

rtio

n/r

emov

al o

f ch

est

drai

nag

e.

Pro

vide

s ca

re fo

r in

fan

t w

ith

ch

est

drai

n in

sit

u.

Edu

cate

s, s

up

ervi

ses

and

men

tors

st

aff

wh

o ar

e ca

rin

g fo

r in

fan

ts w

ho

hav

e a

requ

irem

ent

for

a ch

est

drai

n.

Inse

rts,

sec

ure

s an

d re

mov

es c

hes

t dr

ain

age.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.

Car

es fo

r in

fan

ts w

ho

are

requ

irin

g in

otro

pic

supp

ort

to m

ain

tain

st

abili

ty.

Car

es fo

r in

fan

ts w

ho

are

un

stab

le

and

are

requ

irin

g co

mpl

ex in

otro

pic

supp

ort.

Wea

ns

dow

n s

uch

su

ppor

t ac

cord

ing

to in

otro

pic

prot

ocol

s.

Ass

esse

s th

e n

eed

for

and

pres

crib

es

inot

ropi

c su

ppor

t.

Det

ects

un

derl

yin

g ca

rdia

c an

omal

y or

dis

ease

; for

exa

mpl

e, p

atie

nt

arte

rial

du

ct, p

ersi

sten

t pu

lmon

ary

hyp

erte

nsi

on o

f th

e n

ewbo

rn,

con

gen

ital

hea

rt d

isea

se.



Ski

n, h

ygie

ne a

nd in

fect

ion

cont

rol m

anag

emen

t

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Com

plie

s w

ith

cor

rect

han

d hy

gien

e pr

oced

ure

, im

plem

ents

oth

er

infe

ctio

n p

reve

nti

on a

nd

con

trol

m

easu

res

as p

er lo

cal p

olic

ies.

Supp

orts

fam

ilies

to

com

ply

wit

h

han

d hy

gien

e p

olic

y an

d in

fect

ion

co

ntr

ol s

trat

egie

s.

Impl

emen

ts c

orre

ct h

and

was

hin

g an

d ot

her

infe

ctio

n c

ontr

ol m

easu

res

as p

er lo

cal g

uid

elin

es.

Polic

es c

ompl

ian

ce w

ith

infe

ctio

n

con

trol

gu

idel

ines

.

Perf

orm

s ba

sic

asep

tic

and

non

-tou

ch t

ech

niq

ues

.

Impl

emen

ts c

orre

ct h

and

was

hin

g an

d ot

her

infe

ctio

n c

ontr

ol m

easu

res

as p

er lo

cal g

uid

elin

es.

Edu

cate

s th

e pa

ren

ts in

th

e co

mpl

ian

ce w

ith

infe

ctio

n c

ontr

ol

guid

elin

es.

Perf

orm

s a

ran

ge o

f as

epti

c an

d n

on-t

ouch

tec

hn

iqu

es.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

for

best

pra

ctic

e in

pa

rtn

ersh

ip w

ith

med

ical

sta

ff.

Au

dits

com

plia

nce

wit

h b

est

prac

tice

in

rel

atio

n t

o in

fect

ion

con

trol

m

easu

res.

Res

earc

hes

evi

den

ce-b

ased

pra

ctic

e to

su

ppor

t gu

idel

ines

for

infe

ctio

n

con

trol

.

Perf

orm

s ca

re a

ccor

din

g to

th

e in

fan

t’s c

are

plan

.

Exa

min

es s

kin

, cor

d an

d ey

es u

sin

g as

sess

men

t to

ol(s

) if

app

ropr

iate

to

loca

l pra

ctic

e, r

ecor

ds a

nd

rep

orts

fi

ndi

ngs

.

Supp

orts

par

ents

to

part

icip

ate

in

thei

r in

fan

t’s c

are.

Exa

min

es s

kin

an

d m

uco

us

mem

bran

es, e

yes

and

cord

bas

e fo

r de

viat

ion

s fr

om n

orm

al a

nd

rep

ort.

Pro

vide

s ca

re a

ccor

din

g to

th

e in

fan

ts

care

pla

n.

Impl

emen

ts t

reat

men

t fo

r de

viat

ion

s as

pre

scri

bed.

En

cou

rage

s pa

ren

ts t

o pa

rtic

ipat

e in

th

eir

infa

nt’s

car

e.

Men

tors

an

d su

per

vise

sta

ff in

p

erfo

rmin

g th

e as

sess

men

ts r

equ

ired

to

en

sure

th

e w

ellb

ein

g of

th

e in

fan

t.

(In

par

tner

ship

wit

h t

he

pare

nts

) de

vise

s a

plan

of

care

to

mee

t th

eir

infa

nt’s

nee

ds.

Impl

emen

ts s

trat

egie

s to

pre

ven

t ia

trog

enic

dam

age

and

pot

enti

al

inju

ry.

Edu

cate

s st

aff

in t

he

corr

ect

use

of

tool

s to

ass

ess

skin

.P

resc

ribe

s an

d m

anag

es t

her

apie

s to

pr

omot

e sk

in in

tegr

ity.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.

Pro

vide

s on

goin

g m

anag

emen

t of

es

tabl

ish

ed s

tom

a; r

efer

s to

a Q

IS if

th

ere

is c

once

rn a

s to

ou

tpu

t.

Supp

orts

par

ents

to

part

icip

ate

in

thei

r in

fan

t’s c

are.

Use

s ap

prop

riat

e m

easu

res

to

mai

nta

in h

ygie

ne

and

skin

inte

grit

y.

Pro

vide

s st

oma

care

.

Ass

esse

s n

atu

re a

nd

char

acte

rist

ics

of

stom

a ou

tpu

t re

cogn

ise

devi

atio

ns

from

th

e n

orm

.

En

cou

rage

s pa

ren

ts t

o pa

rtic

ipat

e in

th

eir

infa

nt’s

car

e.

Ass

esse

s w

oun

d h

ealin

g pr

oces

ses.

Ass

esse

s n

atu

re a

nd

char

acte

rist

ics

of

stom

a ou

tpu

t.

Perf

orm

s th

erap

euti

c w

oun

d cl

ean

sin

g te

chn

iqu

es.

App

lies

ther

apeu

tic

dres

sin

gs.

Invo

lves

par

ents

in d

esig

nin

g a

plan

of

car

e to

en

able

th

em t

o pa

rtic

ipat

e in

th

eir

infa

nt’s

car

e.

Edu

cate

s, m

ento

rs a

nd

sup

ervi

ses

staf

f in

th

e ca

re o

f a

vari

ety

of s

tom

a an

d w

hat

th

e u

sual

ou

tpu

t ch

arac

teri

stic

are

.

Ref

ers

to o

ther

sta

ff a

ny

com

plic

atio

ns

wit

h t

he

stom

a as

ap

prop

riat

e.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.

Pre

scri

bes

trea

tmen

ts a

nd

appl

ian

ces.

Ref

ers

as a

ppro

pria

te.

40


Return to contents

Tem

pera

ture

man

agem

ent

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Rou

tin

ely

man

ages

an

infa

nt’s

te

mp

erat

ure

an

d pr

omot

es s

afet

y in

th

e h

ome.

Invo

lves

th

e fa

mily

in t

he

infa

nt’s

ca

re.

Ass

esse

s n

eon

atal

bod

y te

mp

erat

ure

u

sin

g ap

prop

riat

e m

eth

od a

nd

site

fo

r in

fan

ts w

ho

requ

ire

spec

ial c

are

and

rep

ort

devi

atio

ns

from

nor

mal

.

En

cou

rage

s th

e fa

mily

to

be in

volv

ed

in t

he

infa

nt’s

car

e.

Pro

vide

s ex

plan

atio

n a

s to

th

e n

eed

for

the

infa

nt

to b

e ca

red

for

in a

te

mp

erat

ure

su

ited

to

thei

r n

eeds

.

Ass

esse

s n

eon

atal

bod

y te

mp

erat

ure

u

sin

g ap

prop

riat

e m

eth

od a

nd

site

fo

r in

fan

ts w

ho

requ

ire

hig

h

dep

ende

ncy

an

d in

ten

sive

car

e, a

nd

rep

orts

dev

iati

ons

from

nor

mal

.

Mon

itor

s ce

ntr

al a

nd

per

iph

eral

te

mp

erat

ure

gap

, an

d re

por

ts

devi

atio

ns

from

nor

mal

.

Car

es fo

r in

fan

ts w

ho

are

rece

ivin

g th

erap

euti

c hy

pot

her

mia

.

Supp

orts

th

e de

velo

pmen

t of

au

dit

and

revi

ews

nu

rsin

g gu

idel

ines

for

tem

per

atu

re m

onit

orin

g.

Rec

ogn

ises

th

e n

eed

for

ther

apeu

tic

hyp

oth

erm

ia in

follo

win

g th

e re

susc

itat

ion

of

infa

nts

at

risk

of

hyp

oxic

isch

emic

eve

nt

(HIE

).

Car

es fo

r in

fan

ts w

ho

are

rece

ivin

g th

erap

euti

c hy

pot

her

mia

.

Edu

cate

s, s

up

ervi

ses

and

men

tors

st

aff

to c

are

for

infa

nts

wh

o n

eed

to

be p

assi

vely

coo

led

or w

ho

requ

ire

ther

apeu

tic

hyp

oth

erm

ia.

Rei

nfo

rces

th

e ex

plan

atio

n p

rovi

ded

by t

he

med

ical

tea

m t

o th

e fa

mili

es a

s to

th

e n

eed

for

hyp

oth

erm

ia.

Dev

ises

au

dit

and

revi

ews

nu

rsin

g gu

idel

ines

for

tem

per

atu

re

mon

itor

ing.

Com

men

ces

pass

ive

cool

ing.

Mon

itor

s an

d su

per

vise

s th

e ca

re o

f in

fan

ts w

ho

are

rece

ivin

g th

erap

euti

c hy

pot

her

mia

.

Man

ages

th

e ce

rebr

al fu

nct

ion

m

onit

ors

wh

ere

thes

e ar

e in

use

.

(In

par

tner

ship

wit

h t

he

med

ical

te

am)

prov

ides

rat

ion

ale

for

the

use

of

hyp

oth

erm

ia a

nd

ongo

ing

expl

anat

ion

to

the

fam

ilies

wh

o h

ave

infa

nts

wh

o ar

e re

ceiv

ing

hyp

oth

erm

ia.

Mon

itor

s th

e te

mp

erat

ure

in in

fan

ts

wh

o ar

e h

avin

g sk

in-t

o-sk

in c

are,

sw

add

led

for

com

fort

, bat

hin

g, a

nd

so fo

rth

.

Use

s ap

prop

riat

e st

rate

gies

to

mai

nta

in b

ody

tem

per

atu

re w

ith

in

nor

mal

lim

its,

incl

udi

ng

envi

ron

men

tal a

spec

ts, c

loth

ing

and

equ

ipm

ent

for

infa

nts

wh

o re

quir

e sp

ecia

l car

e.

An

tici

pate

s th

e in

fan

t’s r

isk

of

tem

per

atu

re d

evia

tion

s.

Use

s st

rate

gies

to

prev

ent

tem

per

atu

re d

evia

tion

s fo

r in

fan

ts

wh

o re

quir

e h

igh

dep

ende

ncy

an

d in

ten

sive

car

e.

Dev

ises

, au

dits

an

d re

view

s n

urs

ing

guid

elin

es fo

r te

mp

erat

ure

reg

ula

tion

st

rate

gies

.

Pro

mot

es s

afet

y in

th

e h

ome

and

appl

ies

sudd

en in

fan

t de

ath

lite

ratu

re

to c

are

of t

he

infa

nt.

Use

s ap

prop

riat

e in

terv

enti

ons

to

corr

ect

tem

per

atu

re d

evia

tion

s fo

r in

fan

ts w

ho

requ

ire

spec

ial c

are.

Use

s ap

prop

riat

e in

terv

enti

ons

to

corr

ect

tem

per

atu

re d

evia

tion

s fo

r in

fan

ts w

ho

requ

ire

hig

h d

epen

den

cy

and

inte

nsi

ve c

are.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.

Inve

stig

ates

an

d tr

eats

tem

per

atu

re

devi

atio

ns.



Pal

liat

ive

care

, end

-of-

life

car

e an

d be

reav

emen

t m

anag

emen

t

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Follo

ws

plan

of

care

for

the

com

fort

of

an

infa

nt

and

fam

ily w

her

e pa

lliat

ive

care

is a

gree

d.

(Wit

h t

he

supp

ort

of t

he

men

tor)

pa

rtic

ipat

es in

th

e ca

re o

f th

e dy

ing

infa

nt

and

the

infa

nt

wh

o is

rec

eivi

ng

palli

ativ

e ca

re.

Sen

siti

vely

an

d em

path

etic

ally

car

es

for

the

dyin

g in

fan

t an

d h

is/h

er

pare

nts

wit

h s

upp

ort

and

guid

ance

fr

om s

enio

r st

aff.

Supp

orts

an

d gu

ides

sta

ff c

arin

g fo

r th

e dy

ing

infa

nt.

Init

iate

s an

d fa

cilit

ates

sen

siti

ve

disc

uss

ion

wit

h p

aren

ts a

nd

sen

ior

med

ical

sta

ff.

Man

ages

faile

d re

susc

itat

ion

s an

d th

e di

scon

tin

uat

ion

of

aggr

essi

ve a

nd

futi

le s

upp

orti

ng

stra

tegi

es.

Follo

ws

plan

of

care

to

ensu

re

sen

siti

ve a

nd

effe

ctiv

e co

mm

un

icat

ion

wit

h fa

mili

es o

f in

fan

ts w

ho

hav

e di

ed.

Car

es fo

r fa

mily

.

(Wit

h t

he

supp

ort

of t

he

men

tor)

pr

ovid

es a

ppro

pria

te c

are

for

the

infa

nt

wh

o h

as d

ied.

Sen

siti

vely

an

d em

path

etic

ally

car

es

for

the

infa

nt

wh

o h

as d

ied

and

the

bere

aved

par

ents

in a

ccor

dan

ce w

ith

be

reav

emen

t pr

otoc

ol w

ith

su

ppor

t an

d gu

idan

ce fr

om s

enio

r st

aff.

Supp

orts

an

d gu

ides

sta

ff c

arin

g fo

r th

e in

fan

t an

d pa

ren

ts, w

ider

fam

ily

and

frie

nds

aft

er t

he

infa

nt’s

dea

th.

Dev

ises

ber

eave

men

t pr

otoc

ol.

Act

s as

th

e in

fan

t an

d fa

mili

es

advo

cate

an

d le

ad t

he

palli

ativ

e an

d en

d-of

-lif

e ca

re fo

r an

infa

nt

wh

o re

quir

es s

uch

a c

are

plan

.

Rec

ogn

ises

ow

n n

eeds

of

stre

ss a

nd

disc

omfo

rt.

Use

s u

nit

’s s

upp

ort

net

wor

k

Dev

elop

s se

lf-a

war

enes

s an

d th

e n

eed

to r

elie

ve d

istr

ess.

Acc

esse

s th

e u

nit

’s n

etw

ork

of

supp

ort

follo

win

g an

infa

nt’s

dea

th

Dev

elop

s se

lf-a

war

enes

s an

d re

cogn

ises

str

ess/

dis

tres

s in

oth

ers.

Part

icip

ates

in s

upp

ort

net

wor

k;

seek

s ap

prop

riat

e gu

idan

ce a

nd

prov

ides

som

e su

ppor

t an

d gu

idan

ce

for

staf

f.

Supp

orts

an

d gu

ides

sta

ff, i

den

tifi

es

staf

f w

ho

are

stre

ssed

an

d w

ho

nee

d ad

diti

onal

su

ppor

t.

Faci

litat

es s

ensi

tive

dis

cuss

ion

s w

ith

st

aff

and

proa

ctiv

ely

mai

nta

in a

cu

ltu

re o

f ca

re w

hic

h s

upp

orts

all

indi

vidu

als.

Inve

stig

atio

ns, t

ests

and

pro

cedu

res

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Un

dert

akes

a d

efin

ed r

ange

of

inve

stig

atio

ns

and

proc

edu

res

wh

ich

ar

e re

quir

ed b

y th

e in

fan

t.

Perf

orm

s ro

uti

ne

diag

nos

tic

and

ther

apeu

tic

proc

edu

res

acco

rdin

g to

pr

otoc

ols

and

guid

elin

es.

Impl

emen

ts p

resc

ribe

d m

anag

emen

t.

Rec

ogn

ises

th

e si

gnifi

can

ce o

f re

sult

s an

d se

eks

appr

opri

ate

man

agem

ent.

Inst

igat

es a

ppro

pria

te m

anag

emen

t.R

equ

ests

sp

ecim

ens

and

sam

ples

.P

resc

ribe

s ap

prop

riat

e m

anag

emen

t ac

cord

ing

to r

esu

lts.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

.

Ass

ists

in t

he

care

of

infa

nts

req

uir

ing

spec

ial c

are

un

derg

oin

g a

defi

ned

ra

nge

of

non

-inv

asiv

e in

vest

igat

ion

s an

d pr

oced

ure

s.

Ass

ist

in t

he

care

of

infa

nts

req

uir

ing

spec

ial c

are

un

derg

oin

g n

on-i

nvas

ive

inve

stig

atio

ns

and

proc

edu

res

Ass

ists

in t

he

care

of

infa

nts

req

uir

ing

hig

h d

epen

den

cy a

nd

inte

nsi

ve c

are

un

derg

oin

g n

on-i

nvas

ive

and

inva

sive

in

vest

igat

ion

s an

d pr

oced

ure

s.

Perf

orm

s n

on-i

nvas

ive

and

inva

sive

pr

oced

ure

s fo

r ex

ampl

e co

nge

nit

al

hip

an

omal

ies.

Ass

ists

th

e A

NP

/med

ical

tea

m in

su

ppor

t of

infa

nts

wh

o ar

e u

nde

rgoi

ng

inve

stig

atio

ns

and

proc

edu

res;

for

exam

ple,

ve

nep

un

ctu

re o

r ca

nn

ula

tion

.

Ass

ists

in t

he

care

of

infa

nts

req

uir

ing

spec

ial c

are

un

derg

oin

g bl

ood

sam

plin

g. Pe

rfor

ms

capi

llary

blo

od s

ampl

ing.

Ass

ists

in t

he

care

of

infa

nts

req

uir

ing

hig

h d

epen

den

cy a

nd

inte

nsi

ve c

are

un

derg

oin

g bl

ood

sam

plin

g.

Perf

orm

s ve

nep

un

ctu

re a

ccor

din

g to

lo

cal g

uid

elin

es.

Perf

orm

s ar

teri

al a

nd

cen

tral

lin

e sa

mpl

ing.

Inse

rts

arte

rial

, per

cuta

neo

us

cen

tral

ve

nou

s ca

thet

er a

nd

cen

tral

lin

es.

42


Return to contents

Equi

pmen

t an

d m

onit

orin

g

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Cle

ans

and

stor

es a

ran

ge o

f eq

uip

men

t w

hic

h is

nec

essa

ry fo

r th

e ca

re o

f in

fan

ts in

th

e n

eon

atal

un

it

acco

rdan

ce w

ith

loca

l an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Cle

ans

and

stor

es e

quip

men

t n

eces

sary

for

the

care

of

infa

nts

re

quir

ing

spec

ial c

are

in a

ccor

dan

ce

wit

h lo

cal a

nd

man

ufa

ctu

rer’

s in

stru

ctio

n.

Cle

ans

and

stor

es e

quip

men

t n

eces

sary

for

the

care

of

infa

nts

re

quir

ing

hig

h d

epen

den

cy a

nd

inte

nsi

ve c

are

in a

ccor

dan

ce w

ith

lo

cal a

nd

man

ufa

ctu

rer’

s in

stru

ctio

n.

En

sure

s th

at e

quip

men

t is

rea

dy fo

r u

se if

an

d w

hen

req

uir

ed.

En

sure

s th

e fu

nct

ion

alit

y of

su

ppor

tive

equ

ipm

ent.

Has

on

goin

g aw

aren

ess

of n

ew

inn

ovat

ion

s, t

hei

r ap

plic

abili

ty t

o th

e pr

acti

tion

ers

own

un

it a

nd

con

side

rati

on o

f th

e n

eed

for

adop

tin

g n

ew e

quip

men

t.

Sets

up

and

chec

ks e

quip

men

t n

eces

sary

for

the

supp

ort

of in

fan

ts

in t

he

neo

nat

al u

nit

acc

orda

nce

wit

h

loca

l an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Sets

up

and

test

s eq

uip

men

t n

eces

sary

for

the

care

of

infa

nts

re

quir

ing

spec

ial c

are

in a

ccor

dan

ce

wit

h lo

cal a

nd

man

ufa

ctu

rer’

s in

stru

ctio

n.

Sets

up

and

test

s eq

uip

men

t n

eces

sary

for

the

care

of

infa

nts

re

quir

ing

hig

h d

epen

den

cy a

nd

inte

nsi

ve c

are

in a

ccor

dan

ce w

ith

lo

cal a

nd

man

ufa

ctu

rer’

s in

stru

ctio

n

Dev

ises

gu

idel

ines

for

the

sett

ing

up

and

test

ing

of e

quip

men

t.M

akes

th

e bu

sin

ess

case

for

new

te

chn

olog

y, h

as a

cen

tral

rol

e in

th

e ed

uca

tion

an

d de

velo

pmen

t of

th

e st

aff

in t

he

use

of

new

tec

hn

olog

y.

Unr

egis

tere

d an

d su

ppor

t ne

onat

al w

orkf

orce

Nov

ice/

adva

nced

beg

inne

r:

new

ent

rant

Com

pete

nt n

eona

tal n

urse

(Q

IS)

Pro

fici

ent

neon

atal

nur

se/

enha

nced

pra

ctic

e ne

onat

al

nurs

e

Exp

ert

neon

atal

nur

se/

AN

NP

/nur

se c

onsu

ltan

t

Un

dert

akes

mea

sure

men

ts o

f vi

tal

sign

s (t

emp

erat

ure

, hea

rt r

ate,

re

spir

ator

y ra

te a

nd

oxyg

en

satu

rati

on),

rec

ords

an

d re

por

ts.

Obs

erve

s in

fan

t’s c

olou

r, re

cord

s an

d re

por

ts.

Mea

sure

s bl

ood

pres

sure

usi

ng

non

-inv

asiv

e te

chn

iqu

es, r

epor

tin

g de

viat

ion

s fr

om n

orm

al.

Sets

up

arte

rial

blo

od p

ress

ure

tr

ansd

uce

r.

Mea

sure

s ar

teri

al b

lood

pre

ssu

re.

Inte

rpre

ts b

lood

pre

ssu

re r

ecor

din

gs.

Pre

scri

bes

appr

opri

ate

ther

apy

to

mai

nta

in h

omeo

stas

is.

Car

es fo

r in

fan

t re

ceiv

ing

bloo

d tr

ansf

usi

on.

Adm

inis

ters

dru

gs v

ia o

ral,

topi

cal,

rect

al a

nd

intr

amu

scu

lar

rou

tes,

ac

cord

ing

to p

rofe

ssio

nal

an

d lo

cal

pol

icie

s.

Ass

esse

s th

e th

erap

euti

c re

spon

se.

Iden

tifi

es s

ide

effe

cts

and

rep

ort

appr

opri

atel

y.

Car

es fo

r in

fan

t re

ceiv

ing

exch

ange

an

d pa

rtia

l exc

han

ge t

ran

sfu

sion

.

Adm

inis

ters

dru

gs v

ia I

V r

oute

ac

cord

ing

to p

rofe

ssio

nal

an

d lo

cal

pol

icie

s.

Ass

esse

s th

e th

erap

euti

c re

spon

se.

Iden

tifi

es s

ide

effe

cts

and

acts

ap

prop

riat

ely

wit

hin

loca

l gu

idel

ines

.

Rev

iew

th

erap

euti

c re

spon

se t

o ex

chan

ge/p

arti

al e

xch

ange

tr

ansf

usi

on a

nd

prov

ides

car

e ac

cord

ing

to lo

cal g

uid

elin

es.

Pre

scri

bes

bloo

d an

d bl

ood

prod

uct

s ac

cord

ing

to n

atio

nal

an

d lo

cal

pol

icie

s.

Perf

orm

s ex

chan

ge a

nd

part

ial

exch

ange

.

Pre

scri

bes

and

adm

inis

ters

dru

gs v

ia

all r

oute

s, a

ccor

din

g to

nat

ion

al a

nd

loca

l pol

icie

s.

Pla

ns,

impl

emen

ts a

nd

eval

uat

es d

rug

ther

apie

s.

Eval

uat

es t

her

apeu

tic

resp

onse

/sid

e ef

fect

s an

d ac

ts a

ccor

din

gly.

Inve

stig

atio

ns, t

ests

and

pro

cedu

res

(con

tinu

ed)



Add

endu

m: F

ram

ewor

ks fo

r le

vels

2–4

Fl

uid,

ele

ctro

lyte

, nut

riti

on a

nd e

lim

inat

ion

man

agem

ent

Lev

el 2

H

CA/M

SW

/HCS

W

(in

the

wel

l inf

ant)

Lev

el 3

N

urse

ry n

urse

/HCA

/SH

CSW

(i

n th

e in

fant

rec

eivi

ng s

peci

al c

are)

Lev

el 4

N

urse

ry n

urse

/ass

ista

nt p

ract

itio

ner

(in

the

infa

nt r

ecei

ving

spe

cial

car

e)

Adv

ises

on

th

e in

itia

tion

an

d m

ain

ten

ance

of

lact

atio

n.

Adv

ises

an

d su

ppor

ts m

oth

ers

in m

anu

al/m

ech

anic

al e

xpre

ssio

n

of b

reas

t m

ilk a

nd

its

han

dlin

g an

d st

orag

e.

Ass

ists

th

e m

oth

er t

o br

east

feed

acc

ordi

ng

to e

vide

nce

bas

ed/

un

it g

uid

elin

es.

Adv

ises

an

d de

mon

stra

tes

ster

ilisa

tion

pro

cedu

res

of fe

edin

g eq

uip

men

t an

d st

orag

e of

sam

e.

Ass

ists

par

ents

/car

ers

in b

ottl

e fe

edin

g te

chn

iqu

es.

Rec

ogn

ises

typ

ical

an

d at

ypic

al o

ral f

eedi

ng

beh

avio

ur;

rec

ords

an

d re

por

ts fi

ndi

ngs

.

Mea

sure

s an

d w

eigh

s in

fan

ts, r

ecor

ds a

nd

rep

orts

fin

din

gs.

Mon

itor

s in

put

and

outp

ut,

reco

rds

and

rep

orts

fin

din

gs.

App

lies

nu

rsin

g ca

re t

o a

infa

nt

rece

ivin

g ph

otot

her

apy

acco

rdin

g to

loca

l gu

idan

ce.

Rec

ogn

ises

nor

mal

an

d ab

nor

mal

gas

troi

nte

stin

al a

nd

uri

nar

y tr

act

fun

ctio

n.

Rec

ords

an

d re

por

ts d

evia

tion

s fr

om n

orm

al t

o th

e as

sist

ant

prac

titi

oner

/QIS

pra

ctit

ion

er.

Ver

ifies

inta

ke r

equ

irem

ents

for

ente

ral f

eedi

ng

acco

rdin

g to

gu

idel

ines

.

Pro

vide

s ot

her

form

s of

en

tera

l fee

din

g; fo

r ex

ampl

e, c

up,

ga

stri

c an

d ga

stro

stom

y ac

cord

ing

to lo

cal g

uid

ance

.

Sets

up

ente

ral f

eedi

ng

pum

ps a

nd

reco

rds

mea

sure

men

ts.

Adm

inis

ters

ora

l nu

trit

ion

al s

upp

lem

ents

wh

ich

hav

e be

en

chec

ked

by a

reg

iste

red

prac

titi

oner

acc

ordi

ng

to lo

cal p

olic

y.

Init

iate

s ph

otot

her

apy

as d

irec

ted

by a

reg

iste

red

prac

titi

oner

.

Un

ders

tan

ds a

nd

reco

gnis

es n

orm

al a

nd

abn

orm

al

gast

roin

test

inal

fun

ctio

n, u

rin

ary

trac

t fu

nct

ion

an

d bi

liru

bin

el

imin

atio

n.

Rec

ords

an

d re

por

ts d

evia

tion

s fr

om n

orm

al t

o a

QIS

pr

acti

tion

er.

Exp

lain

s th

e m

atu

rati

on o

f fe

edin

g sk

ills

in t

he

new

born

.

Ass

esse

s en

tera

l fee

din

g n

eeds

, dev

ise

plan

an

d re

view

s ap

prop

riat

ely.

Pass

es n

aso/

oral

gas

tric

feed

ing

tube

s.

Adv

ises

on

th

e n

eed

for

nu

trit

ion

al s

upp

lem

ents

as

appr

opri

ate.

An

tici

pat

es a

nd

mon

itor

s in

fan

ts a

t ri

sk o

f hy

pog

lyca

emia

an

d im

plem

ents

pre

ven

tive

an

d, w

her

e n

eces

sary

, cor

rect

ive

man

agem

ent

stra

tegi

es a

ccor

din

g to

loca

l gu

idan

ce.

Mon

itor

s an

d m

easu

res

seru

m b

iliru

bin

leve

ls a

nd

init

iate

s ph

otot

her

apy

acco

rdin

g to

loca

l gu

idan

ce.

Safe

ly m

onit

ors

intr

aven

ous

can

nu

la s

ite,

rec

ogn

ises

an

d re

por

ts

devi

atio

ns/

com

plic

atio

ns.

Safe

ly u

ses

a de

sign

ated

ran

ge o

f eq

uip

men

t n

eces

sary

for

the

obse

rvat

ion

an

d m

onit

orin

g of

in

fan

ts r

equ

irin

g sp

ecia

l car

e in

ac

cord

ance

wit

h lo

cal a

nd

man

ufa

ctu

rer’

s in

stru

ctio

n.

Effi

cien

tly

and

safe

ly u

ses

equ

ipm

ent

nec

essa

ry fo

r th

e ca

re o

f in

fan

ts

requ

irin

g sp

ecia

l car

e in

acc

orda

nce

w

ith

loca

l an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Effi

cien

tly

and

safe

ly u

ses

equ

ipm

ent

nec

essa

ry fo

r th

e ca

re o

f in

fan

ts

requ

irin

g h

igh

dep

ende

ncy

an

d in

ten

sive

car

e in

acc

orda

nce

wit

h

loca

l an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Dev

ises

gu

idel

ines

for

the

safe

use

of

equ

ipm

ent.

Ass

esse

s th

e n

eed

for

equ

ipm

ent

use

d in

neo

nat

al c

are

and

advi

se

appr

opri

atel

y.

Inte

rpre

ts a

nd

resp

onds

to

the

alar

ms

of t

he

equ

ipm

ent

in u

se in

sp

ecia

l ca

re.

Inte

rpre

ts s

ign

ifica

nce

of

equ

ipm

ent

alar

ms

in in

fan

ts r

equ

irin

g sp

ecia

l ca

re a

nd

resp

onds

app

ropr

iate

ly.

Inte

rpre

ts s

ign

ifica

nce

of

equ

ipm

ent

alar

ms

in in

fan

ts r

equ

irin

g h

igh

de

pen

den

cy a

nd

inte

nsi

ve c

are

and

resp

ond

appr

opri

atel

y.

Trou

bles

hoo

ts e

quip

men

t pr

oble

ms.

Dev

ises

, au

dits

an

d re

view

s gu

idel

ines

fo

r be

st p

ract

ice

in p

artn

ersh

ip w

ith

m

edic

al s

taff

for

alar

m p

aram

eter

s.

44


Return to contents

Ski

n, h

ygie

ne a

nd in

fect

ion

cont

rol m

anag

emen

t

Lev

el 2

H

CA/M

SW

/HCS

W

(in

the

wel

l inf

ant)

Lev

el 3

N

urse

ry n

urse

/HCA

/SH

CSW

(i

n th

e in

fant

rec

eivi

ng s

peci

al c

are)

Lev

el 4

N

urse

ry n

urse

/ass

ista

nt p

ract

itio

ner

(in

the

infa

nt r

ecei

ving

spe

cial

car

e)

Exa

min

es s

kin

, cor

d an

d ey

es u

sin

g as

sess

men

t to

ol(s

) if

ap

prop

riat

e to

loca

l pra

ctic

e, r

ecor

ds a

nd

rep

orts

fin

din

gs.

Rec

ogn

ises

an

d su

ppor

ts w

ays

in w

hic

h p

aren

ts c

an b

e in

volv

ed

in t

hei

r in

fan

t’s c

are;

for

exam

ple,

exp

lain

s th

e n

orm

al p

roce

ss o

f co

rd s

epar

atio

n, d

escr

ibes

app

roac

hes

to

prom

otin

g h

ealt

hy

skin

, des

crib

es t

ypes

of

bath

ing

incl

udi

ng

issu

es a

rou

nd

safe

ty.

Com

plie

s w

ith

sta

nda

rd in

fect

ion

pre

ven

tion

an

d co

ntr

ol

prec

auti

ons

and

loca

l pol

icie

s.

Perf

orm

s co

rrec

t h

and

hygi

ene

proc

edu

re a

nd

oth

er in

fect

ion

pr

even

tion

an

d co

ntr

ol m

easu

res

as p

er lo

cal p

olic

ies.

Dem

onst

rate

s an

d ad

vise

s pa

ren

ts, t

hei

r vi

sito

rs a

nd

staf

f ab

out

hygi

ene

and

visi

tin

g gu

idel

ines

.

App

lies

stra

tegi

es t

o m

ain

tain

an

d m

anag

es s

kin

inte

grit

y in

th

e im

mat

ure

an

d vu

lner

able

infa

nt;

for

exam

ple,

sto

ma

care

, ap

plic

atio

n a

nd

rem

oval

of

tap

es a

nd

topi

cal a

pplic

atio

ns.

Des

crib

es s

ign

s of

ski

n in

fect

ion

in t

he

new

born

, rec

ords

an

d re

por

ts o

bser

vati

ons.

Un

dert

akes

rou

tin

e in

fect

ion

/col

onis

atio

n s

cree

nin

g ap

prop

riat

e to

loca

l pra

ctic

e.

Part

icip

ates

in a

udi

t ac

tivi

ties

.

Exp

lain

s to

par

ents

th

eir

infa

nt’s

su

scep

tibi

lity

to in

fect

ion

an

d th

e re

ason

s be

hin

d in

fect

ion

pre

ven

tion

an

d co

ntr

ol m

easu

res

in t

he

un

it.

Exa

min

es a

nd

asse

sses

ski

n, c

ord,

eye

s an

d m

uco

us

mem

bran

es

usi

ng

asse

ssm

ent

tool

(s)

if a

ppro

pria

te t

o lo

cal p

ract

ice,

rec

ords

an

d re

por

ts fi

ndi

ngs

.

An

tici

pat

es t

he

infa

nt

at r

isk

of ia

trog

enic

ski

n d

amag

e; fo

r ex

ampl

e, t

he

imm

atu

re in

fan

t, th

e in

fan

t w

ith

NA

S an

d as

sess

es

skin

inte

grit

y u

sin

g as

sess

men

t to

ol(s

) if

app

ropr

iate

to

loca

l pr

acti

ce.

Impl

emen

ts s

trat

egie

s/tr

eatm

ent

as p

resc

ribe

d to

man

age

skin

in

jury

an

d in

fect

ion

(s)

of s

kin

, cor

d, e

yes

and

mu

cou

s m

embr

anes

, eva

luat

ing

and

rep

orti

ng

to in

form

su

bseq

uen

t ca

re/m

anag

emen

t.

Dem

onst

rate

s an

d su

ppor

ts o

ther

s to

com

ply

wit

h in

fect

ion

pr

even

tion

an

d co

ntr

ol p

olic

ies.

Part

icip

ates

in a

udi

t ac

tivi

ties

th

rou

gh o

bser

vin

g pr

acti

ce a

nd

mon

itor

ing

com

plia

nce

.



Neu

rolo

gica

l, d

evel

opm

enta

l car

e an

d pa

in m

anag

emen

t

Lev

el 2

H

CA/M

SW

/HCS

W

(in

the

wel

l inf

ant)

Lev

el 3

N

urse

ry n

urse

/HCA

/SH

CSW

(i

n th

e in

fant

rec

eivi

ng s

peci

al c

are)

Lev

el 4

N

urse

ry n

urse

/ass

ista

nt p

ract

itio

ner

(in

the

infa

nt r

ecei

ving

spe

cial

car

e)

Rec

ogn

ises

typ

ical

sle

ep/w

ake

stat

es, p

ostu

re a

nd

mov

emen

t in

th

e n

ewbo

rn.

An

tici

pate

s an

d re

cogn

ises

dis

tres

s/pa

in in

th

e n

ewbo

rn a

nd

take

s st

eps

to p

rovi

de c

omfo

rt.

Rec

ogn

ises

beh

avio

ur

asso

ciat

ed w

ith

neo

nat

al a

bsti

nen

ce

syn

drom

e (N

AS)

.

Pro

vide

s ro

uti

ne

nu

rsin

g ca

re t

o al

levi

ate

effe

cts

of N

AS.

Com

plet

es a

sses

smen

t to

ols

acco

rdin

g to

loca

l pra

ctic

e.

Rec

ords

an

d re

por

ts t

ypic

al/a

typi

cal o

bser

vati

ons

of b

ehav

iou

r.

Pro

vide

s pa

ren

ts w

ith

an

exp

lan

atio

n o

f th

e as

sess

men

t to

ol(s

) be

ing

appl

ied

to t

hei

r in

fan

t.

Ass

ists

par

ents

in r

ecog

nis

ing

and

inte

rpre

tin

g th

eir

infa

nt’s

be

hav

iou

ral c

ues

.

Rec

ogn

ises

an

d re

por

ts o

vert

sig

ns

of p

ain

.

Use

s de

velo

pmen

tal c

are

stra

tegi

es t

o pr

omot

e st

abili

ty a

nd

redu

ce p

ain

/dis

tres

s, in

clu

din

g en

viro

nm

enta

l asp

ects

, co

nta

inm

ent,

swad

dlin

g, p

osit

ion

ing

and

han

dlin

g, n

on-

nu

trit

ive

suck

ing.

Rec

ords

an

d re

por

t ty

pica

l/at

ypic

al o

bser

vati

ons

of p

hysi

olog

y an

d be

hav

iou

r.

Res

pon

ds t

o in

fan

t’s c

ues

an

d su

ppor

t pa

ren

ts in

app

lyin

g de

velo

pmen

tally

sen

siti

ve c

are.

Rec

ogn

ises

phy

siol

ogic

al a

nd

beh

avio

ura

l dif

fere

nce

s be

twee

n

slee

p/aw

ake

stat

es, s

tres

s, d

istr

ess,

pai

n, c

onvu

lsio

ns

and

dru

g w

ith

draw

al b

ehav

iou

r in

infa

nts

of

diff

eren

t ge

stat

ion

s.

An

tici

pat

es p

oten

tial

ly d

istr

essi

ng/

pain

ful e

ven

ts, a

pplie

s ap

prop

riat

e as

sess

men

t, im

plem

ents

str

ateg

ies

to s

upp

ort

stab

ility

an

d co

mfo

rt, e

valu

ates

to

info

rm s

ubs

equ

ent

care

pl

ann

ing.

46


Return to contents

Res

pira

tory

and

car

diov

ascu

lar

man

agem

ent

Lev

el 2

H

CA/M

SW

/HCS

W

(in

the

wel

l inf

ant)

Lev

el 3

N

urse

ry n

urse

/HCA

/SH

CSW

(i

n th

e in

fant

rec

eivi

ng s

peci

al c

are)

Lev

el 4

N

urse

ry n

urse

/ass

ista

nt p

ract

itio

ner

(in

the

infa

nt r

ecei

ving

spe

cial

car

e)

Rec

ogn

ises

nor

mal

col

our

and

ton

e in

th

e n

ewbo

rn, r

epor

tin

g de

viat

ion

s fr

om n

orm

al.

Mea

sure

s vi

tal s

ign

s (h

eart

rat

e, r

espi

rato

ry r

ate

and

oxyg

en

satu

rati

on),

rec

ords

an

d re

por

ts r

esu

lts.

An

tici

pate

s an

d re

cogn

ises

det

erio

rati

on in

th

e n

ewbo

rn, r

epor

ts

resu

lts.

Part

icip

ates

in a

loca

l an

d or

an

app

rove

d n

ewbo

rn r

esu

scit

atio

n

prog

ram

me.

Ale

rts

oth

ers

to c

olla

psed

infa

nt

and

init

iate

bas

ic li

fe s

upp

ort

mea

sure

s.

Ass

ists

wit

h a

dvan

ced

stab

ilisa

tion

an

d re

susc

itat

ion

.

Pro

vide

s pa

ren

ts w

ith

an

exp

lan

atio

n o

f in

fan

t’s v

ital

sig

ns

givi

ng

rati

onal

e(s)

for

mea

sure

men

ts a

nd

impl

icat

ion

s of

fi

ndi

ngs

.

Mea

sure

s an

d re

cord

s te

mp

erat

ure

, hea

rt r

ate,

res

pira

tory

rat

e an

d ox

ygen

sat

ura

tion

by

inte

rmit

ten

t an

d co

nti

nu

ous

met

hod

s,

rep

orti

ng

devi

atio

ns

from

nor

mal

.

Safe

ly a

dmin

iste

rs s

upp

lem

enta

l oxy

gen

th

erap

y in

clu

din

g ad

equ

ate

hum

idifi

cati

on w

her

e ap

prop

riat

e vi

a n

on-m

ech

anic

al

mea

ns

acco

rdin

g to

loca

l gu

idel

ines

, rep

orti

ng

chan

ges

in

oxyg

en r

equ

irem

ents

.

Ass

esse

s th

e ai

rway

for

pate

ncy

an

d p

erfo

rms

safe

an

d ef

fect

ive

oral

su

ctio

n a

s di

rect

ed.

Pro

vide

s pa

ren

ts w

ith

an

exp

lan

atio

n o

f th

e ca

re s

pec

ific

to t

he

deliv

ery

of s

upp

lem

enta

l oxy

gen

th

erap

y.

Rec

ogn

ises

th

e n

eed

for

and/

or m

odifi

es v

ital

sig

n m

onit

orin

g ac

cord

ing

to in

fan

t’s c

ondi

tion

an

d lo

cal g

uid

elin

es.

Mea

sure

s bl

ood

pres

sure

usi

ng

non

-inv

asiv

e te

chn

iqu

es,

rep

orti

ng

devi

atio

ns

from

nor

mal

.

Impl

emen

ts s

trat

egie

s to

mai

nta

in a

nd

nor

mal

ise

vita

l sig

ns

wit

hin

acc

epte

d pa

ram

eter

s.

Init

iate

s sa

fe a

nd

effe

ctiv

e n

aso-

phar

ynge

al s

uct

ion

as

clin

ical

ly

indi

cate

d.

Pro

vide

s pa

ren

ts w

ith

an

exp

lan

atio

n o

f th

e ca

re s

pec

ific

to t

he

deliv

ery

of s

upp

lem

enta

l oxy

gen

th

erap

y, h

igh

ligh

tin

g ri

sks

and

ben

efits

, saf

ety

mon

itor

ing

and

proc

edu

res.



Infa

nt t

empe

ratu

re m

anag

emen

t

Lev

el 2

H

CA/M

SW

/HCS

W

(in

the

wel

l inf

ant)

Lev

el 3

N

urse

ry n

urse

/HCA

/SH

CSW

(i

n th

e in

fant

rec

eivi

ng s

peci

al c

are)

Lev

el 4

N

urse

ry n

urse

/ass

ista

nt p

ract

itio

ner

(in

the

infa

nt r

ecei

ving

spe

cial

car

e)

An

tici

pate

s in

fan

ts a

t ri

sk o

f hy

po/

hyp

erth

erm

ia a

nd

proa

ctiv

ely

take

s st

eps

to p

reve

nt

cold

/hea

t st

ress

from

occ

urr

ing.

Perf

orm

s n

urs

ing

proc

edu

res

– fo

r ex

ampl

e, b

ath

ing

– in

th

e n

ewbo

rn t

o pr

omot

e th

erm

al s

tabi

lity

in a

ccor

dan

ce w

ith

loca

l gu

idel

ines

.

Mea

sure

s te

mp

erat

ure

acc

ordi

ng

to lo

cal g

uid

elin

es a

nd

usi

ng

avai

labl

e eq

uip

men

t, re

cord

s an

d re

por

ts r

esu

lts.

Iden

tifi

es w

ith

par

ents

th

e w

ays

in w

hic

h t

emp

erat

ure

can

be

take

n a

nd

the

risk

s of

infa

nt

bein

g to

o h

ot o

r to

o co

ld.

Adv

ises

an

d as

sist

s pa

ren

ts, i

nco

rpor

atin

g th

eir

nee

ds/

pref

eren

ces,

on

how

to

dres

s th

eir

infa

nt

acco

rdin

g to

th

e ca

re

givi

ng

un

dert

aken

; for

exa

mpl

e, b

ath

ing,

th

e te

mp

erat

ure

of

the

envi

ron

men

t (i

ndo

ors

v ou

tdoo

rs)

and

to a

dju

st s

trat

egie

s as

th

e te

mp

erat

ure

ch

ange

s.

An

tici

pate

s in

fan

ts a

t ri

sk o

f th

erm

al in

stab

ility

an

d pr

oact

ivel

y ta

ke s

teps

to

prev

ent

cold

/hea

t st

ress

from

occ

urr

ing;

for

exam

ple,

wh

en t

ran

siti

onin

g fr

om in

cuba

tor

to c

ot, i

nst

igat

ing

incu

bato

r ph

otot

her

apy.

Adj

ust

s en

viro

nm

ent,

clot

hin

g an

d n

urs

ing

acti

viti

es t

o ac

hie

ve/

mai

nta

in n

orm

oth

erm

ia a

s di

rect

ed w

ith

in m

anag

emen

t pl

an.

Use

s sp

ecia

list

equ

ipm

ent;

for

exam

ple,

incu

bato

r, ra

dian

t w

arm

er, h

eate

d co

t to

mai

nta

in t

her

mon

eutr

al e

nvir

onm

ent

as

dire

cted

wit

hin

man

agem

ent

plan

.

Rec

ogn

ises

th

e n

eed

for

and/

or m

odifi

es t

emp

erat

ure

m

onit

orin

g in

clu

din

g co

nti

nu

ousl

y ac

cord

ing

to in

fan

t’s

con

diti

on a

nd

loca

l gu

idel

ines

, rec

ords

an

d re

por

ts r

esu

lts.

Impl

emen

ts s

trat

egie

s to

ach

ieve

/mai

nta

in n

orm

oth

erm

ia

(wit

hin

acc

epte

d pa

ram

eter

s).

Use

s ap

prop

riat

e in

terv

enti

ons

to c

orre

ct t

emp

erat

ure

de

viat

ion

s.

48


Return to contents

Equi

pmen

t an

d m

onit

orin

g

Lev

el 2

H

CA/M

SW

/HCS

W

(in

the

wel

l inf

ant)

Lev

el 3

N

urse

ry n

urse

/HCA

/SH

CSW

(i

n th

e in

fant

rec

eivi

ng s

peci

al c

are)

Lev

el 4

N

urse

ry n

urse

/ass

ista

nt p

ract

itio

ner

(in

the

infa

nt r

ecei

ving

spe

cial

car

e)

Cle

ans

and

stor

es e

quip

men

t n

eces

sary

for

the

care

of

infa

nts

in

acco

rdan

ce w

ith

loca

l gu

idel

ines

an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Effi

cien

tly

and

safe

ly u

ses

equ

ipm

ent

nec

essa

ry fo

r th

e ca

re o

f w

ell i

nfa

nts

in a

ccor

dan

ce w

ith

loca

l gu

idel

ines

an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Stat

es t

he

freq

uen

cy t

hat

equ

ipm

ent

shou

ld b

e ch

ecke

d an

d ch

ange

d an

d be

abl

e to

fin

d re

plac

emen

t eq

uip

men

t.

Ver

ifies

exp

iry/

serv

ice

date

for

con

sum

able

s/eq

uip

men

t an

d pr

oces

ses

for

repl

acem

ent/

repa

ir o

f sa

me.

Loca

tes

and

chec

ks e

quip

men

t re

quir

ed fo

r re

susc

itat

ion

pu

rpos

es.

Pro

vide

s pa

ren

ts w

ith

an

exp

lan

atio

n o

f th

e eq

uip

men

t/m

onit

orin

g in

fan

t is

rec

eivi

ng.

Cle

ans

and

stor

es e

quip

men

t n

eces

sary

for

the

care

of

infa

nts

re

quir

ing

spec

ial c

are

in a

ccor

dan

ce w

ith

loca

l gu

idel

ines

an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Effi

cien

tly

and

safe

ly u

ses

equ

ipm

ent

nec

essa

ry fo

r th

e ca

re o

f in

fan

ts r

equ

irin

g sp

ecia

l car

e in

acc

orda

nce

wit

h lo

cal g

uid

elin

es

and

man

ufa

ctu

rer’

s in

stru

ctio

n.

Sets

up

and

chec

ks e

quip

men

t al

arm

s in

infa

nts

req

uir

ing

spec

ial c

are.

Cle

ans

and

stor

es e

quip

men

t n

eces

sary

for

the

care

of

infa

nts

re

quir

ing

min

imal

hig

h d

epen

den

cy in

acc

orda

nce

wit

h lo

cal

guid

elin

es a

nd

man

ufa

ctu

rer’

s in

stru

ctio

n.

Effi

cien

tly

and

safe

ly u

ses

equ

ipm

ent

nec

essa

ry fo

r th

e ca

re o

f in

fan

ts r

equ

irin

g sp

ecia

l an

d m

inim

al h

igh

dep

ende

ncy

car

e in

ac

cord

ance

wit

h lo

cal g

uid

elin

es a

nd

man

ufa

ctu

rer’

s in

stru

ctio

n.

Sets

up,

ch

ecks

an

d in

terp

rets

sig

nifi

can

ce o

f eq

uip

men

t al

arm

s in

infa

nts

req

uir

ing

spec

ial a

nd

min

imal

hig

h d

epen

den

cy c

are

in a

ccor

dan

ce w

ith

loca

l gu

idel

ines

an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Sets

up

and

chec

ks e

quip

men

t re

quir

ed fo

r re

susc

itat

ion

pu

rpos

es.

Inve

stig

atio

ns, t

ests

and

pro

cedu

res

Lev

el 2

L

evel

3

Lev

el 4

N

urse

ry n

urse

/ass

ista

nt p

ract

itio

ner

Supp

orts

infa

nts

an

d fa

mili

es w

hile

th

e in

fan

t h

as a

req

uir

emen

t fo

r h

eal p

rick

pro

cedu

res

for

bloo

d gl

uco

se m

anag

emen

t.

Col

lect

s u

rin

e an

d st

ool s

pec

imen

s u

sin

g th

e co

rrec

t sp

ecim

en

med

ium

.

Supp

orts

infa

nts

an

d fa

mili

es w

hen

th

ere

is a

nee

d to

col

lect

ora

l an

d n

asal

sec

reti

ons.

Un

der

sup

ervi

sion

may

be

requ

ired

to

un

dert

ake

hea

l pri

ck

proc

edu

re fo

r bl

ood

glu

cose

man

agem

ent.

Col

lect

s u

rin

e an

d st

ool s

pec

imen

s u

sin

g th

e co

rrec

t sp

ecim

en

med

ium

.

Un

der

sup

ervi

sion

may

be

requ

ired

to

colle

ct o

ral a

nd

nas

al

secr

etio

ns

usi

ng

the

corr

ect

spec

imen

med

ium

.

Col

lect

s sk

in s

wab

s u

sin

g th

e co

rrec

t sw

ab fo

r di

ffer

ent

inve

stig

atio

ns.

Un

dert

akes

hea

l pri

ck p

roce

dure

for

bloo

d gl

uco

se m

anag

emen

t.

Un

dert

akes

blo

od s

pot

scr

een

for

new

bor

n s

cree

nin

g, e

xpla

inin

g ra

tion

ale

for

test

.

Col

lect

s u

rin

e an

d st

ool s

pec

imen

s u

sin

g th

e co

rrec

t sp

ecim

en

med

ium

.

Col

lect

s or

al a

nd

nas

al s

ecre

tion

s u

sin

g th

e co

rrec

t sp

ecim

en

med

ium

.

Col

lect

s sk

in s

wab

s u

sin

g th

e co

rrec

t sw

ab fo

r di

ffer

ent

inve

stig

atio

ns.



Curricula/programme preparation and maintaining proficiency

It is a matter of some concern that there are no nationally UK-wide agreed curriculums or programmes of preparation for the neonatal workforce. For the maternity support worker (MSW) or the health care assistant (HCA) there may have been no programme of preparation prior to appointment, so a period of preparation to equip these workers with the knowledge and skills to perform the fundamentals of care will be required as part of an induction, as a minimum. Further training and supervision will be required as the MSW or HCA consolidates this induction and to prepare them to expand their repertoire of skills for use in the service.

Nursery nurse education and training has evolved over a period of years and is currently offered at several levels, from certification to diploma. The focus of nursery nurse education is on the normal development from birth to school years, and will usually not include the sick or premature neonate. When appointed to work in neonatal units these practitioners will also require a period of induction and training, depending on their level of experience.

Associate and assistant practitioners may be educated to foundation degree level but may not have a neonatal specific set of skills, so a period of preparation to equip them with the skills to perform within this specialist area will be required. This could be offered as an in-house induction apprentice-style development programme or provided as a combination of supervised practice and theory, which could be delivered by a local educational establishment; the combination in partnership could provide a neonatal foundation certificate which attracts credits.

4Since 2010, the newly registered entrant to neonatal nursing will have been prepared according to the NMC’s criteria for entering the register and will have grounding of competency within the four domains of nursing:1. professional values2. communication and interpersonal skills3. nursing practice and decision-making4. leadership, management and team working.

These skills are transferable, but vary depending on the field of practice the registrant has specialised in. It is recommended, therefore, that a comprehensive programme equipping the neonatal workforce is provided, commensurate with the level in which the practitioner is expected to function. The new registrant as a novice in neonatal care could undertake a foundation neonatal nursing course, in addition to a suitable induction and close mentoring. However, registration and regulation are no barriers to other members of the neonatal workforce undertaking such certification and flexibility in the entry requirements in HEIs could be considered to accommodate access.

Becoming qualified in speciality

When considering progression within the neonatal speciality, the RCN’s Competence, education and careers in neonatal nursing (2012) and the BAPM’s Matching knowledge and skills for qualified in speciality (QIS) neonatal nurses (2012) went some way in setting benchmarks for HEIs to follow. However, there continues to be a considerable variation in the educational provision and level of training towards QIS provision. The learning outcomes of such programmes of preparation should be fully integrated into the competency framework so there is no theory/practice gap.

It is one thing to prepare a registrant to the QIS level, whether this is for the child field of practice, or as a midwife or ANNP, but it is quite another to determine how they should sustain their level of practice. A rolling programme of revalidation that is built into a system of mentoring and support which complements the annual performance review is to be welcomed and at the time of writing the NMC was in the process of developing this. However, the central ethos of both the individual performance review (IPR) and the revalidation process should be to sustain the learning and development of the practitioner, rather than just monitor a baseline of acceptable performance.

50


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Enhanced practice neonatal nurses/specialist neonatal nurses

The enhanced/specialist neonatal nurse/midwife is a practitioner who has completed a QIS programme and has undertaken further education and training within the field such as cannulation, insertion of lines, and airway and respiratory management. They may be mid-way to considering the full ANNP role, or they may have followed a more holistic path and developed specialist breastfeeding advisor roles, neonatal outreach nursing, or roles to support families – such as family co-ordinators. These roles are flexible and adaptable and reflect the requirements of the neonatal units within which individuals work.

The ANNP is an established and highly valued member of the neonatal workforce and should be funded from whichever budget their roles support and counted within the staffing accordingly. They should not be funded from the nursing budget if their roles are predominately medical.

The importance of the family

Neonatal nurses work in partnership with parents and families. The family should be integrated into everything we do, consequently there is no one section which focuses solely on families. The family has inestimable value in participating in the care which has been planned to ensure the wellbeing of infants who are resident in neonatal care. Therefore, the family’s participation is included throughout; to do otherwise would run the risk of isolating the needs of families from the curriculum. Page 51 shows an example curriculum.

As with the previous section where the skills are progressively gained the curricula can be regarded as a spiral with each phase building on a previous stage. This section has focused on the QIS functioning mainly in high dependency and intensive care. Where skill mix permits they would naturally complement and enhance the special care workforce.



Sug

gest

ed c

urri

culu

m t

o su

ppor

t de

velo

pmen

t of

com

pete

nce/

rete

ntio

n of

com

pete

nces

Flui

d, e

lect

roly

te, n

utri

tion

and

eli

min

atio

n m

anag

emen

t –

lear

ning

out

com

es

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

Th

e le

arn

er w

ill b

e ab

le

to p

rovi

de fo

r th

e n

utr

itio

nal

nee

ds o

f th

e st

able

neo

nat

e/w

ell

infa

nt.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

A p

rogr

amm

e of

pre

para

tion

an

d p

erio

d of

su

per

visi

on t

o eq

uip

th

e pr

acti

tion

er t

o pr

ovid

e ad

vice

on

th

e in

itia

tion

an

d m

ain

ten

ance

of

lact

atio

n.

A p

rogr

amm

e of

pre

para

tion

an

d m

ento

rin

g to

eq

uip

th

e pr

acti

tion

er t

o ad

vise

an

d su

ppor

t m

oth

ers

in t

he

man

ual

/mec

han

ical

exp

ress

ion

of

bre

ast

milk

an

d th

e h

and

ling

and

stor

age

of

this

.

A p

rogr

amm

e of

pre

para

tion

an

d gu

idan

ce t

o eq

uip

th

e pr

acti

tion

er t

o as

sist

th

e m

oth

er t

o br

east

feed

acc

ordi

ng

to e

vide

nce

-bas

ed/u

nit

gu

idel

ines

.

A p

rogr

amm

e of

pre

para

tion

an

d as

sess

men

t to

eq

uip

th

e pr

acti

tion

er t

o ad

vise

an

d de

mon

stra

te s

teri

lisat

ion

pro

cedu

res

of fe

edin

g eq

uip

men

t an

d st

orag

e.

Th

e ab

ove

can

be

asse

ssed

by

a pr

acti

cal

asse

ssm

ent

and

a se

ries

of

wor

kboo

ks.

A p

rogr

amm

e of

pre

para

tion

, obs

erva

tion

an

d as

sess

men

t to

equ

ip t

he

prac

titi

oner

to

prov

ide

advi

ce o

n s

afet

y is

sues

aro

un

d pr

epar

ed fo

rmu

la

milk

, ass

ist

pare

nts

/car

ers

in b

ottl

e-fe

edin

g te

chn

iqu

es.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e ce

rtifi

cate

(N

N)

Incl

usi

ve o

f th

e ab

ility

to

per

form

th

e sk

ills

exp

ecte

d fr

om t

he

Leve

l 2 p

ract

itio

ner

an

d so

me

over

lap

is a

ckn

owle

dged

. Th

e Le

vel 3

pr

acti

tion

er s

hou

ld u

nde

rgo

a pr

ogra

mm

e of

pr

epar

atio

n t

o en

able

th

e le

arn

er t

o re

cogn

ise

nor

mal

an

d ab

nor

mal

gas

troi

nte

stin

al a

nd

uri

nar

y tr

act

fun

ctio

n.

Un

ders

tan

d h

ow t

o re

cord

obs

erva

tion

s re

late

d to

th

e ga

stro

inte

stin

al s

tatu

s of

th

e in

fan

t, m

ake

an a

sses

smen

t on

th

ese

and

rep

ort

devi

atio

ns

from

nor

mal

to

the

assi

stan

t pr

acti

tion

er/Q

IS

prac

titi

oner

.

Un

ders

tan

d th

e ra

tion

ale

for

flu

id m

anag

emen

t on

th

e N

NU

an

d de

velo

p th

e ab

ility

to

calc

ula

te

the

infa

nt’s

nu

trit

ion

al in

take

req

uir

emen

ts fo

r en

tera

l fee

din

g ac

cord

ing

to g

uid

elin

es.

A p

rogr

amm

e of

pre

para

tion

an

d m

ento

rin

g to

eq

uip

th

e pr

acti

tion

er t

o ad

vise

an

d su

ppor

t m

oth

ers

in t

he

man

ual

/mec

han

ical

exp

ress

ion

of

bre

ast

milk

an

d th

e h

and

ling

and

stor

age

of

this

.

Dev

elop

th

e sk

ills

to p

rovi

de o

ther

form

s of

en

tera

l fee

din

g –

for

exam

ple,

cu

p, g

astr

ic a

nd

gast

rost

omy

– ac

cord

ing

to lo

cal g

uid

ance

.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e di

plom

a (N

N)

Ass

ocia

te/a

ssis

tan

t pr

acti

tion

er fo

un

dati

on d

egre

e (A

P)

Incl

usi

ve o

f th

e ab

ility

to

per

form

th

e sk

ills

exp

ecte

d fr

om a

Lev

el 2

an

d 3

prac

titi

oner

an

d so

me

over

lap

is a

ckn

owle

dged

th

e Le

vel 4

pr

acti

tion

er s

hou

ld u

nde

rgo

a pr

ogra

mm

e of

edu

cati

on a

nd

trai

nin

g to

en

able

th

e pr

acti

tion

er t

o u

nde

rsta

nd

and

reco

gnis

e n

orm

al a

nd

abn

orm

al g

astr

oin

test

inal

fun

ctio

n, u

rin

ary

trac

t fu

nct

ion

an

d bi

liru

bin

elim

inat

ion

.

Un

ders

tan

d h

ow t

o re

spon

d to

an

d re

cord

min

or d

evia

tion

s fo

r n

orm

al fu

nct

ion

ing

and

rep

ort

thes

e de

viat

ion

s to

a Q

IS p

ract

itio

ner

.

Be

equ

ipp

ed w

ith

th

e ab

ility

to

expl

ain

th

e m

atu

rati

on o

f fe

edin

g sk

ills

in t

he

new

born

.

Be

able

to

asse

ss t

he

infa

nt’s

en

tera

l fee

din

g n

eeds

, dev

ise

plan

an

d re

view

app

ropr

iate

ly.

Be

edu

cate

d, p

repa

red

and

asse

ssed

on

th

eir

abili

ty t

o pa

ss n

aso/

oral

ga

stri

c fe

edin

g tu

bes

safe

ly a

nd

mon

itor

th

eir

pos

itio

nin

g.

Be

edu

cate

d as

to

the

nee

d fo

r an

d p

osse

ss t

he

abili

ty t

o ad

vise

on

th

e n

eed

for

nu

trit

ion

al s

upp

lem

ents

as

appr

opri

ate

Un

ders

tan

d w

hy s

ome

infa

nts

are

at

risk

of

hyp

ogly

caem

ia a

nti

cipa

te

risk

s an

d m

onit

or in

fan

ts w

ho

are

at r

isk

of h

ypog

lyca

emia

. Be

edu

cate

d to

impl

emen

t pr

even

tive

an

d w

her

e n

eces

sary

cor

rect

ive

man

agem

ent

stra

tegi

es a

ccor

din

g to

loca

l gu

idan

ce.

52


Return to contents

Flui

d, e

lect

roly

te, n

utri

tion

and

eli

min

atio

n m

anag

emen

t –

lear

ning

out

com

es (

c0nt

inue

d)

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

Th

e le

arn

er w

ill b

e ab

le

to p

rovi

de fo

r th

e n

utr

itio

nal

nee

ds o

f th

e st

able

neo

nat

e/w

ell

infa

nt.

A p

rogr

amm

e of

pre

para

tion

an

d de

velo

pmen

t to

equ

ip t

he

prac

titi

oner

to

reco

gnis

e ty

pica

l an

d at

ypic

al o

ral f

eedi

ng

beh

avio

ur;

rec

ord

and

rep

ort

fin

din

gs a

nd

be a

ble

to m

easu

re a

nd

wei

gh in

fan

ts, r

ecor

d an

d re

por

t fi

ndi

ngs

.

A p

rogr

amm

e of

pre

para

tion

to

equ

ip t

he

prac

titi

oner

to

mon

itor

inpu

t an

d ou

tpu

t, re

cord

an

d re

por

t fi

ndi

ngs

A p

rogr

amm

e of

pre

para

tion

, su

ppor

t an

d gu

idan

ce t

o eq

uip

th

e pr

acti

tion

er t

o pr

ovid

e ca

re t

o an

infa

nt

rece

ivin

g ph

otot

her

apy

in

acco

rdan

ce w

ith

th

e lo

cal p

olic

y.

Th

e ab

ove

cou

ld b

e as

sess

ed fo

rmal

ly b

y a

voca

tion

al m

odu

le a

t Le

vel 2

. By

a p

ortf

olio

of

prac

tice

an

d h

ave

the

prac

titi

oner

’s s

kill

leve

l re

view

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al

per

form

ance

rev

iew

.

Sets

up

ente

ral f

eedi

ng

pum

ps a

nd

reco

rds

mea

sure

men

ts.

In s

ome

desi

gnat

ed a

reas

adm

inst

ers

oral

n

utr

itio

nal

su

pple

men

ts w

hic

h h

ave

been

ch

ecke

d by

a r

egis

tere

d pr

acti

tion

er a

ccor

din

g to

loca

l pol

icy.

Th

e Le

vel 3

pra

ctit

ion

er w

ill h

ave

som

e re

mit

to

men

tor,

supp

ort

and

sup

ervi

se L

evel

2

colle

agu

es in

th

e m

ain

ten

ance

of

hig

h s

tan

dard

s an

d sa

fe c

are.

Th

e ab

ove

inte

grat

ed k

now

ledg

e an

d sk

ills

cou

ld b

e as

sess

ed b

y a

por

tfol

io o

f pr

acti

ce o

r co

uld

be

asse

ssed

form

ally

by

a vo

cati

onal

m

odu

le a

t Le

vel 3

. Th

e pr

acti

tion

er’s

ski

ll le

vel

cou

ld b

e re

view

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

Un

ders

tan

ds t

he

basi

cs o

f th

e bi

liru

bin

pat

hway

. In

som

e ar

ea m

ay b

e ed

uca

ted

and

pre

pare

d to

mon

itor

an

d m

easu

re s

eru

m b

iliru

bin

le

vels

an

d in

itia

te p

hot

oth

erap

y ac

cord

ing

to lo

cal g

uid

ance

.

Som

e u

nit

s m

ay r

equ

ire

Leve

l 4 t

o ca

re fo

r in

fan

ts w

ho

are

hav

ing

IV

ther

apy,

so

Leve

l 4 s

tude

nts

may

req

uir

e ed

uca

tion

an

d sk

ills

trai

nin

g on

th

e sa

fety

of

thes

e an

d th

e im

por

tan

ce o

f ob

serv

ing

an

intr

aven

ous

can

nu

la s

ite,

rec

ogn

isin

g an

d re

por

tin

g de

viat

ion

s/co

mpl

icat

ion

s. M

onit

orin

g th

e fu

nct

ion

ing

of t

he

pum

ps

docu

men

tin

g pr

essu

res

and

reco

rdin

g of

th

e fl

uid

s in

fuse

d.

As

a Le

vel 4

pra

ctit

ion

er t

hey

hav

e so

me

rem

it t

o m

ento

r, su

ppor

t an

d su

per

vise

Lev

el 2

an

d Le

vel 3

col

leag

ues

in t

he

mai

nte

nan

ce o

f h

igh

sta

nda

rds

and

safe

car

e.

Th

e ab

ove

inte

grat

ed k

now

ledg

e an

d sk

ill s

et c

ould

be

asse

ssed

by

a p

ortf

olio

of

prac

tice

or

cou

ld b

e as

sess

ed fo

rmal

ly b

y a

voca

tion

al

mod

ule

at

Leve

l 4 o

r a

fou

nda

tion

deg

ree.

Th

e pr

acti

tion

er’s

ski

ll le

vel

cou

ld b

e re

view

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al p

erfo

rman

ce

revi

ew.



Neu

rolo

gica

l, d

evel

opm

enta

l car

e an

d in

fant

pai

n m

anag

emen

t –

lear

ning

out

com

es

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

Th

e le

arn

er w

ould

be

able

to

enh

ance

th

e w

ellb

ein

g of

th

e in

fan

t an

d pr

omot

e n

orm

al

deve

lopm

ent.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

A p

rogr

amm

e of

pre

para

tion

to

enab

le t

he

prac

titi

oner

to

reco

gnis

e ty

pica

l sle

ep/w

ake

stat

es, n

orm

al p

ostu

re a

nd

mov

emen

t be

hav

iou

rs in

th

e n

ewbo

rn.

A p

rogr

amm

e of

pre

para

tion

to

enab

le t

he

prac

titi

oner

to

anti

cipa

te a

nd

reco

gnis

e di

stre

ss/

pain

in t

he

new

born

an

d ta

ke s

teps

to

prov

ide

com

fort

.

A p

rogr

amm

e of

pre

para

tion

, su

ppor

t an

d gu

idan

ce t

o en

able

th

e pr

acti

tion

er t

o re

cogn

ise

beh

avio

ur

asso

ciat

ed w

ith

neo

nat

al a

bsti

nen

ce

syn

drom

e (N

AS)

an

d pr

ovid

e ro

uti

ne

care

to

com

fort

th

e in

fan

t w

ho

has

mild

NA

S.

Th

e pr

epar

atio

n m

ay e

nab

le t

he

prac

titi

oner

to

com

plet

e as

sess

men

t to

ols

acco

rdin

g to

loca

l pr

acti

ce a

nd

prov

ide

an e

xpla

nat

ion

of

the

asse

ssm

ent

tool

(s)

bein

g u

sed

to a

sses

s th

e in

fan

t to

th

e pa

ren

ts.

A p

rogr

amm

e of

pre

para

tion

an

d m

ento

rsh

ip t

o en

able

th

e pr

acti

tion

er t

o as

sist

an

d su

ppor

t pa

ren

ts in

rec

ogn

isin

g an

d in

terp

reti

ng

thei

r in

fan

t’s b

ehav

iou

ral c

ues

.

Th

e at

tain

men

t an

d re

ten

tion

of

the

abov

e sk

ills

can

be

asse

ssed

by

a su

itab

le v

ocat

ion

al m

odu

le

at t

his

leve

l. B

y m

ain

tain

ing

a p

ortf

olio

of

prac

tice

an

d th

e sk

ill le

vel r

evie

wed

an

nu

ally

du

rin

g th

e in

divi

dual

per

form

ance

rev

iew

.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e ce

rtifi

cate

(N

N)

Incl

usi

ve o

f th

e ab

ility

to

per

form

th

e sk

ills

exp

ecte

d fr

om a

Lev

el 2

pra

ctit

ion

er a

nd

som

e ov

erla

p is

ack

now

ledg

ed. L

evel

3 p

ract

itio

ner

s sh

ould

un

derg

o a

prog

ram

me

of p

repa

rati

on t

o en

able

th

e pr

acti

tion

er t

o re

cogn

ise

and

rep

ort

over

t si

gns

of p

ain

.

Be

equ

ipp

ed t

o be

abl

e to

use

dev

elop

men

tal

care

str

ateg

ies

to p

rom

ote

stab

ility

an

d re

duce

pa

in/d

istr

ess

incl

udi

ng

envi

ron

men

tal a

spec

ts,

con

tain

men

t, sw

add

ling,

dis

trac

tion

an

d so

fo

rth

.

Un

ders

tan

d th

e im

por

tan

ce o

f p

osit

ion

ing

and

han

dlin

g an

d pr

ovid

ing

opp

ortu

nit

ies

for

non

-nu

trit

ive

suck

ing

if t

he

pare

nts

’ con

sen

t to

so

oth

ers.

Hav

e so

me

un

ders

tan

din

g of

nor

mal

, del

ayed

an

d al

tere

d de

velo

pmen

t an

d be

abl

e to

tra

nsf

er

this

to

reco

rd a

nd

rep

ort

typi

cal/

atyp

ical

ob

serv

atio

ns

of p

hysi

olog

y an

d be

hav

iou

r.

App

ly t

his

un

ders

tan

din

g to

nu

rsin

g ac

tion

s in

re

spon

se t

o in

fan

t’s c

ues

. Ass

imila

te b

asic

te

ach

ing

skill

s in

ord

er t

o be

abl

e to

tea

ch a

nd

supp

ort

pare

nts

in a

pply

ing

deve

lopm

enta

lly

sen

siti

ve c

are.

Th

e Le

vel 3

pra

ctit

ion

er h

as s

ome

rem

it t

o m

ento

r, su

ppor

t an

d su

per

vise

Lev

el 2

co

lleag

ues

in t

he

mai

nte

nan

ce o

f h

igh

sta

nda

rds

and

safe

car

e. A

n in

trod

uct

ion

to

men

tori

ng

may

be

ben

efici

al t

o su

ppor

t pr

acti

tion

ers

to

fun

ctio

n in

th

is r

ole.

Th

e ab

ove

cou

ld b

e as

sess

ed fo

rmal

ly b

y a

voca

tion

al m

odu

le a

t Le

vel 3

by

a p

ortf

olio

of

prac

tice

an

d th

e pr

acti

tion

er’s

ski

ll le

vel c

ould

be

rev

iew

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al

per

form

ance

rev

iew

.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e di

plom

a (N

N)

Ass

ocia

te/a

ssis

tan

t pr

acti

tion

er fo

un

dati

on d

egre

e (A

P)

Infa

nts

wh

o ar

e in

sp

ecia

l car

e.

Incl

usi

ve o

f th

e ab

ility

to

per

form

th

e sk

ills

exp

ecte

d fr

om L

evel

2-3

pr

acti

tion

ers

and

som

e ov

erla

p is

ack

now

ledg

ed. L

evel

4 p

ract

itio

ner

s sh

ould

un

derg

o a

prog

ram

me

of p

repa

rati

on t

o en

able

th

e pr

acti

tion

er t

o re

cogn

ise

and

rep

ort

over

t si

gns

of p

ain

. A

ppro

pria

te

inte

rpre

tati

on in

th

e u

se o

f to

ols

to s

upp

ort

this

.

A p

rogr

amm

e of

pre

para

tion

to

equ

ip t

he

prac

titi

oner

to

reco

gnis

e ph

ysio

logi

cal a

nd

beh

avio

ura

l dif

fere

nce

s be

twee

n s

leep

/aw

ake

stat

es,

stre

ss, d

istr

ess,

pai

n, c

onvu

lsio

ns

and

dru

g w

ith

draw

al b

ehav

iou

r in

in

fan

ts o

f di

ffer

ent

gest

atio

ns.

Acq

uis

itio

n o

f th

e sk

ills

requ

ired

to

enab

le t

hem

to

anti

cipa

te

pot

enti

ally

dis

tres

sin

g/pa

infu

l eve

nts

, app

ly a

ppro

pria

te a

sses

smen

t an

d im

plem

ent

stra

tegi

es t

o su

ppor

t st

abili

ty a

nd

com

fort

. Th

e pr

acti

tion

er s

hou

ld b

e ab

le t

o ev

alu

ate

the

succ

ess

of t

he

stra

tegi

es

use

d to

info

rm s

ubs

equ

ent

care

pla

nn

ing.

Th

e ab

ove

cou

ld b

e as

sess

ed fo

rmal

ly b

y a

voca

tion

al m

odu

le a

t Le

vel

4, a

s pa

rt o

f a

fou

nda

tion

deg

ree.

Ret

enti

on o

f th

ese

skill

s co

uld

be

dem

onst

rate

d by

mai

nta

inin

g a

por

tfol

io o

f pr

acti

ce a

nd

the

prac

titi

oner

’s s

kill

leve

l cou

ld b

e re

view

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

54


Return to contents

Res

pira

tory

and

car

diov

ascu

lar

man

agem

ent

– le

arni

ng o

utco

mes

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

Lear

ner

s w

ill b

e ab

le t

o m

ake

esse

nti

al

asse

ssm

ents

of

vita

l si

gns.

Abl

e to

rec

ogn

ise

and

resp

ond

to a

n in

fan

t w

ho

dete

rior

ates

an

d re

spon

d ap

prop

riat

ely.

Id

enti

fy t

hos

e w

ho

may

n

eed

resu

scit

atio

n.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

All

leve

ls w

ill r

equ

ire

a pr

ogra

mm

e of

pr

epar

atio

n a

nd

prac

tice

sim

ula

tion

to

enab

le

the

prac

titi

oner

to

asse

ss t

he

resp

irat

ory

and

card

iova

scu

lar

wel

lbei

ng

of a

n in

fan

t.

A p

rogr

amm

e of

pre

para

tion

to

enab

le t

he

prac

titi

oner

to

resp

ond

appr

opri

atel

y to

an

in

fan

t w

ho

has

col

laps

ed a

nd

requ

ires

re

susc

itat

ion

.

A p

rogr

amm

e of

pre

para

tion

to

enab

le t

he

prac

titi

oner

to

asse

ss t

he

nor

mal

pu

lse

and

resp

irat

ory

patt

ern

s of

th

e n

eon

ate

and

aler

t th

e te

am a

ppro

pria

tely

wh

ere

ther

e is

dev

iati

on

from

th

ese.

Follo

win

g th

e p

erio

d of

pre

para

tion

th

e st

ude

nt

shou

ld b

e ab

le t

o pr

ovid

e pa

ren

ts w

ith

an

ex

plan

atio

n o

f th

eir

infa

nt’s

vit

al s

ign

s gi

vin

g ra

tion

ale(

s) fo

r m

easu

rem

ents

an

d im

plic

atio

ns

of fi

ndi

ngs

. Pro

vide

init

ial s

upp

ort

and

reas

sura

nce

to

pare

nts

in t

he

even

t of

th

eir

infa

nt’s

det

erio

rati

on.

Evid

ence

of

thes

e sk

ills

bein

g m

ain

tain

ed d

uri

ng

BL

S an

nu

al m

anda

tory

tra

inin

g. T

he

test

imon

y of

oth

ers,

dir

ect

obse

rvat

ion

, rol

e pl

ay a

nd

revi

ewed

du

rin

g th

e in

divi

dual

per

form

ance

re

view

.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e ce

rtifi

cate

(N

N)

Incl

usi

ve o

f th

e ab

ility

to

per

form

th

e sk

ills

exp

ecte

d fr

om L

evel

2 p

ract

itio

ner

s (s

ome

over

lap

is a

ckn

owle

dged

). A

t th

e en

d of

a

prog

ram

me

of le

arn

ing

and

acco

rdin

g to

rol

e an

d re

spon

sibi

litie

s, s

tude

nts

will

be

able

to

mea

sure

an

d re

cord

tem

per

atu

re, h

eart

rat

e,

resp

irat

ory

rate

an

d ox

ygen

sat

ura

tion

by

inte

rmit

ten

t an

d co

nti

nu

ous

met

hod

s,

rep

orti

ng

devi

atio

ns

from

nor

mal

.

Be

prep

ared

to

safe

ly a

dmin

iste

r su

pple

men

tal

oxyg

en, u

nde

rsta

ndi

ng

the

basi

cs o

n t

he

adva

nta

ges

and

disa

dvan

tage

s of

su

ch t

her

apy.

T

his

sh

ould

incl

ude

th

e u

nde

rsta

ndi

ng

of t

he

imp

orta

nce

of

adeq

uat

e hu

mid

ifica

tion

wh

ere

appr

opri

ate

acco

rdin

g to

loca

l gu

idel

ines

. Th

e st

ude

nt

nee

ds t

o ac

quir

e co

nfi

den

ce in

re

por

tin

g ch

ange

s in

oxy

gen

req

uir

emen

ts a

nd

inte

rpre

tati

on o

f sa

tura

tion

rea

din

gs t

o m

ore

exp

erie

nce

d st

aff.

Th

e pr

acti

tion

er n

eeds

to

deve

lop

skill

s in

as

sess

ing

the

infa

nt’s

air

way

for

pate

ncy

an

d de

velo

p a

know

ledg

e ba

se t

o p

erm

it t

hem

to

inco

rpor

ate

elem

ents

of

the

evid

ence

bas

e le

adin

g on

to

deve

lopi

ng

skill

s in

per

form

ing

safe

an

d ef

fect

ive

oral

su

ctio

n a

s di

rect

ed.

Usi

ng

teac

hin

g sk

ills

acqu

ired

as

part

of

this

pr

ogra

mm

e of

pre

para

tion

, th

e st

ude

nt

shou

ld

be a

ble

to p

rovi

de t

o pa

ren

ts a

n e

xpla

nat

ion

of

the

care

sp

ecifi

c to

th

e de

liver

y of

su

pple

men

tal

oxyg

en t

her

apy.

Pro

vide

su

ppor

t to

par

ents

in

the

even

t of

th

eir

infa

nt’s

det

erio

rati

on a

nd

requ

irem

ent

for

inte

rven

tion

.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e di

plom

a (N

N)

Ass

ocia

te/a

ssis

tan

t pr

acti

tion

er fo

un

dati

on d

egre

e (A

P)

Incl

usi

ve o

f th

e ab

ility

to

per

form

th

e sk

ills

exp

ecte

d fr

om L

evel

2 a

nd

Leve

l 3 p

ract

itio

ner

s, t

he

Leve

l 4 w

ill r

equ

ire

a pr

ogra

mm

e of

pr

epar

atio

n t

o en

able

th

e ac

quis

itio

n o

f co

mp

eten

cies

to

faci

litat

e a

grea

ter

un

ders

tan

din

g of

th

e kn

owle

dge

and

skill

s re

quir

ed t

o fa

cilit

ate

the

card

iova

scu

lar

and

resp

irat

ory

care

/su

ppor

t of

th

e n

eon

ate.

An

in-h

ouse

res

usc

itat

ion

pro

gram

me

wou

ld e

nsu

re t

hat

th

e pr

acti

tion

er c

ould

sta

te t

he

loca

tion

of

and

the

chec

kin

g pr

oced

ure

fo

r th

e em

erge

ncy

equ

ipm

ent

and

the

resu

scit

atio

n t

rolle

y.

Pro

vide

th

e ra

tion

ale

for

wh

en t

he

resu

scit

atio

n e

quip

men

t sh

ould

be

chec

ked,

be

able

to

expl

ain

wh

at e

quip

men

t sh

ould

be

in t

he

nu

rser

y fo

r re

susc

itat

ion

pu

rpos

es a

nd

be a

ble

to fi

nd

and

com

mis

sion

for

use

re

plac

emen

t eq

uip

men

t w

hen

req

uir

ed.

Trai

nin

g w

ill b

e re

quir

ed t

o en

able

th

em t

o pr

ovid

e ex

plan

atio

n o

n

how

freq

uen

tly

equ

ipm

ent

shou

ld b

e ch

ange

d an

d th

ey s

hou

ld b

e ab

le t

o de

mon

stra

te c

orre

ct u

se o

f:1.

bag

an

d m

ask

2. n

eopu

ff3.

oxy

gen

an

d ai

r su

pply

4. s

uct

ion

5. a

larm

lim

its.

Th

ey s

hou

ld b

e pr

epar

ed t

o a

leve

l wh

ere

they

can

com

men

ce a

nd

assi

st in

th

e ba

sic

life

supp

ort

of a

neo

nat

e an

d m

ay g

ain

form

al

cert

ifica

tion

in t

hes

e sk

ills.

Th

ey s

hou

ld b

e pr

epar

ed t

o be

abl

e to

rec

ogn

ise

the

nee

d to

req

ues

t as

sist

ance

in t

he

even

t of

det

erio

rati

on a

nd

reco

gnis

e a

resu

scit

atio

n

situ

atio

n a

nd

shou

ld h

ave

suffi

cien

t ba

ckgr

oun

d kn

owle

dge

to

expl

ain

th

e ra

tion

ale

for

the

acti

ons

duri

ng

this

.



Evid

ence

of

thes

e sk

ills

bein

g at

tain

ed a

nd

mai

nta

ined

cou

ld b

e u

nde

rtak

en d

uri

ng

a B

LS

ann

ual

man

dato

ry t

rain

ing

sess

ion

, ass

esse

d by

di

rect

obs

erva

tion

an

d re

view

ed d

uri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

Th

ey s

hou

ld b

e pr

epar

ed t

o in

tera

ct a

ppro

pria

tely

wit

h t

he

fam

ily

duri

ng

and

afte

r a

resu

scit

atio

n in

cide

nt.

Dep

endi

ng

on lo

cal p

olic

y,

be e

quip

ped

to

dem

onst

rate

neo

nat

al r

esu

scit

atio

n t

o th

e fa

mily

pri

or

to d

isch

arge

hom

e.

Th

ey s

hou

ld b

e ed

uca

ted

to a

leve

l wh

ere

they

can

rec

ogn

ise

devi

atio

n

from

nor

mal

res

pira

tory

fun

ctio

n a

nd

un

ders

tan

d w

hy s

ome

acti

viti

es c

an h

ave

an e

ffec

t on

pre

term

infa

nt’s

res

pira

tion

s.

Dev

elop

ski

lls in

ass

essi

ng

and

reco

rdin

g th

e re

spir

ator

y ra

te o

f a

neo

nat

e an

d t

he

imp

orta

nce

of

corr

ect

inte

rpre

tati

on a

nd

docu

men

tati

on.

Pra

ctic

al p

repa

rati

on t

o eq

uip

th

e st

ude

nt

wit

h t

he

abili

ty t

o se

t u

p a

resp

irat

ory

mon

itor

, in

clu

din

g se

ttin

g ap

prop

riat

e al

arm

lim

its.

Th

e kn

owle

dge

to e

quip

th

em t

o u

nde

rsta

nd

com

mon

dev

iati

ons

and

enab

le t

hem

to

resp

ond

to t

hes

e de

viat

ion

s ac

cord

ingl

y. T

he

stu

den

t sh

ould

be

able

to

dem

onst

rate

th

e ap

prop

riat

e al

erti

ng

proc

esse

s an

d re

por

t th

e es

cala

tion

mec

han

ism

s w

her

e an

infa

nt

requ

ires

mor

e su

ppor

tive

car

e.

Equ

ipp

ed w

ith

a b

asic

un

ders

tan

din

g of

apn

oea

of p

rem

atu

rity

to

enab

le t

hem

to

inte

rven

e an

d pr

ovid

e ap

prop

riat

e st

imu

lati

on in

th

e ev

ent

of a

neo

nat

e be

com

ing

brad

ycar

dic

and

desa

tura

tin

g.

Equ

ipp

ed t

o h

ave

the

skill

s be

abl

e to

adm

inis

ter

oxyg

en

appr

opri

atel

y to

en

sure

th

at s

atu

rati

ons

rem

ain

wit

hin

th

e ap

prop

riat

e se

t lim

its.

Equ

ipp

ed t

o id

enti

fy a

n in

fan

t w

ho

is a

pnoe

ic. I

nit

iate

th

e tr

eatm

ent

and

care

of

an in

fan

t w

ho

is a

pnoe

ic. D

emon

stra

te a

n u

nde

rsta

ndi

ng

of p

ossi

ble

inve

stig

atio

ns

follo

win

g fr

equ

ent

apn

oea.

Th

e pr

ogra

mm

e of

pre

para

tion

sh

ould

incl

ude

ess

enti

al

card

iova

scu

lar

asse

ssm

ent

stra

tegi

es a

nd

the

prac

titi

oner

sh

ould

be

able

to

stat

e th

e n

orm

al r

ange

for

apex

rat

e in

a p

rete

rm a

nd

term

n

eon

ate.

Edu

cate

d in

su

ch a

way

th

at t

hey

can

rec

ogn

ise

devi

atio

ns

from

n

orm

al c

ardi

ovas

cula

r fu

nct

ion

:•

dem

onst

rate

rec

ordi

ng

the

apex

of

a n

eon

ate

and

corr

ect

docu

men

tati

on•

dem

onst

rate

set

tin

g u

p a

card

iac

mon

itor

incl

udi

ng

sett

ing

appr

opri

ate

alar

m li

mit

s•

dem

onst

rate

cle

anin

g te

chn

iqu

es o

f st

eth

osco

pe

and

mon

itor

ing

equ

ipm

ent

• st

ate

acti

viti

es t

hat

can

aff

ect

the

apex

bea

t of

a p

rete

rm in

fan

t

56


Return to contents

Res

pira

tory

and

car

diov

ascu

lar

man

agem

ent

– le

arni

ng o

utco

mes

(co

ntin

ued)

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

• st

ate

the

bloo

d pr

essu

re v

alu

es o

f a

neo

nat

e ta

kin

g in

to a

ccou

nt

thei

r ge

stat

ion

• de

mon

stra

te c

hoi

ce o

f co

rrec

t si

ze c

uff

an

d ap

plic

atio

n•

dem

onst

rate

tak

ing

a re

cord

ing

a bl

ood

pres

sure

on

a p

rete

rm

infa

nt

• st

ate

acti

viti

es t

hat

will

aff

ect

the

read

ing

• di

scu

ss a

nd

sta

te r

easo

ns

why

blo

od p

ress

ure

sh

ould

be

mon

itor

ed•

stat

e re

por

tin

g m

ech

anis

m o

f an

y de

viat

ion

in t

he

card

iova

scu

lar

read

ing

of t

he

pret

erm

infa

nt.

Su

ctio

ning

T

he

prac

titi

oner

will

be

requ

ired

to

be a

ble

to u

nde

rsta

nd

and

appl

y ev

iden

ce-b

ased

pra

ctic

e, r

elat

ed t

o th

is s

kill

and

be a

ble

to a

sses

s th

e n

eed

to a

pply

su

ctio

nin

g to

th

e in

fan

ts a

irw

ays.

Th

e pr

acti

tion

er w

ill n

eed

to b

e pr

epar

ed t

o u

nde

rsta

nd

the

reas

ons

why

th

ere

are

vari

ous

typ

es a

nd

size

s of

su

ctio

n c

ath

eter

sel

ect

the

appr

opri

ate

one

and

un

ders

tan

d th

e im

por

tan

ce o

f u

sin

g a

ster

ile

tech

niq

ue

for

suct

ion

ing.

Sele

ct t

he

appr

opri

ate

suct

ion

pre

ssu

re u

sed

for

neo

nat

es a

nd

be a

ble

to id

enti

fy t

he

risk

s as

soci

ated

wit

h s

uct

ion

ing.

Be

suffi

cien

tly

skill

ed

to s

afel

y as

pira

te o

ral a

nd

nas

o ph

aryn

geal

mu

cou

s sa

fety

an

d ef

fect

ivel

y an

d se

nd

for

mic

rosc

opy

wh

en t

he

nee

d ar

ises

.

Un

ders

tan

d th

e im

por

tan

ce o

f do

cum

enti

ng

the

char

acte

rist

ics,

vo

lum

e an

d ea

se o

f as

pira

tion

th

e se

cret

ion

s ob

tain

ed.

Edu

cati

on a

nd

skill

s re

late

d to

sat

ura

tion

:•

desc

ribe

th

e co

rrec

t sa

tura

tion

leve

ls fo

r th

e pr

eter

m a

nd

neo

nat

e•

dem

onst

rate

ch

oice

of

corr

ect

size

sat

ura

tion

wra

p.

Oxy

gen

• de

mon

stra

tes

care

of

an o

xyge

n d

epen

den

t n

eon

atal

, sh

ow d

ue

rega

rd fo

r m

ain

tain

ing

and

wea

nin

g•

know

s h

ow t

o u

se o

xyge

n fl

ow m

eter

s an

d lo

w fl

ow m

eter

s•

be a

ble

to d

emon

stra

te t

he

abili

ty t

o pr

ovid

e ad

diti

onal

oxy

gen

via

fa

ce m

ask

wh

en r

equ

ired

• de

mon

stra

tes

the

abili

ty t

o ca

re fo

r a

neo

nat

e on

low

flow

an

d h

igh

fl

ow t

her

apy.

Un

ders

tan

ds s

ome

of t

he

adve

rse

effe

cts

of o

xyge

n t

her

apy

incl

udi

ng

a ba

sic

un

ders

tan

din

g of

ret

inop

athy

of

prem

atu

rity

.



Pro

vide

s a

mor

e de

taile

d ex

plan

atio

n t

o pa

ren

ts o

f th

e ca

re s

pec

ific

to

the

deliv

ery

of s

upp

lem

enta

l oxy

gen

th

erap

y.

Pro

vide

s su

ppor

t to

par

ents

in t

he

even

t of

th

eir

infa

nt’s

det

erio

rati

on

and

requ

irem

ent

for

inte

rven

tion

.

Ele

men

ts fr

om t

he

abov

e ca

n b

e fo

rmal

ly a

sses

sed

as p

art

of a

fo

un

dati

on d

egre

e, in

-hou

se s

imu

lati

on o

r an

org

anis

ed s

imu

late

d cl

inic

al e

xam

inat

ion

(O

SCE

). R

eten

tion

of

the

skill

s ca

n b

e as

sess

ed

doin

g th

e in

div

idu

al’s

IP

R.

58


Return to contents

Ski

n, h

ygie

ne a

nd in

fect

ion

cont

rol m

anag

emen

t –

lear

ning

out

com

es

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

Th

e le

arn

er w

ill b

e ab

le

to p

rovi

de e

ssen

tial

in

fan

t ca

re.

Th

e le

arn

er w

ill c

omp

ly

wit

h s

tan

dard

infe

ctio

n

prev

enti

on a

nd

con

trol

pr

ecau

tion

s.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

A p

rogr

amm

e of

pre

para

tion

des

ign

ed t

o eq

uip

th

e pr

acti

tion

er t

o ca

re fo

r th

e w

ell i

nfa

nt;

a

prog

ram

me

of p

repa

rati

on, m

ento

rsh

ip a

nd

supp

ort

to e

nab

le t

he

prac

titi

oner

to

exam

ine

skin

, cor

d an

d ey

es u

sin

g as

sess

men

t to

ol(s

) if

ap

prop

riat

e to

loca

l pra

ctic

e, r

ecor

d an

d re

por

t fi

ndi

ngs

.

A p

rogr

amm

e of

pre

para

tion

to

equ

ip t

he

prac

titi

oner

to

reco

gnis

e an

d su

ppor

t w

ays

in

wh

ich

par

ents

can

be

invo

lved

in t

hei

r in

fan

t’s

care

.

En

able

d to

un

ders

tan

d th

e n

orm

al p

roce

ss o

f co

rd s

epar

atio

n, d

escr

ibe

appr

oach

es t

o pr

omot

ing

hea

lthy

ski

n, d

escr

ibe

typ

es o

f ba

thin

g in

clu

din

g is

sues

aro

un

d sa

fety

.

Req

uir

e re

leva

nt

upd

ates

to

assi

st t

he

prac

titi

oner

to

com

ply

wit

h s

tan

dard

infe

ctio

n

prev

enti

on a

nd

con

trol

pre

cau

tion

s an

d lo

cal

pol

icie

s. A

sses

smen

t in

pra

ctit

ion

er’s

co

mpl

ian

ce t

o p

erfo

rm c

orre

ct h

and

hygi

ene

proc

edu

re a

nd

impl

emen

t ot

her

infe

ctio

n

prev

enti

on a

nd

con

trol

mea

sure

s as

per

loca

l p

olic

ies.

Th

e pr

acti

tion

er s

hou

ld b

e ab

le t

o de

mon

stra

te

and

advi

se p

aren

ts, v

isit

ors

and

staf

f ab

out

hygi

ene

and

visi

tin

g gu

idel

ines

.

Th

e as

sess

men

t of

th

e ab

ove

skill

s co

uld

be

per

form

ed fo

rmal

ly a

s pa

rt o

f a

voca

tion

al

mod

ule

set

at

this

leve

l. R

eten

tion

of

the

abov

e sk

ills

can

be

asse

ssed

by

mai

nta

inin

g a

por

tfol

io

of p

ract

ice

and

the

skill

leve

l rev

iew

ed a

nn

ual

ly

duri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e ce

rtifi

cate

(N

N)

Incl

usi

ve o

f th

e ab

ility

to

per

form

th

e sk

ills

exp

ecte

d fr

om a

Lev

el 2

pra

ctit

ion

er, a

Lev

el 3

pr

acti

tion

er w

ill r

equ

ire:

• a

prog

ram

me

of p

repa

rati

on d

esig

ned

to

equ

ip t

he

prac

titi

oner

to

supp

ort

the

care

of

an in

fan

t re

ceiv

ing

spec

ial c

are

• a

prog

ram

me

of p

repa

rati

on t

o en

able

th

e pr

acti

tion

er t

o ap

ply

stra

tegi

es t

o m

ain

tain

an

d m

anag

e sk

in in

tegr

ity

in t

he

imm

atu

re

and

vuln

erab

le in

fan

t. Fo

r ex

ampl

e, s

tom

a ca

re, a

pplic

atio

n a

nd

rem

oval

of

tap

es a

nd

topi

cal a

pplic

atio

ns.

Leve

l 3 p

ract

itio

ner

s w

ill b

e en

able

d to

des

crib

e th

e si

gns

of s

kin

infe

ctio

n in

th

e n

ewbo

rn,

reco

rd a

nd

rep

ort

obse

rvat

ion

s.

Un

dert

ake

rou

tin

e in

fect

ion

/col

onis

atio

n

scre

enin

g ap

prop

riat

e to

loca

l pra

ctic

e.

Part

icip

ate

in a

udi

t ac

tivi

ties

.

Exp

lain

to

pare

nts

th

eir

infa

nt’s

su

scep

tibi

lity

to

infe

ctio

n a

nd

the

reas

ons

beh

ind

infe

ctio

n

prev

enti

on a

nd

con

trol

mea

sure

s in

th

e u

nit

.

As

a Le

vel 3

pra

ctit

ion

er t

hey

will

hav

e so

me

resp

onsi

bilit

y fo

r th

e su

ppor

t of

Lev

el 2

co

lleag

ues

to

ensu

re h

igh

sta

nda

rds

and

the

mai

nte

nan

ce o

f sa

fe p

ract

ice.

Th

e as

sess

men

t of

th

e ab

ove

skill

s co

uld

be

per

form

ed fo

rmal

ly a

s pa

rt o

f a

voca

tion

al

mod

ule

set

at

Leve

l 3. R

eten

tion

of

the

abov

e co

uld

be

asse

ssed

by

a p

ortf

olio

of

prac

tice

an

d th

e pr

acti

tion

er’s

ski

ll le

vel c

ould

be

revi

ewed

an

nu

ally

du

rin

g th

e in

divi

dual

per

form

ance

re

view

.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e di

plom

a (N

N)

Ass

ocia

te/a

ssis

tan

t pr

acti

tion

er fo

un

dati

on d

egre

e (A

P)

Incl

usi

ve o

f th

e ab

ility

to

per

form

th

e sk

ills

exp

ecte

d fr

om a

Lev

el 3

pr

acti

tion

er, a

Lev

el 4

pra

ctit

ion

er w

ill r

equ

ired

a p

rogr

amm

e of

pr

epar

atio

n t

o fa

cilit

ate

a gr

eate

r u

nde

rsta

ndi

ng

of k

now

ledg

e an

d sk

ills

requ

ired

to

ensu

re t

he

hygi

ene

and

skin

inte

grit

y n

eeds

of

the

neo

nat

e ar

e m

et.

Hav

e ba

ckgr

oun

d kn

owle

dge

to e

quip

th

e pr

acti

tion

er t

o di

scu

ss t

he

app

eara

nce

of

skin

dep

endi

ng

on g

esta

tion

al a

ge. P

repa

red

to

un

ders

tan

d th

e im

por

tan

ce o

f sk

in c

are

and

hygi

ene

requ

irem

ents

.

Be

able

to

disc

uss

th

e im

por

tan

ce o

f fa

mily

par

tici

pati

on in

th

e hy

gien

e an

d ca

re n

eeds

of

the

infa

nt.

Stat

es t

he

imp

orta

nce

of

the

tim

ing

of c

are

incl

udi

ng

reas

ons

for

min

imal

han

dlin

g.

Dis

cuss

es t

he

imp

orta

nce

of

top

and

tail

and

bath

ing,

per

form

th

is

wit

h c

onfi

den

ce a

nd

safe

ty, t

each

th

e sk

ills

to o

ther

s.

Lis

ts t

he

area

s of

par

ticu

lar

imp

orta

nce

to

be w

ash

ed a

nd

obse

rved

w

hils

t at

ten

din

g to

car

e, in

clu

din

g or

al a

nd

eye

care

.

Stat

es s

ymp

tom

s as

soci

ated

wit

h in

fect

ion

in t

he

infa

nt

and

disc

uss

pr

even

tion

an

d tr

eatm

ent

of c

omm

on in

fect

ion

s.

Stat

es t

he

imp

orta

nce

of

rep

osit

ion

ing

mon

itor

ing

equ

ipm

ent

duri

ng

care

s, fo

r ex

ampl

e, S

aO2

prob

e an

d th

e do

cum

enta

tion

ass

ocia

ted

wit

h t

he

chan

ges.

Dis

cuss

es t

he

imm

un

isat

ion

sch

edu

le o

ffer

ed d

uri

ng

the

neo

nat

al

per

iod

and

the

imp

orta

nce

of

pare

nta

l con

sen

t.

Infe

ctio

n co

ntro

l B

e ab

le t

o di

scu

ss t

he

imp

orta

nce

of

fam

ily p

arti

cipa

tion

in in

fect

ion

co

ntr

ol m

easu

res,

can

saf

ely

prom

ote

thes

e in

pra

ctic

e.



Dis

cuss

es t

he

imp

orta

nce

of

impl

emen

tin

g an

d co

mpl

yin

g w

ith

in

fect

ion

con

trol

mea

sure

s as

per

loca

l gu

idel

ines

, in

clu

din

g:•

han

d hy

gien

e

• as

epti

c te

chn

iqu

e•

un

iver

sal p

reca

uti

ons

• cl

inic

al w

aste

seg

rega

tion

.

Has

th

e ba

ckgr

oun

d pr

epar

atio

n t

o eq

uip

th

e pr

acti

tion

er t

o di

scu

ss

wh

ich

infa

nts

wou

ld r

equ

ire

isol

atio

n a

nd

isol

atio

n t

ech

niq

ues

. Saf

ely

per

form

th

ese

skill

s in

pra

ctic

e.

Dem

onst

rate

s th

e co

rrec

t pr

oced

ure

for

un

dert

akin

g sw

abs

for

infe

ctio

n c

ontr

ol p

urp

oses

– s

uch

as

MR

SA.

Can

dem

onst

rate

th

e co

rrec

t pr

oced

ure

for

the

clea

nin

g an

d st

orag

e of

equ

ipm

ent

as p

er in

fect

ion

con

trol

pol

icy.

Dem

onst

rate

s an

aw

aren

ess

of d

isin

fect

ion

an

d st

erili

sati

on (

feed

ing

bott

les/

milk

tan

ks a

nd

so o

n).

Th

e Le

vel 4

pra

ctit

ion

er s

hou

ld b

e eq

uip

ped

to

be a

ble

to p

rovi

de a

m

ore

deta

iled

expl

anat

ion

to

pare

nts

th

eir

infa

nt’s

su

scep

tibi

lity

to

infe

ctio

n a

nd

th

e re

ason

s be

hin

d in

fect

ion

pre

ven

tion

an

d co

ntr

ol

mea

sure

s in

th

e u

nit

.

As

a Le

vel 4

pra

ctit

ion

er t

hey

will

hav

e so

me

resp

onsi

bilit

y fo

r th

e su

ppor

t of

Lev

el 3

an

d Le

vel 2

col

leag

ues

to

ensu

re h

igh

sta

nda

rds

and

the

mai

nte

nan

ce o

f sa

fe p

ract

ice.

Ass

essm

ent

cou

ld b

e pa

rt o

f a

form

al fo

un

dati

on d

egre

e or

a

voca

tion

al m

odu

le s

et a

t Le

vel 4

. An

OSC

E c

ould

incl

ude

th

e op

por

tun

ity

to d

emon

stra

te t

hat

th

e le

arn

er c

an c

orre

ctly

un

dert

ake

han

d w

ash

ing

proc

edu

re a

nd

can

saf

ely

per

form

th

e ca

re

requ

irem

ents

of

a n

eon

ate

in t

hei

r ca

re –

‘top

an

d ta

il’ t

he

infa

nt,

prov

ide

infa

nt

bath

dem

onst

rati

on o

r a

sim

ple

asep

tic

tech

niq

ue.

Ass

essm

ent

of t

he

rete

nti

on o

f sk

ills

rela

ted

to in

fect

ion

con

trol

cou

ld

be u

nde

rtak

en d

uri

ng

the

ann

ual

upd

ates

.

60


Return to contents

Infa

nt t

empe

ratu

re m

anag

emen

t –

lear

ning

out

com

es

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

All

lear

ner

s n

eed

to b

e ab

le t

o su

ppor

t th

e in

fan

t to

mai

nta

in

opti

mal

tem

per

atu

re

man

agem

ent.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

an

d su

per

visi

on d

esig

ned

to

ensu

re t

hat

th

e le

arn

er u

nde

rsta

nds

th

e m

ean

s by

wh

ich

in

fan

t te

mp

erat

ure

s ar

e m

ain

tain

ed a

t th

e op

tim

al le

vel,

dep

endi

ng

on t

he

envi

ron

men

tal t

emp

erat

ure

.

Adv

ises

an

d re

fers

par

ents

to

the

reco

mm

enda

tion

s on

saf

e in

fan

t sl

eep

and

prev

enti

on o

f ov

erh

eati

ng.

Th

e ac

quis

itio

n a

nd

rete

nti

on o

f th

e ab

ove

skill

s ca

n b

e as

sess

ed b

y m

ain

tain

ing

a p

ortf

olio

of

prac

tice

an

d th

e sk

ill le

vel

revi

ewed

an

nu

ally

du

rin

g th

e in

divi

dual

p

erfo

rman

ce r

evie

w.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e ce

rtifi

cate

(N

N)

Incl

usi

ve o

f th

e sk

ills

requ

ired

in a

Lev

el 2

pr

acti

tion

er, t

he

Leve

l 3 p

ract

itio

ner

at

the

end

of a

pro

gram

me

of le

arn

ing

and

acco

rdin

g to

rol

e an

d re

spon

sibi

litie

s, w

ill

be a

ble

to a

nti

cipa

te t

he

infa

nts

at

risk

of

ther

mal

inst

abili

ty a

nd

proa

ctiv

ely

take

st

eps

to p

reve

nt

cold

/hea

t st

ress

from

oc

curr

ing

– fo

r ex

ampl

e, w

hen

tr

ansi

tion

ing

from

incu

bato

r to

cot

, in

stig

atin

g in

cuba

tor

phot

oth

erap

y.

Stu

den

ts s

hou

ld b

e ab

le t

o m

ake

som

e ad

just

men

ts t

o th

e in

fan

t’s e

nvir

onm

ent,

clot

hin

g an

d n

urs

ing

acti

viti

es t

o ac

hie

ve/

mai

nta

in n

orm

oth

erm

ia, a

s di

rect

ed w

ith

in

man

agem

ent

plan

.

Use

sp

ecia

list

equ

ipm

ent

– fo

r ex

ampl

e,

incu

bato

r, ra

dian

t w

arm

er, h

eate

d co

t –

to

mai

nta

in t

her

mon

eutr

al e

nvir

onm

ent

as

dire

cted

wit

hin

man

agem

ent

plan

.

Th

e ac

quis

itio

n a

nd

rete

nti

on o

f th

e ab

ove

skill

s co

uld

be

asse

ssed

form

ally

by

a re

leva

nt

voca

tion

al m

odu

le a

nd

revi

ewed

an

nu

ally

du

rin

g th

e in

divi

dual

p

erfo

rman

ce r

evie

w.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e di

plom

a (N

N)

Ass

ocia

te/a

ssis

tan

t pr

acti

tion

er fo

un

dati

on d

egre

e (A

P)

Incl

usi

ve o

f th

e sk

ills

requ

ired

in a

Lev

el 2

an

d Le

vel 3

pra

ctit

ion

er t

he

leve

l 4

prac

titi

oner

will

nee

d a

prog

ram

me

of p

repa

rati

on t

o fa

cilit

ate

an

un

ders

tan

din

g of

th

e th

erm

oreg

ula

tion

req

uir

emen

ts o

f a

pret

erm

infa

nt.

Be

able

to

stat

e th

e n

orm

al t

emp

erat

ure

val

ues

for

the

pret

erm

/ter

m in

fan

t an

d th

e en

viro

nm

enta

l fac

tors

th

at m

ay a

ffec

t th

e in

fan

t’s t

emp

erat

ure

.

Be

able

to

asse

ss t

he

neo

nat

al b

ody

tem

per

atu

re u

sin

g ap

prop

riat

e m

eth

od

and

site

.

Stat

es p

ossi

ble

cau

ses

oth

er t

han

env

iron

men

tal t

hat

may

cau

se t

emp

erat

ure

in

stab

ility

.

Inte

rven

es t

o pr

even

t te

mp

erat

ure

dev

iati

ons.

Sta

te in

terv

enti

ons

that

can

be

use

d.

Stat

es p

ossi

ble

inte

rven

tion

s if

an

infa

nt’s

tem

per

atu

re is

too

hig

h. D

ocu

men

t te

mp

erat

ure

cor

rect

ly o

n o

bser

vati

on c

har

t.

Dis

cuss

es h

ow t

o m

ain

tain

a t

her

mo-

neu

tral

env

iron

men

t fo

r an

infa

nt

bein

g n

urs

ed in

an

incu

bato

r an

d p

erfo

rm t

he

care

th

ese

infa

nts

req

uir

e sa

fely

.

Kn

ows

wh

en it

is a

ppro

pria

te t

o n

urs

e an

infa

nt

in a

cot

an

d in

con

sult

atio

n

wit

h t

he

fam

ily c

an p

rodu

ce a

car

e pl

an t

o m

ove

an in

fan

t fr

om a

n in

cuba

tor

to a

cot

.

Form

al a

sses

smen

t st

rate

gies

cou

ld in

clu

de p

rovi

din

g th

e le

arn

er w

ith

an

op

por

tun

ity

to d

emon

stra

te h

ow t

o as

sess

an

infa

nt’s

tem

per

atu

re u

sin

g a

ran

ge o

f ap

prop

riat

e m

eth

ods.

Dem

onst

rate

how

to

corr

ectl

y do

cum

ent

the

infa

nt’s

tem

per

atu

re r

eadi

ng.

A r

evie

w o

f th

e sa

fe u

se o

f eq

uip

men

t de

sign

ed t

o m

ain

tain

infa

nt’s

te

mp

erat

ure

cou

ld b

e in

clu

ded

in a

por

tfol

io o

f pr

acti

ce.

Mai

nta

inin

g th

e sk

ill le

vel c

ould

be

part

of

the

indi

vidu

al p

erfo

rman

ce r

evie

w.



Pal

liat

ive

care

, end

-of-

life

and

ber

eave

men

t m

anag

emen

t –

lear

ning

out

com

es

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

Lear

ner

s w

ill n

eed

to b

e ab

le t

o pr

ovid

e pa

lliat

ive

care

/en

d-of

-lif

e ca

re a

nd

bere

avem

ent

man

agem

ent

wit

h s

kills

co

mm

ensu

rate

wit

h

thei

r le

vel o

f se

nio

rity

.

Hea

lth

car

e as

sist

ant (

HC

A)

Mat

ern

ity

sup

por

t wor

ker

(MSW

)H

ealt

h c

are

sup

por

t wor

ker

(HC

SW)

A p

rogr

amm

e of

pre

para

tion

des

ign

ed t

o pr

ovid

e an

intr

odu

ctio

n t

o th

e th

eori

es o

f lo

ss a

nd

grie

f an

d h

ow t

hes

e m

ay a

ffec

t fa

mili

es w

ho

hav

e an

infa

nt

wh

o h

as

palli

ativ

e or

en

d-of

-lif

e ca

re n

eeds

.

Intr

odu

ctio

n t

o th

e de

fin

itio

n a

nd

the

philo

soph

y of

per

inat

al/n

eon

atal

pal

liati

ve

care

an

d en

d-of

-lif

e ca

re.

Aw

aren

ess

of lo

cal a

nd

nat

ion

al n

eon

atal

pa

lliat

ive

care

an

d en

d-of

-lif

e ca

re

guid

elin

es a

nd

fram

ewor

ks.

Lear

ner

s w

ill n

eed

to b

e eq

uip

ped

to

follo

w

a pl

an o

f ca

re, u

nde

rsta

nd

the

imp

orta

nce

of

an

d fa

cilit

ate

mem

ory

mak

ing.

Pro

gram

me

of p

repa

rati

on a

nd

men

tori

ng

to e

nab

le t

he

prac

titi

oner

to

un

ders

tan

d th

e im

por

tan

ce o

f eq

uip

men

t re

quir

ed fo

r su

ppor

tin

g an

infa

nt

wit

h p

allia

tive

car

e n

eeds

.

En

sure

s th

at r

esou

rces

an

d re

leva

nt

equ

ipm

ent

are

avai

labl

e fo

r m

emor

y m

akin

g. E

nsu

re t

he

appr

opri

ate

equ

ipm

ent

is r

eady

an

d av

aila

ble

for

use

. If

ther

e is

a

desi

gnat

ed r

oom

ava

ilabl

e, e

nsu

re t

hat

it is

pr

epar

ed a

ppro

pria

tely

.

On

goin

g m

ento

rsh

ip a

nd

pee

r su

ppor

t to

en

sure

th

at t

he

opti

mal

mea

ns

of

com

mu

nic

atio

n a

re u

sed

wit

h fa

mili

es.

Dev

elop

ski

lls in

sen

siti

ve a

nd

effe

ctiv

e co

mm

un

icat

ion

wit

h fa

mili

es o

f in

fan

ts

wh

o h

ave

palli

ativ

e an

d en

d-of

-lif

e ca

re

nee

ds, o

r w

hen

an

infa

nt

has

die

d.

Hea

lth

car

e as

sist

ant (

HC

A)

Mat

ern

ity

sup

por

t wor

ker

(MSW

)H

ealt

h c

are

sup

por

t wor

ker

(HC

SW)

Nu

rser

y n

urs

e ce

rtifi

cate

(N

N)

A p

rogr

amm

e of

pre

para

tion

to

prov

ide

the

prac

titi

oner

wit

h a

n a

war

enes

s of

th

e th

eori

es o

f lo

ss a

nd

grie

f an

d an

u

nde

rsta

ndi

ng

of t

he

imp

orta

nce

of

sen

siti

ve a

nd

effe

ctiv

e co

mm

un

icat

ion

wit

h

fam

ilies

.

Un

ders

tan

d th

e im

por

tan

ce o

f ef

fect

ive

com

mu

nic

atio

n w

ith

oth

er p

rofe

ssio

nal

s.

Dem

onst

rate

aw

aren

ess

and

un

ders

tan

din

g of

th

e de

fin

itio

n a

nd

philo

soph

y of

p

erin

atal

/neo

nat

al p

allia

tive

car

e an

d en

d-of

-lif

e ca

re lo

cal g

uid

elin

es. K

now

ledg

e an

d aw

aren

ess

of lo

cal a

nd

nat

ion

al

neo

nat

al p

allia

tive

car

e an

d en

d-of

-lif

e ca

re

guid

elin

es a

nd

fram

ewor

ks.

Pla

nnin

g of

car

eU

nde

rsta

nd

the

imp

orta

nce

an

d si

gnifi

can

ce o

f m

emor

y m

akin

g. E

nsu

re

that

res

ourc

es a

nd

rele

van

t eq

uip

men

t ar

e av

aila

ble

for

mem

ory

mak

ing.

Un

ders

tan

d th

e im

por

tan

ce o

f h

avin

g re

leva

nt

equ

ipm

ent

avai

labl

e an

d re

ady.

Con

side

r in

volv

ing

sibl

ings

, ste

p-fa

mily

an

d gr

andp

aren

ts in

th

e ca

re o

f th

e in

fan

t in

lin

e w

ith

th

e pa

ren

ts’ w

ish

es.

Un

ders

tan

din

g th

e ro

le o

f a

child

ren’

s h

ospi

ce, a

nd

wh

at s

ervi

ces

may

be

avai

labl

e.

If t

her

e is

a d

esig

nat

ed r

oom

ava

ilabl

e,

ensu

re t

hat

it is

pre

pare

d ap

prop

riat

ely.

Dem

onst

rate

kn

owle

dge

how

to

con

tact

m

ult

i fai

th c

hap

lain

cy t

eam

an

d ot

her

su

ppor

t se

rvic

es.

Hea

lth

car

e as

sist

ant (

HC

A)

Mat

ern

ity

sup

por

t wor

ker

(MSW

)H

ealt

h c

are

sup

por

t wor

ker

(HC

SW)

Nu

rser

y n

urs

e d

iplo

ma

(NN

)A

ssoc

iate

/ass

ista

nt p

ract

itio

ner

fou

nd

atio

n d

egre

e (A

P)

Incl

usi

ve o

f th

e ab

iliti

es e

xpec

ted

of L

evel

2 a

nd

3, p

ract

itio

ner

s at

Lev

el 4

re

quir

e a

prog

ram

me

of p

repa

rati

on t

o fa

cilit

ate

an u

nde

rsta

ndi

ng

of t

he

theo

reti

cal b

asis

of

bere

avem

ent

man

agem

ent

of t

he

fam

ily, s

uffi

cien

tly

deta

iled

to e

nsu

re t

hat

th

e fo

llow

ing

outc

omes

can

be

met

.

Dis

cuss

es t

he

imp

orta

nce

of

com

mu

nic

atin

g an

d in

tera

ctin

g in

a p

rofe

ssio

nal

m

ann

er w

ith

par

ents

an

d m

embe

rs o

f th

e m

ult

i-di

scip

linar

y te

am.

Stat

es t

he

imp

orta

nce

of

fam

ily-c

entr

ed c

are

and

how

it is

impl

emen

ted

on

the

un

it.

Rec

ogn

ises

th

e fa

mily

’s fe

elin

gs o

f gr

ief

and

loss

. Can

ass

ess

the

indi

vidu

al

nee

ds o

f th

e fa

mily

.

Supp

orts

th

e fa

mily

du

rin

g be

reav

emen

t.

Is a

ble

to g

ive

fam

ilies

info

rmat

ion

of

supp

ort

mec

han

ism

s an

d ag

enci

es

wit

hin

an

d ou

tsid

e th

e h

ospi

tal e

nvir

onm

ent.

Stat

es t

he

imp

orta

nce

of

pare

nt

info

rmat

ion

wit

h r

egar

din

g to

ber

eave

men

t an

d su

ppor

t.

Dem

onst

rate

s an

aw

aren

ess

of c

ult

ura

l div

ersi

ty r

elat

ing

to a

ttit

ude

s an

d be

hav

iou

rs s

urr

oun

din

g de

ath

.

Cre

ates

mem

orie

s fo

r fa

mily

mem

bers

.

Sen

siti

vely

rev

iew

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

62


Return to contents

Pal

liat

ive

care

, end

-of-

life

and

ber

eave

men

t m

anag

emen

t –

lear

ning

out

com

es (

cont

inue

d)

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

Aw

aren

ess

of t

he

nee

d fo

r a

pos

tnat

al c

are

plan

an

d a

mid

wif

ery

care

pra

ctit

ion

er a

nd

shou

ld s

upp

ort

and

faci

litat

e th

e m

oth

er t

o ac

cess

th

is.

Dem

onst

rate

s kn

owle

dge

of h

ow t

o co

nta

ct

mu

lti-

fait

h c

hap

lain

cy t

eam

an

d ot

her

su

ppor

t se

rvic

es.

End-

of-l

ife

care

pla

nD

emon

stra

tes

know

ledg

e an

d aw

aren

ess

of

the

proc

ess

of t

ran

sfer

rin

g an

infa

nt

wh

o h

as d

ied

to t

he

mor

tuar

y.

Post

-dea

th c

are

Aw

aren

ess

of w

hat

pap

erw

ork

is r

equ

ired

w

hen

an

infa

nt

is h

avin

g a

crem

atio

n o

r p

ost

mor

tem

exa

min

atio

n.

Aw

aren

ess

of o

ther

pro

fess

ion

als

invo

lved

in

th

e ca

re o

f th

e in

fan

t af

ter

deat

h –

mor

tuar

y te

chn

icia

n, p

ath

olog

ist,

coro

ner

.

Dev

elop

s se

lf-a

war

enes

s an

d re

cogn

ises

ow

n n

eeds

of

stre

ss a

nd

disc

omfo

rt. S

eeks

su

ppor

t fr

om c

olle

agu

es o

r su

ppor

t or

gan

isat

ion

s. Id

enti

fies

furt

her

lear

nin

g n

eeds

. Aw

aren

ess

of o

wn

su

ppor

t n

eeds

an

d w

her

e to

get

su

ppor

t fr

om.

Th

e ab

ove

leve

l of

skill

s an

d aw

aren

ess

can

be

pro

vide

d by

th

e pr

acti

tion

er’s

abi

lity

to

give

ver

bal c

onfi

rmat

ion

of

thei

r u

nde

rsta

ndi

ng

of t

hei

r n

eon

atal

pal

liati

ve

care

pat

hway

an

d id

enti

fy w

her

e th

is

info

rmat

ion

can

be

fou

nd.

Dem

onst

rate

met

hod

of

mai

nte

nan

ce o

f cl

ean

lines

s an

d su

pply

of

equ

ipm

ent.

Iden

tifi

es w

hic

h in

fan

ts a

re a

ppro

pria

te fo

r re

ferr

al fo

r co

nti

nu

ing

care

.

Com

mun

icat

ion

Dem

onst

rate

s ab

ility

to

prov

ide

appr

opri

ate

prac

tica

l su

ppor

t fo

r th

e fa

mily

.

Dem

onst

rate

s th

e ab

ility

to

com

mu

nic

ate

wit

h t

he

fam

ily s

ensi

tive

ly a

nd

empa

thet

ical

ly.

Para

llel c

are

plan

ning

D

emon

stra

tes

clin

ical

ski

lls r

equ

ired

to

care

fo

r th

e in

fan

t w

ith

pal

liati

ve a

nd/

or

end-

of-l

ife

nee

ds a

nd

thei

r fa

mily

wit

h

sen

ior

supp

ort

if a

ppro

pria

te.

Adv

ises

mot

her

reg

ardi

ng

supp

ress

ion

of

milk

su

pply

or

opti

on o

f do

nat

ing

EB

M.

Post

nata

l car

eA

dvis

es m

oth

er r

egar

din

g h

er o

wn

hea

lth

n

eeds

an

d re

fers

app

ropr

iate

ly t

o co

nti

nu

ing

mid

wif

ery

care

.

Aw

aren

ess

that

par

ents

will

be

exh

aust

ed

wit

h la

ck o

f sl

eep,

wor

ry a

nd

trav

ellin

g. En

d-of

-lif

e ca

re p

lann

ing

Supp

orts

th

e pa

ren

ts in

car

ing

for

thei

r in

fan

t at

th

e en

d of

life

.

Del

iver

s ca

re w

hic

h fo

cuse

s on

th

e in

fan

t’s

com

fort

an

d em

otio

nal

an

d pr

acti

cal

supp

ort

for

the

fam

ily.

Adv

ises

par

ents

how

to

prov

ide

com

fort

for

the

infa

nt,

cudd

ling,

con

tain

men

t, su

cklin

g,

resp

ondi

ng

to c

ues

, mu

sic.

Kn

owle

dge

of t

he

proc

ess

in t

ran

sfer

rin

g a

infa

nt

to t

he

mor

tuar

y. K

now

ledg

e of

th

e pa

per

wor

k re

quir

ed t

o ac

com

pany

th

e in

fan

t to

th

e m

ortu

ary.



Des

crib

es t

hei

r re

spon

sibi

litie

s w

ith

reg

ards

to

com

mu

nic

atio

n w

ith

col

leag

ues

an

d th

e w

ider

tea

m a

rou

nd

an in

fan

t re

ceiv

ing

palli

ativ

e/en

d-of

-lif

e ca

re.

Des

crib

es t

he

atti

tude

s an

d be

hav

iou

rs

nec

essa

ry w

hen

dea

ling

wit

h a

fam

ily w

hos

e in

fan

t is

rec

eivi

ng

palli

ativ

e/en

d-of

-lif

e ca

re.

Sen

siti

vely

rev

iew

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

Post

-dea

th c

are

Iden

tifi

es t

he

corr

ect

proc

ess

for

fam

ilies

vi

ewin

g an

infa

nt

afte

r de

ath

. Aw

aren

ess

that

ber

eave

d fa

mili

es m

ay v

isit

th

e u

nit

or

retu

rn fo

r fo

llow

up

app

oin

tmen

t.

Dev

elop

s se

lf-a

war

enes

s in

str

essf

ul

circ

um

stan

ces.

Rec

ogn

ise

own

nee

ds

rega

rdin

g st

ress

an

d di

scom

fort

in c

arin

g fo

r an

infa

nt

wit

h p

allia

tive

an

d en

d-of

-lif

e ca

re n

eeds

. See

k su

ppor

t fr

om c

olle

agu

es

and

oth

er s

upp

ort

orga

nis

atio

ns.

Iden

tifi

es fu

rth

er le

arn

ing

nee

ds.

Th

e ab

ove

cou

ld b

e as

sess

ed b

y a

por

tfol

io

of p

ract

ice

and

the

prac

titi

oner

’s s

kill

leve

l co

uld

be

revi

ewed

an

nu

ally

wit

h s

ensi

tivi

ty

duri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

64


Return to contents

Inve

stig

atio

ns, t

ests

and

pro

cedu

res

– le

arni

ng o

utco

mes

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

Th

e le

arn

er w

ill b

e eq

uip

ped

to

supp

ort

infa

nts

wh

o n

eed

inve

stig

atio

ns

or t

o u

nde

rtak

e a

defi

ned

ra

nge

of

inve

stig

atio

ns

and

proc

edu

res

wh

ich

ar

e re

quir

ed b

y th

e in

fan

t.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

in

orde

r to

equ

ip t

he

prac

titi

oner

to

assi

st t

he

AN

P/m

edic

al t

eam

in s

upp

ort

of in

fan

ts

wh

o ar

e u

nde

rgoi

ng

inve

stig

atio

ns

and

proc

edu

res,

for

exam

ple,

ven

epu

nct

ure

, ca

nn

ula

tion

.

Rec

ogn

ises

nor

mal

an

d ab

nor

mal

vit

al

sign

s an

d co

lou

r –

cros

s re

fere

nce

d to

ca

rdio

vasc

ula

r an

d re

spir

ator

y sk

ills

set.

Pro

vide

s pa

ren

ts w

ith

an

exp

lan

atio

n o

f th

e in

vest

igat

ion

s an

d pr

oced

ure

s th

e in

fan

t is

re

ceiv

ing.

Un

dert

akes

mea

sure

men

ts o

f vi

tal s

ign

s (t

emp

erat

ure

, hea

rt r

ate,

res

pira

tory

rat

e an

d ox

ygen

sat

ura

tion

), r

ecor

ds a

nd

rep

orts

re

sult

s.

An

tici

pate

s an

d re

cogn

ises

det

erio

rati

on in

th

e n

ewbo

rn a

nd

take

s st

eps

to r

equ

est

assi

stan

ce a

nd

init

iate

bas

ic li

fe s

upp

ort

mea

sure

s.

Perf

orm

s/as

sist

s w

ith

rou

tin

e di

agn

osti

c an

d th

erap

euti

c pr

oced

ure

s ac

cord

ing

to

loca

l gu

idel

ines

; for

exa

mpl

e, n

ewbo

rn

bloo

d sp

ot s

cree

nin

g, M

RSA

scr

een

ing,

sw

abs,

blo

od g

luco

se m

onit

orin

g, s

eru

m/

tran

scu

tan

eou

s bi

liru

bin

est

imat

ion

, ad

min

istr

atio

n o

f ph

otot

her

apy.

Rec

ords

an

d re

por

ts fi

ndi

ngs

of

proc

edu

res.

Be

awar

e of

pot

enti

al a

dver

se r

eact

ion

s to

in

vest

igat

ion

s an

d pr

oced

ure

s; im

plem

ent

safe

ty p

roce

dure

s an

d ta

ke s

teps

to

prov

ide

com

fort

.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e ce

rtifi

cate

(N

N)

Incl

usi

ve o

f th

e sk

ills

of L

evel

2, t

he

Leve

l 3

prac

titi

oner

will

req

uir

e a

prog

ram

me

of

prep

arat

ion

to

equ

ip t

he

prac

titi

oner

to

mea

sure

an

d re

cord

vit

al s

ign

s by

in

term

itte

nt

and/

or c

onti

nu

ous

met

hod

s,

rep

orti

ng

devi

atio

ns.

Edu

cate

d an

d eq

uip

ped

wit

h t

he

abili

ty t

o ad

just

su

pple

men

tal o

xyge

n a

ccor

din

g to

lo

cal g

uid

elin

es, r

epor

tin

g ch

ange

s in

ox

ygen

con

cen

trat

ion

del

iver

y.

Edu

cate

d an

d eq

uip

ped

wit

h t

he

abili

ty a

nd

skill

s re

quir

ed t

o p

erfo

rm o

ral s

uct

ion

as

dire

cted

.

Ass

ists

wit

h a

nd/

or p

erfo

rms

rou

tin

e sc

reen

ing

incl

udi

ng

obta

inin

g co

nse

nt,

acco

rdin

g to

rol

e de

scri

pti

on; f

or e

xam

ple,

h

eari

ng

scre

enin

g.

Ass

ists

wit

h r

outi

ne

inve

stig

atio

ns,

su

ch a

s X

-ray

, acc

ordi

ng

to lo

cal g

uid

elin

es.

Impl

emen

ts p

resc

ribe

d m

anag

emen

t pl

ans

in r

esp

onse

to

fin

din

gs; f

or e

xam

ple,

blo

od

glu

cose

est

imat

ion

.

Esc

orts

infa

nts

un

derg

oin

g n

on-i

nvas

ive

proc

edu

res

outs

ide

the

neo

nat

al u

nit

, for

ex

ampl

e, u

ltra

sou

nd.

Ass

esse

d by

pee

r re

view

of

per

form

ance

, th

e m

ain

ten

ance

of

a p

ortf

olio

of

prac

tice

an

d on

goin

g sk

ills

leve

l ret

enti

on c

an b

e re

view

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al

per

form

ance

rev

iew

.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e di

plom

a (N

N)

Ass

ocia

te/a

ssis

tan

t pr

acti

tion

er fo

un

dati

on d

egre

e (A

P)

Incl

usi

ve o

f th

e sk

ills

of L

evel

2 a

nd

3, t

he

Leve

l 4 p

ract

itio

ner

will

req

uir

e a

prog

ram

me

to e

quip

th

em t

o ca

re fo

r th

e in

fan

t re

ceiv

ing

spec

ial c

are

wh

o m

ay h

ave

un

derg

one

rou

tin

e di

agn

osti

c pr

oced

ure

s; t

hey

may

be

requ

ired

to

impl

emen

t tr

eatm

ent

stra

tegi

es a

ccor

din

g to

inst

ruct

ion

/loc

al g

uid

elin

es.

Ass

ists

wit

h, a

nd

as d

irec

ted

un

dert

akes

sp

ecifi

c co

mpl

ex p

roce

dure

s su

ch a

s w

oun

d ca

re, l

ong-

term

tra

cheo

stom

y ca

re, u

rin

alys

is.

Be

able

to

mea

sure

blo

od p

ress

ure

usi

ng

non

-inv

asiv

e te

chn

iqu

es, e

valu

ate

the

resu

lts

and

rep

ort

devi

atio

ns

from

nor

mal

as

appr

opri

ate.

Rec

ogn

ises

th

e n

eed

for

and/

or m

odif

y vi

tal s

ign

mon

itor

ing

incl

udi

ng

bloo

d pr

essu

re a

ccor

din

g to

infa

nt’s

con

diti

on a

nd

loca

l gu

idel

ines

.

Impl

emen

ts s

trat

egie

s to

mai

nta

in a

nd

nor

mal

ise

vita

l sig

ns

wit

hin

acc

epte

d pa

ram

eter

s.

Init

iate

s sa

fe a

nd

effe

ctiv

e or

al a

nd

nas

al/p

har

ynge

al s

uct

ion

as

clin

ical

ly

indi

cate

d.

Adm

inis

ters

dru

gs v

ia o

ral a

nd

topi

cal r

oute

s ac

cord

ing

to lo

cal p

olic

ies.

Form

al a

sses

smen

t co

uld

be

un

dert

aken

as

part

of

a fo

un

dati

on d

egre

e. P

eer

revi

ew a

nd

evid

ence

of

skill

ret

enti

on e

xam

ined

by

an a

nn

ual

mat

hs

and

safe

m

edic

atio

n a

dmin

istr

atio

n a

sses

smen

t w

her

e th

is is

app

ropr

iate

. Th

ere

is a

lso

the

opp

ortu

nit

y to

rev

iew

com

pet

ence

du

rin

g th

e IP

R.



Rec

ords

an

d re

por

ts p

hysi

olog

y an

d be

hav

iou

r re

spon

ses

to in

vest

igat

ion

s an

d pr

oced

ure

s.

Rec

ogn

ises

an

d su

ppor

ts w

ays

in w

hic

h

pare

nts

can

be

invo

lved

in t

he

care

of

thei

r in

fan

t du

rin

g an

inve

stig

atio

n/p

roce

dure

; fo

r ex

ampl

e, t

alki

ng

to t

hei

r in

fan

t, of

feri

ng

skin

-to-

skin

car

e, b

reas

tfee

din

g/bo

ttle

fe

edin

g.

Ass

esse

d by

mai

nta

inin

g a

por

tfol

io o

f pr

acti

ce a

nd

ongo

ing

skill

s le

vel c

an b

e re

view

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al

per

form

ance

rev

iew

.

66


Return to contents

Equi

pmen

t an

d m

onit

orin

g –

lear

ning

out

com

es

Lev

els

2-4

Lev

el 2

unr

egis

tere

d L

evel

3 u

nreg

iste

red

Lev

el 4

unr

egis

tere

d

All

lear

ner

s w

ill b

e re

quir

ed t

o u

se t

he

equ

ipm

ent

the

infa

nt

requ

ires

saf

ely,

pre

serv

e in

fan

t sa

fety

an

d m

onit

or t

he

stab

ility

of

the

infa

nt.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

rais

e aw

aren

ess

of t

he

pot

enti

al r

isks

to

infa

nt

and

fam

ily s

afet

y.

Con

trol

of

subs

tan

ces

haz

ardo

us

to h

ealt

h

(CO

SHH

), m

anu

al h

and

ling

and

rep

orti

ng

clin

ical

inci

den

ts.

Th

e pr

acti

tion

er s

hou

ld b

e ab

le t

o lo

cate

an

d ch

eck

emer

gen

cy e

quip

men

t.

Dem

onst

rate

s ap

prop

riat

e u

se o

f co

t si

de

infa

nt

bath

s an

d ot

her

typ

e of

ch

angi

ng

equ

ipm

ent.

Kn

ows

how

to

trig

ger

alar

ms

in t

he

clin

ical

ar

ea; fi

re a

larm

s, e

mer

gen

cy a

larm

s.

Dem

onst

rate

s fa

mili

arit

y w

ith

eva

cuat

ion

p

olic

y.

Cle

ans

and

stor

es e

quip

men

t n

eces

sary

for

the

care

of

an in

fan

t in

acc

orda

nce

wit

h

loca

l gu

idel

ines

an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Effi

cien

tly

and

safe

ly u

ses

equ

ipm

ent

nec

essa

ry fo

r th

e ca

re o

f w

ell i

nfa

nts

in

acco

rdan

ce w

ith

loca

l gu

idel

ines

an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Stat

es t

he

freq

uen

cy t

hat

equ

ipm

ent

shou

ld

be c

hec

ked

and

chan

ged

and

be a

ble

to fi

nd

repl

acem

ent

equ

ipm

ent.

Ver

ifies

‘exp

iry’

/’ser

vice

’ dat

e fo

r co

nsu

mab

les/

equ

ipm

ent

and

proc

esse

s fo

r re

plac

emen

t/re

pair

of

sam

e.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e ce

rtifi

cate

(N

N)

At

the

end

of a

pro

gram

me

of le

arn

ing

and

acco

rdin

g to

rol

e an

d re

spon

sibi

litie

s,

stu

den

ts w

ill b

e ab

le t

o p

erfo

rm t

he

skill

set

ex

pec

ted

of a

Lev

el 2

pra

ctit

ion

er a

nd

also

ac

t in

a s

up

ervi

sory

cap

acit

y to

en

sure

saf

e u

se, s

tora

ge a

nd

the

clea

nin

g of

th

e eq

uip

men

t n

eces

sary

for

the

care

of

infa

nts

re

quir

ing

spec

ial c

are,

in a

ccor

dan

ce w

ith

lo

cal g

uid

elin

es a

nd

man

ufa

ctu

rer’

s in

stru

ctio

n.

Effi

cien

tly

and

safe

ly u

ses

equ

ipm

ent

nec

essa

ry fo

r th

e ca

re o

f in

fan

ts r

equ

irin

g sp

ecia

l car

e in

acc

orda

nce

wit

h lo

cal

guid

elin

es a

nd

man

ufa

ctu

rer’

s in

stru

ctio

n.

Sets

up

and

chec

ks e

quip

men

t al

arm

s fo

r in

fan

ts r

equ

irin

g sp

ecia

l car

e.

Pro

vide

s an

exp

lan

atio

n t

o pa

ren

ts o

f th

e eq

uip

men

t/m

onit

orin

g th

eir

infa

nt

is

rece

ivin

g.

Th

e ab

ove

skill

set

cou

ld b

e fo

rmal

ly

un

dert

aken

as

part

of

a Le

vel 3

voc

atio

nal

pr

ogra

mm

e. T

he

abov

e sk

ill s

et c

an b

e re

view

ed d

uri

ng

man

dato

ry t

rain

ing

and

duri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

Hea

lth

car

e as

sist

ant

(HC

A)

Mat

ern

ity

supp

ort

wor

ker

(MSW

)H

ealt

h c

are

supp

ort

wor

ker

(HC

SW)

Nu

rser

y n

urs

e di

plom

a (N

N)

Ass

ocia

te/a

ssis

tan

t pr

acti

tion

er fo

un

dati

on d

egre

e (A

P)

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

allo

w a

cqu

isit

ion

of

com

pet

ence

s de

sign

ed t

o fa

cilit

ate

an u

nde

rsta

ndi

ng

of t

he

equ

ipm

ent

use

d on

th

e n

eon

atal

u

nit

wh

ich

will

inco

rpor

ate

the

skill

s re

quir

ed fo

r pr

acti

ce a

t Le

vel 2

an

d

Leve

l 3.

Dem

onst

rate

s th

e co

rrec

t pr

oced

ure

for

the

clea

nin

g an

d st

orag

e of

equ

ipm

ent

as p

er in

fect

ion

con

trol

pol

icy.

Dem

onst

rate

s an

aw

aren

ess

of d

isin

fect

ion

an

d st

erili

sati

on t

ech

niq

ues

. St

ates

loca

tion

of

and

th

e ch

ecki

ng

proc

edu

re fo

r re

susc

itat

ion

an

d pr

oced

ure

eq

uip

men

t.

Stat

es h

ow t

o ch

eck

oxyg

en, a

ir a

nd

suct

ion

equ

ipm

ent.

Dem

onst

rate

s h

ow t

o pr

epar

e eq

uip

men

t in

rea

din

ess

for

clin

ical

use

.

Dem

onst

rate

s w

hen

equ

ipm

ent

nee

ds s

ervi

cin

g or

rep

airi

ng.

Safe

use

of

a ra

nge

of

mon

itor

ing

equ

ipm

ent.

Pro

vide

s pa

ren

ts w

ith

a m

ore

deta

iled

expl

anat

ion

of

the

equ

ipm

ent/

mon

itor

ing

thei

r in

fan

t is

rec

eivi

ng.

Th

e ab

ove

skill

set

cou

ld b

e fo

rmal

ly u

nde

rtak

en a

s pa

rt o

f a

Leve

l 4

voca

tion

al p

rogr

amm

e or

be

asse

ssed

as

a co

mp

onen

t of

a fo

un

dati

on d

egre

e.

Th

e as

sess

men

ts o

f le

arn

ing

and

profi

cien

cies

cou

ld in

volv

e a

dem

onst

rati

on

that

th

e pr

acti

tion

er c

an c

lean

an

d st

ore

equ

ipm

ent

corr

ectl

y, c

an c

hec

k eq

uip

men

t pr

ior

to u

se a

nd

can

dem

onst

rate

how

to

use

equ

ipm

ent

for

exam

ple

how

to

mak

e be

st u

se o

f th

e eq

uip

men

t de

sign

ed t

o m

ain

tain

an

in

fan

t’s t

emp

erat

ure

.



Loca

tes

and

chec

ks e

quip

men

t re

quir

ed fo

r re

susc

itat

ion

pu

rpos

es.

Pro

vide

s pa

ren

ts w

ith

a b

asic

exp

lan

atio

n

of t

he

equ

ipm

ent/

mon

itor

ing

that

th

eir

infa

nt

is r

ecei

vin

g.

Th

e ab

ove

skill

set

cou

ld b

e fo

rmal

ly

un

dert

aken

as

part

of

a Le

vel 2

voc

atio

nal

pr

ogra

mm

e. T

hes

e sk

ills

can

be

revi

ewed

du

rin

g m

anda

tory

tra

inin

g an

d du

rin

g th

e in

divi

dual

per

form

ance

rev

iew

.

68


Return to contents

Flui

d, e

lect

roly

te, n

utri

tion

and

eli

min

atio

n m

anag

emen

t –

lear

ning

out

com

es

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

Th

e le

arn

er w

ill b

e eq

uip

ped

to

prov

ide

skill

ed c

are

to t

he

infa

nt

wh

o h

as m

ore

com

plex

fl

uid

, ele

ctro

lyte

, n

utr

itio

nal

an

d el

imin

atio

n s

upp

ort

nee

ds.

All

lear

ner

s w

ill

un

ders

tan

d th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in t

he

infa

nt’s

ca

re p

lan

.

Th

eore

tica

l an

d pr

acti

cal p

repa

rati

on in

ord

er t

o de

velo

p kn

owle

dge

and

skill

s in

un

ders

tan

din

g th

e n

eon

atal

flu

id r

egim

es. A

ccu

rate

ly c

alcu

late

dai

ly fl

uid

re

quir

emen

ts fo

r te

rm a

nd

pret

erm

neo

nat

es u

sed

in

the

regi

stra

nt’s

clin

ical

are

a.

Ass

essm

ent

of t

he

abili

ty t

o ca

lcu

late

tot

al d

aily

vol

um

e an

d in

divi

dual

feed

req

uir

emen

ts. U

nde

rsta

nd

why

da

ily fe

edin

g vo

lum

es a

re in

crea

sed,

usi

ng

un

it

guid

elin

es.

Dem

onst

rate

s ab

ility

to

wei

gh a

nd

mea

sure

infa

nts

, do

cum

ent

chan

ges

in w

eigh

t u

sin

g ce

nti

le c

har

t.

Supp

orts

bre

astf

eedi

ng

wit

h c

orre

ct p

osit

ion

ing

and

atta

chm

ent.

Dev

elop

s sk

ills

in s

upp

orti

ng

mot

her

s w

ith

han

d ex

pres

sion

an

d w

ith

th

e u

se o

f br

east

pu

mps

.

Safe

ly a

ble

to s

tore

exp

ress

ed b

reas

t m

ilk.

Iden

tifi

es t

he

reas

ons

for

usi

ng

brea

st m

ilk fo

rtifi

er.

Kn

owle

dge

of t

he

diff

eren

t ar

tifi

cial

feed

s an

d id

enti

fies

indi

cati

ons

for

use

.

Safe

ly m

akes

up

feed

s w

hen

req

uir

ed a

nd

dem

onst

rate

s h

ow t

o m

ake

up

arti

fici

al fe

eds

to fa

mili

es in

lin

e w

ith

lo

cal a

nd

nat

ion

al p

olic

ies.

Safe

ly in

sert

s, t

ests

an

d u

ses

a fe

edin

g tu

be. A

sses

s le

ngt

h o

f tu

be t

o be

inse

rted

. In

sert

tu

be s

afel

y.

Test

s pH

of

aspi

rate

. Sec

ure

tu

be a

nd

docu

men

t in

sert

ion

. Ide

nti

fy w

hen

not

to

use

a fe

edin

g tu

be.

Feed

s in

fan

t vi

a tu

be in

lin

e w

ith

un

it g

uid

elin

es a

nd

docu

men

t. Su

ppor

t fa

mili

es in

tu

be fe

edin

g th

eir

infa

nts

.

Safe

ly fe

eds

infa

nts

en

tera

lly u

sin

g a

vari

ety

of o

ral

stra

tegi

es. A

bilit

y to

iden

tify

sig

ns

and

sym

pto

ms

of

refl

ux

and

follo

w a

pre

pare

d re

flu

x m

anag

emen

t pl

an.

Follo

ws

a pr

ogra

mm

e to

pro

vide

th

e th

eore

tica

l an

d pr

acti

cal p

repa

rati

on t

o de

velo

p kn

owle

dge

and

skill

s in

un

ders

tan

din

g th

e m

ore

com

plex

neo

nat

al fl

uid

re

gim

es. C

itin

g th

e re

leva

nt

liter

atu

re, p

rovi

de

evid

ence

-bas

ed c

are

of I

V a

cces

s de

vice

s, k

now

ledg

e,

awar

enes

s an

d ab

ility

to

teac

h o

ther

s th

e re

quir

emen

t fo

r vi

gila

nce

in t

he

care

of

thes

e.

Dev

elop

s th

e ab

ility

to

un

dert

ake

a h

olis

tic

and

com

preh

ensi

ve n

utr

itio

nal

an

d di

etar

y as

sess

men

t of

th

e in

fan

t in

hig

h d

epen

den

cy c

are.

Acc

ura

tely

cal

cula

tes

and

prep

ares

th

e fl

uid

an

d el

ectr

olyt

e re

quir

emen

ts fo

r te

rm a

nd

pret

erm

n

eon

ates

in t

he

hig

h d

epen

den

cy a

rea.

Th

eore

tica

l aw

aren

ess

of a

ran

ge o

f co

nge

nit

al a

nd

acqu

ired

con

diti

ons

wh

ich

res

ult

in a

lter

ed g

ut

phys

iolo

gy. S

kille

d, in

form

ed a

dmin

istr

atio

n o

f tr

ansp

aren

tal n

utr

itio

n.

Th

eore

tica

lly r

evie

w t

he

evid

ence

on

gu

t pr

imin

g an

d ap

ply

this

to

infa

nts

in t

he

hig

h d

epen

den

cy a

rea.

Un

ders

tan

ds t

he

use

of

cen

tile

ch

arts

. Usi

ng

evid

ence

, ba

sed

on t

he

prin

cipl

es o

f n

utr

itio

n, p

rom

otes

th

e u

se

of m

oth

er’s

ow

n m

ilk a

nd

mon

itor

th

e de

velo

pmen

t of

th

e in

fan

t’s r

eflex

es a

s an

indi

cati

on o

f th

e em

ergi

ng

abili

ty t

o co

-ord

inat

e su

ck a

nd

swal

low

.

Supp

orts

bre

astf

eedi

ng

wit

h c

orre

ct p

osit

ion

ing

and

atta

chm

ent,

con

solid

ate

skill

s in

su

ppor

tin

g m

oth

ers

wit

h h

and

expr

essi

on a

nd

wit

h t

he

use

of

brea

st

pum

ps. A

nal

ysis

of

brea

stfe

edin

g pr

oble

ms

and

wor

kin

g w

ith

th

e fa

mili

es d

evel

op t

he

form

ula

tion

of

solu

tion

s to

res

olve

th

ese.

Wit

h a

ppro

pria

te r

efer

ence

to

mic

robi

olog

y sa

fe

stor

age

and

usa

ge o

f ex

pres

sed

brea

st m

ilk.

Wit

h r

efer

ence

to

the

evid

ence

eva

luat

e th

e re

quir

emen

t fo

r en

tera

l add

itiv

es t

o en

tera

l fee

ds s

uch

as

sod

ium

an

d br

east

milk

fort

ifier

.

Follo

ws

a pr

ogra

mm

e of

th

eore

tica

l an

d pr

acti

cal

prep

arat

ion

to

enab

le t

he

neo

nat

al in

ten

sive

car

e n

urs

e to

init

iate

follo

win

g as

sess

men

t th

e m

anag

emen

t fo

r su

stai

nin

g th

e in

fan

t’s h

omoe

osta

tic

requ

irem

ents

. Th

is

shou

ld in

clu

de d

etai

led

embr

yolo

gy, a

nat

omy,

ph

ysio

logy

an

d pa

thol

ogy

of t

he

gast

roin

test

inal

tra

ct,

ren

al t

ract

an

d a

ran

ge o

f ex

cret

ory

mec

han

ism

s an

d pa

thw

ays.

Th

is s

hou

ld in

clu

de u

nde

rsta

ndi

ng

and

inte

rpre

tati

on o

f n

orm

al a

nd

abn

orm

al v

alu

es a

nd

thei

r m

anag

emen

t, th

e n

orm

al m

atu

rati

onal

dev

elop

men

t of

in

fan

t re

flex

es a

nd

infa

nt

grow

th t

raje

ctor

ies.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

revi

ew t

he

com

plex

itie

s of

tra

nse

pide

rmal

wat

er lo

ss a

nd

the

nu

rsin

g st

rate

gies

to

redu

ce t

hes

e. T

her

e sh

ould

als

o be

pr

epar

atio

n o

n t

he

requ

irem

ents

for

flu

id r

estr

icti

on

and

com

plex

flu

id a

nd

elec

trol

yte

calc

ula

tion

s. T

he

adm

inis

trat

ion

of

thes

e fl

uid

s is

like

ly t

o in

clu

de

mu

ltip

le li

nes

an

d sk

ills

to m

anag

e th

ese

lines

nee

d to

be

acq

uir

ed a

ccor

din

gly.

Th

e n

eon

atal

inte

nsi

ve c

are

nu

rse

shou

ld b

e eq

uip

ped

an

d pr

epar

ed t

o as

sess

infa

nt’s

sta

bilit

y fo

r gu

t pr

imin

g,

skill

ed a

nd

info

rmed

to

adm

inis

ter

TP

N a

s a

mea

ns

of

nu

trit

ion

un

til t

he

infa

nt

is s

uffi

cien

tly

stab

le t

o to

lera

te

ente

ral f

eeds

. Th

ey s

hou

ld b

e co

mm

itte

d to

a p

ract

ice

and

cult

ure

des

ign

ed t

o pr

omot

e br

east

feed

ing.

Wh

ere

infa

nts

are

nil

by m

outh

for

prol

onge

d p

erio

ds,

wor

kin

g w

ith

oth

ers

colle

giat

ely

the

neo

nat

al n

urs

e sh

ould

be

equ

ipp

ed t

o pr

ovid

e a

plan

of

care

for

oral

st

imu

lati

on.

Wh

ere

infa

nts

are

su

ffici

entl

y st

able

to

tole

rate

en

tera

l fe

eds

the

nu

rse

shou

ld b

e pr

epar

es w

ith

a s

uit

able

ba

ckgr

oun

d of

pre

para

tion

to

skilf

ully

adm

inis

ter

a ra

nge

of

nu

trit

ion

al s

upp

lem

ents

. Be

wel

l in

form

ed o

f th

e sp

ecia

list

form

ula

s su

itab

le fo

r th

e pr

eter

m a

nd

the

infa

nt

wh

o h

as in

tole

ran

ce, m

alab

sorp

tion

or

a re

quir

emen

t fo

r m

etab

olic

man

agem

ent.



Un

dert

akes

a b

lood

glu

cose

an

alys

is.

Dem

onst

rate

s pa

in m

anag

emen

t st

rate

gies

.

Sele

cts

appr

opri

ate

sam

plin

g de

vice

. Sam

ple

from

co

rrec

t ar

ea o

f h

eel.

Dis

pos

es o

f sh

arps

an

d co

nta

min

ated

mat

eria

l ap

prop

riat

ely.

Use

s u

nit

gu

idel

ines

to

disc

uss

abn

orm

al v

alu

es.

An

atom

ical

an

d ph

ysio

logi

cal u

nde

rsta

ndi

ng

of t

he

ren

al t

ract

to

iden

tify

nor

mal

neo

nat

al u

rin

e ou

tpu

t in

m

ls/k

g/h

our.

Ass

ess

and

docu

men

t u

rin

ary

outp

ut.

Perf

orm

uri

nal

ysis

an

d id

enti

fy a

bnor

mal

val

ues

.

Un

ders

tan

din

g of

th

e pr

inci

ples

of

labo

rato

ry

proc

esse

s to

obt

ain

uri

ne

sam

ple

usi

ng

ster

ile b

ag.

An

atom

ical

an

d ph

ysio

logi

cal u

nde

rsta

ndi

ng

of t

he

gast

roin

test

inal

tra

ct t

o ap

ply

to n

orm

al n

ewbo

rn

bow

el o

utp

ut

in t

he

firs

t w

eek

of li

fe.

Phy

siol

ogic

al u

nde

rsta

ndi

ng

of t

he

elim

inat

ion

pa

thw

ay o

f bi

liru

bin

in o

rder

to

prov

ide

info

rmed

car

e of

a n

eon

ate

rece

ivin

g ph

otot

her

apy

in s

pec

ial c

are.

T

heo

reti

cal a

nd

prac

tica

l pre

para

tion

in o

rder

to

be

able

to

com

men

ce n

eon

atal

ph

otot

her

apy.

Pre

pare

s eq

uip

men

t fo

r ph

otot

her

apy

and

just

ifies

th

e ch

oice

of

equ

ipm

ent

use

d.

Iden

tifi

es n

urs

ing

inte

rven

tion

s to

min

imis

e si

de

effe

cts

of p

hot

oth

erap

y.

App

reci

atio

n o

f th

e im

por

tan

ce o

f u

sin

g ch

arts

an

d do

cum

enta

tion

in t

he

reco

rdin

g of

ser

um

bili

rubi

n

leve

ls.

Th

e le

arn

er a

nd

men

tor

may

agr

ee t

o ot

her

lear

nin

g ou

tcom

es w

hic

h e

nh

ance

th

e le

vel o

f co

mp

eten

ce s

uch

as

gas

tros

tom

y fe

edin

g bu

t al

l cor

e le

arn

ing

outc

omes

m

ust

be

sign

ed o

ff b

y a

QIS

neo

nat

al n

urs

e.

Com

preh

ensi

ve k

now

ledg

e of

pro

prie

tary

bra

nds

of

arti

fici

al fe

eds

and

the

acqu

isit

ion

of

know

ledg

e of

sp

ecia

list

form

ula

. Id

enti

fy in

dica

tion

s fo

r u

se.

Th

e ab

ility

to

safe

ly m

ake

up

feed

s w

hen

req

uir

ed a

nd

dem

onst

rate

how

to m

ake

up

arti

fici

al fe

eds

to fa

mili

es

in li

ne

wit

h lo

cal a

nd

nat

ion

al p

olic

ies.

Usi

ng

guid

elin

es s

afel

y in

sert

, tes

t an

d u

se a

feed

ing

tube

. Tea

ch a

nd

supp

ort

the

nov

ice

neo

nat

al n

urs

e th

e im

por

tan

ce o

f as

sess

ing

tube

len

gth

an

d to

tes

t th

e pH

of

asp

irat

e. A

cqu

isit

ion

of

the

abili

ty t

o re

cogn

ise

abn

orm

al c

har

acte

rist

ics

in c

har

acte

r an

d vo

lum

e in

ga

stri

c as

pira

tes.

Saf

ely

calc

ula

te g

astr

ic lo

ss

repl

acem

ent

if r

equ

ired

.

Iden

tifi

es in

fan

ts s

uff

erin

g fr

om r

eflu

x an

d de

sign

a

step

ped

an

d st

aged

indi

vidu

al p

lan

for

the

man

agem

ent

of t

hes

e in

fan

ts. E

valu

ate

the

infa

nt’s

re

spon

se t

o th

e ef

fect

iven

ess

of t

he

step

s ta

ken

to

alle

viat

e.

Bas

ed o

n t

he

un

ders

tan

din

g of

hom

eost

asis

u

nde

rsta

nd

the

requ

irem

ents

for

bloo

d gl

uco

se

anal

ysis

, ju

stif

y an

d pr

omot

e pa

in m

anag

emen

t st

rate

gies

. Tea

ch t

he

requ

irem

ent

and

imp

orta

nce

of

usi

ng

the

appr

opri

ate

sam

plin

g de

vice

an

d ac

cess

ing

the

corr

ect

area

of

hee

l.

An

atom

ical

an

d ph

ysio

logi

cal u

nde

rsta

ndi

ng

of t

he

ren

al t

ract

to

asse

ss t

he

infa

nt’s

neo

nat

al u

rin

e ou

tpu

t in

mls

/kg/

hou

r. U

nde

rsta

nd

the

ran

ge o

f al

tere

d st

ates

w

hic

h m

ay im

pact

on

uri

nar

y ou

tpu

t. Pa

ss u

rin

ary

cath

eter

s, a

ccu

rate

ly w

eigh

nap

pies

. Su

ppor

t an

d te

ach

ot

her

s to

per

form

uri

nal

ysis

an

d id

enti

fy a

bnor

mal

va

lues

. Su

ppor

t an

d te

ach

oth

ers

to o

btai

n u

rin

e sa

mpl

es.

An

atom

ical

an

d ph

ysio

logi

cal u

nde

rsta

ndi

ng

of t

he

gast

ro in

test

inal

tra

ct t

o ap

ply

to n

orm

al n

ewbo

rn

bow

el o

utp

ut

in t

he

firs

t w

eek

of li

fe. D

evel

op

un

ders

tan

din

g of

a r

ange

of

con

diti

ons

wh

ich

may

re

sult

in d

evia

tion

s fr

om t

his

.

Wh

ere

infa

nts

are

su

ffici

entl

y st

able

to

tole

rate

en

tera

l fe

eds

the

nu

rse

shou

ld b

e su

itab

ly p

repa

red

to m

anag

e a

ran

ge o

f fe

edin

g tu

bes,

ora

l, n

asal

or

gast

rost

omy.

W

her

e th

ere

are

re-f

eedi

ng

or r

epla

cem

ent ‘

feed

ing/

flu

id’ m

anag

emen

t st

rate

gies

, th

e n

eon

atal

nu

rse

nee

ds

to b

e ab

le t

o m

anag

e th

e ca

lcu

lati

ons

and

the

proc

ess

effe

ctiv

ely.

Neo

nat

al in

ten

sive

car

e n

urs

es w

ill b

e pr

epar

ed w

ith

th

e th

eore

tica

l bac

kgro

un

d to

iden

tify

infa

nts

wit

h

abn

orm

al g

ut

fun

ctio

nin

g an

d se

t of

ski

lls t

o eq

uip

th

em t

o ca

re fo

r th

e u

nst

able

infa

nt

wit

h N

EC

. In

som

e u

nit

s th

is w

ill in

clu

de a

req

uir

emen

t fo

r ac

ute

su

rgic

al

nu

rsin

g sk

ills.

Th

e n

eon

atal

inte

nsi

ve c

are

nu

rse

will

req

uir

e a

theo

reti

cal b

ackg

rou

nd

on a

sses

sin

g re

nal

ou

tpu

t an

d m

anag

emen

t st

rate

gies

to

addr

ess

pol

y/ol

igu

ria.

Be

skill

ed t

o pa

ss u

rin

ary

cath

eter

s an

d m

anag

e w

hen

re

quir

ed s

upr

a-pu

bic

cath

eter

s. I

n s

ome

un

its

ther

e m

ay

be a

req

uir

emen

t to

hav

e sk

ills

in m

anag

ing

per

iton

eal

dial

ysis

or

extr

acor

por

eal r

enal

su

ppor

t st

rate

gies

to

man

age

dera

nge

d el

ectr

olyt

e va

lues

or

ren

al fa

ilure

. U

nit

s w

ho

requ

ire

thes

e sk

ills

will

nee

d to

hav

e an

in

-ser

vice

tra

inin

g an

d as

sess

men

t st

rate

gy.

Som

e u

nit

s m

ay p

rovi

de in

-ser

vice

tra

inin

g an

d as

sess

men

t on

mol

ecu

lar

adso

rben

t re

circ

ula

tin

g sy

stem

s (M

AR

S).

Th

e n

urs

e w

orki

ng

in n

eon

atal

inte

nsi

ve c

are

nee

ds t

o be

pre

pare

d an

d sk

illed

in a

sses

sin

g bi

liru

bin

leve

ls,

prov

idin

g a

ran

ge o

f lig

ht

ther

apie

s as

req

uir

ed a

nd

in

part

icip

atin

g in

exc

han

ge t

ran

sfu

sion

.

Th

e n

eon

atal

inte

nsi

ve c

are

nu

rse

shou

ld b

e pr

epar

ed

and

equ

ipp

ed t

o be

abl

e to

nu

rse

crit

ical

ly u

nst

able

in

fan

ts a

nd

supp

ort

neo

nat

al e

xper

t n

urs

es in

m

onit

orin

g th

e ef

fect

iven

ess

and

curr

ency

of

un

it

guid

elin

es r

elat

ed t

o fl

uid

, ele

ctro

lyte

, nu

trit

ion

al a

nd

elim

inat

ion

man

agem

ent.

70


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Flui

d, e

lect

roly

te, n

utri

tion

and

eli

min

atio

n m

anag

emen

t –

lear

ning

out

com

es (

cont

inue

d)

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

Ass

essm

ent

of t

he

abov

e sk

ills

cou

ld b

e ba

sed

on a

fo

rmal

str

uct

ure

d as

sign

men

t/ex

amin

atio

n/m

ult

iple

ch

oice

qu

esti

ons

(MC

Qs)

, pos

ter

pres

enta

tion

pr

ovid

ed b

y re

cogn

ised

edu

cati

onal

est

ablis

hm

ents

or

prov

ided

in-h

ouse

usi

ng

dire

ct o

bser

vati

on fr

om

men

tor

to c

ompl

ete

a sk

ills

and

per

form

ance

log.

A

blen

d of

th

e ab

ove

cou

ld b

e u

sed.

Skill

leve

ls r

evie

wed

an

nu

ally

du

rin

g th

e in

divi

dual

p

erfo

rman

ce r

evie

w.

Evid

ence

from

fam

ilies

cou

ld b

e ga

ther

ed t

o su

ppor

t th

e cl

aim

to

con

tin

ued

exp

erti

se in

som

e el

emen

ts o

f th

ese

skill

s.

Iden

tify

ch

arac

teri

stic

s of

abn

orm

al n

eon

atal

faec

es,

abili

ty t

o as

sess

an

infa

nt

at r

isk

of n

ecro

tisi

ng

ente

roco

litis

. Acq

uis

itio

n o

f th

e th

eore

tica

l bas

is

requ

ired

to

com

pet

entl

y ca

re fo

r an

infa

nt

bein

g m

anag

ed c

onse

rvat

ivel

y fo

r m

ild n

ecro

tisi

ng

ente

roco

litis

in t

he

hig

h d

epen

den

cy a

rea.

Un

ders

tan

din

g th

e re

quir

emen

t fo

r an

d th

e ab

ility

to

per

form

rec

tal w

ash

outs

.

Phy

siol

ogic

al u

nde

rsta

ndi

ng

of t

he

elim

inat

ion

pa

thw

ay o

f bi

liru

bin

in o

rder

to

prov

ide

evid

ence

-ba

sed

care

of

a n

eon

ate

rece

ivin

g ph

otot

her

apy

in t

he

hig

h d

epen

den

cy a

rea.

Th

eore

tica

l an

d pr

acti

cal

prep

arat

ion

in o

rder

to

be a

ble

to c

omm

ence

neo

nat

al

phot

oth

erap

y, p

rom

ote

the

use

of

nu

rsin

g in

terv

enti

ons

to m

inim

ise

pot

enti

al s

ide

effe

cts

of

phot

oth

erap

y.

Th

eore

tic

and

prac

tica

l ski

lls in

th

e pr

oces

s of

ex

chan

ge t

ran

sfu

sion

.

Th

e h

igh

dep

enda

ncy

neo

nat

al n

urs

e sh

ould

be

suffi

cien

tly

skill

ed t

o h

ave

un

dert

aken

an

d co

mpl

eted

a

prog

ram

me

of m

ento

rsh

ip s

o th

at t

hey

can

su

ppor

t th

eir

mor

e ju

nio

r co

lleag

ues

.

Ass

essm

ent

of t

he

abov

e sk

ill s

et a

nd

know

ledg

e co

uld

be

bas

ed o

n a

form

al t

heo

reti

cal a

ssig

nm

ent

or

exam

inat

ion

by

essa

y/M

CQ

an

d so

fort

h, a

s pa

rt o

f a

path

way

bas

ed w

ith

in a

n in

stit

uti

on o

f h

igh

er

lear

nin

g.

Ass

essm

ent

of c

omp

eten

cy –

dir

ect

obse

rvat

ion

of

infa

nts

car

e, d

iary

refl

ecti

ons,

lite

ratu

re c

riti

ques

an

d a

case

stu

dy. E

vide

nce

th

at t

he

skill

set

is b

ein

g m

ain

tain

ed c

an b

e re

view

ed d

uri

ng

the

ann

ual

in

divi

dual

per

form

ance

rev

iew

.

Th

e n

urs

e w

orki

ng

in n

eon

atal

inte

nsi

ve c

are

un

its

nee

ds t

o be

com

pass

ion

atel

y su

ppor

tive

of

the

pare

nts

an

d fa

mili

es o

f th

e in

fan

ts in

th

eir

care

an

d se

ek t

o pr

ovid

e op

por

tun

itie

s to

con

sult

an

d in

volv

e th

em.

Ass

essm

ent

and

adm

inis

trat

ion

of

dru

gs a

nd

spec

ialis

t fe

eds

diar

y –

revi

ewin

g th

e u

se o

f di

ure

tics

an

d sp

ecia

list

form

ula

s.

Spec

ialis

t as

sess

men

t st

rate

gies

for

dial

ysis

, MA

RS

or

com

plex

re-

feed

ing

stra

tegi

es.

Th

e n

eon

atal

QIS

sh

ould

be

sign

off

men

tors

so

that

th

ey c

an d

evel

op, s

upp

ort

and

take

pro

fess

ion

al

resp

onsi

bilit

y in

mak

ing

valu

e ju

dgem

ents

as

to t

he

com

pet

ence

of

thei

r m

ore

jun

ior

colle

agu

es a

nd

endo

rse

thei

r pr

ogre

ssio

n.

Ass

essm

ent

of t

he

skill

s an

d kn

owle

dge

con

side

red

abov

e co

uld

be

form

al u

nde

r th

e au

spic

es o

f an

HE

I an

d co

uld

incl

ude

cas

e st

udi

es, O

SCE

, MC

Qs.

Th

e ac

quis

itio

n o

f cl

inic

al s

kills

can

be

con

firm

ed b

y th

e co

mpl

etio

n o

f pr

acti

ce a

sses

smen

t do

cum

ents

or

enh

ance

d sk

ills

clu

ster

s. T

he

ongo

ing

asse

ssm

ent

of

prac

tice

an

d th

e ev

iden

ce t

hat

th

e Q

IS s

kills

are

bei

ng

mai

nta

ined

cou

ld b

e as

cert

ain

ed b

y th

e lin

e m

anag

er

duri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.



Neu

rolo

gica

l, d

evel

opm

enta

l car

e an

d pa

in m

anag

emen

t –

lear

ning

out

com

es

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

Th

e le

arn

er w

ill b

e ab

le

to p

rovi

de c

are

to

supp

ort

an in

fan

t’s

neu

rolo

gica

l wel

lbei

ng.

All

lear

ner

s to

pro

vide

ca

re w

hic

h is

de

velo

pmen

tally

ap

prop

riat

e an

d ca

n

prov

ide

infa

nt

pain

m

anag

emen

t.

All

lear

ner

s w

ill

un

ders

tan

d th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in t

he

infa

nt’s

ca

re p

lan

.

Follo

ws

a pr

ogra

mm

e of

th

eore

tica

l an

d pr

acti

cal s

kills

to

equ

ip t

he

stu

den

t to

be

able

to

asse

ss a

n in

fan

t’s

stat

e of

com

fort

an

d w

ellb

ein

g. I

den

tify

th

e ph

arm

acol

ogic

al a

nd

non

-ph

arm

acol

ogic

al m

eth

ods

of p

ain

man

agem

ent.

An

atom

ical

an

d ph

ysio

logi

cal u

nde

rsta

ndi

ng

of t

he

infa

nts

mu

scu

lar

skel

etal

sys

tem

to

aid

the

un

ders

tan

din

g th

e im

por

tan

ce o

f su

ppor

tive

p

osit

ion

ing

for

sick

an

d pr

emat

ure

infa

nts

– s

ide

lyin

g,

pron

e, s

upi

ne.

Th

eore

tica

l epi

stem

olog

y to

aid

th

e te

ach

ing

of p

aren

ts

to g

ive

skin

-to-

skin

car

e, p

osit

ion

th

eir

infa

nts

an

d to

pr

ovid

e a

leve

l of

sen

sory

sti

mu

lus

appr

opri

ate

to t

he

stab

ility

of

thei

r in

fan

t.

Aw

aren

ess

of t

he

liter

atu

re o

n t

he

adve

rse

effe

cts

on

the

infa

nt

beca

use

of

the

neo

nat

al e

nvir

onm

ent

and

wh

at c

an b

e do

ne

to a

mel

iora

te t

his

. In

fan

t ps

ych

olog

y an

d th

e re

quir

emen

t fo

r st

imu

lati

on,

the

use

of

play

to

prom

ote

phys

ical

an

d ps

ych

olog

ical

de

velo

pmen

t.

Th

eore

tica

l acq

uis

itio

n o

f fa

mily

an

d re

lati

onsh

ip

stu

dies

an

d th

e tr

ansf

eren

ce o

f th

ese

to t

he

neo

nat

al

un

it.

Be

equ

ipp

ed t

o u

nde

rsta

nd

the

con

sequ

ence

s of

n

eon

atal

abs

tin

ence

syn

drom

e (N

AS)

an

d th

e ra

tion

ale

for

the

phar

mac

olog

ical

an

d n

on-p

har

mac

olog

ical

m

anag

emen

t st

rate

gies

. Th

e u

se o

f to

ols

to a

sses

s an

d su

ppor

t th

e in

fan

t.

Ass

essm

ent

may

be

form

ally

com

plet

ed b

y pa

rtic

ipat

ion

in a

pro

gram

me

offe

red

by a

n H

EI,

p

erh

aps

incl

udi

ng

an a

ssig

nm

ent

base

d on

th

e ca

re o

f a

case

.

Th

eore

tica

l an

d pr

acti

cal p

repa

rati

on in

th

e an

atom

y an

d ph

ysio

logy

of

the

cen

tral

ner

vou

s sy

stem

in o

rder

to

dev

elop

kn

owle

dge

and

skill

s in

un

ders

tan

din

g an

d ca

rin

g fo

r in

fan

ts w

ith

mor

e co

mpl

ex n

euro

logi

cal

con

diti

ons.

Dev

elop

th

e ab

ility

to

un

dert

ake

a h

olis

tic

and

com

preh

ensi

ve n

euro

logi

cal a

sses

smen

t of

th

e in

fan

t in

hig

h d

epen

den

cy c

are.

Abi

lity

to r

ecog

nis

e a

ran

ge o

f n

eon

atal

con

vuls

ion

s an

d re

spon

d ap

prop

riat

ely.

Th

eore

tica

l u

nde

rsta

ndi

ngs

of

how

th

e co

mm

on a

nti

-con

vuls

ing

ther

apie

s w

ork

and

wh

at t

hei

r si

de e

ffec

ts a

re. M

onit

or

infa

nts

wh

o ar

e at

ris

k of

sei

zure

an

d su

ppor

t th

eir

fam

ilies

.

Wit

h r

efer

ence

to

the

liter

atu

re, d

emon

stra

te s

kills

in

the

asse

ssm

ent

of n

eon

atal

pai

n in

hig

h d

epen

den

cy

area

. Cri

tiqu

e a

ran

ge o

f a

pain

ass

essm

ent

tool

s, h

ave

com

preh

ensi

ve fa

mili

arit

y w

ith

th

e on

e u

sed

in t

hei

r ow

n c

linic

al a

rea

and

the

abili

ty t

o su

ppor

t ot

her

tea

m

mem

bers

in t

he

con

sist

ent

use

of

such

too

ls.

Un

ders

tan

d an

d de

mon

stra

te t

he

use

of

phar

mac

olog

ical

an

d n

on-p

har

mac

olog

ical

met

hod

s of

pai

n a

nd

dist

ract

ion

man

agem

ent

in t

he

hig

h

dep

ende

ncy

are

a.

Wor

kin

g w

ith

par

ents

, tea

ch t

hem

to

reco

gnis

e th

e be

hav

iou

ral d

iffe

ren

ces

betw

een

str

ess,

dis

tres

s an

d di

scom

fort

in t

hei

r in

fan

t an

d h

ow t

o re

spon

d to

th

ese

cues

.

Rec

ogn

ise

and

resp

ond

to t

he

effe

cts

of N

AS.

Fo

rmu

late

on

th

e ba

sis

of e

vide

nce

an

indi

vidu

alis

ed

plan

of

care

for

such

infa

nts

tak

ing

into

acc

oun

t th

e in

fan

t an

d fa

mily

’s u

niq

ue

soci

al r

equ

irem

ent

for

supp

ort.

Abi

lity

to w

ork

inte

r-co

llegi

ally

acr

oss

the

prof

essi

onal

dis

cipl

ines

for

the

ongo

ing

care

of

thes

e in

fan

ts.

Follo

ws

a pr

ogra

mm

e of

th

eore

tica

l an

d pr

acti

cal

prep

arat

ion

to

enab

le t

he

neo

nat

al in

ten

sive

car

e n

urs

e to

pro

vide

an

ass

essm

ent

of t

he

infa

nt’s

neu

rolo

gica

l st

atu

s an

d st

abili

ty. T

his

sh

ould

incl

ude

det

aile

d em

bryo

logy

, an

atom

y an

d ph

ysio

logy

of

the

ner

vou

s sy

stem

an

d an

un

ders

tan

din

g of

th

e p

oten

tial

for

path

olog

y.

Th

is s

hou

ldin

clu

de, a

mon

g ot

her

th

ings

: th

e an

ten

atal

/p

erin

atal

/pos

tnat

al r

isk

fact

ors

wh

ich

may

con

trib

ute

to

brai

n in

jury

; for

exa

mpl

e, m

ater

nal

infe

ctio

n, t

erm

inal

ap

noe

a, in

tran

atal

asp

hyxi

a/p

ost

nat

al h

ypox

ia,

dera

nge

d bl

ood

gass

es a

nd

hae

mod

ynam

ic in

stab

ility

.

Th

e n

eon

atal

QIS

nu

rse

shou

ld b

e pr

epar

ed t

o m

anag

e br

ain

spa

rin

g fl

uid

res

tric

tion

, un

ders

tan

d th

e th

eore

tica

l ris

ks o

f p

oor

per

fusi

on a

nd

rep

erfu

sion

in

juri

es a

nd

take

ste

ps t

o am

elio

rate

th

e ri

sk o

f ph

ysio

logi

cal i

nst

abili

ty o

n t

he

neo

nat

al b

rain

. Th

is

wou

ld in

clu

de, a

mon

g ot

her

th

ings

: car

e st

rate

gies

to

prev

ent

flu

ctu

atio

ns

of c

ereb

ral b

lood

flow

by

care

ful

mid

line

hea

d p

osit

ion

ing,

avo

idan

ce o

f ti

ght

fixa

tion

an

d st

rapp

ing.

Set

tin

g th

e pr

essu

res

of s

uct

ion

to

the

low

est

for

fun

ctio

nal

effi

cacy

.

Som

e u

nit

s w

ill r

equ

ire

skill

s re

late

d to

mon

itor

ing

cere

bral

fun

ctio

nin

g, c

ereb

ral b

lood

flow

an

d th

erap

euti

c hy

pot

her

mia

. Th

is w

ill r

equ

ire

in-h

ouse

tr

ain

ing

and

asse

ssm

ent.

Som

e u

nit

s w

ill r

equ

ire

nu

rses

to

hav

e kn

owle

dge

and

skill

s to

man

age

intr

acra

nia

l pr

essu

re m

onit

orin

g an

d sh

ut

man

agem

ent.

Th

is w

ill

requ

ire

in-h

ouse

tra

inin

g an

d as

sess

men

t.

Neo

nat

al n

urs

es w

orki

ng

in in

ten

sive

car

e w

ill b

e pr

epar

ed t

o id

enti

fy s

ign

s of

hyp

oxic

isch

aem

ic

ence

phal

opat

hy, i

ntr

aven

tric

ula

r h

aem

orrh

age

and

seiz

ure

act

ivit

y. T

hey

will

nee

d to

be

know

ledg

eabl

e ab

out

anti

conv

uls

ant

man

agem

ent.

72


Return to contents

Neu

rolo

gica

l, d

evel

opm

enta

l car

e an

d pa

in m

anag

emen

t –

lear

ning

out

com

es (

cont

inue

d)

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

Clin

ical

ass

ign

men

t co

uld

be

thro

ugh

th

e u

se o

f di

rect

ob

serv

atio

n o

f cl

inic

al c

are

by t

he

stu

den

ts m

ento

r. C

ompl

etio

n o

f n

euro

logi

cal w

orkb

ook.

Ski

ll le

vels

re

view

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al p

erfo

rman

ce

revi

ew.

Hav

e th

e th

eore

tica

l bac

kgro

un

d re

quir

ed t

o ju

stif

y an

d se

lect

su

ppor

tive

pos

itio

nin

g fo

r n

eon

ates

in t

he

hig

h-d

epen

den

cy a

rea:

1. s

ide

lyin

g2.

pro

ne

3. s

upi

ne

4. r

ecei

vin

g su

pple

men

tary

oxy

gen

5. r

ecei

vin

g co

nti

nu

al p

osit

ive

airw

ays

pres

sure

(C

PAP

)6.

ass

essm

ent

of s

uit

abili

ty t

o si

t in

infa

nt

chai

r.

Un

ders

tan

ds t

he

theo

reti

cal b

enefi

ts a

nd

be a

ble

to

init

iate

ski

n-t

o-sk

in c

are

betw

een

infa

nt

and

pare

nt

in

hig

h-d

epen

den

cy a

rea.

Su

ppor

t fa

mili

es d

uri

ng

this

.

Dem

onst

rate

s ot

her

nu

rsin

g in

terv

enti

ons

to r

edu

ce

pare

nta

l an

d n

eon

atal

str

ess

in t

he

hig

h d

epen

den

cy

area

. Pro

mot

e an

d de

mon

stra

te t

he

use

of

play

to

enh

ance

phy

sica

l an

d ps

ych

olog

ical

dev

elop

men

t in

th

e h

igh

dep

ende

ncy

are

a.

Un

ders

tan

ds t

he

imp

orta

nce

of

supp

orti

ng

the

opti

mal

dev

elop

men

t o

f a

neo

nat

e w

ith

com

plex

n

eeds

by:

• id

enti

fyin

g co

nta

ct d

etai

ls in

you

r cl

inic

al a

rea

for:

a

. pl

ay s

pec

ialis

t

b.

phys

ioth

erap

ist

c

. oc

cupa

tion

al t

her

apis

t

d.

spee

ch a

nd

lan

guag

e th

erap

ist.

• S

upp

orts

gro

wth

of

pare

nti

ng

skill

s:

a.

iden

tifi

es fa

mily

su

ppor

t se

rvic

es a

vaila

ble

in

clin

ical

are

a an

d on

-lin

e re

sou

rces

for

pare

nts

b

. co

-ord

inat

e th

e tr

ansf

er o

r di

sch

arge

of

a n

eon

ate

wit

h c

ompl

ex n

eeds

to

hom

e or

an

oth

er c

linic

al

sett

ing.

Ass

essm

ent

of k

now

ledg

e an

d co

mp

eten

cy c

ould

be

un

dert

aken

usi

ng

a bl

end

of t

heo

reti

cal a

sses

smen

t an

d di

rect

obs

erva

tion

of

infa

nts

car

e, d

iary

re

flec

tion

s, li

tera

ture

cri

tiqu

es a

nd

case

stu

dy.

Nu

rses

wor

kin

g w

ith

th

e pr

eter

m w

ill r

equ

ire

prep

arat

ion

to

un

ders

tan

d an

d pr

even

t re

tin

opat

hy o

f pr

emat

uri

ty –

vas

cula

risa

tion

, ris

k fa

ctor

s, c

ause

s an

d co

nse

quen

ces

of d

amag

e to

ret

ina

and

corr

ecti

ve

man

agem

ent.

Neo

nat

al n

urs

es n

eed

to b

e in

form

ed o

n t

he

impa

ct o

f sh

ort

and

lon

g te

rm p

ain

an

d st

ress

on

imm

atu

re

syst

ems.

Th

ey w

ill n

eed

skill

s in

th

e as

sess

men

t of

pai

n

in in

fan

ts w

ho

are

seda

ted

and

hav

e m

usc

le r

elax

ant

infu

sion

s in

pro

gres

s. T

hey

will

nee

d pr

epar

atio

n a

nd

skill

to

care

for

the

mor

e se

vere

ly a

ffec

ted

NA

S in

fan

t. T

hei

r pr

ogra

mm

e of

pre

para

tion

sh

ould

incl

ude

u

nde

rsta

ndi

ng

the

deve

lopm

ent

of in

fan

t re

flex

es a

nd

devi

atio

ns.

Neo

nat

al n

urs

es s

hou

ld b

e su

ffici

entl

y w

ell

info

rmed

to

prom

ote

the

use

of

deve

lopm

enta

l car

e st

rate

gies

.

Dep

endi

ng

on lo

cal p

olic

ies,

th

e st

ude

nt

may

nee

d to

be

prep

ared

to

pres

crib

e a

ran

ge o

f an

alge

sics

an

d ot

her

th

erap

euti

c ag

ents

. Th

is w

ill r

equ

ire

in-h

ouse

tra

inin

g an

d as

sess

men

t.

Ass

essm

ent

cou

ld b

e pa

rt o

f a

form

al m

odu

le o

n

neo

nat

al in

ten

sive

car

e as

off

ered

by

a re

cogn

ised

HE

I.

Th

e st

ude

nt

cou

ld b

e re

quir

ed t

o co

mpl

ete

a pr

acti

ce

asse

ssm

ent

docu

men

t re

late

d to

th

ese

them

es.

Evid

ence

of

PR

EP

cou

ld in

clu

de a

stu

den

t’s

anti

conv

uls

ant

dru

gs d

iary

a c

ase

stu

dy a

nd

hav

e ev

iden

ce o

f be

ing

dire

ctly

obs

erve

d p

erfo

rmin

g ca

re.

Evid

ence

th

at t

he

skill

s ar

e be

ing

mai

nta

ined

cou

ld b

e as

cert

ain

ed d

uri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.



Res

pira

tory

and

car

diov

ascu

lar

man

agem

ent

– le

arni

ng o

utco

mes

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

Th

e le

arn

er w

ill b

e ab

le

to a

sses

s, s

upp

ort

and

man

age

infa

nts

wh

o h

ave

resp

irat

ory

and

card

iova

scu

lar

fun

ctio

n

care

nee

ds.

All

lear

ner

s w

ill

un

ders

tan

d th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in t

he

infa

nt’s

ca

re p

lan

.

Usi

ng

know

ledg

e de

velo

ped

from

un

ders

tan

din

g th

e ph

ysio

logy

of

the

pret

erm

res

pira

tory

sys

tem

, ide

nti

fy

the

clin

ical

sig

ns

of r

espi

rato

ry d

istr

ess

and

wor

k to

war

ds t

he

abili

ty t

o di

stin

guis

h b

etw

een

cya

nos

is o

f re

spir

ator

y an

d ca

rdia

c or

igin

s.

Inst

ruct

ion

on

th

e ox

ygen

dis

asso

ciat

ion

cu

rve

and

id

enti

fy o

xyge

n s

atu

rati

on le

vels

wh

ich

wou

ld in

dica

te

the

nee

d to

adm

inis

ter

supp

lem

enta

l oxy

gen

as

pres

crib

ed fo

r pr

emat

ure

infa

nts

/ter

m in

fan

ts.

Th

eore

tica

l an

d pr

acti

cal u

nde

rsta

ndi

ng

of s

afe

and

com

pet

ent

nu

rsin

g m

anag

emen

t of

a n

eon

ate

rece

ivin

g su

pple

men

tary

oxy

gen

.

Iden

tifi

es t

he

risk

s an

d be

nefi

ts o

f ox

ygen

th

erap

y fo

r pr

emat

ure

an

d te

rm in

fan

tsId

enti

fy n

urs

ing

inte

rven

tion

s to

min

imis

e th

e ri

sk o

f ad

vers

e ef

fect

s of

su

pple

men

tary

oxy

gen

th

erap

y.

Un

ders

tan

ds a

lter

ed a

irw

ays

and

evid

ence

-bas

ed c

are

of t

he

trac

heo

stom

y. S

upp

ort

pare

nts

in t

he

man

agem

ent

of t

hei

r in

fan

t w

ith

a t

rach

eost

omy.

Dem

onst

rate

s so

me

phys

iolo

gica

l un

ders

tan

din

g,

revi

ew t

he

nor

mal

par

amet

ers

of t

he

neo

nat

al h

eart

ra

te a

nd

bloo

d pr

essu

re fo

r th

e te

rm a

nd

pret

erm

n

eon

ate.

Defi

nes

bra

dyca

rdia

an

d ta

chyc

ardi

a in

th

e te

rm a

nd

pret

erm

neo

nat

e an

d de

mon

stra

tes

accu

rate

do

cum

enta

tion

.

Perf

orm

s bl

ood

pres

sure

an

d as

sess

es p

erfu

sion

.

Th

eore

tica

l an

d pr

acti

cal a

pplic

atio

n o

f sk

ills

and

know

ledg

e of

neo

nat

al r

esu

scit

atio

n.

Th

eore

tica

l an

d pr

acti

cal p

repa

rati

on in

ord

er t

o de

velo

p th

e kn

owle

dge

and

skill

s in

ass

essi

ng

and

mon

itor

ing

the

hig

hly

dep

ende

nt

(HD

) in

fan

t’s

card

iore

spir

ator

y an

d ci

rcu

lato

ry s

tatu

s. H

ave

a ph

ysio

logi

cal k

now

ledg

e of

th

e ex

pec

ted

para

met

ers

and

dete

ct d

evia

tion

s fr

om t

hes

e. T

heo

reti

cal

un

ders

tan

din

g of

em

bryo

logi

cal,

deve

lopm

enta

l an

d m

atu

rati

onal

cir

cum

stan

ces

wh

ich

may

impa

ct o

n t

he

neo

nat

e in

HD

car

e. T

heo

reti

cal u

nde

rsta

ndi

ng

of a

ra

nge

of

resp

irat

ory

and

card

iac

con

diti

ons

wh

ich

may

af

fect

th

e n

eon

ate.

Just

ify

nu

rsin

g in

terv

enti

ons

to r

esto

re/m

ain

tain

ca

rdio

resp

irat

ory

stab

ility

acc

ordi

ng

to lo

cal

guid

elin

es. A

nal

ysis

an

d sa

mpl

ing

of b

lood

an

d u

se o

f th

eore

tica

l kn

owle

dge

skilf

ully

det

ect

devi

atio

ns

from

n

orm

al v

alu

es.

Just

ify

leve

ls o

f m

onit

orin

g an

d ob

serv

atio

n

com

men

sura

te w

ith

th

e in

fan

t’s s

tatu

s. E

duca

te a

nd

info

rm t

he

fam

ily a

s to

th

e re

quir

emen

t fo

r th

ese.

Init

iate

an

d p

erfo

rm b

asic

life

su

ppor

t, sk

ilfu

l as

sist

ance

wit

h in

tuba

tion

, adv

ance

d re

susc

itat

ion

an

d st

abili

sati

on.

Th

eore

tica

l un

ders

tan

din

g of

th

e ph

ysio

logi

cal b

asis

of

the

ben

efits

of

CPA

P, b

iPA

P o

r ot

her

form

s of

pos

itiv

e pr

essu

re. S

afe

set

up

and

usa

ge o

f th

ese

(see

equ

ipm

ent

and

mon

itor

ing)

. Abi

lity

to le

ad in

fan

t le

d w

ean

ing

from

res

pira

tory

su

ppor

t.

Un

ders

tan

din

g of

th

e an

atom

y of

th

e in

fan

t’s a

irw

ays

and

thor

ax a

nd

how

pro

ne

pos

itio

nin

g ca

n b

e u

sed

to

enh

ance

oxy

gen

atio

n.

Th

eore

tica

l un

ders

tan

din

g of

th

e re

quir

emen

t fo

r ox

ygen

an

d hu

mid

ifica

tion

th

erap

y an

d fa

mili

arit

y w

ith

th

e va

riet

y of

met

hod

s u

sed

to s

upp

ly t

his

su

ppor

t.

Follo

ws

a pr

ogra

mm

e of

th

eore

tica

l an

d pr

acti

cal

prep

arat

ion

to

enab

le t

he

neo

nat

al in

ten

sive

car

e n

urs

e to

pro

vide

an

ass

essm

ent

of t

he

infa

nt’s

res

pira

tory

fu

nct

ion

an

d ca

rdio

vasc

ula

r st

abili

ty.

Th

is s

hou

ld

incl

ude

det

aile

d em

bryo

logy

, an

atom

y an

d ph

ysio

logy

of

th

e h

eart

, cir

cula

tion

an

d lu

ngs

an

d an

u

nde

rsta

ndi

ng

of t

he

mor

e co

mm

on c

ardi

ovas

cula

r an

d re

spir

ator

y pa

thol

ogie

s.

Neo

nat

al Q

IS n

urs

es n

eed

to b

e eq

uip

ped

an

d h

ave

the

con

fide

nce

to

mak

e qu

ick

and

effe

ctiv

e de

cisi

ons

on

airw

ay s

tabi

lity

and

resp

irat

ory

man

agem

ent

as w

ell a

s be

abl

e to

inte

rpre

t tr

ends

an

d ev

alu

ate

the

effe

ctiv

enes

s of

th

e se

lect

ed m

anag

emen

t. T

hey

will

nee

d to

be

prep

ared

to

deal

app

ropr

iate

ly w

ith

infa

nts

wh

o h

ave

apn

oea,

bra

dyca

rdia

an

d de

satu

rati

ons.

Th

ey w

ill r

equ

ire

un

ders

tan

din

g of

th

e pr

inci

ples

of

basi

c an

d ad

van

ced

life

supp

ort

and

the

prio

riti

es o

f ac

tion

in t

he

man

agem

ent

of s

udd

en c

olla

pse.

Th

e pr

epar

atio

n s

hou

ld b

e de

sign

ed t

o en

able

to

neo

nat

al n

urs

e to

saf

ely

nu

rse

an in

fan

t w

ho

is

intu

bate

d. R

evie

w t

he

clin

ical

indi

cati

ons

for

ET

in

tuba

tion

, rev

iew

ven

tila

tion

, oxy

gen

atio

n a

nd

resp

irat

ory

supp

ort

stra

tegi

es.

Be

equ

ipp

ed w

ith

th

e kn

owle

dge

and

skill

s re

quir

ed t

o pr

epar

e in

tuba

tion

dru

gs a

nd

prep

are

intu

bati

on

equ

ipm

ent.

Pre

pare

su

rfac

tan

t in

lin

e w

ith

loca

l p

olic

ies.

Be

able

to

iden

tify

th

e si

de e

ffec

ts o

f in

tuba

tion

m

edic

atio

n a

nd

surf

acta

nt.

Be

able

to

iden

tify

th

e co

rrec

t si

ze o

f E

T t

ube

an

d in

trod

uce

r, co

rrec

t u

se o

f la

ryn

gosc

ope

and

be a

ble

to

ausc

ult

ate

brea

th/v

enti

lato

r so

un

ds w

ith

ste

thos

cop

e.

74


Return to contents

Res

pira

tory

and

car

diov

ascu

lar

man

agem

ent

– le

arni

ng o

utco

mes

(co

ntin

ued)

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

Res

usc

itat

ion

pra

ctic

e u

sin

g in

fan

t m

ann

equ

in:

• de

mon

stra

te t

he

init

ial a

sses

smen

t •

call

for

hel

p•

asse

ss t

one,

col

our,

hea

rt r

ate,

bre

ath

ing

• in

itia

l sti

mu

lati

on•

com

pet

ent

ches

t in

flat

ion

• h

ead

in n

eutr

al p

osit

ion

• ap

ply

corr

ect

size

d m

ask

• de

mon

stra

te fi

ve in

flat

ion

bre

ath

s (l

asti

ng

two

seco

nds

eac

h)

• ch

eck

for

ches

t m

ovem

ent

and

HR

.

Trou

bles

hoo

ts p

oor/

non

-in

flat

ion

com

pet

ent

jaw

th

rust

• re

chec

k h

ead

pos

itio

n/a

pply

jaw

th

rust

• re

pea

t in

flat

ion

bre

ath

s•

chec

k H

R a

nd

ches

t m

ovem

ent

• co

mp

eten

t ch

est

infl

atio

n a

fter

air

way

man

oeuv

re.

Dem

onst

rate

s tw

o-p

erso

n ja

w t

hru

st o

r in

sert

. cor

rect

si

ze G

ued

el a

irw

ay u

sin

g la

ryn

gosc

ope.

Rep

eat

infl

atio

n b

reat

hs.

Ch

eck

HR

an

d ch

est

mov

emen

t.

Perf

orm

s ca

rdia

c m

assa

ge:

• h

ead

in n

eutr

al p

osit

ion

• co

mm

ence

app

ropr

iate

car

diac

mas

sage

(H

R<

60

bpm

, rat

io 3

:1, r

ate

120b

pm, c

orre

ct p

osit

ion

an

d de

pth

of

com

pres

sion

s).

Dis

cuss

es o

pti

ons

and

the

nee

d fo

r va

scu

lar

acce

ss a

nd

dru

gs.

Abl

e to

rev

iew

th

e ox

ygen

con

trov

ersy

.

Abl

e to

con

trib

ute

to

the

man

agem

ent

of t

he

infa

nt

of

bord

erlin

e vi

abili

ty.

Skill

s as

sess

ed b

y O

SCE

, an

onym

ous

crit

ical

refl

ecti

ons

on r

esu

scit

atio

ns

wit

nes

sed

and

evid

ence

th

at t

hes

e ar

e be

ing

reta

ined

by

ann

ual

man

dato

ry t

rain

ing

and

duri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

Un

ders

tan

ds t

he

anat

omy

of t

he

infa

nt’s

air

way

s an

d th

orax

an

d h

ow p

ron

e p

osit

ion

ing

can

be

use

d to

en

han

ce o

xyge

nat

ion

.

Th

eore

tica

l un

ders

tan

din

g of

th

e re

quir

emen

t fo

r ox

ygen

an

d hu

mid

ifica

tion

th

erap

y an

d fa

mili

arit

y w

ith

th

e va

riet

y of

met

hod

s u

sed

to s

upp

ly t

his

su

ppor

t.

Th

eore

tica

l un

ders

tan

din

g of

th

e an

atom

y of

th

e u

pper

air

way

s an

d th

e re

quir

emen

t fo

r su

ctio

n o

f re

spir

ator

y se

cret

ion

s. C

itin

g lit

erat

ure

rev

iew

th

e sa

fe

and

effe

ctiv

e en

dotr

ach

eal t

ube

/tra

cheo

stom

y su

ctio

n

tech

niq

ues

.

App

lies

theo

reti

cal k

now

ledg

e of

ch

est

phys

iolo

gy t

o th

e de

velo

pmen

t of

a p

neu

mot

hor

ax, c

hes

t au

scu

ltat

ion

an

d sk

ilfu

lly p

erfo

rm c

hes

t ph

ysio

ther

apy.

Th

eore

tica

l un

ders

tan

din

g of

air

way

an

d pu

lmon

ary

mec

han

ics

and

the

use

of

trac

heo

stom

y. C

itin

g th

e re

leva

nt

liter

atu

re s

kilf

ully

pro

vide

car

e to

th

e in

fan

t w

ith

a t

rach

eost

omy.

Tea

ch a

nd

supp

ort

pare

nts

wh

o h

ave

an in

fan

t w

ith

a t

rach

eost

omy

to c

are

for

thei

r ch

ild.

Ass

essm

ent

of o

r m

ain

ten

ance

of

com

pet

ency

OSC

E

or o

ther

sim

ula

tion

of

resu

scit

atio

n/i

nfa

nt

colla

pse.

Ev

iden

ce t

hat

th

e sk

ill s

et is

bei

ng

mai

nta

ined

an

d ca

n

be r

evie

wed

du

rin

g m

anda

tory

tra

inin

g an

d du

rin

g th

e in

divi

dual

per

form

ance

rev

iew

.

Dem

onst

rate

s n

urs

ing

inte

rven

tion

s to

op

tim

ise

intu

bati

on p

roce

dure

, su

pplie

s O

P s

uct

ion

as

requ

ired

, ob

serv

es v

ital

sig

ns

duri

ng

proc

edu

re a

nd

info

rms

team

of

abn

orm

al v

alu

es, h

as a

bilit

y to

ch

eck

plac

emen

t of

tu

be. A

ble

to s

ecu

re t

ube

, dec

ompr

essi

on o

f st

omac

h.

Dem

onst

rate

str

ateg

ies

to p

rom

ote

airw

ay p

aten

cy in

lin

e w

ith

loca

l pol

icie

s, o

pti

mu

m p

osit

ion

ing

of

neo

nat

e, ju

stifi

es a

ppro

pria

te in

terv

al o

f E

T t

ube

su

ctio

nin

g, t

ech

niq

ue

of E

T t

ube

su

ctio

nin

g re

view

th

e ev

iden

ce b

ase

on E

T t

ube

lava

ge.

Invo

lves

, in

form

s an

d su

ppor

ts p

aren

ts w

hos

e in

fan

ts

are

crit

ical

ly u

nwel

l.

Be

able

to

set

up

the

ven

tila

tors

an

d hu

mid

ifier

s m

ost

freq

uen

tly

use

d in

th

eir

clin

ical

are

a to

sta

nda

rd

sett

ings

. In

som

e ar

eas

nit

ric

oxid

e is

in u

se a

nd

ther

e sh

ould

be

an in

-hou

se e

duca

tion

an

d tr

ain

ing

prov

isio

n

to e

quip

th

e n

eon

atal

nu

rse

for

safe

use

.

Dem

onst

rate

s sa

fe a

nd

com

pet

ent

nu

rsin

g m

anag

emen

t of

th

e ve

nti

late

d n

eon

ate.

Exp

lain

th

e di

ffer

ence

be

twee

n t

he

mod

es o

f ve

nti

lati

on a

vaila

ble

in t

hei

r cl

inic

al a

rea

and

iden

tify

clin

ical

indi

cati

ons

for

the

use

of

th

ese.

Just

ifies

th

e fr

equ

ency

an

d ty

pe

of n

urs

ing

obse

rvat

ion

s re

quir

ed fo

r a

ven

tila

ted

neo

nat

e. R

evie

w t

he

resu

lts

of a

bl

ood

gas

anal

ysis

an

d u

se t

hem

to

expl

ain

med

ical

an

d n

urs

ing

man

agem

ent

of t

he

ven

tila

ted

neo

nat

e. I

den

tify

th

e bl

ood

gas

anal

ysis

as

nor

mal

/abn

orm

al. I

den

tify

th

e bl

ood

gas

anal

ysis

as

com

pen

sate

d/u

nco

mp

ensa

ted.

Iden

tifi

es t

he

bloo

d ga

s an

alys

is a

s re

spir

ator

y or

m

etab

olic

or

mix

ed a

cido

sis/

alka

losi

s

Iden

tifi

es t

he

mos

t lik

ely

med

ical

an

d/or

nu

rsin

g in

terv

enti

on.

Neo

nat

al n

urs

es m

ay n

eed

to c

are

for

infa

nts

wh

o ar

e ve

nti

late

d vi

a a

trac

heo

stom

y so

will

req

uir

e ed

uca

tion

an

d sk

ills

wit

h r

egar

ds t

o th

is fo

rm o

f m

anag

emen

t.



In s

ome

un

its

extr

acor

por

eal c

ircu

its

are

use

d to

su

ppor

t in

fan

ts w

ho

do n

ot r

esp

ond

to c

onve

nti

onal

or

enh

ance

d th

erap

ies.

An

in-h

ouse

tra

inin

g an

d as

sess

men

t pr

ogra

mm

e w

ill n

eed

to b

e pr

ovid

ed.

Th

e n

eon

atal

inte

nsi

ve c

are

nu

rse

shou

ld b

e pr

epar

ed t

o pr

ovid

e op

tim

um

ch

est

care

. Be

skill

ed in

iden

tify

ing

abn

orm

al a

ir e

ntr

y an

d re

view

th

e m

ost

likel

y n

urs

ing

and

med

ical

inte

rven

tion

to

man

age

this

, an

d m

ake

refe

rral

to

phys

ioth

erap

ist.

Des

crib

es c

omm

on c

har

acte

rist

ics

of n

eon

atal

ch

est

x-ra

ys fo

r th

e fo

llow

ing

clin

ical

con

diti

ons:

a. r

espi

rato

ry d

istr

ess

syn

drom

eb.

tra

nsi

ent

tach

ypn

oea

of t

he

new

born

c. p

neu

mot

hor

axd.

pu

lmon

ary

inte

rsti

tial

em

phys

ema

e. i

nfe

ctio

n.

Abi

lity

to id

enti

fy n

urs

ing

inte

rven

tion

s w

hic

h c

an

min

imis

e th

e ri

sk o

f co

mm

on c

ompl

icat

ion

s of

lon

g te

rm v

enti

lati

on:

a. c

hro

nic

lun

g di

seas

eb.

arc

hed

pal

ate

c. o

ral a

vers

ion

d. o

piat

e de

pen

den

cye.

in

fect

ion

.

Des

crib

es s

afe

and

com

pet

ent

nu

rsin

g m

anag

emen

t of

pn

eum

oth

orax

in li

ne

wit

h lo

cal p

olic

ies:

a. i

den

tify

clin

ical

sig

ns

of p

neu

mot

hor

axb.

ide

nti

fy r

isks

of

neo

nat

al p

neu

mot

hor

axc.

loc

ate

cold

ligh

t so

urc

ed.

ide

nti

fy e

quip

men

t fo

r m

anag

emen

t of

pn

eum

oth

orax

e.

ass

embl

e ch

est

drai

n c

ircu

itf.

des

crib

e fi

xati

on o

f ch

est

drai

ng.

ide

nti

fy e

mer

gen

cy e

quip

men

t ke

pt

at t

he

cot

side

of

a n

eon

ate

wit

h a

ch

est

drai

n in

sit

uh

. de

scri

be fr

equ

ency

an

d ty

pe

of n

urs

ing

obs

erva

tion

s re

quir

ed fo

r a

neo

nat

e w

ith

a c

hes

t dr

ain

in s

itu

.

76


Return to contents

Res

pira

tory

and

car

diov

ascu

lar

man

agem

ent

– le

arni

ng o

utco

mes

(co

ntin

ued)

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

Dem

onst

rate

s sa

fe a

nd

com

pet

ent

nu

rsin

g m

anag

emen

t of

ET

ext

uba

tion

:a.

pre

pare

neo

nat

e an

d eq

uip

men

t fo

r pr

oced

ure

b. d

escr

ibe

nu

rsin

g ob

serv

atio

ns

requ

ired

for

the

rece

ntl

y ex

tuba

ted

neo

nat

e.

Be

able

to

dem

onst

rate

ass

essm

ent,

care

an

d m

anag

emen

t of

infa

nts

wit

h m

ult

iple

lin

es in

clu

din

g U

VC

, UA

C a

nd

per

iph

eral

art

eria

l lin

es. T

his

sh

ould

in

clu

de t

he

abili

ty t

o id

enti

fy in

dica

tion

s fo

r th

e in

sert

ion

of

arte

rial

lin

es, k

now

ledg

e of

th

e ri

sks

asso

ciat

ed w

ith

indw

ellin

g ce

ntr

al a

nd

per

iph

eral

ar

teri

al li

nes

, abi

lity

to c

orre

ctly

sec

ure

th

e ar

teri

al li

nes

in

use

, abi

lity

to r

ecog

nis

e th

e co

rrec

t pl

acem

ent

of

lines

.

Pre

pare

s tr

ansd

uce

r ci

rcu

it fo

r u

se. C

alib

rate

s tr

ansd

uce

r an

d se

ts a

larm

lim

its.

Pos

itio

ns

neo

nat

e co

rrec

tly

in r

elat

ion

to

tran

sdu

cer

and

con

nec

tion

. Id

enti

fies

an

d re

ads

a sa

tisf

acto

ry t

race

, ide

nti

fies

nee

d fo

r re

calib

rati

on a

nd

chan

ges

circ

uit

in a

ccor

dan

ce w

ith

u

nit

pol

icy.

Iden

tifi

es s

hor

t an

d lo

ng

term

ris

ks a

ssoc

iate

d w

ith

n

eon

atal

hyp

oten

sion

.

Iden

tifi

es r

isks

ass

ocia

ted

wit

h t

he

med

ical

man

agem

ent

of n

eon

atal

hyp

oten

sion

usi

ng

the

follo

win

g ex

ampl

es:

• n

orm

al s

alin

e bo

lus

• bl

ood

tran

sfu

sion

• do

pam

ine

• do

buta

min

e.

Ass

essm

ent

of s

afe

and

com

pet

ent

nu

rsin

g m

anag

emen

t of

th

e hy

pot

ensi

ve n

eon

ate.



Dem

onst

rate

s sa

fe a

nd

com

pet

ent

nu

rsin

g m

anag

emen

t of

th

e in

sert

ion

of

a ce

ntr

al v

enou

s lin

e in

lin

e w

ith

lo

cal p

olic

y. I

den

tifi

es in

dica

tion

s fo

r in

sert

ion

of

a ce

ntr

al v

enou

s lin

e. P

repa

res

equ

ipm

ent

for

use

. P

repa

res

neo

nat

e an

d fa

mily

for

proc

edu

re. O

pti

mal

p

osit

ion

ing.

Ide

nti

fies

ris

ks a

ssoc

iate

d w

ith

an

in

dwel

ling

cen

tral

ven

ous

line.

Ide

nti

fies

cor

rect

m

eth

od fo

r fi

xati

on o

f ce

ntr

al v

enou

s lin

e. I

den

tifi

es

nu

rsin

g ac

tion

s to

pro

mot

e pa

ten

cy o

f lin

e w

hile

p

osit

ion

is c

onfi

rmed

by

X-r

ay. D

escr

ibes

freq

uen

cy a

nd

typ

e of

nu

rsin

g ob

serv

atio

ns

for

a n

eon

ate

wit

h a

ce

ntr

al v

enou

s lin

e in

sit

u.

A n

eon

atal

nu

rse

may

be

requ

ired

to

care

for

infa

nts

w

ith

con

gen

ital

car

diac

def

ects

an

d sh

ould

be

able

to

revi

ew t

he

mor

e co

mm

on a

nom

alie

s. P

aten

t du

ctu

s ar

teri

osis

(P

DA

), a

tria

l sep

tal d

efec

t (A

SD),

ven

tric

ula

r se

pta

l def

ect

(VSD

), t

ran

spos

itio

n o

f th

e gr

eat

arte

ries

an

d so

fort

h. T

hey

will

req

uir

e pr

epar

atio

n t

o ca

re fo

r in

fan

ts w

ho

are

in a

cute

car

diac

com

prom

ise,

th

ey

shou

ld b

e ab

le t

o re

view

th

e in

dica

tion

s fo

r u

se o

f in

trav

enou

s pr

osta

glan

din

, un

ders

tan

d th

e p

oten

tial

ri

sks

and

ben

efits

ass

ocia

ted

wit

h t

he

use

of

this

m

edic

atio

n.

Ass

essm

ent

of t

heo

ry a

nd

prac

tice

cou

ld b

e u

nde

rtak

en

by m

ain

tain

ing

a re

leva

nt

dru

gs d

iary

, OSC

E, M

CQ

s, a

ca

se s

tudy

an

d di

rect

obs

erva

tion

of

care

. Evi

den

ce t

hat

th

e sk

ills

are

bein

g m

ain

tain

ed c

ould

be

asce

rtai

ned

du

rin

g th

e in

divi

dual

per

form

ance

rev

iew

.

78


Return to contents

Ski

n, h

ygie

ne a

nd in

fect

ion

cont

rol m

anag

emen

t –

lear

ning

out

com

es

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

All

lear

ner

s w

ill b

e ab

le

to m

ain

tain

ski

n,

inte

grit

y, m

anag

e an

in

fan

t’s h

ygie

ne

and

prom

ote

effe

ctiv

e in

fect

ion

con

trol

.

All

lear

ner

s w

ill

un

ders

tan

d th

e im

por

tan

ce o

f in

volv

ing

the

fam

ily in

th

e in

fan

t’s

care

pla

nn

ing.

An

atom

ical

, th

eore

tica

l an

d pr

acti

cal p

repa

rati

on in

or

der

to d

evel

op k

now

ledg

e an

d sk

ills

in a

sses

sin

g an

in

fan

t’s s

kin

an

d pr

ovid

ing:

• m

outh

car

e•

nap

py a

rea

care

• ca

re o

f st

oma

• im

mer

sion

bat

h•

eye

care

an

d ta

kin

g an

eye

sw

ab.

Supp

orts

th

e pa

ren

ts in

th

e ac

quis

itio

n o

f pa

ren

tin

g sk

ills

to u

nde

rtak

e th

e es

sen

tial

car

e of

th

eir

infa

nt.

Hea

ling

phys

iolo

gy, w

oun

d ca

re a

nd

the

appl

icat

ion

of

rese

arch

to

the

choi

ce o

f dr

essi

ngs

.

Usi

ng

sele

cted

lite

ratu

re r

evie

w t

he

appr

opri

ate

dres

sin

gs fo

r va

scu

lar

acce

ss d

evic

es, fi

xati

on a

nd

inse

rtio

n s

ite.

Ris

k as

sess

th

e n

eed

for,

and

the

use

of,

splin

t an

d lim

b re

stra

ints

as

the

use

of

thes

e ar

e co

ntr

over

sial

.

Th

eore

tica

l an

d pr

acti

cal d

emon

stra

tion

of

the

imp

orta

nce

of

usi

ng

per

son

al p

rote

ctio

n c

loth

ing

and

the

use

of

glov

es. T

heo

reti

cal a

nd

prac

tica

l co

nsi

dera

tion

s of

th

e ri

sks

of in

fect

ion

an

d co

nta

inin

g in

fect

ion

in n

eon

ates

.

Rat

ion

ale

and

evid

ence

use

d to

just

ify

the

com

pon

ents

of

th

e in

fect

ion

scr

een

.

Abi

lity

to lo

cate

an

d ap

ply

loca

l pol

icy

for

anti

biot

ic

safe

sto

rage

an

d u

sage

.

Abi

lity

to r

evie

w t

he

man

agem

ent

of a

neo

nat

e re

ceiv

ing

anti

biot

ics.

Dem

onst

rate

s u

nde

rsta

ndi

ng

of t

he

com

mon

an

tibi

otic

s u

sed

and

thei

r co

mm

on s

ide

effe

cts.

Ass

essm

ents

of

thes

e sk

ills

duri

ng

the

prog

ram

me

of

prep

arat

ion

cou

ld b

e by

an

obs

erva

tion

of

the

nu

rse

in

prac

tice

in t

he

clin

ical

are

a.

A t

heo

reti

cal a

nd

prac

tica

l pre

para

tion

in b

ody

defe

nce

mec

han

ism

s, t

he

imm

un

e re

spon

se a

nd

infl

amm

ator

y ca

scad

e, t

o en

able

th

e co

mp

eten

t ca

re o

f in

fect

ed n

eon

ates

an

d pr

even

t sp

read

. In

tegr

ated

kn

owle

dge

and

skill

s in

all

asp

ects

of

infe

ctio

n

prev

enti

on. A

bilit

y to

iden

tify

sig

ns

and

sym

pto

ms

of

seps

is.

Will

hav

e th

e sk

ills

requ

ired

to

teac

h, m

ento

r an

d su

per

vise

new

en

tran

ts t

o n

eon

atal

nu

rsin

g, n

ew

fam

ilies

an

d co

lleag

ues

from

th

e N

MT

in e

nsu

rin

g th

at t

hey

uph

old

the

infe

ctio

n p

reve

nti

on a

nd

con

trol

st

rate

gies

.

Com

pet

ent

in t

he

care

of

infa

nts

wh

o re

quir

e ba

rrie

r n

urs

ing.

Wit

h r

efer

ence

to

un

derp

inn

ing

mic

robi

olog

y,

dem

onst

rate

com

pet

ence

in a

ran

ge o

f as

epti

c te

chn

iqu

es a

nd

man

agem

ent

of s

teri

le li

nes

.

A t

heo

reti

cal u

nde

rsta

ndi

ng

of t

he

anat

omy

and

phys

iolo

gy o

f th

e n

ewbo

rn p

rem

atu

re s

kin

wit

h

un

ders

tan

din

g of

th

e ke

rati

nis

atio

n a

nd

redu

cin

g n

eed

for

hum

idifi

cati

on a

s sk

in m

atu

rity

pro

gres

ses.

T

heo

reti

cal u

nde

rsta

ndi

ng

of t

he

wou

nd

hea

ling

proc

esse

s. P

erfo

rm t

her

apeu

tic

wou

nd

clea

nsi

ng

tech

niq

ues

, abi

lity

to s

elec

t as

app

ropr

iate

an

d co

rrec

tly

appl

y th

erap

euti

c an

d pr

ophy

lact

ic s

kin

dr

essi

ngs

.

Abi

lity

to c

riti

que

a ra

nge

of

skin

ass

essm

ent

tool

s an

d fa

mili

arit

y w

ith

th

e u

nit

s ow

n s

elec

ted

tool

. C

omp

eten

t in

th

e u

se o

f th

is t

ool a

nd

abili

ty t

o te

ach

ot

her

s to

ass

ess

skin

an

d im

plem

ent

stra

tegi

es t

o pr

even

t ia

trog

enic

dam

age

and

pot

enti

al in

jury

. Tea

ch

oth

ers

to o

bser

ve a

nd

un

ders

tan

d th

e st

ages

of

wou

nd

hea

ling.

Un

ders

tan

d a

ran

ge o

f co

ndi

tion

s w

hic

h m

ay le

ad t

o al

tere

d sk

in c

are

requ

irem

ents

.

Nu

rses

wh

o ca

re fo

r in

fan

ts in

inte

nsi

ve c

are

will

req

uir

e a

theo

reti

cal a

nd

prac

tica

l pre

para

tion

in t

he

embr

yolo

gy, a

nat

omy,

phy

siol

ogy

and

mat

ura

tion

of

the

skin

. Th

ey w

ill n

eed

a th

eore

tica

l gro

un

din

g in

hea

ling.

T

hey

will

nee

d to

hav

e so

me

un

ders

tan

din

g of

m

icro

biol

ogy

and

be s

kille

d in

har

vest

ing

a ra

nge

of

spec

imen

s. T

hey

will

nee

d to

un

ders

tan

d th

e bo

dy

defe

nce

mec

han

ism

s, t

he

imm

un

e re

spon

se, t

he

infl

amm

ator

y ca

scad

e to

en

able

th

e co

mp

eten

t ca

re o

f ex

trem

ely

pret

erm

infa

nts

, in

fect

ed n

eon

ates

an

d u

nde

rsta

nd

the

stra

tegi

es u

sed

to p

reve

nt

the

spre

ad o

f in

fect

ion

.

Nu

rses

wor

kin

g in

inte

nsi

ve c

are

will

be

requ

ired

to

com

ply

wit

h a

nd

mon

itor

th

e co

mpl

ian

ce o

f th

eir

un

it’s

in

fect

ion

con

trol

gu

idel

ines

.

Nu

rses

wor

kin

g in

inte

nsi

ve c

are

will

be

cari

ng

for

infa

nts

wh

o ar

e se

date

d an

d h

ave

thei

r m

usc

les

rela

xed

and

are

at r

isk

of ia

trog

enic

ski

n d

amag

e an

d w

ill n

eed

to b

e sk

illed

in a

sses

sin

g th

e sk

in a

nd

per

form

ing

esse

nti

al s

kin

car

e. T

hey

will

be

able

to

crit

ical

ly r

evie

w

a ra

nge

of

skin

ass

essm

ent

tool

s an

d be

par

ticu

larl

y fa

mili

ar w

ith

th

e to

ols

that

are

use

d in

th

eir

un

it.

Wor

kin

g in

par

tner

ship

wit

h t

he

pare

nts

agr

eein

g th

e ba

lan

ce b

etw

een

th

e n

eed

for

care

wit

h t

he

requ

irem

ent

for

min

imal

han

dlin

g. S

upp

ort

the

infa

nt’s

par

ents

to

mak

e in

form

ed c

hoi

ces

abou

t n

eon

atal

ski

n c

are

in li

ne

wit

h lo

cal p

olic

ies

by d

iscu

ssin

g th

e u

se o

f n

appy

wip

es,

infa

nt

skin

cle

ansi

ng

and

skin

loti

ons/

oils

.

Infa

nts

wh

o ar

e m

usc

le r

elax

ed m

ay lo

se t

hei

r sw

allo

w

and

gag

and

hav

e sp

ecia

l req

uir

emen

t fo

r sk

illed

mou

th

care

.

Inte

grat

ed k

now

ledg

e an

d sk

ills

in a

ll as

pec

ts o

f in

fect

ion

pre

ven

tion

incl

udi

ng

ven

tila

tor

asso

ciat

ed

pneu

mon

ia. A

bilit

y to

rev

iew

th

e si

gns

and

sym

pto

ms

of lo

cal i

nfe

ctio

n a

nd

syst

emic

sep

sis.



Safe

car

e as

sess

men

t fo

r a

neo

nat

e w

ith

a v

ascu

lar

acce

ss d

evic

e in

sit

u, t

heo

reti

cally

rev

iew

how

th

e n

urs

e w

ould

iden

tify

clin

ical

sig

ns

of lo

cal i

nfe

ctio

n, c

linic

al

sign

s of

sys

tem

ic in

fect

ion

.

Ris

k as

sess

men

t ex

erci

se. S

tora

ge o

f E

BM

, th

e u

se o

f n

on-s

teri

le w

ater

on

ext

rem

ely

pret

erm

ski

n. U

se o

f n

on-s

teri

le a

ddit

ives

in p

rete

rm fe

eds.

Abl

e to

app

ly t

he

prin

cipl

es o

f in

fect

ion

con

trol

an

d as

epsi

s to

th

e n

eon

atal

are

a. U

nde

rsta

nd

the

rati

onal

e fo

r ba

rrie

r n

urs

ing.

Rev

iew

an

d cr

itiq

ue

loca

l in

fect

ion

con

trol

pol

icie

s.

Ass

essm

ent

pare

nta

l tea

chin

g pa

ck, r

eflec

tive

dia

ry.

Ass

essm

ent

by p

aren

ts.

Skill

bas

e co

uld

be

revi

ewed

an

nu

ally

du

rin

g th

e in

divi

dual

per

form

ance

rev

iew

.

Com

pet

ent

in t

he

care

of

new

ly fo

rmed

sto

ma

and

in

the

obse

rvat

ion

an

d ea

rly

dete

ctio

n o

f st

oma

com

plic

atio

ns.

Men

tors

an

d su

ppor

ts n

ew e

ntr

ant

into

neo

nat

al

nu

rsin

g an

d pa

ren

ts t

o p

erfo

rm s

afe

esse

nti

al in

fan

t ca

re o

f th

e ey

es, m

outh

, beh

ind

the

ears

wh

en w

eari

ng

CPA

P c

ap, s

kin

cre

ases

, nap

py a

rea,

ski

n, u

mbi

lical

st

um

p ot

her

pre

ssu

re a

reas

. Ide

nti

fy fu

nga

l in

fect

ion

of

th

e ga

stro

-in

test

inal

tra

ct.

Ass

essm

ent

of c

omp

eten

cy, l

iter

atu

re c

riti

ques

an

d ob

serv

atio

n o

f cl

inic

al t

each

ing

opp

ortu

nit

ies.

Ev

iden

ce t

hat

th

e sk

ill s

et is

bei

ng

mai

nta

ined

can

be

prov

ided

du

rin

g an

nu

al m

anda

tory

tra

inin

g an

d re

view

ed a

s pa

rt o

f th

e in

divi

dual

per

form

ance

rev

iew

.

Ass

essm

ent

of s

kills

an

d kn

owle

dge

cou

ld b

e vi

a M

CQ

s th

e pr

ovis

ion

of

a ca

se s

tudy

an

d on

goin

g as

sess

men

t in

pr

acti

ce. O

nce

qu

alifi

ed, n

eon

atal

nu

rses

wh

o fu

nct

ion

at

th

is le

vel o

f pr

ofici

ency

will

su

ppor

t th

e w

ider

MD

T

in e

valu

atin

g th

e u

nit

gu

idel

ines

for

best

pra

ctic

e.

Evid

ence

th

at t

he

skill

set

is b

ein

g m

ain

tain

ed c

ould

be

exam

ined

du

rin

g th

e an

nu

al p

erfo

rman

ce r

evie

w.

80


Return to contents

Infa

nt t

empe

ratu

re m

anag

emen

t –

lear

ning

out

com

es

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

All

lear

ner

s w

ill b

e ab

le

to m

ain

tain

th

e op

tim

al

tem

per

atu

re r

equ

ired

for

the

infa

nt.

All

lear

ner

s w

ill

un

ders

tan

d th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in t

he

infa

nt’s

ca

re p

lan

.

An

atom

ical

an

d ph

ysio

logi

cal d

iffe

ren

ces

impa

ct o

n

the

infa

nt’s

abi

lity

to s

ust

ain

th

erm

oneu

tral

ity.

Th

e m

ech

anis

ms

of h

eat

loss

.

Th

e n

orm

al n

eon

atal

tem

per

atu

re v

alu

es id

enti

fy

neo

nat

al h

ypot

her

mia

an

d py

rexi

a an

d re

late

th

e si

gnifi

can

ce o

f th

ese

to a

ran

ge o

f co

ndi

tion

s.

Ris

ks a

sses

smen

t on

th

e th

reat

s to

neo

nat

al

ther

mon

eutr

alit

y, fr

om b

irth

to

disc

har

ge.

Use

of

plas

tic

con

tain

men

t at

bir

th, c

ot w

arm

er,

over

hea

d h

eate

r, in

cuba

tor.

Exp

osu

re fo

r ph

otot

her

apy/

oth

er p

roce

dure

s.

Kan

garo

o ca

re.

Hu

mid

ifica

tion

. Rec

ap t

he

ener

gy t

rian

gle.

Pra

ctic

al a

pplic

atio

n a

nd

clin

ical

ass

essm

ent

on t

akin

g th

e n

eon

ate’

s te

mp

erat

ure

.

Th

e ac

quis

itio

n a

nd

rete

nti

on o

f th

e ab

ove

skill

s ca

n b

e as

sess

ed b

y th

e u

se o

f cl

inic

al s

cen

ario

s. S

kill

base

co

uld

be

revi

ewed

an

nu

ally

du

rin

g th

e in

divi

dual

p

erfo

rman

ce r

evie

w

A t

heo

reti

cal a

nd

prac

tica

l pre

para

tion

in t

he

infa

nt’s

th

erm

oreg

ula

tion

, app

reci

atio

n o

f th

e di

ffer

ence

be

twee

n t

he

pret

erm

an

d th

e IU

GR

. Th

is p

repa

rati

on

shou

ld fo

cus

on t

he

risk

s to

th

e n

eon

ate

of h

eat

loss

, in

effi

cien

t h

eat

prod

uct

ion

an

d la

ck o

f br

own

fat

rese

rves

an

d re

ason

s be

hin

d th

e te

mp

erat

ure

gap

. A

bilit

y to

ass

ess

neo

nat

al b

ody

tem

per

atu

re u

sin

g ap

prop

riat

e m

eth

ods

and

site

s fo

r in

fan

ts w

ho

requ

ire

hig

h d

epen

den

cy c

are.

Det

ect

and

resp

ond

to

devi

atio

ns

from

nor

mal

.

Men

tors

an

d su

per

vise

s th

e n

ew e

ntr

ant

to m

anag

e ef

fect

ivel

y th

e in

fan

t’s t

emp

erat

ure

, tea

ches

th

e si

gns,

sy

mp

tom

s an

d ri

sks

of h

ypot

her

mia

. Ide

nti

fies

th

e in

fan

ts m

ost

at r

isk

of t

emp

erat

ure

dev

iati

ons,

use

st

rate

gies

to

prev

ent

tem

per

atu

re d

evia

tion

s fo

r in

fan

ts w

ho

requ

ire

hig

h d

epen

den

cy c

are:

• in

cuba

tor/

over

hea

d h

eate

r (O

HH

)•

prep

are

equ

ipm

ent

for

use

• di

scu

ss fr

equ

ency

of

tem

per

atu

re a

sses

smen

t•

prov

ide

reas

ons

for

choi

ce o

f te

mp

erat

ure

as

sess

men

t eq

uip

men

t•

disc

uss

op

tion

s fo

r be

ddin

g an

d cl

oth

ing

• d

iscu

ss w

ith

par

ents

nu

rsin

g in

terv

enti

ons

avai

labl

e to

min

imis

e h

eat

loss

du

rin

g h

and

ling.

Abi

lity

to a

sses

s in

fan

t’s s

uit

abili

ty fo

r tr

ansf

er in

to a

co

t. D

iscu

ss fr

equ

ency

of

tem

per

atu

re a

sses

smen

t. P

rovi

de r

easo

ns

for

choi

ce o

f te

mp

erat

ure

ass

essm

ent

equ

ipm

ent.

Dis

cuss

op

tion

s fo

r be

ddin

g an

d cl

oth

ing.

Te

ach

par

ent

to a

sses

s n

eon

atal

tem

per

atu

re.

Wh

en c

arin

g fo

r H

IE in

fan

ts w

ho

are

to b

e tr

ansf

erre

d to

cen

tres

for

cool

ing,

saf

ely

com

men

ce p

assi

ve

cool

ing

stra

tegi

es a

ccor

din

g to

pro

toco

l.

Car

e an

d m

anag

emen

t of

infa

nts

rec

over

ing

from

ev

ents

wh

ich

lead

to

the

requ

irem

ents

of

ther

apeu

tic

hyp

oth

erm

ia. O

ngo

ing

ther

mal

mon

itor

ing

of t

hes

e in

fan

ts a

ccor

din

g to

loca

l pro

toco

ls d

uri

ng

step

dow

n

care

.

Nu

rses

wh

o ca

re fo

r in

fan

ts in

inte

nsi

ve c

are

will

req

uir

e a

theo

reti

cal a

nd

prac

tica

l pre

para

tion

in s

upp

orti

ng

the

neo

nat

e to

mai

nta

in a

n o

pti

mu

m t

emp

erat

ure

. T

hey

will

nee

d to

un

ders

tan

d th

e m

ech

anis

ms

of h

eat

loss

an

d th

e en

ergy

tri

angl

e.

Rev

iew

s a

ran

ge o

f n

urs

ing

inte

rven

tion

s av

aila

ble

to

min

imis

e h

eat

loss

du

rin

g h

and

ling/

med

ical

pro

cedu

res

such

as

intu

bati

on a

nd

inse

rtio

n o

f a

ches

t dr

ain

. Be

able

to

iden

tify

th

e in

dica

tion

s fo

r u

sin

g in

cuba

tor

hum

idit

y an

d fa

mili

ar w

ith

th

e u

nit

pol

icy

for

wea

nin

g in

cuba

tor

hum

idit

y an

d te

mp

erat

ure

.

Th

ey w

ill b

e re

quir

ed t

o de

mon

stra

te s

afe

and

com

pet

ent

nu

rsin

g m

anag

emen

t of

th

erm

al in

stab

ility

fo

r a

neo

nat

e re

ceiv

ing

inte

nsi

ve c

are.

Tak

e ap

prop

riat

e st

eps

at d

eliv

ery

to p

reve

nt

hea

t lo

ss. R

evie

w t

he

indi

cati

ons

for

the

use

of

the

plas

tic

bag.

Ju

stif

y th

eir

choi

ce o

f te

mp

erat

ure

ass

essm

ent

prob

es a

nd

equ

ipm

ent

and

the

mer

its

of c

onti

nu

al v

ersu

s in

term

itte

nt

mon

itor

ing.

In c

onju

nct

ion

wit

h t

he

fam

ily, r

evie

w t

he

opti

ons

for

bedd

ing

and

clot

hin

g an

d ex

plai

n t

o th

e pa

ren

ts h

ow

incu

bato

r hu

mid

ity

hel

ps t

o m

ain

tain

neo

nat

al

tem

per

atu

re.

For

infa

nts

wh

o n

eed

tran

spor

tati

on fo

r in

vest

igat

ion

s,

surg

ical

inte

rven

tion

s or

rem

oval

to

anot

her

un

it t

he

neo

nat

al n

urs

e sh

ould

be

able

to

revi

ew t

he

stra

tegi

es

use

d to

su

stai

n a

nd

mon

itor

th

e in

fan

t’s t

emp

erat

ure

in

the

tran

spor

t in

cuba

tor

and

min

imis

e th

e ri

sk o

f h

eat

loss

du

rin

g h

and

ling

and

tran

spor

t.

Neo

nat

al n

urs

es w

orki

ng

at t

his

leve

l sh

ould

be

able

to

supp

ort

the

deve

lopm

ent

of a

udi

tin

g th

e su

cces

s of

n

urs

ing

stra

tegi

es in

mai

nta

inin

g in

fan

t’s t

emp

erat

ure

s an

d re

view

nu

rsin

g gu

idel

ines

for

tem

per

atu

re

mon

itor

ing.

In u

nit

s w

her

e th

erap

euti

c hy

pot

her

mia

is p

ract

iced

, an

in

-hou

se p

rogr

amm

e of

pre

para

tion

an

d as

sess

men

t w

ill b

e re

quir

ed.



Th

ere

shou

ld b

e co

nti

nu

al a

sses

smen

t of

clin

ical

co

mp

eten

ces,

wh

ich

cou

ld in

clu

de s

ucc

essf

ul

com

plet

ion

of

clin

ical

sce

nar

ios,

sim

ula

tion

or

oth

er

evid

ence

th

at t

he

skill

set

is b

ein

g re

tain

ed/m

ain

tain

ed

and

this

can

be

revi

ewed

du

rin

g th

e in

divi

dual

p

erfo

rman

ce r

evie

w.

82


Return to contents

Pal

liat

ive

care

, end

-of-

life

car

e an

d be

reav

emen

t m

anag

emen

t –

lear

ning

out

com

es

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

All

lear

ner

s w

ill b

e re

quir

ed t

o pr

ovid

e op

tim

al p

allia

tive

car

e/

end-

of-l

ife

care

an

d be

reav

emen

t m

anag

emen

t.

All

lear

ner

s w

ill

un

ders

tan

d th

e im

por

tan

ce o

f in

clu

din

g th

e ex

ten

ded

fam

ily in

th

e in

fan

t’s c

are

plan

an

d ot

her

age

nci

es o

f su

ppor

t to

pro

vide

on

goin

g ca

re.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

equ

ip t

he

nov

ice

to u

nde

rsta

nd

how

th

e th

eori

es o

f lo

ss a

nd

grie

f ca

n in

form

th

eir

prac

tice

.

Lear

ner

s sh

ould

be

able

to

dem

onst

rate

a w

orki

ng

un

ders

tan

din

g of

th

e de

fin

itio

n a

nd

philo

soph

y of

p

erin

atal

/neo

nat

al p

allia

tive

car

e an

d lo

cal g

uid

elin

e an

d tr

ansl

ate

into

clin

ical

pra

ctic

e.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

prep

are

the

prac

titi

oner

to

wor

k w

ith

in p

allia

tive

car

e gu

idel

ines

an

d fr

amew

orks

.

Follo

win

g th

is t

he

prac

titi

oner

sh

ould

be

able

to

plan

ca

re w

hic

h r

ecog

nis

es a

nd

resp

ects

th

e pr

efer

ence

s an

d be

liefs

of

fam

ilies

.

Lear

ner

s sh

ould

be

able

to

init

iate

opp

ortu

nit

ies

for

mem

ory

mak

ing

from

th

e ti

me

of a

dmis

sion

.

If t

her

e is

a d

esig

nat

ed r

oom

ava

ilabl

e, e

nsu

re t

hat

it is

pr

epar

ed a

ppro

pria

tely

an

d re

ady

for

use

, if

faci

litie

s ar

e m

ore

limit

ed p

riva

te s

pace

wit

hin

a u

nit

iden

tifi

ed

and

use

d w

hen

nee

ded.

Com

mun

icat

ion

Dem

onst

rate

s th

e ab

ility

to

com

mu

nic

ate

effe

ctiv

ely

and

effi

cien

tly

wit

h c

olle

agu

es.

Dem

onst

rate

s ef

fect

ive

com

mu

nic

atio

n s

trat

egie

s to

w

ork

in p

artn

ersh

ip w

ith

fam

ilies

, giv

e th

em a

ll in

form

atio

n n

eces

sary

to

assi

st in

form

ed c

hoi

ce, t

o m

eet

the

nee

ds o

f th

e in

fan

t w

ith

pal

liati

ve a

nd

end-

of-l

ife

care

nee

ds.

Iden

tifi

es w

ays/

styl

es in

wh

ich

you

com

mu

nic

ate

and

the

impa

ct o

f yo

ur

com

mu

nic

atio

n o

n fa

mili

es a

nd

oth

er p

rofe

ssio

nal

s.

Init

iate

s di

scu

ssio

ns

wit

h t

he

fam

ily r

egar

din

g ac

cess

ing

the

mu

lti f

aith

ch

apla

incy

tea

m a

nd

oth

er

supp

ort

serv

ices

.

Follo

ws

a pr

ogra

mm

e to

pro

vide

th

eore

tica

l de

velo

pmen

tal,

mat

ura

tion

al u

nde

rsta

ndi

ng

of

viab

ility

an

d bo

rder

line

viab

ility

.

Un

ders

tan

din

g of

par

enta

l str

ess

and

pres

sure

an

d th

e th

eori

es o

f gr

ief

and

mou

rnin

g.

App

reci

ates

an

d re

spec

ts c

ult

ura

l rit

ual

an

d re

ligio

us

prac

tice

s su

rrou

ndi

ng

the

deat

h o

f th

e in

fan

t.

Abi

lity

to p

erfo

rm e

mer

gen

cy n

amin

g an

d ba

pti

sm if

th

e pa

ren

ts w

ould

like

th

is.

Tran

slat

ing

the

philo

soph

y of

per

inat

al/n

eon

atal

pa

lliat

ive

care

into

clin

ical

pra

ctic

e.

Dem

onst

rate

s ab

ility

to

appl

y th

e th

eori

es o

f lo

ss a

nd

grie

f w

hen

car

ing

for

and

supp

orti

ng

fam

ilies

of

infa

nts

wit

h p

allia

tive

an

d en

d-of

-lif

e ca

re n

eeds

.

Dem

onst

rate

s ap

prop

riat

e u

se o

f lo

cal a

nd

nat

ion

al

neo

nat

al p

allia

tive

car

e gu

idel

ines

an

d fr

amew

orks

.

Un

ders

tan

ds t

he

imp

orta

nce

of

hav

ing

rele

van

t eq

uip

men

t av

aila

ble

and

read

y. E

nsu

re r

esou

rces

an

d re

leva

nt

equ

ipm

ent

are

avai

labl

e fo

r m

emor

y m

akin

g.

Init

iate

opp

ortu

nit

ies

for

mem

ory

mak

ing

from

tim

e of

adm

issi

on.

Faci

litat

es o

ppor

tun

itie

s fo

r m

emor

y m

akin

g as

a

fam

ily –

pri

vacy

, goi

ng

for

a w

alk

wit

h a

pra

m.

Con

trib

ute

s to

, an

d de

velo

ps, l

ocal

clin

ical

an

d pr

acti

cal g

uid

elin

es.

Dem

onst

rate

s th

e ab

ility

to

com

mu

nic

ate

effe

ctiv

ely

and

effi

cien

tly

wit

h c

olle

agu

es.

Dem

onst

rate

s th

e ab

ility

to

com

mu

nic

ate

sen

siti

vely

an

d em

path

etic

ally

wit

h fa

mili

es.

Iden

tifi

es w

hic

h in

fan

ts a

re e

ligib

le fo

r pa

lliat

ive

care

an

d in

itia

te d

iscu

ssio

ns

on t

he

war

d ro

un

d.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

equ

ip t

he

neo

nat

al n

urs

e to

su

ppor

t an

d gu

ide

staf

f w

ho

are

cari

ng

for

the

dyin

g in

fan

t.

Supp

orts

an

d gu

ides

sta

ff c

arin

g fo

r th

e in

fan

t an

d pa

ren

ts a

fter

th

e in

fan

t’s d

eath

. Dev

ises

ber

eave

men

t pr

otoc

ol. S

upp

ort

and

guid

e st

aff.

Dem

onst

rate

s kn

owle

dge

and

un

ders

tan

din

g of

th

e ke

y th

eori

es o

f lo

ss a

nd

grie

f.

Init

iati

ng

care

pat

hway

s in

acc

orda

nce

wit

h lo

cal a

nd

nat

ion

al g

uid

ance

.

Lead

s cl

inic

al c

are

acco

rdin

g to

th

e n

eeds

of

infa

nts

.

Init

iate

s di

scu

ssio

ns

wit

h fa

mili

es r

egar

din

g ch

oice

, op

tion

s an

d de

cisi

on-m

akin

g. L

eadi

ng

disc

uss

ion

s w

ith

th

e te

am a

nd

fam

ilies

.

Rec

eive

s an

d pr

oces

s co

mpl

ex, s

ensi

tive

an

d co

nte

nti

ous

info

rmat

ion

, in

itia

tin

g ac

tion

s re

quir

ed.

Wor

ks c

lose

ly w

ith

sp

ecia

list

palli

ativ

e ca

re p

rovi

ders

in

deliv

erin

g h

igh

sta

nda

rds

of c

are.

Com

preh

ensi

ve k

now

ledg

e of

sym

pto

m c

ontr

ol a

nd

man

agem

ent;

may

incl

ude

pre

scri

bin

g ap

prop

riat

e m

edic

atio

n.

Lead

s m

eeti

ngs

, giv

e pr

esen

tati

ons

and

infl

uen

ce a

wid

e ra

nge

of

indi

vidu

als

and

grou

ps a

t st

rate

gic

leve

l to

take

ac

tion

an

d m

ake

chan

ges.

Inst

igat

es a

nd

faci

litat

es r

esea

rch

an

d au

dit.

Pro

acti

vely

fost

ers

a cu

ltu

re o

f en

quir

y an

d fa

cilit

ate

chan

ge t

o in

tegr

ate

best

evi

den

ce in

to n

eon

atal

car

e.

En

sure

s th

ere

is e

ffec

tive

com

mu

nic

atio

n b

etw

een

pr

ofes

sion

als.

En

sure

s th

ere

is e

ffec

tive

an

d se

nsi

tive

com

mu

nic

atio

n

betw

een

sta

ff a

nd

fam

ilies

.



Para

llel c

are

plan

ning

Sen

siti

vely

car

es fo

r th

e in

fan

t w

ho

is li

fe li

mit

ed o

r dy

ing

and

thei

r fa

mily

.

Pro

vide

s ap

prop

riat

e pr

acti

cal s

kills

an

d su

ppor

t fo

r th

e in

fan

t w

ith

pal

liati

ve c

are

nee

ds a

nd

thei

r fa

mily

.

Act

ivel

y in

volv

es s

iblin

gs, g

ran

dpar

ents

an

d st

ep fa

mily

, w

ider

fam

ily a

nd

frie

nds

in t

he

care

of

the

infa

nt

in

acco

rdan

ce w

ith

th

e pa

ren

ts’ w

ish

es.

Ant

enat

al c

are

Aw

aren

ess

of t

he

ante

nat

al p

lan

for

the

infa

nt

wh

o is

lif

e lim

ited

.

Con

side

rs a

dvan

ced

care

pla

nn

ing

wit

h r

egar

ds t

o en

d-of

-lif

e ca

re p

lan

.

Com

mu

nic

ates

wit

h t

he

fam

ily s

ensi

tive

ly a

nd

empa

thet

ical

ly. U

nde

rsta

nd

the

prin

cipl

es o

f th

e la

w

and

eth

ics

in r

elat

ion

to

wit

hh

oldi

ng

and

wit

hdr

awin

g lif

e su

stai

nin

g tr

eatm

ent.

Post

nata

l car

e Id

enti

fies

wh

ich

infa

nts

are

elig

ible

for

palli

ativ

e ca

re in

a

tim

ely

man

ner

an

d in

itia

tes

disc

uss

ion

s on

th

e w

ard

rou

nd

wit

h c

olle

agu

es.

Kn

owle

dge

of w

hic

h p

allia

tive

car

e/co

nti

nu

ing

care

se

rvic

e is

mos

t ap

prop

riat

e fo

r th

e in

fan

t’s s

pec

ific

nee

ds a

nd

thei

r fa

mily

.

Un

ders

tan

ds t

he

role

of

a ch

ildre

n’s

hos

pice

, an

d w

hat

se

rvic

es a

re a

vaila

ble.

Fol

low

ing

disc

uss

ion

s w

ith

th

e m

ult

idis

cipl

inar

y te

am, c

omm

ence

th

e re

ferr

al p

roce

ss.

Supp

orts

th

e fa

mily

wit

h d

iffi

cult

dis

cuss

ion

s,

deci

sion

-mak

ing

and

choi

ce.

Kn

owle

dge

and

un

ders

tan

din

g of

app

ropr

iate

sy

mp

tom

con

trol

-dif

fere

nt

rou

tes

(bu

ccal

/su

bcu

t) a

nd

how

to

adm

inis

ter

appr

opri

atel

y.

Iden

tifi

es e

ligib

le in

fan

ts fo

r re

ferr

al t

o pa

lliat

ive

care

/co

nti

nu

ing

care

ser

vice

s an

d co

mm

ence

th

e re

ferr

al

proc

ess.

Kn

owle

dge

of t

he

mos

t ap

prop

riat

e pa

lliat

ive

care

/co

nti

nu

ing

care

ser

vice

for

the

infa

nt

wit

h p

allia

tive

ca

re/e

nd-

of-l

ife

care

an

d th

eir

fam

ily.

Mai

nta

ins

robu

st w

orki

ng

rela

tion

ship

s w

ith

pr

ofes

sion

als

for

con

tin

uin

g ca

re in

th

e co

mm

un

ity.

Sen

siti

vely

car

es fo

r th

e in

fan

t w

ith

pal

liati

ve c

are

and

end-

of-l

ife

care

nee

ds a

nd

thei

r fa

mily

. In

itia

tes

disc

uss

ion

s w

ith

par

ents

rel

ated

to

invo

lvin

g si

blin

gs,

gran

dpar

ents

an

d st

ep fa

mily

in c

are

plan

nin

g fo

r th

e in

fan

t.

Rec

ogn

ises

th

e n

eeds

of

sibl

ings

, gra

ndp

aren

ts a

nd

step

fam

ily. I

den

tify

sp

ecifi

c on

goin

g n

eeds

of

the

fam

ily a

nd

be fl

exib

le w

ith

th

e ca

re p

lan

.

Dis

cuss

es e

nd-

of-l

ife

care

pla

n a

s pa

rt o

f ad

van

ced

care

pla

n w

ith

par

ents

an

d fa

mily

. Pro

vide

s ap

prop

riat

e pr

acti

cal s

upp

ort

for

the

fam

ily w

ith

a

infa

nt

wit

h p

allia

tive

car

e n

eeds

.

Act

ivel

y in

volv

es s

iblin

gs, g

ran

dpar

ents

an

d st

ep

fam

ily in

th

e ca

re o

f th

e in

fan

t w

ith

th

e pa

ren

ts’

wis

hes

.

Faci

litat

e pa

ralle

l pla

nn

ing

wit

hin

infa

nt’s

m

ult

idis

cipl

inar

y ca

re p

lan

. Con

side

r ad

van

ced

care

pl

ann

ing

wit

h r

egar

ds t

o en

d-of

-lif

e ca

re p

lan

.

Un

ders

tan

ds t

he

role

of

a ch

ildre

n’s

hos

pice

, an

d w

hat

se

rvic

es a

re a

vaila

ble.

Abi

lity

to c

omm

un

icat

e w

ith

th

e fa

mily

sen

siti

vely

an

d em

phat

ical

ly u

se m

ore

adva

nce

d co

mm

un

icat

ion

st

rate

gies

.

Kn

owle

dge

and

un

ders

tan

din

g of

app

ropr

iate

sy

mp

tom

con

trol

-dif

fere

nt

rou

tes

(bu

ccal

/su

bcu

t) a

nd

how

to

adm

inis

ter

appr

opri

atel

y.

Defi

nes

th

e pr

inci

ples

of

colla

bora

tive

MD

T w

orki

ng.

Pro

vide

s ef

fect

ive

prof

essi

onal

lead

ersh

ip, f

acili

tati

ng

chan

ge.

Allo

cate

s, d

eleg

ates

, co-

ordi

nat

es, m

onit

ors

and

asse

sses

th

e w

ork

of t

he

team

an

d in

divi

dual

s.

Dem

onst

rate

s ab

ility

to

supp

ort

and

con

trib

ute

to

edu

cati

ng

staf

f on

car

ing

for

infa

nts

wit

h p

allia

tive

car

e an

d en

d-of

-lif

e ca

re n

eeds

, con

tin

uin

g on

ce a

n in

fan

t h

as d

ied.

Th

e sk

ills

and

know

ledg

e re

quir

ed t

o pr

ovid

e h

igh

st

anda

rds

of c

are

for

the

infa

nt

and

thei

r fa

mily

.

Dev

ises

loca

l gu

idel

ines

an

d gu

idan

ce, p

arti

cipa

te w

ith

n

atio

nal

gu

idan

ce.

Est

ablis

hes

an

d m

ain

tain

com

mu

nic

atio

n w

ith

in

divi

dual

s an

d gr

oups

abo

ut

com

plex

an

d di

fficu

lt

mat

ters

, ove

rcom

ing

any

prob

lem

s.

Col

labo

rate

s an

d w

ork

clos

ely

wit

h r

elev

ant

nat

ion

al

orga

nis

atio

ns.

Cri

tica

lly r

evie

ws

lega

l an

d et

hic

al is

sues

th

at a

rise

in

the

prac

tice

of

neo

nat

al p

allia

tive

car

e.

Infl

uen

ces

stra

tegi

c p

olic

y m

akin

g at

loca

l an

d n

atio

nal

le

vel.

Dem

onst

rate

s or

gan

isat

ion

al s

kills

to

faci

litat

e th

e sm

ooth

tra

nsf

er o

f an

infa

nt

for

pos

t m

orte

m

exam

inat

ion

.

Dem

onst

rate

s kn

owle

dge

of le

gal r

equ

irem

ents

for

the

fam

ily a

fter

dea

th.

Dem

onst

rate

s kn

owle

dge

of r

egis

teri

ng

a de

ath

wh

en

the

fam

ily li

ve o

uts

ide

the

area

loca

l to

the

orga

nis

atio

n.

Dem

onst

rate

s sk

ills

to m

ain

tain

con

tin

uin

g su

ppor

t fo

r th

e fa

mily

aft

er t

hei

r in

fan

t h

as d

ied.

Dem

onst

rate

s kn

owle

dge

rega

rdin

g al

tern

ativ

e pl

aces

of

rest

for

the

infa

nt

afte

r de

ath

an

d h

ow t

o fa

cilit

ate

tran

sfer

of

the

body

.

84


Return to contents

Pal

liat

ive

care

, end

-of-

life

car

e an

d be

reav

emen

t m

anag

emen

t –

lear

ning

out

com

es (

cont

inue

d)

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

Defi

nes

th

e pr

inci

ples

of

effe

ctiv

e co

llabo

rati

ve M

DT

w

orki

ng.

End-

of-l

ife

care

pla

nnin

gD

emon

stra

tes

the

ben

efits

of

an in

divi

dual

ised

ad

van

ced

care

pla

n a

nd

limit

atio

ns

of r

esu

scit

atio

n

guid

ance

/doc

um

ent.

Kn

owle

dge

of t

he

proc

ess

for

tran

sfer

rin

g an

infa

nt

for

a p

ost

mor

tem

exa

min

atio

n a

nd

the

pap

erw

ork

requ

ired

.

Post

dea

th c

are

Dem

onst

rate

s su

ppor

tive

mea

sure

s en

ablin

g pa

ren

ts t

o ca

re fo

r th

eir

infa

nt

pos

t de

ath

. D

emon

stra

tes

un

ders

tan

din

g of

pos

t m

orte

m c

onse

nt

and

supp

orts

fam

ilies

wit

h t

hei

r de

cisi

on.

Dem

onst

rate

s kn

owle

dge

of le

gal r

equ

irem

ents

for

pare

nts

on

ce a

infa

nt

has

die

d, s

uch

as

regi

ster

ing

the

infa

nt’s

bir

th a

nd

deat

h

Is a

war

e of

an

d id

enti

fies

lim

itat

ion

s of

ski

lls, s

cop

e of

pr

ofes

sion

al p

ract

ice.

Exe

rcis

es a

ccou

nta

bilit

y an

d se

eks

advi

ce a

nd

supp

ort

acco

rdin

gly.

Supp

orts

an

d su

per

vise

s ju

nio

r st

aff

in c

arin

g fo

r in

fan

ts w

ith

pal

liati

ve c

are

nee

ds, c

linic

al s

up

ervi

sion

an

d re

flec

tive

pra

ctic

e.

Rec

ogn

ises

ow

n fe

elin

gs a

bou

t de

ath

an

d de

velo

ps a

gr

eate

r se

lf-a

war

enes

s.

Dem

onst

rate

s a

com

mit

men

t to

con

tin

uou

s pr

ofes

sion

al d

evel

opm

ent.

Act

ivel

y pa

rtic

ipat

es in

tea

chin

g pr

ogra

mm

es a

nd

faci

litat

e le

arn

ing

of ju

nio

r st

aff.

Rec

ogn

ises

sig

ns

of o

wn

neg

ativ

e st

ress

an

d se

eks

appr

opri

ate

supp

ort.

Supp

orts

par

enta

l ch

oice

.

Un

ders

tan

ds t

he

prin

cipl

es o

f th

e la

w a

nd

eth

ics

in

rela

tion

to

wit

hh

oldi

ng

and

wit

hdr

awin

g lif

e su

stai

nin

g tr

eatm

ent.

Supp

orts

th

e fa

mily

wit

h d

iffi

cult

dis

cuss

ion

s an

d de

cisi

on-m

akin

g.

Dem

onst

rate

s u

nde

rsta

ndi

ng

of p

ost

mor

tem

pro

cess

an

d su

ppor

t fa

mili

es w

ith

th

eir

deci

sion

.

Kn

owle

dge

of p

aper

wor

k re

quir

ed a

nd

the

proc

ess

for

pos

t m

orte

ms.

Dev

elop

s le

ader

ship

pot

enti

al w

ith

in t

he

clin

ical

en

viro

nm

ent,

acti

ng

as a

rol

e m

odel

for

staf

f an

d p

eers

.

Part

icip

ates

in p

artn

ersh

ip, w

orki

ng

wit

h in

divi

dual

s,

grou

ps a

nd

oth

ers

wit

hin

th

e n

eon

atal

un

it a

nd

acro

ss

orga

nis

atio

ns.

Iden

tifi

es a

reas

for

prac

tice

dev

elop

men

t.

Dem

onst

rate

s sk

ills

and

un

ders

tan

din

g of

au

dit

met

hod

olog

y, p

rin

cipl

es a

nd

evid

ence

-bas

ed p

ract

ice.

Dev

elop

s ra

ppor

t an

d co

mm

un

icat

es e

ffec

tive

ly w

ith

in

the

neo

nat

al t

eam

an

d ot

her

HC

P.

Dem

onst

rate

s an

d pr

omot

es e

ffec

tive

com

mu

nic

atio

n

wit

h fa

mili

es a

nd

colle

agu

es.

Wit

hin

th

e re

alm

of

allo

cate

d re

spon

sibi

lity

infl

uen

ces

and

teac

hes

oth

ers.

Abi

lity

to c

omm

un

icat

e w

ith

th

e fa

mily

sen

siti

vely

an

d em

path

etic

ally

– u

ses

mor

e ad

van

ced

skill

s.

Kn

owle

dge

and

un

ders

tan

din

g of

app

ropr

iate

sy

mp

tom

con

trol

-dif

fere

nt

rou

tes

(bu

ccal

/su

b-cu

tan

eou

s/re

ctal

) an

d h

ow t

o ad

min

iste

r ap

prop

riat

ely.

En

sure

s th

at fa

mili

es r

ecei

ve a

ppro

pria

te in

form

atio

n,

both

ver

bal a

nd

wri

tten

reg

ardi

ng

supp

ort

orga

nis

atio

ns,

an

d w

hat

will

hap

pen

now

.

Dem

onst

rate

s kn

owle

dge

of o

rgan

isat

ion

al fu

ner

al

proc

edu

res.

Info

rms

pare

nts

of

follo

w-u

p ap

poi

ntm

ents

an

d re

mem

bran

ce d

ays.

Aw

aren

ess

of o

wn

feel

ings

abo

ut

deat

h a

nd

deve

lop

se

lf-a

war

enes

s.

Dev

elop

s ow

n k

now

ledg

e, s

kills

an

d pr

acti

ce a

nd

con

trib

ute

to

the

deve

lopm

ent

of o

ther

s.

Act

s as

a r

esou

rce

of s

pec

ialis

t kn

owle

dge

and

clin

ical

pr

acti

ce fo

r ca

rin

g fo

r in

fan

ts w

ith

pal

liati

ve/e

nd-

of-l

ife

care

nee

ds o

r w

hen

an

infa

nt

has

die

d.

Ass

essm

ent

wou

ld b

e vi

a se

nsi

tive

rev

iew

of

skill

bas

e du

rin

g an

nu

al p

erfo

rman

ce r

evie

w.



Iden

tifi

es fu

rth

er le

arn

ing

nee

ds a

nd

seek

s op

por

tun

itie

s.

Act

s as

a r

ole

mod

el fo

r ju

nio

r co

lleag

ues

an

d le

arn

ers;

en

sure

s yo

u p

rovi

des

a su

ppor

tive

lear

nin

g en

viro

nm

ent.

Sen

siti

vely

rev

iew

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al

per

form

ance

rev

iew

.

Defi

nes

th

e pr

inci

ples

of

colla

bora

tive

MD

T w

orki

ng.

Un

ders

tan

ds t

he

prin

cipl

es o

f th

e la

w a

nd

eth

ics

in

rela

tion

to

wit

hh

oldi

ng

and

wit

hdr

awin

g lif

e su

stai

nin

g tr

eatm

ent.

Supp

orts

th

e fa

mily

wit

h d

iffi

cult

dis

cuss

ion

s an

d de

cisi

on-m

akin

g.

Iden

tifi

es s

elf-

copi

ng

mec

han

ism

s an

d is

aw

are

of

supp

ort

avai

labl

e.

Dem

onst

rate

s u

nde

rsta

ndi

ng

of w

hat

ser

vice

s ar

e pr

ovid

ed b

y a

child

ren’

s h

ospi

ce a

nd

mu

st s

eek

opp

ortu

nit

ies

to v

isit

th

e se

rvic

e.

Kn

owle

dge

of a

ll ot

her

inte

rdis

cipl

inar

y pr

ofes

sion

als

invo

lved

in t

he

infa

nt’s

car

e an

d h

ow t

o tr

ansi

tion

an

d tr

ansf

er c

are.

Be

part

of

the

care

tea

m fa

cilit

atin

g co

mpa

ssio

nat

e ex

tuba

tion

in a

var

iety

of

sett

ings

(in

clu

din

g h

ome

and

hos

pice

) as

per

loca

l gu

idel

ines

.

Mu

st h

ave

the

know

ledg

e an

d th

e ab

ility

to

offe

r pa

lliat

ive

care

op

tion

s (s

uch

as

loca

tion

of

care

).

Supp

orts

ch

oice

s an

d de

cisi

on m

akin

g fo

r fa

mili

es a

nd

offe

r re

alis

tic

opti

ons.

Abl

e to

rec

ogn

ise

and

expl

ain

to

jun

ior

staf

f an

d pa

ren

ts t

he

exp

ecte

d ph

ysic

al c

han

ges

wh

en a

n in

fan

t di

es.

Lia

ises

wit

h m

ortu

ary

staf

f an

d p

erin

atal

pat

hol

ogis

t re

gard

ing

tran

sfer

of

the

infa

nt

for

pos

t m

orte

m

exam

inat

ion

.

Dem

onst

rate

s kn

owle

dge

of le

gal r

equ

irem

ents

for

the

fam

ily o

nce

a in

fan

t h

as d

ied.

Iden

tifi

es o

wn

lim

itat

ion

s an

d/or

kn

owle

dge

and

skill

de

fici

ts, f

orm

ula

tes

a pl

an o

f ac

tion

an

d or

gan

ises

de

velo

pmen

t op

por

tun

itie

s to

en

han

ce c

onti

nu

ous

prof

essi

onal

dev

elop

men

t.

86


Return to contents

Pal

liat

ive

care

, end

-of-

life

car

e an

d be

reav

emen

t m

anag

emen

t –

lear

ning

out

com

es (

cont

inue

d)

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

Dem

onst

rate

s in

crea

sed

con

fide

nce

in o

wn

ski

lls fo

r de

velo

pin

g an

d su

stai

nin

g ro

bust

inte

rdis

cipl

inar

y w

orki

ng

rela

tion

ship

s.

Rec

ogn

ises

sig

ns

of n

egat

ive

stre

ss in

oth

ers,

off

er

supp

ort

and

wor

ks t

owar

ds a

llevi

atio

n o

f te

nsi

on.

Supp

orts

an

d su

per

vise

s ju

nio

r st

aff,

by p

rovi

din

g 1:

1 su

ppor

t, cl

inic

al s

up

ervi

sion

, refl

ecti

ve p

ract

ice.

Rec

ogn

ises

ow

n fe

elin

gs o

f de

ath

an

d de

velo

ps a

gr

eate

r se

lf-a

war

enes

s.

Rec

ogn

ises

ow

n e

mot

ion

al n

eeds

an

d se

eks

supp

ort.

Iden

tifi

es a

nd

seek

s fu

rth

er le

arn

ing

opp

ortu

nit

ies.

En

sure

s sk

ills

base

is s

ensi

tive

ly r

evie

wed

du

rin

g th

e an

nu

al in

divi

dual

per

form

ance

mee

tin

g.



Inve

stig

atio

ns, t

ests

and

pro

cedu

res

– le

arni

ng o

utco

mes

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

All

lear

ner

s w

ill b

e re

quir

ed t

o su

ppor

t th

e in

fan

t u

nde

rgoi

ng

inve

stig

atio

ns

and

proc

edu

res

safe

ly a

nd

wit

h d

ue

rega

rd t

o th

eir

dign

ity

and

com

fort

.

All

lear

ner

s w

ill

un

ders

tan

d th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in t

he

infa

nt’s

ca

re p

lan

.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

prov

ide

an

anat

omic

al a

nd

theo

reti

cal r

evie

w o

f a

ran

ge o

f co

mm

on in

vest

igat

ion

s.

Ref

ers

to c

ardi

ovas

cula

r/re

spir

ator

y se

ctio

n fo

r vi

tal

sign

s sk

ill p

repa

rati

on.

Ref

ers

to h

ydra

tion

, nu

trit

ion

an

d el

ectr

olyt

es s

ecti

on

for

bloo

d sa

mpl

ing

skill

pre

para

tion

. Con

side

rs v

alu

e ob

tain

ed g

luco

se/b

iliru

bin

an

d re

spon

ds a

ppro

pria

tely

. T

heo

reti

cal r

evie

w o

f th

e ac

tion

s to

be

take

n w

hen

al

tere

d va

lues

are

obt

ain

ed.

Un

ders

tan

ds t

he

prin

cipl

es o

f x-

ray

and

inte

rpre

tati

on

of s

tan

dard

film

s.

Clin

ical

ass

essm

ent

of t

he

infa

nt’s

ch

est

and

abdo

men

.

Pass

age

of a

n e

nte

ral t

ube

may

be

eith

er o

ral o

r n

asal

.

Perf

orm

s n

asop

har

ynge

al a

spir

ates

, an

d co

rrec

tly

proc

esse

s th

ese

so t

hey

go

to t

he

labo

rato

ry in

op

tim

um

con

diti

on.

Ass

ists

wit

h lu

mba

r pu

nct

ure

s, o

bser

ves

for

com

plic

atio

ns

afte

rwar

ds a

nd

resp

onds

app

ropr

iate

ly.

Skill

s an

d kn

owle

dge

base

cou

ld b

e as

sess

ed b

y O

SCE

. Ev

iden

ce o

f th

e m

ain

ten

ance

of

the

skill

s co

uld

be

by

the

deve

lopm

ent

of a

ski

lls lo

g an

d re

view

ed a

nn

ual

ly

duri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

acqu

ire

the

abili

ty t

o sa

fely

per

form

rou

tin

e, d

iagn

osti

c an

d th

erap

euti

c pr

oced

ure

s ac

cord

ing

to p

roto

cols

an

d gu

idel

ines

an

d de

velo

p co

mp

eten

ce in

pre

pari

ng

the

infa

nt,

assi

stin

g w

ith

pro

cedu

res

such

as

supr

a pu

bic

aspi

rati

on, l

um

ber

pun

ctu

re a

nd

reti

nal

exa

min

atio

n.

Mon

itor

s in

fan

ts u

nde

rgoi

ng

proc

edu

res

and

reco

gnis

es w

hen

th

ere

nee

ds t

o be

a p

ause

in

proc

eedi

ngs

to

allo

w t

he

infa

nt

to r

ecov

er. A

bilit

y to

re

ad t

he

resu

lts

of c

omm

on in

vest

igat

ion

s su

ch a

s x-

ray

and

reco

gnis

e th

e si

gnifi

can

ce o

f de

viat

ion

s fr

om

nor

mal

res

ult

s an

d se

ek a

ppro

pria

te m

anag

emen

t.

Com

pet

ent

in t

he

care

of

infa

nts

req

uir

ing

hig

h

dep

ende

ncy

an

d in

ten

sive

car

e, u

nde

rgoi

ng

bloo

d sa

mpl

ing

can

nu

lati

on o

f ve

ins

and

arte

ries

. Set

up

arte

rial

blo

od p

ress

ure

tra

nsd

uce

r m

easu

re a

rter

ial

bloo

d pr

essu

re.

Com

pet

ent

in c

alcu

lati

ng

and

the

adm

inis

trat

ion

of

dru

gs v

ia I

V r

oute

acc

ordi

ng

to p

rofe

ssio

nal

an

d lo

cal

pol

icie

s. A

bilit

y to

ass

ess

the

ther

apeu

tic

resp

onse

an

d th

e ab

ility

to

iden

tify

sid

e ef

fect

s an

d ac

t ap

prop

riat

ely

wit

hin

loca

l gu

idel

ines

. Men

tor

and

supp

ort

the

mor

e ex

per

ien

ced

entr

ant

in t

he

safe

adm

inis

trat

ion

of

IV

med

icat

ion

s.

Com

pet

ent

in t

he

care

of

infa

nts

rec

eivi

ng

exch

ange

an

d pa

rtia

l exc

han

ge t

ran

sfu

sion

.

Teac

hes

, men

tors

an

d su

ppor

ts n

ew e

ntr

ant

in t

he

safe

h

arve

stin

g of

cap

illar

y bl

ood

sam

ples

.

Ass

essm

ent

cou

ld b

e p

erfo

rmed

by

men

tors

pro

vidi

ng

sup

ervi

sed

prac

tice

. Th

e co

mpl

etio

n o

f a

skill

s lo

g.

Evid

ence

th

at t

he

skill

s se

t ar

e be

ing

mai

nta

ined

cou

ld

be p

rovi

ded

by t

he

mai

nte

nan

ce o

f a

diar

y of

in

vest

igat

ion

s an

d pr

oced

ure

s an

d du

rin

g th

e an

nu

al

indi

vidu

al p

erfo

rman

ce r

evie

w.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

prep

are

the

QIS

n

urs

e to

res

pon

d to

infa

nt’s

req

uir

emen

ts fo

r in

vest

igat

ion

.

Perf

orm

s ar

teri

al a

nd

cen

tral

lin

e sa

mpl

ing.

In

terp

ret

bloo

d pr

essu

re r

ecor

din

gs. E

duca

tion

of

staf

f to

equ

ip

them

to

safe

ly c

are

for

infa

nt

rece

ivin

g bl

ood

tran

sfu

sion

, exc

han

ge a

nd

part

ial e

xch

ange

tra

nsf

usi

on.

Dev

elop

s th

e sk

ills

requ

ired

to

per

form

, au

dit

and

revi

ew n

urs

ing

guid

elin

es fo

r th

e m

anag

emen

t of

in

fan

ts r

equ

irin

g su

ch t

ran

sfu

sion

s.

Rev

iew

s th

erap

euti

c re

spon

se a

nd

acts

acc

ordi

ngl

y w

ith

in lo

cal g

uid

elin

es.

Dev

ises

, au

dits

an

d re

view

s n

urs

ing

guid

elin

es fo

r th

e ad

min

istr

atio

n o

f m

edic

ines

. Man

age

med

icat

ion

in

cide

nts

.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

ers

skill

s ar

e lik

ely

to b

e n

egot

iate

d in

su

ch a

way

as

to m

eet

the

requ

irem

ents

of

reva

lidat

ion

an

d ca

n b

e m

onit

ored

du

rin

g th

e in

divi

dual

’s a

nn

ual

per

form

ance

rev

iew

.

88


Return to contents

Equi

pmen

t an

d m

onit

orin

g –

lear

ning

out

com

es

Lev

els

5 +

Nov

ice/

adva

nced

beg

inne

r: n

ew e

ntra

nt H

igh

depe

nden

cy n

eona

tal n

urse

Neo

nata

l int

ensi

ve c

are

nurs

e

All

lear

ner

s ar

e re

quir

ed

to u

se e

quip

men

t an

d m

onit

orin

g de

vice

s sa

fely

an

d in

acc

orda

nce

w

ith

th

e m

anu

fact

ure

r’s

inst

ruct

ion

s.

All

lear

ner

s w

ill

un

ders

tan

d th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in t

he

infa

nt’s

ca

re p

lan

.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

enab

le t

he

regi

stra

nt

to m

onit

or a

nd

be v

igila

nt

abou

t ri

sk.

Loca

tes

and

chec

ks e

mer

gen

cy e

quip

men

t.

Safe

use

of

OH

H, i

ncu

bato

rs a

nd

oth

er e

quip

men

t u

sed

in t

he

clin

ical

are

a.

Ala

rms

in t

he

clin

ical

are

a: fi

re a

larm

s, e

mer

gen

cy

alar

ms,

equ

ipm

ent

alar

ms.

Wor

kin

g fa

mili

arit

y w

ith

CO

SHH

, man

ual

han

dlin

g p

olic

ies

and

the

requ

irem

ents

of

rep

orti

ng

clin

ical

in

cide

nts

.

Mak

es li

nks

to

the

rele

van

t sy

stem

s u

nde

rtak

e cl

inic

al

asse

ssm

ent

of v

ital

sig

ns

obse

rvat

ion

.

Mak

es li

nks

to

infe

ctio

n c

ontr

ol, d

emon

stra

tes

in t

he

clin

ical

are

a th

e ab

ility

to

clea

n a

nd

stor

e eq

uip

men

t n

eces

sary

for

the

care

of

infa

nts

req

uir

ing

spec

ial a

nd

hig

h d

epen

den

cy c

are

in a

ccor

dan

ce w

ith

loca

l an

d m

anu

fact

ure

r’s

inst

ruct

ion

s.

Follo

win

g de

mon

stra

tion

, edu

cati

on a

nd

supp

ort

un

dert

akes

ass

essm

ent

to e

ffici

entl

y an

d sa

fely

use

eq

uip

men

t n

eces

sary

for

the

care

of

infa

nts

req

uir

ing

spec

ial c

are

in a

ccor

dan

ce w

ith

loca

l an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Mak

es li

nks

wit

h t

he

nor

mal

par

amet

ers

of t

he

resp

irat

ory

and

card

iova

scu

lar

syst

em d

emon

stra

tes

in

the

clin

ical

are

a th

e ab

ility

to

set

safe

par

amet

ers

and

inte

rpre

t th

e si

gnifi

can

ce o

f eq

uip

men

t al

arm

s in

in

fan

ts r

equ

irin

g sp

ecia

l car

e an

d pr

ovid

e a

theo

reti

cal

acco

un

t of

th

e ap

prop

riat

e re

spon

ses.

Obs

erve

s bl

ood

glu

cose

, mon

itor

s ca

libra

tion

.

Th

eore

tica

l con

side

rati

on o

f de

com

mis

sion

ing

fau

lty

equ

ipm

ent

and

elem

enta

ry t

rou

ble

shoo

tin

g co

mm

on

equ

ipm

ent.

Th

e ab

ove

skill

s co

uld

be

asse

ssed

by

OSC

E d

uri

ng

the

prog

ram

me

and

evid

ence

th

at t

he

skill

set

is b

ein

g m

ain

tain

ed c

an b

e re

view

ed d

uri

ng

man

dato

ry

trai

nin

g an

d du

rin

g th

e in

divi

dual

per

form

ance

re

view

.

Com

pet

ent

in c

lean

ing

and

ensu

rin

g sa

fe s

tora

ge o

f eq

uip

men

t n

eces

sary

for

the

care

of

infa

nt’s

req

uir

ing

hig

h c

are

in a

ccor

dan

ce w

ith

loca

l an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Supp

orts

an

d su

per

vise

s th

e n

ew e

ntr

ant

in d

evel

opin

g sk

ills

requ

ired

for

the

safe

use

of

equ

ipm

ent.

Com

pet

ent

to s

et u

p an

d te

st e

quip

men

t n

eces

sary

for

the

care

of

infa

nts

req

uir

ing

hig

h d

epen

den

cy a

nd

inte

nsi

ve c

are

in a

ccor

dan

ce w

ith

loca

l an

d m

anu

fact

ure

r’s

inst

ruct

ion

.

Com

pet

ent

to e

ffici

entl

y an

d sa

fely

use

equ

ipm

ent

nec

essa

ry fo

r th

e ca

re o

f in

fan

ts r

equ

irin

g h

igh

de

pen

den

cy a

nd

inte

nsi

ve c

are

in a

ccor

dan

ce w

ith

lo

cal a

nd

man

ufa

ctu

rer’

s in

stru

ctio

n.

Com

pet

ent

in t

he

inte

rpre

tati

on o

f th

e si

gnifi

can

ce o

f eq

uip

men

t al

arm

s in

infa

nts

req

uir

ing

hig

h

dep

ende

ncy

an

d in

ten

sive

car

e an

d re

spon

d ap

prop

riat

ely.

Trou

bles

hoo

t eq

uip

men

t pr

oble

ms.

Ass

essm

ent

cou

ld b

e by

th

e di

rect

clin

ical

obs

erva

tion

of

th

e sa

fe s

et u

p of

equ

ipm

ent

by t

he

men

tor.

Th

e le

arn

er c

ould

des

ign

a t

each

ing

pack

age

for

new

en

tran

ts in

th

e sa

fe s

etti

ng

up

of e

quip

men

t. M

ain

tain

ing

an e

quip

men

t lo

g.

Th

e ev

iden

ce t

hat

th

e sk

ill s

ets

are

bein

g m

ain

tain

ed

cou

ld b

e re

view

ed d

uri

ng

the

ann

ual

indi

vidu

al

per

form

ance

rev

iew

.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

prep

are

the

QIS

n

urs

e to

an

tici

pate

, or

resp

ond

to in

fan

ts r

equ

irem

ents

fo

r su

ppor

tive

equ

ipm

ent

and

for

mon

itor

ing.

Dev

elop

s th

e sk

ills

to a

sses

s th

e in

fan

t’s r

equ

irem

ents

an

d se

lect

s th

e m

onit

orin

g eq

uip

men

t th

at t

he

infa

nt

requ

ires

, dem

onst

rate

s sa

fe a

nd

com

pet

ent

use

of

the

equ

ipm

ent.

Con

tin

ual

ly m

onit

ors

infa

nt’s

nee

ds a

nd

requ

irem

ents

an

d re

mov

es t

he

com

pon

ents

of

mon

itor

ing

wh

en n

o lo

nge

r re

quir

ed.

Au

dits

an

d m

onit

ors

com

plia

nce

wit

h u

nit

gu

idel

ines

an

d pr

otoc

ols

in t

he

safe

use

an

d cl

ean

ing

of

equ

ipm

ent.

Wh

en n

ew e

quip

men

t is

bei

ng

intr

odu

ced,

arr

ange

s de

mon

stra

tion

s, e

duca

tion

an

d tr

ain

ing

of s

taff

.

Dev

ises

gu

idel

ines

for

the

sett

ing

up

and

test

ing

of

equ

ipm

ent.

Dev

ises

gu

idel

ines

for

the

safe

use

of

equ

ipm

ent.

Edu

cate

s n

ew e

ntr

ants

in t

he

safe

use

of

equ

ipm

ent.

Mon

itor

com

plia

nce

wit

h u

nit

pol

icie

s.

Th

e as

sess

men

ts o

f le

arn

ing

and

profi

cien

cies

cou

ld

incl

ude

an

equ

ipm

ent

pass

por

t w

hic

h p

rovi

des

deta

il of

th

e eq

uip

men

t on

th

e u

nit

an

d th

e pr

acti

tion

er c

ould

lo

g th

e da

tes

that

th

ey w

ere

edu

cate

d to

saf

ely

use

eac

h

piec

e of

equ

ipm

ent

and

date

s eq

uip

men

t w

as u

sed.

Th

e ev

iden

ce t

hat

th

e sk

ill s

ets

are

bein

g m

ain

tain

ed

cou

ld b

e re

view

ed d

uri

ng

the

ann

ual

indi

vidu

al

per

form

ance

rev

iew

.



Flui

d, e

lect

roly

te, n

utri

tion

and

eli

min

atio

n m

anag

emen

t –

lear

ning

out

com

es

Qua

lifi

ed in

sp

ecia

lity

B

ands

6-8

+

E

nhan

ced

prac

tice

nur

se/

spec

iali

st n

urse

A

dvan

ced

neon

atal

nur

se p

ract

itio

ner

(AN

NP

) C

onsu

ltan

t nu

rse

Kn

owle

dge

and

skill

s ou

tcom

es.

All

prac

titi

oner

s ar

e re

quir

ed t

o sk

ilfu

lly

man

age

an in

fan

t’s fl

uid

, el

ectr

olyt

e, n

utr

itio

nal

an

d el

imin

atio

n n

eeds

.

All

pra

ctit

ion

ers

will

u

nde

rsta

nd

and

prom

ote

the

imp

orta

nce

of

incl

udi

ng

the

fam

ily in

th

e in

fan

t’s c

are

plan

May

be

clin

ical

ly s

upp

orte

d an

d pr

epar

ed t

o de

velo

p an

en

han

ced

set

of c

linic

al s

kills

bu

ildin

g on

th

ose

of

the

QIS

an

d w

orki

ng

tow

ards

th

ose

of t

he

AN

NP.

May

be

QIS

wit

h a

sp

ecia

list

inte

rest

in o

r fo

r ex

ampl

e ac

tive

ly r

esea

rch

ing

asp

ects

of

neo

nat

al n

utr

itio

n a

nd

grow

th.

Lik

ely

to b

e a

besp

oke

role

bu

t th

e pr

ofes

sion

al w

ould

re

quir

e pr

epar

atio

n o

n t

he

eth

ical

an

d th

eore

tica

l as

pec

ts o

f p

erfo

rmin

g re

sear

ch o

n t

his

coh

ort

of

subj

ects

.

Lik

ely

to b

e ed

uca

ted

to a

mas

ter’

s le

vel w

ith

add

itio

nal

qu

alifi

cati

ons

to p

rovi

de in

sigh

t in

to q

ual

itat

ive

and

quan

tita

tive

met

hod

olog

ies.

May

per

form

res

earc

h a

s pa

rt o

f a

rese

arch

tea

m o

r as

an

indi

vidu

al, p

erh

aps

in p

art

fulfi

lmen

t of

doc

tori

al

rese

arch

bu

t pr

opos

al w

ill h

ave

been

scr

een

ed a

nd

ongo

ing

wor

k w

ill b

e m

onit

ored

by

rese

arch

eth

ics

com

mit

tees

an

d ot

her

s.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

ers

skill

s ar

e lik

ely

to b

e n

egot

iate

d in

su

ch a

way

as

to m

eet

the

requ

irem

ents

of

reva

lidat

ion

an

d ca

n b

e m

onit

ored

du

rin

g th

e in

divi

dual

’s a

nn

ual

per

form

ance

rev

iew

.

Req

uir

emen

ts in

clu

de a

pro

gram

me

of p

repa

rati

on

desi

gned

to

equ

ip t

he

AN

NP

to

un

dert

ake

an

appr

opri

ate

his

tory

, exa

min

atio

n, a

sses

smen

t, an

d p

erfo

rm in

vest

igat

ion

to

supp

ort

the

deve

lopm

ent

of

diff

eren

tial

dia

gnos

is, s

o al

low

ing

the

deliv

ery

of

appr

opri

ate

firs

t lin

e an

d co

nti

nu

ing

con

serv

ativ

e,

supp

orti

ve o

r ac

tive

man

agem

ent

and

trea

tmen

t fo

r an

y su

spec

ted

GI

prob

lem

, or

prob

lem

wit

h u

rin

ary

trac

t fu

nct

ion

an

d bi

liru

bin

elim

inat

ion

.

Th

e pr

ogra

mm

e w

ill p

rovi

de t

he

theo

reti

cal b

asis

for

the

deve

lopm

ent

of p

ract

ical

ski

lls r

equ

ired

in o

rder

to

supp

ort

effe

ctiv

e in

fan

t’s fl

uid

, ele

ctro

lyte

, nu

trit

ion

an

d el

imin

atio

n fu

nct

ion

. Th

is w

ill in

clu

de

embr

yolo

gy, a

nat

omy

and

phys

iolo

gy o

f th

e re

nal

, ga

stro

inte

stin

al, a

nd

hep

atic

sys

tem

s an

d co

mm

on

con

gen

ital

an

omal

ies.

Th

e ex

pec

tati

on is

th

at t

he

deve

lopi

ng

or e

xper

ien

ced

AN

NP

will

uti

lise

loca

l un

it a

nd

nat

ion

al g

uid

elin

es a

s a

ben

chm

ark

for

exp

ecte

d pr

acti

ce in

th

is a

rea.

Th

e pr

ogra

mm

e of

stu

dy w

ill in

clu

de c

onte

nt

on

mu

ltid

isci

plin

ary

wor

kin

g, c

olla

bora

tion

an

d le

ader

ship

to

prom

ote

pos

itiv

e ou

tcom

es fo

r in

fan

ts

and

thei

r fa

mili

es w

hen

face

d w

ith

a G

I, u

rin

ary

or

flu

id-r

elat

ed c

ondi

tion

.

Th

is p

rogr

amm

e w

ill in

clu

de t

he

spec

ific

con

ten

t fo

r n

on-m

edic

al p

resc

ribi

ng

to t

he

acce

pte

d pr

ofes

sion

al

stan

dard

, to

supp

ort

pres

crib

ing

of in

trav

enou

s/in

tra-

arte

rial

flu

ids,

tot

al p

aren

tera

l nu

trit

ion

an

d fl

uid

/nu

trit

ion

su

pple

men

tati

on.

Th

e op

erat

ion

of

the

AN

NP

pro

gram

me

will

en

sure

th

at t

he

stu

den

t pr

ogre

sses

alo

ng

a co

nti

nu

um

tow

ards

co

mp

eten

ce in

flu

id, e

lect

roly

te, n

utr

itio

n a

nd

elim

inat

ion

, by

dire

ct s

upp

ort

thro

ugh

clin

ical

m

ento

rin

g (f

ello

w A

NN

P/c

onsu

ltan

t) a

nd

prac

tice

su

per

visi

on (

sen

ior

AN

NP

/reg

istr

ar o

r co

nsu

ltan

t) t

o m

ain

tain

pat

ien

t sa

fety

an

d en

able

con

fide

nce

wit

hin

th

e ch

angi

ng

para

digm

of

prac

tice

.

Post

hol

ders

sh

ould

be

edu

cate

d to

Ph

D le

vel.

Th

e ro

le o

f th

e n

urs

e co

nsu

ltan

t w

ith

in t

his

are

a w

ould

in

clu

de t

hei

r ab

ility

to

asse

ss, p

lan

an

d m

anag

e in

fan

ts.

Wit

h in

crea

sin

g aw

aren

ess

of t

he

imp

orta

nce

of

neo

nat

al n

utr

itio

n, t

he

role

of

con

sult

ant

neo

nat

al

nu

rse

nu

trit

ion

ist

cou

ld b

e de

velo

ped

.

Th

is w

ould

be

likel

y to

be

a be

spok

e ro

le a

nd

the

prog

ram

me

of p

repa

rati

on w

ould

incl

ude

ele

men

ts

from

die

teti

c pr

ogra

mm

es. W

her

e th

e ro

le in

clu

ded

resp

onsi

bilit

y fo

r pr

escr

ibin

g T

PN

, som

e ph

arm

aceu

tica

l pre

para

tion

wou

ld e

nh

ance

th

e qu

alit

y of

car

e of

fere

d to

th

e in

fan

t.

Mot

her

s of

neo

nat

al in

fan

ts a

re in

a u

niq

uel

y vu

lner

able

p

osit

ion

wit

h r

egar

ds t

o es

tabl

ish

ing

lact

atio

n a

nd

succ

essf

ul b

reas

tfee

din

g. M

any

un

its

hav

e de

velo

ped

th

e ro

le o

f co

nsu

ltan

t n

urs

e to

ove

rsee

, dev

elop

an

d su

ppor

t th

e su

cces

s of

th

e u

nit

’s b

reas

tfee

din

g ag

enda

.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

er’s

ski

lls

are

likel

y to

be

neg

otia

ted

in s

uch

a w

ay a

s to

mee

t th

e re

quir

emen

ts o

f re

valid

atio

n a

nd

can

be

mon

itor

ed

duri

ng

the

indi

vidu

al’s

an

nu

al p

erfo

rman

ce r

evie

w. I

n

the

case

of

infa

nt

feed

ing,

th

ere

is li

kely

to

be u

pdat

ed

evid

ence

from

UN

ICE

F an

d/or

ESP

GH

AN

(E

uro

pea

n

Soci

ety

for

Paed

iatr

ic G

astr

oen

tero

logy

, Hep

atol

ogy

and

Nu

trit

ion

) w

hic

h t

he

clin

icia

n w

ould

nee

d to

kee

p u

pdat

ed w

ith

, an

d as

su

ch w

ould

nee

d to

be

able

to

cite

th

is a

s ev

iden

ce.

90


Return to contents

Flui

d, e

lect

roly

te, n

utri

tion

and

eli

min

atio

n m

anag

emen

t –

lear

ning

out

com

es (

cont

inue

d)

Qua

lifi

ed in

sp

ecia

lity

B

ands

6-8

+

E

nhan

ced

prac

tice

nur

se/

spec

iali

st n

urse

A

dvan

ced

neon

atal

nur

se p

ract

itio

ner

(AN

NP

) C

onsu

ltan

t nu

rse

Th

e de

velo

pmen

t of

com

pet

ence

in p

ract

ical

ski

lls

(in

trav

enou

s an

d in

tra-

arte

rial

acc

ess,

um

bilic

al li

nes

an

d so

fort

h)

will

be

supp

orte

d by

a c

lear

rat

ion

ale

wh

ich

iden

tifi

es t

he

theo

reti

cal u

nde

rpin

nin

g,

sup

ervi

sed

sim

ula

ted

prac

tice

(w

her

e p

ossi

ble)

, su

per

vise

d pr

acti

ce, d

evel

opm

ent

of p

ract

ical

an

d th

eore

tica

l com

pet

ence

, an

d su

bseq

uen

tly

self

- re

flec

tive

on

goin

g as

sess

men

t of

com

pet

ence

. Th

is

latt

er e

lem

ent

will

be

supp

orte

d by

an

nu

al u

pdat

es a

s de

fin

ed w

ith

in t

he

orga

nis

atio

n, a

nd

will

incl

ude

re

vert

ing

to s

up

ervi

sed

prac

tice

in t

he

even

t of

ski

ll de

teri

orat

ion

in li

ne

wit

h p

rofe

ssio

nal

exp

ecta

tion

s.

Spec

ifica

lly, t

he

AN

NP

pro

gram

me

will

pro

vide

op

por

tun

itie

s an

d pr

epar

e th

e st

ude

nt

to:

• as

sess

nu

trit

ion

al s

tatu

s de

viat

ion

s in

gro

wth

tr

ajec

tory

an

d re

view

th

e n

eed

for

supp

lem

enta

tion

an

d pr

escr

ibe

thes

e•

asse

ss t

he

stab

ility

of

the

infa

nt

to p

resc

ribe

tro

pic

feed

ing

and

take

th

e le

ad o

n t

ailo

rin

g th

e pr

ogre

ssio

n o

f th

is p

roce

ss t

o in

crea

se fe

eds

• as

sess

th

e fu

nct

ion

of

the

gut,

diag

nos

is o

f N

EC

, pr

escr

ibe

man

agem

ent

of N

EC

• pr

escr

ibe

TP

N a

nd

elec

trol

yte

supp

lem

enta

tion

ac

cord

ing

to t

he

infa

nt’s

un

iqu

e n

eeds

• d

iagn

ose

hyp

erbi

liru

bin

aem

ia p

erfo

rm

mea

sure

men

t of

th

is a

nd

pres

crib

e as

app

ropr

iate

th

e co

rrec

t st

rate

gy t

o m

anag

e th

is a

ccor

din

g to

th

e u

niq

ue

nee

ds o

f th

e in

fan

t•

per

form

exc

han

ge t

ran

sfu

sion

s, in

itia

lly u

nde

r su

per

visi

on p

rogr

essi

ng

tow

ards

au

ton

omou

s pr

acti

ce•

asse

ss t

he

infa

nt’s

su

ckin

g ab

ility

, pla

n a

str

ateg

y to

be

follo

wed

wh

en in

fan

ts c

ann

ot b

e fe

d or

ally

• p

erfo

rm e

mer

gen

cy a

nd

rou

tin

e re

plac

emen

ts o

f ga

stro

stom

y tu

bes.

Con

solid

atio

n o

f cr

itic

al a

nal

ysis

ski

lls w

ill e

nab

le t

he

AN

NP

to

rese

arch

, au

dit

and

revi

se g

uid

elin

es a

nd

evid

ence

to

prom

ote

best

pra

ctic

e w

ith

med

ical

an

d n

urs

ing

colle

agu

es, a

nd

deve

lop

prac

tice

in li

ne

wit

h

tech

nol

ogic

al a

dvan

ces.



Exp

erie

nce

d A

NN

Ps w

ill t

ake

the

lead

in t

he

teac

hin

g an

d su

per

visi

on o

f m

edic

al s

taff

wh

o h

ave

limit

ed

exp

erie

nce

of

neo

nat

al c

are

and

oth

er n

urs

ing

grad

es

to h

elp

role

pro

gres

sion

.

Neo

nat

al s

taff

dev

elop

men

t ed

uca

tors

req

uir

ed t

o co

-ord

inat

e th

e ed

uca

tion

an

d de

velo

pmen

t of

th

e n

eon

atal

nu

rsin

g te

am. M

ust

be

skill

ed a

nd

equ

ipp

ed

to le

ad e

xper

t ed

uca

tion

al s

essi

ons

in H

EIs

.

It is

rec

ogn

ised

th

an n

ot a

ll u

nit

s h

ave

the

acu

ity

to

ensu

re t

hat

ski

lls a

re r

etai

ned

at

an a

dvan

ced

leve

l. St

rate

gies

su

ch a

s p

eer

revi

ew, s

imu

lati

on o

r ro

tati

on

to o

ther

mor

e ac

ute

un

its

will

en

sure

ret

enti

on o

f co

mp

eten

ces.

Ret

enti

on o

f co

mp

eten

ces

can

be

asse

ssed

by

mai

nta

inin

g a

skill

s lo

g an

d re

view

ing

it a

nn

ual

ly

duri

ng

the

indi

vidu

al p

erfo

rman

ce r

evie

w.

92


Return to contents

Neu

rolo

gica

l, d

evel

opm

enta

l car

e an

d pa

in m

anag

emen

t –

lear

ning

out

com

es

Qua

lifi

ed in

sp

ecia

lity

B

ands

6-8

+

E

nhan

ced

prac

tice

nur

se/

spec

iali

st n

urse

A

dvan

ced

neon

atal

nur

se p

ract

itio

ner

(AN

NP

) C

onsu

ltan

t nu

rse

All

prac

titi

oner

s ar

e re

quir

ed t

o sk

ilfu

lly

asse

ss a

nd

prom

ote

the

care

req

uir

ed t

o m

eet

opti

mal

neu

rolo

gica

l w

ellb

ein

g.

All

prac

titi

oner

s w

ill

un

ders

tan

d an

d pr

omot

e th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in

the

infa

nt’s

car

e pl

an.

En

han

ced

prac

tice

rol

es m

ay in

volv

e tr

ain

ing

and

deve

lopm

ent

desi

gned

to

build

on

th

e Q

IS s

kill

set

and

be w

orki

ng

tow

ards

th

e sk

ills

iden

tifi

ed w

ith

in t

he

AN

NP

sec

tion

.

Neo

nat

al n

urs

es m

ay d

evel

op s

pec

ialis

t n

urs

ing

role

s to

m

anag

e th

e h

olis

tic

care

of

infa

nts

wh

o h

ave

neu

rolo

gica

l car

e re

quir

emen

ts, a

nee

d fo

r on

goin

g de

velo

pmen

tal c

are

and

nu

rses

wh

o sp

ecia

lise

in in

fan

t pa

in m

anag

emen

t. T

hes

e ar

e lik

ely

to h

ave

besp

oke

role

s re

flec

tin

g th

e re

quir

emen

ts o

f th

e u

nit

s in

wh

ich

th

ey w

ork.

For

exam

ple

nu

rses

wh

o m

anag

e de

velo

pmen

t ca

re

follo

w-u

ps m

ay h

old

qual

ifica

tion

s in

psy

chol

ogy,

h

ospi

tal p

lay

ther

apy

or p

hysi

oth

erap

y.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

er’s

ski

lls

are

likel

y to

be

neg

otia

ted

in s

uch

a w

ay a

s to

mee

t th

e re

quir

emen

ts o

f re

valid

atio

n a

nd

can

be

mon

itor

ed

duri

ng

the

indi

vidu

al’s

an

nu

al p

erfo

rman

ce r

evie

w.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

des

ign

ed t

o eq

uip

th

e A

NN

P t

o u

nde

rtak

e an

app

ropr

iate

his

tory

, ex

amin

atio

n, a

sses

smen

t, an

d p

erfo

rm in

vest

igat

ion

to

supp

ort

the

deve

lopm

ent

of d

iffe

ren

tial

dia

gnos

is, s

o al

low

ing

the

deliv

ery

of a

ppro

pria

te fi

rst

line

and

con

tin

uin

g co

nse

rvat

ive,

su

ppor

tive

or

acti

ve

man

agem

ent

and

trea

tmen

t fo

r an

y su

spec

ted

com

mon

neu

rolo

gica

l, de

velo

pmen

tal a

nd

sen

sory

co

ndi

tion

.

Th

e pr

ogra

mm

e w

ill p

rovi

de t

he

theo

reti

cal b

asis

for

the

deve

lopm

ent

of p

ract

ical

ski

lls r

equ

ired

in o

rder

to

supp

ort

appr

opri

ate

neu

rolo

gica

l fu

nct

ion

. T

his

will

in

clu

de e

mbr

yolo

gy, a

nat

omy

and

phys

iolo

gy o

f th

e n

euro

logi

cal,

mu

scu

lar-

skel

etal

, an

d n

ervo

us

syst

ems

and

com

mon

con

gen

ital

an

omal

ies.

Th

e ex

pec

tati

on is

th

at t

he

deve

lopi

ng

or e

xper

ien

ced

AN

NP

will

uti

lise

loca

l un

it a

nd

nat

ion

al g

uid

elin

es a

s a

ben

chm

ark

for

exp

ecte

d pr

acti

ce in

th

is a

rea.

Th

is p

rogr

amm

e w

ill in

clu

de t

he

spec

ific

con

ten

t fo

r n

on-m

edic

al p

resc

ribi

ng

to t

he

acce

pte

d pr

ofes

sion

al

stan

dard

, to

supp

ort

pres

crib

ing

of m

edic

atio

n t

o m

anag

e/al

levi

ate

sym

pto

ms

and

prov

ide

com

fort

.

Th

e pr

ogra

mm

e of

stu

dy w

ill in

clu

de c

onte

nt

on

mu

ltid

isci

plin

ary

wor

kin

g, c

olla

bora

tion

an

d le

ader

ship

to

prom

ote

pos

itiv

e ou

tcom

es fo

r in

fan

ts

and

thei

r fa

mili

es w

hen

face

d w

ith

an

infa

nt

wit

h

neu

rolo

gica

l, de

velo

pmen

tal o

r se

nso

ry a

nom

alie

s an

d w

ill u

se t

he

sam

e op

erat

ion

al s

upp

ort,

supp

orti

ve

com

pet

ence

dev

elop

men

t st

rate

gy, a

nd

ongo

ing

mai

nte

nan

ce o

f co

mp

eten

ce a

s pr

evio

usl

y st

ated

.

Nu

rse

con

sult

ants

wor

kin

g w

ith

in t

he

spec

ialis

t ar

ea o

f de

velo

pmen

tal c

are

may

hav

e u

nde

rgon

e tr

ain

ing

such

as

NID

CA

P (

New

born

In

divi

dual

ized

Dev

elop

men

tal

Car

e an

d A

sses

smen

t P

rogr

amm

e) t

rain

ing

or/a

nd

Bra

zelt

on N

BA

S tr

ain

ing

(neo

nat

al b

ehav

iou

ral

asse

ssm

ent

scal

e) o

r si

mila

r.

Th

ere

will

th

eref

ore

be a

req

uir

emen

t to

kee

p th

is u

p to

da

te a

nd

retr

ain

as

requ

ired

wit

hin

eac

h in

divi

dual

tr

ain

ing

prog

ram

me.

NID

CA

P t

rain

ing,

for

exam

ple,

h

as e

nco

mpa

ssed

clin

ical

su

per

visi

on w

ith

in it

an

d th

is

hel

ps s

upp

ort

subs

equ

ent

per

form

ance

man

agem

ent.

Spec

ific

skill

s in

rel

atio

n t

o n

euro

logy

su

ch a

s u

ltra

sou

nd

scan

nin

g w

ill b

e ta

ugh

t as

an

d w

hen

th

e n

urs

e co

nsu

ltan

t is

goi

ng

to s

pec

ialis

e w

ith

in t

hat

are

a an

d is

not

a s

kill

that

all

will

pos

sess

. In

th

e fu

ture

, h

owev

er, t

he

abili

ty t

o u

nde

rtak

e a

‘fun

ctio

nal

’ sca

n m

ay

be p

art

of t

he

role

in t

his

par

ticu

lar

area

. Th

is w

ould

th

en b

e as

sess

ed a

s ap

prop

riat

e, b

ut

may

be

by p

airi

ng

scan

s w

ith

an

oth

er p

ract

itio

ner

an

d co

mpa

rin

g re

sult

s.



Th

e de

velo

pmen

t of

com

pet

ence

in p

ract

ical

ski

lls

(lu

mba

r pu

nct

ure

, cer

ebra

l fu

nct

ion

ing

mon

itor

ing,

in

ter-

cran

ial t

aps,

inte

r-cr

ania

l pre

ssu

re d

evic

es,

ther

apeu

tic

cool

ing)

will

be

supp

orte

d by

a c

lear

ra

tion

ale

wh

ich

iden

tifi

es t

he

theo

reti

cal

un

derp

inn

ing)

, su

per

vise

d si

mu

late

d pr

acti

ce (

wh

ere

pos

sibl

e, s

up

ervi

sed

prac

tice

, dev

elop

men

t of

pra

ctic

al

and

theo

reti

cal c

omp

eten

ce, a

nd

subs

equ

entl

y se

lf-r

eflec

tive

on

goin

g as

sess

men

t of

com

pet

ence

. Th

is

latt

er e

lem

ent

will

be

supp

orte

d by

an

nu

al u

pdat

es a

s de

fin

ed w

ith

in t

he

orga

nis

atio

n, a

nd

will

incl

ude

re

vert

ing

to s

up

ervi

sed

prac

tice

in t

he

even

t of

ski

ll de

teri

orat

ion

in li

ne

wit

h p

rofe

ssio

nal

exp

ecta

tion

s.

Spec

ifica

lly t

he

AN

NP

pro

gram

me

will

pro

vide

op

por

tun

itie

s an

d pr

epar

e th

e st

ude

nt

to:

• ta

ke t

he

lead

on

ass

essi

ng

the

infa

nt’s

pai

n a

nd

the

phar

mac

olog

ical

an

d n

on-p

har

mac

olog

ical

met

hod

s of

pai

n m

anag

emen

t•

asse

ss a

nd

man

age

the

infa

nt

wit

h N

AS

• as

sess

an

d m

anag

e in

fan

ts w

ho

hav

e a

ran

ge o

f n

euro

logi

cal p

ath

olog

y an

d p

oten

tial

defi

cits

; for

ex

ampl

e, t

he

infa

nt

wh

o is

con

vuls

ing,

has

ex

per

ien

ced

hae

mor

rhag

e an

d in

fan

ts w

ho

are

deve

lopi

ng

hydr

ocep

hal

us.

Con

solid

atio

n o

f cr

itic

al a

nal

ysis

ski

lls w

ill e

nab

le t

he

AN

NP

to

rese

arch

, au

dit

and

revi

se g

uid

elin

es a

nd

evid

ence

to

prom

ote

best

pra

ctic

e w

ith

med

ical

an

d n

urs

ing

colle

agu

es, a

nd

deve

lop

prac

tice

in li

ne

wit

h

tech

nol

ogic

al a

dvan

ces

wit

hin

neu

rolo

gica

l, de

velo

pmen

tal a

nd

sen

sory

con

diti

ons.

Exp

erie

nce

d A

NN

Ps w

ill t

ake

the

lead

in t

he

teac

hin

g an

d su

per

visi

on o

f m

edic

al s

taff

wh

o h

ave

limit

ed

exp

erie

nce

of

neo

nat

al c

are

and

oth

er n

urs

ing

grad

es

to h

elp

role

pro

gres

sion

in t

his

are

a.It

is r

ecog

nis

ed t

han

not

all

un

its

hav

e th

e ac

uit

y to

en

sure

th

at s

kills

are

att

ain

ed o

r re

tain

ed a

t an

ad

van

ced

leve

l. St

rate

gies

su

ch a

s p

eer

revi

ew,

sim

ula

tion

or

rota

tion

to

oth

er m

ore

acu

te u

nit

s w

ill

ensu

re d

evel

opm

ent

and

rete

nti

on o

f co

mp

eten

ces.

Ret

enti

on o

f co

mp

eten

ces

can

be

asse

ssed

by

the

mai

nta

inin

g of

a s

kills

log

and

revi

ewed

an

nu

ally

du

rin

g th

e in

divi

dual

per

form

ance

rev

iew

.

94


Return to contents

Res

pira

tory

and

car

diov

ascu

lar

man

agem

ent

– le

arni

ng o

utco

mes

Qua

lifi

ed in

sp

ecia

lity

B

ands

6-8

+

E

nhan

ced

prac

tice

nur

se/

spec

iali

st n

urse

A

dvan

ced

neon

atal

nur

se p

ract

itio

ner

(AN

NP

) C

onsu

ltan

t nu

rse

All

prac

titi

oner

s ar

e re

quir

ed t

o m

ain

tain

th

e op

tim

al r

espi

rato

ry a

nd

card

iova

scu

lar

fun

ctio

nin

g of

th

e in

fan

t.

All

prac

titi

oner

s w

ill

un

ders

tan

d an

d pr

omot

e th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in

the

infa

nt’s

car

e pl

an.

En

han

ced

clin

ical

pra

ctic

e.

Th

e U

K m

ay fo

llow

th

e ex

ampl

e of

som

e A

mer

ican

neo

nat

al u

nit

s an

d co

nsi

der

the

role

of

the

resp

irat

ory

ther

apis

t to

en

han

ce t

he

care

of

infa

nts

wh

o ar

e ox

ygen

dep

ende

nt

or h

ave

ven

tila

tion

req

uir

emen

ts w

hic

h w

ould

fall

un

der

a de

sign

ated

sco

pe

wit

hin

pra

ctic

e.

Such

indi

vidu

als

wou

ld b

e ed

uca

ted

to m

aste

r’s

leve

l an

d h

old

addi

tion

al q

ual

ifica

tion

refl

ecti

ng

thei

r ex

per

tise

in a

dvan

ced

phys

iolo

gy.

Neo

nat

al n

urs

es m

ay p

erfo

rm r

esea

rch

in a

reas

re

late

d to

res

pira

tory

an

d ca

rdio

vasc

ula

r sy

stem

s m

anag

emen

t. T

his

may

eit

her

be

as p

art

of a

re

sear

ch t

eam

or

as a

n in

divi

dual

, per

hap

s in

par

t fu

lfilm

ent

of d

octo

rial

res

earc

h u

nde

r th

e gu

idan

ce o

f a

sup

ervi

sory

tea

m.

Such

res

earc

h

will

hav

e be

en s

cree

ned

an

d on

goin

g w

ork

will

be

mon

itor

ed b

y re

sear

ch e

thic

s co

mm

itte

es a

nd

so

fort

h.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

er’s

sk

ills

are

likel

y to

be

neg

otia

ted

in s

uch

a w

ay a

s to

m

eet

the

requ

irem

ents

of

reva

lidat

ion

an

d ca

n b

e m

onit

ored

du

rin

g th

e in

divi

dual

’s a

nn

ual

p

erfo

rman

ce r

evie

w.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

des

ign

ed t

o eq

uip

th

e A

NN

P t

o u

nde

rtak

e an

app

ropr

iate

his

tory

, exa

min

e,

asse

ss, a

nd

per

form

inve

stig

atio

n t

o su

ppor

t th

e de

velo

pmen

t of

dif

fere

nti

al d

iagn

osis

, so

allo

win

g th

e in

stig

atio

n a

nd

deliv

ery

of a

ppro

pria

te fi

rst-

line

and

con

tin

uin

g co

nse

rvat

ive,

su

ppor

tive

or

acti

ve m

anag

emen

t an

d tr

eatm

ent

for

com

mon

su

spec

ted

resp

irat

ory

or

card

iova

scu

lar

prob

lem

s.

Th

e pr

ogra

mm

e w

ill p

rovi

de t

he

theo

reti

cal b

asis

for

the

deve

lopm

ent

of p

ract

ical

ski

lls r

equ

ired

to s

upp

ort

effe

ctiv

e re

spir

ator

y an

d ca

rdio

vasc

ula

r fu

nct

ion

. Th

is w

ill in

clu

de

embr

yolo

gy, a

nat

omy,

phy

siol

ogy

and

mat

ura

tion

al

deve

lopm

ent

of t

he

resp

irat

ory

and

card

iova

scu

lar

syst

ems,

an

d co

mm

on c

onge

nit

al a

nom

alie

s.

Th

e ex

pec

tati

on is

th

at t

he

deve

lopi

ng

or e

xper

ien

ced

AN

NP

will

uti

lise

loca

l un

it a

nd

nat

ion

al g

uid

elin

es a

s a

ben

chm

ark

for

exp

ecte

d pr

acti

ce in

th

is a

rea.

Th

is p

rogr

amm

e w

ill in

clu

de t

he

spec

ific

con

ten

t fo

r n

on-m

edic

al p

resc

ribi

ng

to t

he

acce

pte

d pr

ofes

sion

al

stan

dard

, to

supp

ort

pres

crib

ing

of m

edic

atio

ns

for

effe

ctiv

e re

spir

ator

y an

d ca

rdio

vasc

ula

r fu

nct

ion

su

ch a

s se

dat

ion

/an

alge

sia

and

mu

scle

rel

axat

ion

to

mai

nta

in

infa

nt

com

fort

an

d co

mpl

ian

ce w

ith

su

ppor

tive

ven

tila

tion

.

Th

e pr

ogra

mm

e w

ill in

clu

de c

onte

nt

on m

ult

idis

cipl

inar

y w

orki

ng,

col

labo

rati

on a

nd

lead

ersh

ip t

o pr

omot

e p

osit

ive

outc

omes

for

infa

nts

an

d th

eir

fam

ilies

wh

en fa

ced

wit

h a

n

infa

nt

wit

h r

espi

rato

ry o

f ca

rdio

vasc

ula

r pr

oble

ms

and

will

u

se t

he

sam

e op

erat

ion

al s

upp

ort,

supp

orti

ve c

omp

eten

ce

deve

lopm

ent

stra

tegy

, an

d on

goin

g m

ain

ten

ance

of

com

pet

ence

, as

prev

iou

sly

stat

ed.

Spec

ifica

lly t

he

AN

NP

pro

gram

me

will

pro

vide

op

por

tun

itie

s an

d pr

epar

e th

e st

ude

nt

to:

• p

erfo

rm a

nd

lead

adv

ance

d re

susc

itat

ion

an

d on

goin

g st

abili

sati

on

• re

cogn

ise

devi

atio

ns

from

nor

mal

res

pira

tory

an

d ca

rdio

vasc

ula

r fu

nct

ion

Nu

rse

con

sult

ants

may

lead

a t

eam

of

peo

ple

in

per

form

ing

wit

hin

th

e ro

les

requ

ired

in t

he

neo

nat

al

tran

spor

t se

rvic

es. T

hey

wou

ld u

sual

ly fo

llow

a c

aree

r pa

thw

ay fr

om A

NN

P a

nd

spec

ialis

t to

nu

rse

con

sult

ant

but

cou

ld h

ave

care

ers

wh

ich

hav

e in

clu

ded

para

med

ical

pa

thw

ays

and

neo

nat

al q

ual

ifica

tion

s.

Th

ere

is n

o sp

ecifi

c tr

ain

ing

wh

ich

is r

ecog

nis

ed fo

r n

urs

e co

nsu

ltan

ts in

tra

nsp

ort,

thou

gh t

her

e ar

e so

me

cou

rses

wh

ich

wou

ld s

upp

ort

thei

r n

eeds

. Th

ese

may

be

likel

y to

hav

e be

en u

nde

rtak

en a

s st

aff

nu

rses

/sis

ter

role

s. T

his

incl

ude

s Pa

NST

aR (

Paed

iatr

ic a

nd

Neo

nat

al

Safe

Tra

nsf

er a

nd

Ret

riev

al C

ours

e) a

nd

the

STA

BL

E

prog

ram

me,

con

cen

trat

ing

on s

tabi

lisat

ion

pri

or t

o tr

ansp

ort.

Th

ere

may

be

som

e ot

her

s w

hic

h m

ay h

elp

to a

ssis

t pr

acti

tion

ers

wit

h t

he

diffi

cult

an

d se

riou

s n

atu

re o

f u

nde

rtak

ing

com

plex

cas

es s

uch

as

the

AR

NI

cou

rse

(adv

ance

d re

susc

itat

ion

of

the

new

born

infa

nt)

bu

t th

ey a

re n

ot s

pec

ific

to t

ran

spor

t. O

ther

s m

ay

un

dert

ake

in-h

ouse

tra

inin

g w

ith

th

eir

med

ical

co

un

terp

arts

or

may

als

o ge

t so

me

trai

nin

g fr

om

over

seas

.

Ass

essm

ent

and

rete

nti

on o

f sk

ills

wou

ld n

eed

to b

e re

view

ed a

t an

nu

al r

evie

w o

r ag

ain

via

OSC

Es

or p

eer

revi

ew.

Th

e n

urs

e co

nsu

ltan

t w

ould

nee

d sk

ills

of x

-ray

in

terp

reta

tion

as

wel

l as

som

e ba

sic

skill

s of

ult

raso

un

d sc

an fo

r fu

nct

ion

.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

ers

skill

s ar

e lik

ely

to b

e n

egot

iate

d in

su

ch a

way

as

to m

eet

the

requ

irem

ents

of

reva

lidat

ion

an

d ca

n b

e m

onit

ored

du

rin

g th

e in

divi

dual

s an

nu

al p

erfo

rman

ce r

evie

w.

Ass

essm

ent

of s

can

rea

din

g ab

iliti

es fo

r ex

ampl

e co

uld

be

by

pair

ing

scan

s an

d X

-ray

s an

d co

mpa

rin

g th

e di

agn

osis

an

d fi

ndi

ngs

of

the

prac

titi

oner

wit

h a

not

her

cl

inic

ian

.



• in

itia

te, i

nte

rpre

t an

d re

spon

d to

tre

nds

in t

he

resu

lts

of

bloo

d ga

s an

alys

is•

dia

gnos

e re

spir

ator

y pa

thol

ogy

inte

rpre

tati

on o

f ch

est

radi

ogra

phy

and

pres

crib

e an

d in

stig

ate

supp

orti

ve

inte

rven

tion

s an

d th

erap

ies

follo

win

g in

fan

t as

sess

men

t •

per

form

intu

bati

on, a

dmin

iste

r su

rfac

tan

t•

asse

ss t

he

infa

nt’s

indi

vidu

al a

nd

ongo

ing

resp

irat

ory

requ

irem

ents

an

d in

itia

te a

ran

ge o

f n

on-i

nvas

ive

and

inva

sive

ven

tila

tion

mod

alit

ies

(TV

V, P

TV

, PSV

, HFO

V),

in

clu

din

g th

e su

bseq

uen

t m

anag

emen

t of

ch

ron

ic lu

ng

dis

ease

• de

mon

stra

te u

nde

rsta

ndi

ng

and

appl

icat

ion

of

adju

nct

ive

resp

irat

ory

supp

ort,

for

exam

ple

nit

ric

oxid

e in

hal

atio

n (

iNO

), s

yste

mic

pu

lmon

ary

vaso

dila

tors

• em

erge

ncy

man

agem

ent

of p

neu

mot

hor

ax a

nd

inse

rtio

n,

secu

rin

g an

d re

mov

e ch

est

drai

ns

• as

sess

th

e n

eed

for

and

pres

crib

e in

otro

pic

supp

ort

• as

sess

res

pira

tory

an

d ca

rdia

c so

un

ds, a

nd

exam

ine

the

infa

nt

to s

upp

ort

diag

nos

is o

f u

nde

rlyi

ng

card

iore

spir

ator

y di

seas

e or

def

ect

• le

ad in

th

e m

anag

emen

t of

com

plex

cas

e di

sch

arge

p

lan

nin

g.

Con

solid

atio

n o

f cr

itic

al a

nal

ysis

ski

lls w

ill e

nab

le t

he

AN

NP

to

rese

arch

, au

dit

and

revi

se g

uid

elin

es a

nd

evid

ence

to

prom

ote

best

pra

ctic

e w

ith

med

ical

an

d n

urs

ing

colle

agu

es, a

nd

deve

lop

prac

tice

in li

ne

wit

h

tech

nol

ogic

al a

dvan

ces.

Exp

erie

nce

d A

NN

Ps w

ill t

ake

the

lead

in t

he

teac

hin

g an

d su

per

visi

on o

f m

edic

al s

taff

wh

o h

ave

limit

ed e

xper

ien

ce

of n

eon

atal

car

e an

d ot

her

nu

rsin

g gr

ades

to

hel

p ro

le

prog

ress

ion

.

It is

rec

ogn

ised

th

an n

ot a

ll u

nit

s h

ave

the

acu

ity

to e

nsu

re

that

ski

lls a

re r

etai

ned

at

an a

dvan

ced

leve

l. St

rate

gies

su

ch

as p

eer

revi

ew, s

imu

lati

on o

r ro

tati

on t

o ot

her

mor

e ac

ute

u

nit

s w

ill e

nsu

re r

eten

tion

of

com

pet

ence

s.

It is

als

o re

cogn

ised

th

at s

ome

spec

ialis

t ar

eas

of

empl

oym

ent

will

res

ult

in a

ddit

ion

al c

omp

eten

ce

requ

irem

ents

su

ch a

s pa

ce-m

akin

g, E

CM

O (

incl

udi

ng

resc

ue

EC

MO

) or

ven

tric

ula

r as

sist

dev

ices

. App

ropr

iate

in

-hou

se o

r sp

ecia

list

trai

nin

g m

ust

be

un

dert

aken

ou

tsid

e of

th

e A

NN

P p

rogr

amm

e to

su

ppor

t th

is.

Ret

enti

on o

f co

mp

eten

ces

can

be

asse

ssed

by

the

mai

nta

inin

g of

a s

kills

log

and

revi

ewed

an

nu

ally

du

rin

g th

e in

divi

dual

per

form

ance

rev

iew

.

96


Return to contents

Ski

n, h

ygie

ne a

nd in

fect

ion

cont

rol m

anag

emen

t –

lear

ning

out

com

es

Qua

lifi

ed in

sp

ecia

lity

B

ands

6-8

+

E

nhan

ced

prac

tice

nur

se/

spec

iali

st n

urse

A

dvan

ced

neon

atal

nur

se p

ract

itio

ner

(AN

NP

) C

onsu

ltan

t nu

rse

Kn

owle

dge

and

skill

s ou

tcom

es.

Skin

, hyg

ien

e an

d in

fect

ion

con

trol

m

anag

emen

t.

All

prac

titi

oner

s w

ill

un

ders

tan

d an

d pr

omot

e th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in

the

infa

nt’s

car

e pl

an.

Th

ere

wou

ld b

e sc

ope

wh

en d

evel

opin

g a

com

preh

ensi

ve c

aree

r fr

amew

ork

for

neo

nat

al n

urs

es

to c

onsi

der

spec

ialis

t ro

les

in t

issu

e vi

abili

ty a

nd

in

infe

ctio

n c

ontr

ol a

nd

man

agem

ent.

Th

e pr

ogra

mm

e of

pre

para

tion

wou

ld b

e lik

ely

to b

e be

spok

e bu

t th

e p

ost

hol

der

wou

ld o

rdin

arily

be

edu

cate

d to

mas

ter’

s le

vel i

n p

hysi

olog

y or

m

icro

biol

ogy.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

ers

skill

s ar

e lik

ely

to b

e n

egot

iate

d in

su

ch a

way

as

to m

eet

the

requ

irem

ents

of

reva

lidat

ion

an

d ca

n b

e m

onit

ored

du

rin

g th

e in

divi

dual

’s a

nn

ual

per

form

ance

rev

iew

.

Th

e pr

ogra

mm

e of

pre

para

tion

is d

esig

ned

to

equ

ip

the

AN

NP

to

un

dert

ake

an a

ppro

pria

te h

isto

ry,

exam

ine,

ass

ess,

an

d p

erfo

rm in

vest

igat

ion

to

supp

ort

the

deve

lopm

ent

of d

iffe

ren

tial

dia

gnos

is, s

o al

low

ing

the

inst

igat

ion

an

d de

liver

y of

app

ropr

iate

firs

t lin

e an

d co

nti

nu

ing

con

serv

ativ

e, s

upp

orti

ve o

r ac

tive

m

anag

emen

t an

d tr

eatm

ent

for

com

mon

su

spec

ted

skin

, hyg

ien

e an

d in

fect

ion

rel

ated

pro

blem

s.

Th

e pr

ogra

mm

e w

ill p

rovi

de t

he

theo

reti

cal b

asis

for

the

deve

lopm

ent

of p

ract

ical

ski

lls r

equ

ired

to s

upp

ort

infe

ctio

n c

ontr

ol. T

his

will

incl

ude

em

bryo

logy

, an

atom

y, p

hysi

olog

y an

d m

atu

rati

onal

dev

elop

men

t of

th

e im

mu

ne

syst

em a

nd

inte

gum

enta

ry s

yste

ms,

an

d co

mm

on c

onge

nit

al a

nom

alie

s.

Th

e ex

pec

tati

on is

th

at t

he

deve

lopi

ng

or e

xper

ien

ced

AN

NP

will

uti

lise

loca

l un

it a

nd

nat

ion

al g

uid

elin

es a

s a

ben

chm

ark

for

exp

ecte

d pr

acti

ce in

th

is a

rea.

Th

is p

rogr

amm

e w

ill in

clu

de t

he

spec

ific

con

ten

t fo

r n

on-m

edic

al p

resc

ribi

ng

to t

he

acce

pte

d pr

ofes

sion

al

stan

dard

, to

supp

ort

pres

crib

ing

of m

edic

atio

ns

for

effe

ctiv

e m

anag

emen

t of

infe

ctio

ns,

an

d su

ppor

t fo

r m

ain

tain

ing

skin

inte

grit

y.

Th

e pr

ogra

mm

e of

stu

dy w

ill in

clu

de c

onte

nt

on

mu

ltid

isci

plin

ary

wor

kin

g, c

olla

bora

tion

an

d le

ader

ship

to

prom

ote

pos

itiv

e ou

tcom

es fo

r in

fan

ts

and

thei

r fa

mili

es w

hen

face

d w

ith

an

infa

nt

wit

h

infe

ctio

n o

r sk

in a

nom

aly

and

will

use

th

e sa

me

oper

atio

nal

su

ppor

t, su

ppor

tive

com

pet

ence

de

velo

pmen

t st

rate

gy, a

nd

ongo

ing

mai

nte

nan

ce o

f co

mp

eten

ce a

s pr

evio

usl

y st

ated

.

Tis

sue

viab

ility

con

sult

ants

an

d in

fect

ion

con

trol

co

nsu

ltan

ts a

re in

vari

ably

cen

tral

ly h

eld

role

s. H

owev

er,

wit

h in

crea

sin

g ce

ntr

alis

atio

n a

nd

neo

nat

al u

nit

s of

50

-60

cots

th

ere

cou

ld b

e m

erit

in c

onsi

deri

ng

besp

oke

role

s in

ord

er t

o m

eet

indi

vidu

al u

nit

’s r

equ

irem

ents

.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

ers

skill

s ar

e lik

ely

to b

e n

egot

iate

d in

su

ch a

way

as

to m

eet

the

requ

irem

ents

of

reva

lidat

ion

an

d ca

n b

e m

onit

ored

du

rin

g th

e in

divi

dual

’s a

nn

ual

per

form

ance

rev

iew

.



Spec

ifica

lly, t

he

AN

NP

pro

gram

me

will

pro

vide

op

por

tun

itie

s an

d pr

epar

e th

e st

ude

nt

to:

• le

ad in

man

agin

g in

fusi

on in

juri

es, s

urg

ical

wou

nds

an

d p

oten

tial

oth

er ia

trog

enic

wou

nd

care

•

per

form

infe

ctio

n s

cree

nin

g •

pres

crib

e an

d m

onit

or t

he

effe

ct o

f th

e th

erap

euti

c ag

ents

req

uir

ed t

o m

anag

e n

eon

atal

infe

ctio

ns.

Con

solid

atio

n o

f cr

itic

al a

nal

ysis

ski

lls w

ill e

nab

le t

he

AN

NP

to

rese

arch

, au

dit

and

revi

se g

uid

elin

es a

nd

evid

ence

to

prom

ote

best

pra

ctic

e w

ith

med

ical

an

d n

urs

ing

colle

agu

es, a

nd

deve

lop

prac

tice

in li

ne

wit

h

tech

nol

ogic

al a

dvan

ces.

Exp

erie

nce

d A

NN

Ps w

ill t

ake

the

lead

in t

he

teac

hin

g an

d su

per

visi

on o

f m

edic

al s

taff

in t

his

are

a w

ho

hav

e lim

ited

exp

erie

nce

of

neo

nat

al c

are

and

oth

er n

urs

ing

grad

es t

o h

elp

role

pro

gres

sion

.

It is

rec

ogn

ised

th

an n

ot a

ll u

nit

s h

ave

the

acu

ity

to

ensu

re t

hat

ski

lls a

re r

etai

ned

at

an a

dvan

ced

leve

l. St

rate

gies

su

ch a

s p

eer

revi

ew, s

imu

lati

on o

r ro

tati

on

to o

ther

mor

e ac

ute

un

its

will

en

sure

ret

enti

on o

f co

mp

eten

ces.

Ret

enti

on o

f co

mp

eten

ces

can

be

asse

ssed

by

the

mai

nta

inin

g of

a s

kills

log

and

revi

ewed

an

nu

ally

du

rin

g th

e in

divi

dual

’s p

erfo

rman

ce r

evie

w.

98


Return to contents

Infa

nt t

empe

ratu

re m

anag

emen

t –

lear

ning

out

com

es

Qua

lifi

ed in

sp

ecia

lity

B

ands

6-8

+

E

nhan

ced

prac

tice

nur

se/

spec

iali

st n

urse

A

dvan

ced

neon

atal

nur

se p

ract

itio

ner

(AN

NP

) C

onsu

ltan

t nu

rse

All

pra

ctit

ion

ers

will

u

nde

rsta

nd

and

prom

ote

the

imp

orta

nce

of

incl

udi

ng

the

fam

ily in

th

e in

fan

t’s c

are

plan

Som

e sp

ecia

list

un

its

use

pro

cedu

ral h

ypot

her

mia

as

part

of

a su

rgic

al p

roce

ss a

nd

in N

NU

s th

e be

nefi

ts o

f th

erap

euti

c hy

pot

her

mia

as

part

of

the

man

agem

ent

stra

tegi

es fo

r H

IE s

eem

to

be c

lear

. In

fan

ts w

ho

hav

e a

requ

irem

ent

for

this

th

erap

y co

uld

ben

efit

from

th

e ex

per

tise

of

a sp

ecia

list

nu

rse

wit

h e

xper

tise

in t

his

ar

ea. T

he

role

of

cool

ing

and

re-w

arm

ing

infa

nts

is

likel

y to

be

besp

oke

and

the

prep

arat

ion

req

uir

ed

equ

ippi

ng

a n

urs

e to

fun

ctio

n in

th

is a

rea

likel

y to

be

an in

hou

se p

rogr

amm

e.

Res

earc

h n

urs

es in

to t

he

use

of

ther

apeu

tic

hyp

oth

erm

ia. S

uch

nu

rses

wou

ld o

rdin

arily

be

prep

ared

to

the

edu

cati

onal

leve

l of

a m

aste

r’s

degr

ee,

wit

h a

ddit

ion

al q

ual

ifica

tion

s to

pro

vide

insi

ght

into

qu

alit

ativ

e an

d qu

anti

tati

ve m

eth

odol

ogie

s.

May

per

form

res

earc

h a

s pa

rt o

f a

rese

arch

tea

m o

r as

an

indi

vidu

al p

erh

aps

in p

art

fulfi

lmen

t of

doc

tori

al

rese

arch

bu

t pr

opos

al w

ill h

ave

been

scr

een

ed a

nd

ongo

ing

wor

k w

ill b

e m

onit

ored

by

rese

arch

eth

ics

com

mit

tees

.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

ers

skill

s ar

e lik

ely

to b

e n

egot

iate

d in

su

ch a

way

as

to m

eet

the

requ

irem

ents

of

reva

lidat

ion

an

d ca

n b

e m

onit

ored

du

rin

g th

e in

divi

dual

’s a

nn

ual

per

form

ance

rev

iew

.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

enab

le t

he

un

ders

tan

din

g of

th

e ef

fect

s th

at d

evia

tion

s fr

om t

he

nor

mal

tem

per

atu

re c

an h

ave

on t

he

infa

nt’s

m

etab

olis

m.

Th

e ex

pec

tati

on is

th

at t

he

deve

lopi

ng

or e

xper

ien

ced

AN

NP

will

uti

lise

loca

l un

it a

nd

nat

ion

al g

uid

elin

es a

s a

ben

chm

ark

for

exp

ecte

d pr

acti

ce in

th

is a

rea.

T

he

prog

ram

me

of s

tudy

will

incl

ude

con

ten

t on

m

ult

idis

cipl

inar

y w

orki

ng,

col

labo

rati

on a

nd

lead

ersh

ip t

o pr

omot

e p

osit

ive

outc

omes

for

infa

nts

an

d th

eir

fam

ilies

wh

en fa

ced

wit

h a

n in

fan

t w

ith

poo

r th

erm

al c

ontr

ol a

nd

will

use

th

e sa

me

oper

atio

nal

su

ppor

t, su

ppor

tive

com

pet

ence

dev

elop

men

t st

rate

gy,

and

ongo

ing

mai

nte

nan

ce o

f co

mp

eten

ce a

s pr

evio

usl

y st

ated

.

As

an e

xper

ien

ced

neo

nat

al n

urs

e, t

he

AN

NP

will

al

read

y h

ave

the

theo

reti

cal b

asis

an

d pr

acti

cal s

kills

to

supp

ort

ther

mal

con

trol

, bu

t w

ill e

xten

d th

ese

to t

he

new

are

as o

f w

ork.

Th

e A

NN

P w

ill:

• ac

t in

a s

upp

orti

ve c

apac

ity

to g

uid

e ef

fect

ive

stra

tegi

es o

f at

tain

ing

and

sust

ain

ing

opti

mal

th

erm

al c

ontr

ol fo

r th

e in

fan

t•

in u

nit

s w

her

e th

erap

euti

c hy

pot

her

mia

is u

sed

the

AN

NP

cou

ld t

ake

the

lead

in t

he

re-w

arm

ing

proc

ess

• m

ain

tain

th

e op

tim

al t

emp

erat

ure

of

an in

fan

t w

ho

is in

tra

nsi

t.

Con

solid

atio

n o

f cr

itic

al a

nal

ysis

ski

lls w

ill e

nab

le t

he

AN

NP

to

rese

arch

, au

dit

and

revi

se g

uid

elin

es a

nd

evid

ence

to

prom

ote

best

pra

ctic

e w

ith

med

ical

an

d n

urs

ing

colle

agu

es, a

nd

deve

lop

prac

tice

in li

ne

wit

h

tech

nol

ogic

al a

dvan

ces.

Exp

erie

nce

d A

NN

Ps w

ill t

ake

the

lead

in t

he

teac

hin

g an

d su

per

visi

on o

f m

edic

al s

taff

wh

o h

ave

limit

ed

exp

erie

nce

of

neo

nat

al c

are

and

oth

er n

urs

ing

grad

es

to h

elp

role

pro

gres

sion

.

All

nu

rse

con

sult

ants

hav

e an

ele

men

t of

res

earc

h in

th

eir

role

; it

is p

art

of t

hei

r jo

b de

scri

pti

ons.

How

ever

, in

ord

er t

o be

pre

pare

d fo

r th

is t

hey

sh

ould

hav

e an

ac

adem

ic p

rogr

amm

e of

pre

para

tion

rou

te. T

he

coor

din

atio

n o

f th

e T

OB

Y t

rial

cou

ld b

e ci

ted

as a

n

exam

ple.



It is

rec

ogn

ised

th

an n

ot a

ll u

nit

s h

ave

the

acu

ity

to

ensu

re t

hat

ski

lls a

re r

etai

ned

at

an a

dvan

ced

leve

l. St

rate

gies

su

ch a

s p

eer

revi

ew, s

imu

lati

on o

r ro

tati

on

to o

ther

mor

e ac

ute

un

its

will

en

sure

ret

enti

on o

f co

mp

eten

ces.

Ret

enti

on o

f co

mp

eten

ces

can

be

asse

ssed

by

the

mai

nta

inin

g of

a s

kills

log

and

revi

ewed

an

nu

ally

du

rin

g th

e in

divi

dual

per

form

ance

rev

iew

.

100


Return to contents

Pal

liat

ive

care

, end

-of-

life

car

e an

d be

reav

emen

t m

anag

emen

t –

lear

ning

out

com

es

Qua

lifi

ed in

sp

ecia

lity

B

ands

6-8

+

E

nhan

ced

prac

tice

nur

se/

spec

iali

st n

urse

A

dvan

ced

neon

atal

nur

se p

ract

itio

ner

(AN

NP

) C

onsu

ltan

t nu

rse

All

pra

ctit

ion

ers

will

u

nde

rsta

nd

and

prom

ote

the

imp

orta

nce

of

incl

udi

ng

the

fam

ily in

th

e in

fan

t’s c

are

plan

.

Infa

nts

an

d fa

mili

es w

ho

hav

e re

quir

emen

ts fo

r pa

lliat

ive

care

or

end-

of-l

ife

care

wou

ld b

enefi

t co

nsi

dera

bly

if t

hei

r ca

re w

as c

o-or

din

ated

or

per

form

ed b

y n

urs

es e

quip

ped

to

prac

tice

in t

his

are

a.

Such

sp

ecia

lists

are

like

ly t

o be

edu

cate

d to

a m

aste

r’s

degr

ee le

vel a

nd

hol

d re

cogn

ised

pos

tgra

duat

e sp

ecia

list

qual

ifica

tion

s in

th

is fi

eld.

Th

eir

prog

ram

me

of p

repa

rati

on w

ould

incl

ude

ber

eave

men

t m

anag

emen

t an

d co

un

selli

ng.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

er’s

ski

lls

are

likel

y to

refl

ect

the

lear

nin

g ou

tcom

es a

nd

skill

s ac

quir

ed d

uri

ng

the

pos

tgra

duat

e pr

ogra

mm

e of

pr

epar

atio

n o

r be

neg

otia

ted

in s

uch

a w

ay a

s to

mee

t th

e re

quir

emen

ts o

f pr

ofes

sion

al r

eval

idat

ion

. Th

e m

ain

ten

ance

of

the

skill

s an

d ex

per

tise

can

be

mon

itor

ed b

y p

eers

an

d co

nsi

dere

d w

ith

sen

siti

vity

du

rin

g th

e in

divi

dual

’s a

nn

ual

per

form

ance

rev

iew

.

Alt

hou

gh a

sen

siti

ve a

rea

to r

esea

rch

, neo

nat

al r

esea

rch

n

urs

es w

ho

hav

e a

focu

s on

ber

eave

men

t w

ould

gre

atly

ad

d to

th

e bo

dy o

f kn

owle

dge

wh

ich

is r

equ

ired

to

supp

ort

this

asp

ect

of c

are.

Res

earc

h n

urs

es w

ould

req

uir

e a

prog

ram

me

of

prep

arat

ion

to

equ

ip t

hem

to

adva

nce

neo

nat

al

evid

ence

. Th

is p

rogr

amm

e w

ould

incl

ude

mod

ule

s on

et

hic

s, r

esea

rch

met

hod

s an

d da

ta m

anag

emen

t to

eq

uip

th

em t

o w

ork

as lo

ne

rese

arch

ers,

lead

nu

rsin

g re

sear

ch t

eam

s or

fun

ctio

n a

s pa

rt o

f a

mu

ltid

isci

plin

ary

team

.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

enab

le t

he

acqu

isit

ion

of

know

ledg

e an

d in

-dep

th u

nde

rsta

ndi

ng

of t

he

key

theo

ries

of

loss

an

d gr

ief.

Th

is w

ill in

clu

de

deve

lopm

ent

of t

he

abili

ty t

o cr

itic

ally

an

alys

e h

ow

fam

ilies

may

be

pres

ent

in r

elat

ion

to

the

abov

e.

Th

e ex

pec

tati

on is

th

at t

he

deve

lopi

ng

or e

xper

ien

ced

AN

NP

will

uti

lise

loca

l un

it a

nd

nat

ion

al g

uid

elin

es a

s a

ben

chm

ark

for

exp

ecte

d pr

acti

ce in

th

is a

rea.

Th

e pr

ogra

mm

e of

stu

dy w

ill in

clu

de c

onte

nt

on

mu

ltid

isci

plin

ary

wor

kin

g, c

olla

bora

tion

an

d le

ader

ship

to

prom

ote

pos

itiv

e ou

tcom

es fo

r in

fan

ts

and

thei

r fa

mili

es w

hen

face

d w

ith

an

infa

nt

wh

o re

quir

es p

allia

tive

or

end-

of-l

ife

care

an

d w

ill u

se t

he

sam

e op

erat

ion

al s

upp

ort,

supp

orti

ve c

omp

eten

ce

deve

lopm

ent

stra

tegy

, an

d on

goin

g m

ain

ten

ance

of

com

pet

ence

, as

prev

iou

sly

stat

ed.

Th

e A

NN

P w

ill:

• de

velo

p ad

van

ced

com

mu

nic

atio

n s

kills

an

d th

e co

nfi

den

ce t

o in

itia

te a

nd

faci

litat

e se

nsi

tive

di

scu

ssio

n w

ith

par

ents

an

d se

nio

r m

edic

al s

taff

• le

ad t

he

clin

ical

car

e ac

cord

ing

to t

he

nee

ds o

f th

e in

fan

t an

d fa

mily

; th

ese

situ

atio

ns

init

iati

ng

disc

uss

ion

s w

ith

fam

ilies

reg

ardi

ng

choi

ces,

op

tion

s an

d su

ppor

t th

eir

deci

sion

mak

ing

• le

ad m

eeti

ngs

, giv

e pr

esen

tati

ons

and

infl

uen

ce a

w

ide

ran

ge o

f in

divi

dual

s an

d gr

oups

at

stra

tegi

c le

vel t

o ta

ke a

ctio

n a

nd

mak

e ch

ange

s to

en

han

ce t

he

care

of

the

infa

nt

and

the

fam

ily•

lead

pol

y ph

arm

aceu

tica

l dis

cuss

ion

s w

ith

th

e M

D

team

an

d fa

mili

es, p

resc

ribi

ng

med

icat

ion

s ap

prop

riat

ely

to a

id c

omfo

rt p

rior

to

deat

h•

rece

ive

and

proc

ess

com

plex

, sen

siti

ve a

nd

con

ten

tiou

s in

form

atio

n, i

nit

iati

ng

acti

ons

requ

ired

• ar

ran

ge a

nd

lead

deb

rief

s fo

r st

aff

as r

equ

ired

aft

er

the

deat

h o

f an

infa

nt

• p

arti

cipa

te in

par

alle

l pla

nn

ing

and

adva

nce

d ca

re

plan

nin

g (i

ncl

udi

ng

requ

ests

for

pos

t m

orte

m

exam

inat

ion

an

d th

e p

oten

tial

for

orga

n d

onat

ion

)

A c

onsu

ltan

t sp

ecia

list

in e

nd-

of-l

ife

care

is li

kely

to

hav

e a

besp

oke

role

in o

rder

to

mee

t in

divi

dual

un

it’s

re

quir

emen

ts a

nd

will

hav

e en

gage

d in

a d

evel

opm

ent

plan

to

equ

ip t

hem

to

fun

ctio

n in

th

is r

ole.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

er’s

ski

lls

are

likel

y to

be

neg

otia

ted

in s

uch

a w

ay a

s to

mee

t th

e re

quir

emen

ts o

f re

valid

atio

n a

nd

can

be

mon

itor

ed

duri

ng

the

indi

vidu

al’s

an

nu

al p

erfo

rman

ce r

evie

w.



• de

velo

p, s

ust

ain

an

d ev

alu

ate

part

ner

ship

wor

kin

g w

ith

indi

vidu

als,

gro

ups

, age

nci

es a

nd

oth

ers

invo

lved

in t

he

prov

isio

n o

f n

eon

atal

car

e•

supp

ort

the

deve

lopm

ent

of a

cu

ltu

re in

wh

ich

in

divi

dual

s ar

e va

lued

an

d in

ter-

prof

essi

onal

le

arn

ing

is e

nco

ura

ged

• id

enti

fy a

nd

deliv

er s

trat

egie

s to

en

sure

th

e pr

ovis

ion

of

edu

cati

on a

nd

deve

lopm

ent

prog

ram

mes

to

mee

t th

e n

eeds

of

the

neo

nat

al s

ervi

ce

• id

enti

fy o

wn

feel

ings

abo

ut

deat

h a

nd

deve

lop

self

-aw

aren

ess,

rec

ogn

ise

own

tri

gger

s fo

r st

ress

an

d be

pro

acti

ve in

see

kin

g su

ppor

t fo

r se

lf.

Con

solid

atio

n o

f cr

itic

al a

nal

ysis

ski

lls w

ill e

nab

le t

he

AN

NP

to

rese

arch

, au

dit

and

revi

se g

uid

elin

es a

nd

evid

ence

to

prom

ote

best

pra

ctic

e w

ith

med

ical

an

d n

urs

ing

colle

agu

es, a

nd

deve

lop

prac

tice

in li

ne

wit

h

tech

nol

ogic

al a

dvan

ces.

Exp

erie

nce

d A

NN

Ps w

ill t

ake

the

lead

in t

he

teac

hin

g an

d su

per

visi

on o

f m

edic

al s

taff

wh

o h

ave

limit

ed

exp

erie

nce

of

neo

nat

al c

are

and

oth

er n

urs

ing

grad

es

to h

elp

role

pro

gres

sion

.

It is

rec

ogn

ised

th

an n

ot a

ll u

nit

s h

ave

the

acu

ity

to

ensu

re t

hat

ski

lls a

re r

etai

ned

at

an a

dvan

ced

leve

l. St

rate

gies

su

ch a

s p

eer

revi

ew, s

imu

lati

on o

r ro

tati

on

to o

ther

mor

e ac

ute

un

its

will

en

sure

ret

enti

on o

f co

mp

eten

ces.

Sen

siti

vely

rev

iew

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al

per

form

ance

rev

iew

.

102


Return to contents

Inve

stig

atio

ns, t

ests

and

pro

cedu

res

– le

arni

ng o

utco

mes

Qua

lifi

ed in

sp

ecia

lity

B

ands

6-8

+

E

nhan

ced

prac

tice

nur

se/

spec

iali

st n

urse

A

dvan

ced

neon

atal

nur

se p

ract

itio

ner

(AN

NP

) C

onsu

ltan

t nu

rse

All

prac

titi

oner

s w

ill

ensu

re t

hat

th

e in

fan

t re

quir

ing

inve

stig

atio

ns

and

proc

edu

res

rece

ives

th

e ca

re, a

tten

tion

an

d su

per

visi

on

com

men

sura

te w

ith

th

eir

nee

ds.

All

prac

titi

oner

s w

ill

un

ders

tan

d an

d pr

omot

e th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in

the

infa

nt’s

car

e pl

an.

In m

any

un

its,

au

diom

etry

an

d re

tin

al e

xam

inat

ion

s ar

e ca

rrie

d ou

t. T

he

care

of

infa

nts

un

derg

oin

g re

tin

al

imag

ing

cou

ld b

e en

han

ced

if t

her

e w

ere

spec

ialis

t n

urs

e ro

les

deve

lop

ed t

o su

ppor

t th

e op

hth

alm

ic/

med

ical

tea

m. S

uch

oph

thal

mic

nu

rses

are

like

ly t

o be

ed

uca

ted

to m

aste

r’s

leve

l an

d u

nde

rtak

e so

me

inte

r-pr

ofes

sion

al e

duca

tion

.

Ass

essm

ents

of

the

rete

nti

on o

f th

e pr

acti

tion

er’s

ski

lls

leve

ls a

re li

kely

to

be n

egot

iate

d in

su

ch a

way

as

to

mee

t th

e re

quir

emen

ts o

f pr

ofes

sion

al r

eval

idat

ion

. T

he

mai

nte

nan

ce o

f th

e sk

ills

and

exp

erti

se c

an b

e m

onit

ored

by

pee

rs a

nd

con

side

red

duri

ng

the

indi

vidu

al’s

an

nu

al p

erfo

rman

ce r

evie

w.

Th

ere

are

spec

ialis

t pr

ogra

mm

es o

f pr

epar

atio

n t

o eq

uip

pra

ctit

ion

ers

to p

erfo

rm a

ran

ge o

f au

diom

etry

as

sess

men

ts.

Ass

essm

ent

and

rete

nti

on o

f th

e pr

acti

tion

er’s

ski

ll le

vel w

ould

be

likel

y to

refl

ect

the

lear

nin

g ou

tcom

es

and

skill

s ac

quir

ed d

uri

ng

the

spec

ialis

t pr

ogra

mm

e of

pr

epar

atio

n o

r ar

e n

egot

iate

d in

su

ch a

way

as

to m

eet

the

requ

irem

ents

of

prof

essi

onal

rev

alid

atio

n.

Follo

ws

a pr

ogra

mm

e of

pre

para

tion

to

enab

le t

he

acqu

isit

ion

of

know

ledg

e an

d in

-dep

th u

nde

rsta

ndi

ng

of t

he

key

theo

ries

of

loss

an

d gr

ief.

Th

is w

ill in

clu

de

deve

lopm

ent

of t

he

abili

ty t

o cr

itic

ally

an

alys

e h

ow

fam

ilies

may

be

pres

ent

in r

elat

ion

to

the

abov

e.

Th

e ex

pec

tati

on is

th

at t

he

deve

lopi

ng

or e

xper

ien

ced

AN

NP

will

uti

lise

loca

l un

it a

nd

nat

ion

al g

uid

elin

es a

s a

ben

chm

ark

for

exp

ecte

d pr

acti

ce in

th

is a

rea.

Th

e pr

ogra

mm

e of

stu

dy w

ill in

clu

de c

onte

nt

on

mu

ltid

isci

plin

ary

wor

kin

g, c

olla

bora

tion

an

d le

ader

ship

to

prom

ote

pos

itiv

e ou

tcom

es fo

r in

fan

ts

and

thei

r fa

mili

es w

hen

face

d w

ith

an

infa

nt

wh

o re

quir

es p

allia

tive

or

end-

of-l

ife

care

an

d w

ill u

se t

he

sam

e op

erat

ion

al s

upp

ort,

supp

orti

ve c

omp

eten

ce

deve

lopm

ent

stra

tegy

, an

d on

goin

g m

ain

ten

ance

of

com

pet

ence

as

prev

iou

sly

stat

ed.

Th

e A

NN

P w

ill:

• de

velo

p ad

van

ced

com

mu

nic

atio

n s

kills

an

d th

e co

nfi

den

ce t

o in

itia

te a

nd

faci

litat

e se

nsi

tive

di

scu

ssio

n w

ith

par

ents

an

d se

nio

r m

edic

al s

taff

• le

ad t

he

clin

ical

car

e ac

cord

ing

to t

he

nee

ds o

f th

e in

fan

t an

d fa

mily

th

ese

situ

atio

ns

init

iati

ng

disc

uss

ion

s w

ith

fam

ilies

reg

ardi

ng

choi

ces,

op

tion

s an

d su

ppor

t th

eir

deci

sion

-mak

ing

• le

ad m

eeti

ngs

, giv

e pr

esen

tati

ons

and

infl

uen

ce a

w

ide

ran

ge o

f in

divi

dual

s an

d gr

oups

at

stra

tegi

c le

vel t

o ta

ke a

ctio

n a

nd

mak

e ch

ange

s to

en

han

ce t

he

care

of

the

infa

nt

and

the

fam

ily•

lead

pol

y ph

arm

aceu

tica

l dis

cuss

ion

s w

ith

th

e M

D

team

an

d fa

mili

es p

resc

ribi

ng

med

icat

ion

s ap

prop

riat

ely

to a

id c

omfo

rt p

rior

to

deat

h•

rece

ive

and

proc

ess

com

plex

, sen

siti

ve a

nd

con

ten

tiou

s in

form

atio

n, i

nit

iati

ng

acti

ons

requ

ired

• ar

ran

ge a

nd

lead

deb

rief

s fo

r st

aff

as r

equ

ired

aft

er

the

deat

h o

f an

infa

nt

• p

arti

cipa

te in

par

alle

l pla

nn

ing

and

adva

nce

d ca

re

plan

nin

g (i

ncl

udi

ng

requ

ests

for

pos

t m

orte

m

exam

inat

ion

an

d th

e p

oten

tial

for

orga

n d

onat

ion

)

Th

e ro

le o

f th

e n

eon

atal

nu

rse

con

sult

ant

in r

elat

ion

to

inve

stig

atio

ns

and

proc

edu

res

is li

kely

to

be g

ener

ally

si

mila

r to

th

at o

f th

e A

NN

P a

nd

the

prog

ram

me

of

prep

arat

ion

cou

ld b

e si

mila

r.

Wh

ere

ther

e ar

e sp

ecifi

c ro

le r

equ

irem

ents

, a b

esp

oke

prog

ram

me

wou

ld n

eed

to b

e de

sign

ed.

For

exam

ple,

if u

ltra

sou

nd

scan

nin

g w

ere

part

of

the

con

sult

ant’s

rol

e th

en t

rain

ing

in t

hat

wou

ld h

ave

to b

e in

clu

ded

and

thes

e sk

ills

asse

ssed

to

ensu

re t

hes

e re

mai

n

at a

sat

isfa

ctor

y le

vel.

Nu

rse

con

sult

ants

may

als

o be

com

e in

volv

ed in

ar

ran

gin

g in

nov

atio

n fo

r w

hic

h t

her

e is

no

prec

eden

t;

for

exam

ple

deve

lopi

ng

the

path

way

s fo

r A

NN

Ps t

o pr

escr

ibe

bloo

d, o

r ar

ran

ge t

he

MD

T m

anag

emen

t of

a

com

plex

air

way

or

resp

irat

ory

requ

irem

ent.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

er s

kills

are

lik

ely

to b

e n

egot

iate

d in

su

ch a

way

as

to m

eet

the

requ

irem

ents

of

reva

lidat

ion

an

d ca

n b

e m

onit

ored

du

rin

g th

e in

divi

dual

’s a

nn

ual

per

form

ance

rev

iew

.



• de

velo

p, s

ust

ain

an

d ev

alu

ate

part

ner

ship

wor

kin

g w

ith

indi

vidu

als,

gro

ups

, age

nci

es a

nd

oth

ers

invo

lved

in t

he

prov

isio

n o

f n

eon

atal

car

e •

supp

ort

the

deve

lopm

ent

of a

cu

ltu

re in

wh

ich

in

divi

dual

s ar

e va

lued

an

d in

ter-

prof

essi

onal

le

arn

ing

is e

nco

ura

ged

• id

enti

fy a

nd

deliv

er s

trat

egie

s to

en

sure

th

e pr

ovis

ion

of

edu

cati

on a

nd

deve

lopm

ent

prog

ram

mes

to

mee

t th

e n

eeds

of

the

neo

nat

al s

ervi

ce

• id

enti

fy o

wn

feel

ings

abo

ut

deat

h a

nd

deve

lop

self

-aw

aren

ess;

rec

ogn

ises

ow

n t

rigg

ers

for

stre

ss a

nd

is p

roac

tive

in s

eeki

ng

supp

ort

for

self

.

Con

solid

atio

n o

f cr

itic

al a

nal

ysis

ski

lls w

ill e

nab

le t

he

AN

NP

to

rese

arch

, au

dit

and

revi

se g

uid

elin

es a

nd

evid

ence

to

prom

ote

best

pra

ctic

e w

ith

med

ical

an

d n

urs

ing

colle

agu

es, a

nd

deve

lop

prac

tice

in li

ne

wit

h

tech

nol

ogic

al a

dvan

ces.

Exp

erie

nce

d A

NN

Ps w

ill t

ake

the

lead

in t

he

teac

hin

g an

d su

per

visi

on o

f m

edic

al s

taff

wh

o h

ave

limit

ed

exp

erie

nce

of

neo

nat

al c

are

and

oth

er n

urs

ing

grad

es

to h

elp

role

pro

gres

sion

.

It is

rec

ogn

ised

th

at n

ot a

ll u

nit

s h

ave

the

acu

ity

to

ensu

re t

hat

ski

lls a

re r

etai

ned

at

an a

dvan

ced

leve

l. St

rate

gies

su

ch a

s p

eer

revi

ew, s

imu

lati

on o

r ro

tati

on

to o

ther

mor

e ac

ute

un

its

will

en

sure

ret

enti

on o

f co

mp

eten

ces.

Sen

siti

vely

rev

iew

ed a

nn

ual

ly d

uri

ng

the

indi

vidu

al

per

form

ance

rev

iew

.

104


Return to contents

Equi

pmen

t an

d m

onit

orin

g –

lear

ning

out

com

es

Qua

lifi

ed in

sp

ecia

lity

B

ands

6-8

+

E

nhan

ced

prac

tice

nur

se/

spec

iali

st n

urse

A

dvan

ced

neon

atal

nur

se p

ract

itio

ner

(AN

NP

) C

onsu

ltan

t nu

rse

All

prac

titi

oner

s w

ill

prov

ide

care

, su

per

visi

on

or d

irec

tion

to

ensu

re

that

th

e in

fan

ts r

equ

irin

g su

ppor

tive

equ

ipm

ent

and

mon

itor

ing

rece

ive

this

com

men

sura

te w

ith

th

eir

nee

ds.

All

prac

titi

oner

s w

ill

un

ders

tan

d an

d pr

omot

e th

e im

por

tan

ce o

f in

clu

din

g th

e fa

mily

in

the

infa

nt’s

car

e pl

an.

As

part

of

a cl

inic

al e

duca

tion

al r

ole,

a n

eon

atal

sp

ecia

list

nu

rse

wou

ld b

e re

spon

sibl

e fo

r th

e te

ach

ing

and

prep

arat

ion

for

the

staf

f to

en

sure

th

e sa

fe u

se o

f th

e ra

nge

of

equ

ipm

ent

use

d on

th

e u

nit

.

Pre

para

tion

for

such

a r

ole

is li

kely

to

invo

lve

clos

e re

lati

onsh

ips

wit

h m

anu

fact

ure

rs a

nd

atte

ndi

ng

the

edu

cati

onal

opp

ortu

nit

ies

prov

ided

by

them

to

mak

e be

st u

se o

f th

e eq

uip

men

t. T

hey

may

ben

efit

from

a

clin

ical

tea

chin

g pr

ogra

mm

e of

pre

para

tion

to

ensu

re

that

th

eir

teac

hin

g st

rate

gies

are

eff

ecti

ve a

nd

ther

e ar

e se

vera

l HE

Is w

ho

offe

r su

ch m

odu

les.

Ass

essm

ent

of t

he

rete

nti

on o

f th

e pr

acti

tion

er’s

ski

lls

are

likel

y to

be

neg

otia

ted

in s

uch

a w

ay a

s to

mee

t th

e re

quir

emen

ts o

f re

valid

atio

n a

nd

can

be

mon

itor

ed

duri

ng

the

indi

vidu

al’s

an

nu

al p

erfo

rman

ce r

evie

w.

Som

e u

nit

s u

se E

CM

O a

nd

oth

er e

xtra

corp

orea

l ci

rcu

its

or u

se s

pec

ially

tra

ined

nu

rses

as

per

fusi

onis

ts.

Th

e pr

ogra

mm

e of

pre

para

tion

may

be

sim

ilar

to s

ome

thea

tre

spec

ialis

t ro

les.

Ass

essm

ent

and

rete

nti

on o

f th

e pr

acti

tion

er’s

ski

ll le

vel w

ould

be

likel

y to

refl

ect

the

lear

nin

g ou

tcom

es

and

skill

s ac

quir

ed d

uri

ng

the

spec

ialis

t pr

ogra

mm

e of

pr

epar

atio

n, a

sses

sed

by s

imu

lati

on a

nd

by p

eers

.

Th

e pr

ogra

mm

e of

pre

para

tion

faci

litat

es t

he

acqu

isit

ion

of

theo

reti

cal k

now

ledg

e to

un

derp

in t

he

abili

ty o

f th

e A

NN

P

to p

erfo

rm a

ran

ge o

f in

vest

igat

ion

s an

d pr

oced

ure

s.

Th

e pr

ogra

mm

e w

ill p

rovi

de t

he

theo

reti

cal b

asis

for

the

deve

lopm

ent

of a

ny s

pec

ific

prac

tica

l ski

lls r

equ

ired

, in

clu

din

g em

bryo

logy

, an

atom

y, p

hysi

olog

y an

d m

atu

rati

onal

dev

elop

men

t of

any

sys

tem

invo

lved

.

In a

ddit

ion

, th

e pr

ogra

mm

e m

ust

en

sure

th

at s

tude

nts

mee

t an

y st

atu

tory

/leg

al r

adio

logi

cal r

equ

irem

ents

to

supp

ort

the

requ

est

and

inte

rpre

tati

on o

f x-

rays

an

d th

e sa

fe

man

agem

ent

of t

he

mic

ro a

nd

mac

ro e

nvir

onm

ent.

Th

e ex

pec

tati

on is

th

at t

he

deve

lopi

ng

or e

xper

ien

ced

AN

NP

w

ill u

tilis

e lo

cal u

nit

an

d n

atio

nal

gu

idel

ines

as

a be

nch

mar

k fo

r ex

pec

ted

prac

tice

in t

his

are

a.

Th

e pr

ogra

mm

e of

stu

dy w

ill in

clu

de c

onte

nt

on

mu

ltid

isci

plin

ary

wor

kin

g, c

olla

bora

tion

an

d le

ader

ship

to

prom

ote

pos

itiv

e ou

tcom

es fo

r in

fan

ts a

nd

thei

r fa

mili

es

wh

en fa

ced

wit

h a

n in

fan

t re

quir

ing

the

proc

edu

re a

nd

will

u

se t

he

sam

e op

erat

ion

al s

upp

ort,

supp

orti

ve c

omp

eten

ce

deve

lopm

ent

stra

tegy

, an

d on

goin

g m

ain

ten

ance

of

com

pet

ence

as

prev

iou

sly

stat

ed.

Th

e A

NN

P w

ill b

e re

quir

ed t

o:•

gain

ski

lls in

ass

essi

ng

the

requ

irem

ent

of s

pec

imen

s an

d sa

mpl

es, t

he

inte

rpre

tati

on o

f re

sult

s an

d th

e in

itia

tion

of

appr

opri

ate

man

agem

ent

• pr

escr

ibe

bloo

d an

d bl

ood

prod

uct

s•

per

form

a r

ange

of

inve

stig

atio

ns

such

as

supr

a pu

bic

aspi

rati

on, i

nse

rtio

n o

f lin

es t

o m

onit

or p

ress

ure

s,

infu

sion

s et

c by

mea

ns

of a

rter

ial,

per

cuta

neo

us

cen

tral

ve

nou

s ca

thet

er a

nd

cen

tral

lin

es a

nd

so fo

rth

•

requ

est

a ra

nge

of

x-ra

ys a

nd

inte

rpre

t th

e sa

me

• u

nde

rtak

e su

turi

ng

and

stab

ilisi

ng

ches

t dr

ain

s an

d ch

est

drai

n w

oun

ds w

hen

req

uir

ed•

chec

k fo

r h

ip s

tabi

lity

and

take

th

e le

ad in

th

e on

goin

g m

anag

emen

t of

iden

tifi

ed in

fan

ts.

Evid

ence

of

the

mai

nte

nan

ce o

f th

e sk

ills

cou

ld b

e by

th

e de

velo

pmen

t of

a s

kills

log

and

revi

ewed

an

nu

ally

du

rin

g th

e in

divi

dual

per

form

ance

rev

iew

.

As

NIC

U is

on

e of

th

e sp

ecia

lised

ser

vice

s, N

ICU

n

urs

es m

ust

be

equ

ipp

ed s

o th

ey c

an r

epre

sen

t th

e se

rvic

e at

bot

h lo

cal t

rust

boa

rd a

nd

net

wor

k bo

ard

leve

ls. M

any

of t

hes

e n

urs

es w

ill b

e h

igh

ly

exp

erie

nce

d an

d h

ave

had

car

eer

path

way

s ta

kin

g th

em t

hro

ugh

AN

NP

an

d se

nio

r m

anag

emen

t ro

les.

Nu

rse

con

sult

ants

may

be

resp

onsi

ble

for

capi

tal

budg

et a

nd

proc

ure

men

t pl

ans

for

esse

nti

al

equ

ipm

ent.

How

nu

rse

con

sult

ants

are

edu

cate

d an

d eq

uip

ped

for

this

rol

e lik

ely

to b

e be

spok

e bu

t co

uld

incl

ude

MB

A.

Mai

nta

inin

g an

d re

tain

ing

thes

e sk

ills

will

req

uir

e th

e in

divi

dual

to

hav

e in

sigh

t an

d aw

aren

ess

of

per

son

al d

evel

opm

ent

and

the

auto

nom

y to

de

velo

p a

mea

nin

gfu

l per

son

al d

evel

opm

ent

plan

.



Del

iver

ing

and

supp

orti

ng t

he n

eona

tal n

ursi

ng c

urri

culu

m

NV

Qs,

nu

rser

y n

urs

e cu

rric

ulu

ms,

ass

ocia

te/

assi

stan

t pr

acti

tion

ers

trai

nin

g m

ay b

e pr

epar

ed

in-h

ouse

an

d de

liver

ed

in c

olle

ges

of fu

rth

er o

r h

igh

er e

duca

tion

. T

he

flex

ible

lear

nin

g an

d bl

ende

d ap

proa

ch c

ould

in

clu

de m

odu

les

from

sk

ills

for

hea

lth

. See

w

ww

.ski

llsfo

rhea

lth

.org

.u

k

Neo

nat

al c

linic

al e

duca

tors

will

be

exp

erie

nce

d n

eon

atal

nu

rses

an

d re

quir

ed t

o ed

uca

te, s

up

ervi

se a

nd

supp

ort

the

un

regi

ster

ed n

eon

atal

wor

kfor

ce, n

ovic

e n

eon

atal

nu

rses

an

d st

ude

nts

on

neo

nat

al p

athw

ay

prog

ram

mes

in c

linic

al p

ract

ice.

Th

ey n

eed

to h

ave

per

son

al in

sigh

t an

d aw

aren

ess

that

th

ey h

ave

the

skill

s re

quir

ed t

o m

ake

them

exe

mpl

ary

role

mod

els,

upd

ate

and

reta

in t

hei

r sk

ills

com

men

sura

te w

ith

th

eir

role

.

AN

NPs

may

be

prep

ared

usi

ng

a co

mbi

nat

ion

of

exp

erie

nce

d A

NN

Ps o

r m

edic

al c

onsu

ltan

ts t

o eq

uip

th

em t

o fu

nct

ion

in t

hei

r cl

inic

ally

adv

ance

d ro

les.

Pro

gram

mes

are

val

idat

ed a

gain

st a

n H

E e

duca

tion

al

fram

ewor

k.

Neo

nat

al le

ctu

rers

an

d pa

thw

ay le

ader

s w

ill b

e re

quir

ed

to d

evel

op t

he

curr

icu

lum

an

d co

mp

eten

ces

requ

ired

re

flec

tin

g th

e de

velo

pin

g an

d ad

van

cin

g sp

ecia

lism

.

Pro

gram

mes

are

val

idat

ed a

gain

st a

n H

E e

duca

tion

al

fram

ewor

k.

106


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References and key documents of interestBritish Association of Perinatal Medicine (2010) Service standards for hospitals providing neonatal care (3rd edition), London: BAPM. Available from: www.bapm.org (Accessed 1 May 2014).

British Association of Perinatal Medicine (2012) Matching knowledge and skills for qualified in speciality (QIS) neonatal nurses: a core syllabus for clinical competency, London: BAPM. Available from: www.bapm.org (Accessed 1 May 2014).

Bliss (2013) Bliss baby charter audit tool: helping to make family-centred care a reality on your neonatal unit, London: Bliss. Available from www.bliss.org.uk (Accessed 1 May 2014).

The Cavendish Review (2013) An independent review into healthcare assistants and support workers in the NHS and social care settings, London: DH. Available from: www.gov.uk (Accessed 1 May 2014).

Centre for Workforce Intelligence (2010) Recommended workforce models, London: CfWI. Available online only from: www.cfwi.org.uk (Accessed 1 May 2014).

Council of Deans of Health (2013a) See www.councilofdeans.org.uk (Accessed 1 May 2014).

Council of Deans of Health (2013b) Healthcare support workers in England: five proposals for investing in education and development to deliver high quality, effective and compassionate care, London: Council of Deans of Health. Available from: www.councilofdeans.org.uk (Accessed 1 May 2014).

Department of Health (2004) The NHS knowledge and skills framework (NHS KSF) and the development review process, London: DH. Available from: www.webarchive.nationalarchives.gov.uk (Accessed 1 May 2014).

Department of Health (2009) Toolkit for high quality neonatal services, London: DH. Available from: www.webarchive.nationalarchives.gov.uk (Accessed 1 May 2014).

Department of Health (2012) Compassion in practice: nursing, midwifery and care staff – our vision and strategy, London: DH. Available from: www.england.nhs.uk (Accessed 1 May 2014).

Department of Health (2013) Education outcomes framework indicators: technical guidance 2013/14, London: DH. Available from www.gov.uk (Accessed 1 May 2014).

Department of Health (2013a) Hard truths: the journey to putting patients first. Volume one of the government response to the Mid Staffordshire NHS Foundation Trust public inquiry, London: DH. Available from www.gov.uk (Accessed 1 May 2014).

Department of Health (2013b) Hard truths: the journey to putting patients first. Volume two of the government response to the Mid Staffordshire NHS Foundation Trust public inquiry: response to the inquiry’s recommendations, London: DH. Available from www.gov.uk (Accessed 1 May 2014).

Health Education England (2013) See www.hee.nhs.uk (Accessed 1 May 2014).

Institute for Patient and Family Centred Care (2013) Changing the concept from families as visitors to families as partners (toolkit), Bethseda: IPFCC. Available from: www.ipfcc.org (Accessed 1 May 2014).

Kain V (2013) An exploration of the grief experience of neonatal nurses, Journal of Neonatal Nursing, 19 (2), pp.80-87.

The Law Commission (2012) Regulation of health care professionals; regulation of social care professionals in England: summary of joint consultation paper, London: Law Commission (LLP 2020/SLCDP 153/NILC 12 (2012). Available from: www.lawcommission.justic.gov.uk (Accessed 1 May 2014).

Mancini A, Uthaya S, Beardsley C, Wood D and Modi N (2014) Practical guidance for the management of palliative care on neonatal units. 1st Edition. London: Royal College of Paediatrics and Child Health and Chelsea and Westminster Foundation Trust

National Audit Office (2007) Caring for vulnerable babies: the reorganisation of neonatal services in England, London: NAO. Available from: www.nao.org.uk (Accessed 1 May 2014).

http://www.bapm.org/publications/documents/guidelines/BAPM_Standards_Final_Aug2010.pdf

http://www.bapm.org/publications/documents/training/Matching%20Knowledge%20and%20Skills%20for%20QIS%20Neonatal%20nurses%20-%20a%20core%20syllabus%20for%20cllinical%20competency.pdf

http://www.bliss.org.uk/wp-content/uploads/2013/05/Baby_Charter_Audit-tool_13_web.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/236212/Cavendish_Review.pdf

http://www.cfwi.org.uk/intelligence/projects/recommended-workforce-models

http://www.councilofdeans.org.uk/Data/Sites/8/codhhcsw5proposalsforinvestingineduc&devforhighqualitycare.pdf



http://webarchive.nationalarchives.gov.uk/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/@sta/@perf/documents/digitalasset/dh_108435.pdf




http://www.england.nhs.uk/wp-content/uploads/2012/12/compassion-in-practice.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/225361/EOF_Indicators_-_Technical_Guidance_2013_14.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/270368/34658_Cm_8777_Vol_1_accessible.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/270103/35810_Cm_8777_Vol_2_accessible_v0.2.pdf

www.hee.nhs.uk

http://www.ipfcc.org/advance/topics/better-together.html

http://lawcommission.justice.gov.uk/docs/cp202_regulation_of_healthcare_professionals_summary.pdf

http://www.nao.org.uk/wp-content/uploads/2007/12/0708101.pdf



National Assembly for Wales (2012a) Children and Young People Committee: neonatal capacity review January 2012 – overview summary, Cardiff: NAW. Available from: www.senedd.assemblywales.org (Accessed 1 May 2014).

National Assembly for Wales (2012b) Children and Young People Committee: inquiry into neonatal care, Cardiff: NAW. Available from: www.assemblywales.org (Accessed 1 May 2014).

National Assembly for Wales (2013) Neonatal capacity review: January 2013, Cardiff: NAW. Available from: www.senedd.assemblywales.org (Accessed 1 May 2014).

Neonatal Services Working Group Northern Ireland (2006) Position Paper on Specialist Neonatal Services in Northern Ireland, Northern Ireland: NSWG. Available from: www.dhsspsni.gov.uk/neonatalservicesinni.pdf (Accessed 13 November 2014).

Northern Ireland Department of Health, Social Services and Public Safety (2012) Maternity Strategy 2012-2018, Northern Ireland: DHSSPSNI. Available from: www.dhsspsni.gov.uk (Accessed 13 November 2014).

Northern Ireland Department of Health, Social Services and Public Safety (2011) Quality 2020, Northern Ireland: DHSSPSNI. Available from: www.dhsspsni.gov.uk (Accessed 13 November 2014).

Picker Institute Europe (2011) Parents’ experiences of neonatal care: a report on the finding from a national survey, Oxford: Picker Institute Europe. Available from: www.bliss.org.uk (Accessed 1 May 2014).

Royal College of Nursing (2009) Integrated core career and competence framework for registered nurses, London: RCN. Available from: www.rcn.org.uk (Accessed 1 May 2014).

Royal College of Nursing (2010) Principles of nursing practice: principles and measures consultation. Summary report for nurse leaders, London: RCN. Available from: www.rcn.org.uk (Accessed 1 May 2014).

Royal College of Nursing (2012) Becoming and being a nurse consultant: towards greater effectiveness through a programme of support, London: RCN. Available from: www.rcn.org.uk (Accessed 1 May 2014).

Royal College of Nursing (2012a) Advanced nurse practitioners: an RCN guide to advanced nursing practice, advanced nurse practitioners and programme accreditation, London: RCN. Available from: www.rcn.org.uk (Accessed 1 May 2014).

Royal College of Nursing (2012b) Competence, education and careers in neonatal nursing: RCN guidance, London: RCN. Available from: www.rcn.org.uk (Accessed 1 May 2014).

Royal College of Nursing (2012c) Response of the Royal College of Nursing to the law commission consultation on the future regulation of health care professionals, London: RCN. Available from: www.rcn.org.uk (Accessed 1 May 2014).

Royal College of Nursing (2013) First steps for health care assistants (website of resources). See www.rcnhca.org.uk (Accessed 1 May 2014).

Royal College of Nursing (2013b) Defining staffing levels for children and young people’s services: RCN standards for clinical professionals and service managers, London: RCN. Available from: www.rcn.org.uk (Accessed 1 May 2014).

Scottish Neonatal Nurses’ Group (2005) The competency framework and core clinical skills for neonatal nurses, Edinburgh: SNNG. Available from: www.snng.org.uk (Accessed 1 May 2014).

Scottish Neonatal Nurses’ Group (2012) Career and development framework for healthcare support workers providing neonatal care in hospital settings in Scotland: career framework levels 2-4, Edinburgh: SNNG. Available from: www.snng.org.uk (Accessed 1 May 2014).

Skills for Health and Skills for Care (2013) National minimum training standards for healthcare support workers and adult social care workers in England, Leeds and Bristol: joint publication by Skills for Care and Skills for Health. Available from: www.skillsforcare.org.uk (Accessed 1 May 2014).

Skills for Health (2014) Employability skills matrix for the health sector, Bristol: SfH. Available from: www.skillsforhealth.org.uk (Accessed 1 May 2014).

The Mid Staffordshire NHS Foundation Trust (2013) Report of the Mid Staffordshire NHS Foundation Trust public inquiry: executive summary, London: The Stationery Office (Chairman: R Francis), Available from: www.gov.uk (Accessed 1 May 2014).

www.senedd.assemblywales.org

http://www.senedd.assemblywales.org/documents/s5349/CYP4-05-12%20Paper%206%20-%20Royal%20College%20of%20Paediatrics%20and%20Child%20Health%20Wales.pdf

http://www.senedd.assemblywales.org/documents/s14703/CYP4-08-13%20Paper%203%20-%20Wales%20Neonatal%20Network%20Capacity%20Review.pdf

http://www.dhsspsni.gov.uk/neonatalservicesinni.pdf

www.dhsspsni.gov.uk

www.dhsspsni.gov.uk

http://www.bliss.org.uk/wp-content/uploads/2012/02/Neonatal-Survey_National-Report_v3_0-FINAL.pdf

http://www.rcn.org.uk/__data/assets/pdf_file/0005/276449/003053.pdf




http://www.rcn.org.uk/__data/assets/pdf_file/0015/401118/RCN_Competences_Neonatal.pdf

http://www.rcn.org.uk/__data/assets/pdf_file/0020/470621/17.12_RCN_response_-_Law_Commission_Response_Final.pdf

http://rcnhca.org.uk/


http://www.snng.org.uk/publications/datafiles/SNNG%20Competency%20Framework.PDF

http://www.snng.org.uk/publications/datafiles/Career%20Framework%20for%20Neonatal%20Support%20Workers.pdf

http://www.skillsforcare.org.uk/codeofconductandtrainingstandards/

http://www.skillsforhealth.org.uk/about-us/news/employability-skills-matrix/

http://www.skillsforhealth.org.uk/about-us/news/employability-skills-matrix/

http://www.official-documents.gov.uk/document/hc1213/hc09/0947/0947.pdf

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November 2014Review date: November 2016

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