1) A portfolio of evidence : a record of learning in and through practice which should demonstrate the achievement of the module learning outcomes.
a) Each student is expected to work through a series of questions in a workbook, designed to facilitate active learning. The midwife will develop appropriate levels of understanding in relation to both normal and abnormal physiology.
b) A record of 50 examinations of the newborn, 5 of which must be under the designated paediatrician’s/ qualified midwife’s supervision and a further 5 (10th, 15th ,20th , 30th and 45th) as identified to assess progress. The record should constitute all findings on each of the 50 examinations and to include outcomes as compared with a suitably qualified practitioner’s examination to identify any omissions by the midwife. Each examination to be completed and signed by the paediatrician or qualified practitioner.
2) A case study constituting a critical analysis of the full examination of one newborn and the professional implications of the extended role for midwifery practice.
Word Limit: Approximately 8000-10,000 words to include the case study of approximately 2000-3000 words.
|Qualified midwives with at least one year post-registration experience
Level 2 midwifery studies
|The module aims to prepare midwives to undertake the complete physical examination of the healthy newborn, between 37-42 completed gestational weeks. This examination will replace that which has traditionally been undertaken by a paediatrician or a GP. The rationale for the neonatal examination conducted within the first 24 hours and days after delivery will be to detect any signs of acute illness or abnormalities, to allow prompt diagnosis and intervention without which many of the acute conditions which afflict newborn babies can lead to serious consequences.
The midwife as the lead professional is increasingly expected to manage a caseload, diagnose and refer appropriately and communicate effectively with a variety of other disciplines and the multidisciplinary team.
However, in the interest of clients, this constantly changing and expanding role requires midwives to develop new skills and competencies, which necessitate appropriate education. This module seeks to develop such skills, underpinned by a sound knowledge base to support clinical practice. Skills development is within the context of holistic care and therefore the emphasis is on recognition of the theory and practice to develop and expand these new skills, which are based on evidence based practice.
This new role undertaken will enhance independent and autonomous practice whilst improving continuity of care and facilitate more timely discharge of babies from the postnatal area, reducing paediatric workload. In addition such a role will enable birth at home to be easily facilitated where the GP has not been contracted to provide neonatal examination.
|By the end of this module the student should be able to:
Subject Knowledge and Understanding
• Assess the physiological adaptation of each system in the fetus-neonate and relate these to the examination of the newborn
• Determine risk factors in relation to neonatal well-being and identify deviations from the norm in the newborn
• Assess the neonatal condition to determine the involvement of the multidisciplinary team, through referral to a paediatrician and the need for any urgent intervention through locally agreed channels
• Consider critically the ethical and moral dilemmas parents may encounter when faced with a deviation from the normal in the newborn and to improve skills of the midwife in breaking bad news
• Critically evaluate the evidence and research base of new approaches to judgement and decision-making in relation to care of the newborn
• Analyse and evaluate contemporary issues in the field of neonatology using appropriate evidence.
• Critically evaluate the relevant research studies to underpin best practice in the care of the newborn
• Critically evaluate and reflect on own learning
• Engage in effective communication with the parents and members of the multi-disciplinary team whilst developing the skills of history taking
• Critically reflect on own practice as a means of improving care for newborn babies
• Determine the professional, moral, legal and ethical issues in relation to midwifery practice.
• Carry out the examination of the newborn competently
• embryology and fetal development of the neurological system
• adaptation to extra-uterine life
• the neurological abnormalities that can be detected on examination in relation to this system
• the neurological common problems in relation to the well neonate
• the explanations and information that is given to parents
• the information from maternal history that is required to relate findings to management
• choice of a specific neurological problem and outline the management and the short and long term care and prognosis for that neonate
• exploration of the processes involved in integrating parental and professional model of care
Repeat as above for each of the systems below:
Urogenital/ chromosomal sexual differentiation
Sensory organs – including skin
Metabolic and Endocrine system
Immune system – infection
|Methods of Teaching/Learning
|Tutor/Student Contact Hours 80 hours
Self Directed Study Hours 120 hours
Work-based Hours 140 hours
|Baston H & Durward H(2001) Examination of the New Born : A practical guide Routledge, London
Blackburn (2003) (2nd edition) Fetal & Neonatal Physiology
Bloomfield L, Townsend J & Rogers C (2003) Qualitative study exploring junior paediatricians, midwives, GPs and mothers’ experiences and views of the examination of the newborn Midwifery 19 (1) pp37-45
Coad J, Dunstall M (2001) Anatomy & Physiology for Midwives Mosby Woolfe, London
Firth L (1996) Ethics and Midwifery : Butterworth Heinemann, Oxford
Gaedeke MK (1998) Paediatric and Neonatal Critical Care Mosby, London
Kelnar C, Harvey D, Simpson C (1995) The Sick Newborn Baby Balliere Tindall, London
Klaus M, Fanaroff A (1993) Care of the High Risk Neonate Philadelphia WB Saunders, USA
Levene M et al (1993) Essentials of Neonatal Medicine Blackwell, London
Lumsden H (2005) Midwives experience of examination of the newborn as an additional aspect of their role: a qualitative study MIDIRS Midwifery Digest 15 (4) pp450-457
Milner RDG & Herber T (1984) A colour atlas of the newborn Oxford University Press, Oxford
Robertson NRC (1992) Textbook of Neonatology Churchill Livingstone, London
Rogers C, Bloomfield L & Townsend J (2003) A qualitative study exploring midwives perceptions and views of extending their role to the examination of the newborn baby Midwifery 19 (1) pp 55-68
Stables D (1999) Physiology of Childbearing Balliere Tindall, London
Tappero & Honeyfield (2003) (3rd edition) Physical Examination of the Newborn
Townsend J et al (2004) Routine examination of the newborn EMREN study Research findings register – summary minutes 1380 www.refer.nhs.uk/view record
Journal of Neonatal & Gynaecological Nursing
|29TH JULY 2010