ADVANCED ASSESSMENT OF THE NEWBORN FOR MIDWIVES - 2018/9
Module code: NURM104
School of Health Sciences
BROWN A Dr (Health Sci.)
Number of Credits
FHEQ Level 7
Module cap (Maximum number of students)
Overall student workload
Independent Study Hours: 150
Lecture Hours: 25
|Assessment type||Unit of assessment||Weighting|
Prerequisites / Co-requisites
The module aims to develop skills for complex assessment of the newborn. These systems would include theoretical and practical knowledge of the central nervous system, respiratory system, cardiovascular system, gastrointestinal system, genitourinary system, skin, musculoskeletal system and the special senses. This will enable analysis of clinical cases to develop differential diagnosis skills focusing on undifferentiated neonatal problems for the above body systems. In addition analysis of current frameworks for assessment is developed to include critical analysis and reflection on the practitioner’s role and evidence of contribution to the development of the role. Evidence of autonomous and advanced practice and critical analysis of the evidence for practice is explored.
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.
|001||Assess the physiological adaptation of each system in the fetus-neonate and relate these to a competent examination of the newborn and critically evaluate the relevant research studies to underpin best practice in the care of the newborn and demonstrate systematic newborn assessment and physical examinations within clinical settings.||KP|
|002||Critically evaluate the evidence and research base of new approaches to judgement and decision-making in relation to risk factors in the care of the newborn, applying skills of systematic and holistic assessment of undifferentiated newborn problems to make accurate differential diagnoses, develop safe management plans and appropriate referrals.||CT|
|003||Analyse and evaluate contemporary issues in the field of neonatology using appropriate evidence to determine the involvement of the multidisciplinary team, through referral to a paediatrician and the need for any urgent intervention through locally agreed channels.||CP|
|004||Consider critically the ethical, legal 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 using effective communication skills.||CP|
|005||Critically examine clinical judgement by identifying clinical phenomena that manifest in the newborn, examining clinical data that refer to clinical phenomena (including assessment data & current assessment frameworks ), considering the outcome of assessment (the condition, clinical or health state), and exploring the diagnostic reasoning process whilst acting autonomously, using skills acquired, within guidelines of supervision||CP|
|006||Demonstrate systematic newborn assessment and physical examinations within clinical settings||P|
|007||Apply complex skills of systematic and holistic assessment of undifferentiated newborn problems to make accurate differential diagnoses, safe management plans and appropriate referrals||PT|
|008||Act autonomously, using skills acquired, within guidelines of supervision.||PT|
C - Cognitive/analytical
K - Subject knowledge
T - Transferable skills
P - Professional/Practical skills
Assessment: Principles, definitions, purposes. Clinical Judgement / clinical reasoning (includes identification of clinical phenomena, types of clinical data, identifying the clinical condition, the clinical reasoning process and differential diagnosis).
The Health History: Communication skills and interviewing techniques in health assessment. Legal and ethical aspects of the newborn assessment. Review of body systems, application of communication skills, and documentation of findings.
Advanced clinical assessment: Development of skills for complex assessment of altered health states for the main body systems. These systems would include the central nervous system, respiratory system, cardiovascular system, gastrointestinal system, genitourinary system, skin, musculoskeletal system and the special senses: (eyes/ vision, ears/ auditory, vestibular/ equilibrium).
Differential diagnosis: Analysis of clinical cases to develop differential diagnosis skills focusing on undifferentiated health problems for the above body systems.
Evaluation: Critical analysis of current frameworks for assessment. Critical analysis and reflection on the practitioner’s role and evidence of contribution to the development of the role. Evidence of autonomous and advanced practice and critical analysis of the evidence for practice.
Theoretical input of:
embryology and fetal development of a specific system
adaptation of this system to extra-uterine life
the abnormalities that can be detected on examination in relation to this system
the common problems in relation to the well neonate for this system
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 problem related to this system 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
Repeated as above for each of the systems indicated below:
Urogenital/ chromosomal sexual differentiation
Sensory organs – including skin
Metabolic and Endocrine system
Immune system – infection
Methods of Teaching / Learning
Delivery of the module:
7 study days in theory on the following: assessment strategy, history taking, and peer evaluation, accountability in advanced practice, clinical reasoning and diagnosis in certain conditions of a number of body systems as applicable to the newborn eg heart sounds, hip assessment and respiratory conditions
Teaching will be by interactive lectures/discussions/seminar presentations and practical experience.
Students will be enrolled through VLE Surrey learn for blended learning using e-learning technology. Academic component of the assignment will be submitted on line. Practice component of the assignment will be submitted as paper copies.
For legal and professional implications, it is important that all examinations of the new born undertaken throughout this module should also be examined by a suitably qualified practitioner (paediatrician or midwife with the qualification of examination of the newborn). A practice assessment document should be used to record all findings on each examination. For those examinations which midwives will undertake without supervision it may be useful to compare notes with the results of the examinations of the same babies conducted by the paediatrician? This will give them “practical” feedback regarding the adequacy of their own examination and interpretations of the findings. It is the midwife’s responsibility to seek further experience if certain routine conditions have not been encountered by the completion of the required number of examinations.
Self directed study will be the primary process of learning with students taking responsibility for their own educational development. Students are expected to develop skills in reflection and negotiate appropriate clinical experience to achieve specific skills required to expand this role. A workbook is provided to complement the theoretical component.
The assessment strategy is designed to provide students with the opportunity to demonstrate
development of skills in the examination of the newborn 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.
Thus, the summative assessment for this module consists of:
Forty (40) newborn clinical assessments in placements
CASE STUDY which will focus on the following elements and will require:
Critical analyses of the full physical examination of the newborn, including history and findings relating this to evidence based practice
Parent education as a teaching activity throughout the examination
Identification of professional implications for this extended role in midwifery practice
Advanced assessment underpinned by an identified assessment tool/s or framework/s and differential diagnosis devised to develop management plans and make appropriate referral
Theoretical marking grid at level M
A workbook is provided to complement the theoretical component. Each student is expected to work through a series of questions in the workbook, designed to facilitate active learning. The midwife will develop appropriate levels of understanding in relation to both normal and abnormal physiology
5 Reading Logs expected and these must be well structured and adequately demonstrate how the content is relevant to practice. Good analysis must be demonstrated, identifying methodological issues etc.
Reflections must be sensitive, analytic and integrated to current practice. One or two are sufficient to demonstrate progression from the first examination of the newborn to the final assessment carried out. Identifying a reflective model on which to base the structure of this section must be included.
The above are submitted as part of the final portfolio and are awarded a Pass/Fail
Through Surrey/ Learn
Please note that the information detailed within this record is accurate at the time of publishing and may be subject to change. This record contains information for the most up to date version of the programme / module for the 2018/9 academic year.