Model for Educational Program Design

1
Community Partnership for Level III
NICU Skills Angela A. LaRuffa, RN,
MSN, CCRC, Education Specialist II, Newborn
Intensive Care Unit , Cincinnati Childrens
Hospital Christina Rust, RN, MSN, RNC-OB,
C-EFM, Nursing Educator, Maternal Child Health,
Saint Elizabeth Healthcare

• Purpose
• St. Elizabeth Healthcare - Edgewood is preparing
  to transition from a Level II to a Level III
  NICU.
• The overall aim was to increase knowledge,
  confidence and skills for the RNs in training.
• The proposed Level III NICU will provide
  ventilation and other services to babies born
  between 28 and 32 weeks gestation.
• Institutions who are seeking certification as a
  Level III NICU have identified educational needs
  in terms of skills, training and equipment to
  support Level III services.
• This level of educational preparation
  necessitates a strong, collaborative, working
  relationship with a Level III NICU in an academic
  setting.

• Implications
• Individualized education plan provided
  orientation focused on the specific needs and
  skill level of each nurse
• NICU Nurses have increased knowledge,
  confidence and clinical skills to care for high
  risk babies.
• Standardized, quality, evidence-based Level III
  NICU care
• Infants receive care based on developmentally
  sound concepts (NIDCAP Program) which also
  supports kangaroo care/ skin-to-skin contact.
• NICU infants born between 28 and 32 weeks stay at
  their birth hospital, allowing for easier mother,
  baby and family bonding.
• Supports family-centered care.
• Promotes breastfeeding.

• Magnet Concepts
• SEH Edgewood and CCHMC are Magnet facilities
  working collaboratively to promote Magnet model
  components as essential elements of this program.
  
• Some of the components include
• Transformational Leadership
• Leadership collaboration across state lines,
  Management and Nurse Educators work with contract
  development, initial needs assessment,
  implementation and evaluation
• Structural Empowerment
• Commitment to the community to keep babies with
  their mothers in their own community when
  possible
• Exemplary Professional Practice
• Sharing professional model of care
• Nurses as Teachers
• Consultation and Resources
• Quality of Care
• New Knowledge, Innovations and Improvements
• Educational collaboration across state lines has
  long been a community standard in the Tristate
  area.
• Focus on best interest of infants and not
  competition between facilities

• Background
• The program was developed by Nursing Leadership,
  Management and Nurse Educators from St. Elizabeth
  Healthcare (SEH) Edgewood - Maternal Child Health
  Division and Cincinnati Childrens Hospital
  Medical Center NICU (CCHMC).

• Model for Educational Program Design
• .

• Education Evaluation
• Survey outcomes provided high ratings for staff
  satisfaction in communication skills, clinical
  skills and confidence levels.

• Methods
• The training program was a blended learning
  experience with online and classroom education
  along with clinical time in the CCHMC NICU.
• During the 160 hours of hands-on training at
  CCHMC, the RNs were under the direct supervision
  of a preceptor who were clinically advanced RN in
  the NICU.
• Weekly meetings took place with the NICU Educator
  to discuss individualized learning experiences
  for each RN, including observations with
  Respiratory Therapy, Unit Charge Nurse, Speech
  Pathologist and time with specially trained PICC
  (peripherally inserted central catheter) nurses.
• Newborn Individualized Developmental Care and
  Assessment Program (NIDCAP) theory, principles
  and techniques introduced at CCHMC and reinforced
  with programs at SEH.
• As a final evaluation, simulation was completed
  to practice interaction, communication and
  clinical skills without compromising the safety
  of real NICU patients.

• Demographics
• 9 Registered Nurses
• Range of 7 to 32 years of Level I, II or III
  NICU experience

Being around the preemie infants and caring for
ventilated infants has made me less fearful of
them - RN trainee.