Normal Newborn Nursery (MBU) Rotation Curriculum
Goal 1: Provide comprehensive care in a level I nursery.
Objectives
1.
2.
3.
4.
5.
6.
Explain the role of the primary care pediatrician in the level I nursery and how it
relates to the continuum of office health supervision care.
Effectively communicate with the mother's obstetrician during the hospital stay and
her primary care provider prior to the infant's discharge
Recognize normal physiologic changes in neonatal transition, signs of abnormal
responses and implement strategies for their management.
Describe the rationale behind various nursery and delivery routines and how these
affect the health and well-being of families and newborns (e.g., rooming in, ondemand feeding, 24 hour discharge of the newborn).
Function as a pediatric consultant to health professionals in the newborn nursery for
routine, normal pregnancies, deliveries and newborn care.
Identify the role and scope of practice of general pediatricians, neonatologists,
perinatologists, obstetricians, family physicians, nurse midwives, lactation
consultants, primary care nurses for OB/Newborn, and social workers in relation to
the normal nursery; and work collaboratively with these professionals in the care of
newborns.
Instructional Strategies
Direct Patient Care
Family-centered patient
care rounds
Formal and informal
lectures
Rotation readings
Learner
Evaluation
Global Rotation
Evaluation
Direct
observation of
patient care
Competencies
Addressed
X MK X ICS
XP
X PC
X PBLI X SBP
Verbal feedback
on rounds
Goal 2: Assess newborns, using history, physical exam and routine screening procedures, and provide preventive counseling and intervention as indicated.
Objectives
Instructional Strategies
Learner
Competencies
Evaluation
Addressed
1. Obtain and interpret prenatal information relevant to newborn health
Direct Patient Care
Resident global
X MK X ICS
2. Obtain and interpret a social history to assess the physical and psychosocial environment in
evaluation
XP
X PC
the infant's home.
Daily patient care rounds
3. Perform a complete neonatal physical examination and identify normal and abnormal
Direct
� PBLI X SBP
findings
Formal and informal
observation of
4. Describe current standards for newborn screening, including newborn metabolic screening,
lectures
patient care
hearing screening, and bilirubin screening.
5. Communicate effectively with parents and family in a professional and caring manner that
Rotation readings
Verbal feedback
honors family values and enhances their parenting skills and confidence.
on rounds
6. Provide anticipatory guidance and prevention counseling throughout hospital stay and at
time of discharge, according to recommended guidelines
MBU PL-1
Communication
Direct
Observation
Form
Normal Newborn Nursery (MBU) Rotation Curriculum
Goal 3: Evaluate and appropriately treat or refer newborns with commonly presenting signs and symptoms or conditions.
Objectives
Instructional Strategies
1.
2.
Recognize, describe clinical significance of, and develop a strategy to evaluate,
manage and/or refer newborns with common newborn conditions such as
birthmarks/rashes, temperature instability, heart murmur, hip examination
abnormalities, palsies, undescended testes etc.)
Recognize, describe clinical significance of, and develop a strategy to evaluate,
manage and/or refer newborns with common newborn clinical situations including
infants of diabetic mothers, infants of substance abusing mothers, Rh or ABO
incompatability, hyperbilirubinemia, feeding issues etc.
Direct Patient Care
Learner
Evaluation
Resident global
evaluation
Daily patient care rounds
Formal and informal
lectures
Rotation readings
Direct
observation of
patient care
Competencies
Addressed
X MK
X ICS
�P
X PC
� PBLI X SBP
Verbal feedback
on rounds
Goal 4: When appropriate, describe and competently perform the technical /therapeutic procedures and diagnostic /screening procedures commonly used on the
Normal Newborn Service.
Objectives
Instructional Strategies
Learner
Competencies
Evaluation
1. Use and/or interpret clinical tests commonly used in Newborn Nursery setting, such
Direct Patient Care
Resident global
X MK X ICS
as physiologic monitoring (HR, RR, pulse oximetry), CBC, ABO typing and
evaluation
XP
X PC
Coombs testing, blood glucose/glucometer, bilirubin, maternal cord blood
Daily patient care rounds
antibodies.
Direct
� PBLI X SBP
Formal and informal
observation of
lectures
patient care
Rotation readings
Verbal feedback
on rounds
Normal Newborn Nursery (MBU) Rotation Curriculum
Goal 5: Manage breast- and bottle-feeding in the newborn period.
Objectives
1.
2.
Counsel parents about feeding choices and assess for potential risks/difficulties.
Encourage and support mothers who are breastfeeding or formula feeding.
Instructional Strategies
Direct Patient Care
Learner
Evaluation
Resident global
evaluation
Daily patient care rounds
Direct
observation of
patient care
Rounds with lactation
consultant
Rotation readings
Goal 6: Assess and manage common infections in the normal newborn nursery.
Objectives
1.
2.
3.
4.
Identify common and important perinatal infections and initiate their management.
Discuss methods for screening and, where appropriate, preventive treatment of
mother and infant (chlamydia, CMV, gonorrhea, group B strep, hepatitis B,
hepatitis C, HSV, HIV, tuberculosis, HPV, parvovirus, rubella, syphilis,
toxoplasmosis, and varicella).
Identify newborns at risk for bacterial sepsis by history, physical exam, and
laboratory studies and initiate appropriate treatment.
Recognize and manage common infectious conditions in the newborn including
newborns with signs of sepsis, infant born to mother with fever, infant born to
mother with a history of a perinatal infectious disease (e.g., group B strep,
chlamydia, syphilis, HSV) andnfant born to mother with prolonged rupture of
membranes
Direct Patient Care
Learner
Evaluation
Resident global
evaluation
Daily patient care rounds
Rotation readings
X MK
X ICS
XP
X PC
� PBLI � SBP
Verbal feedback
on rounds
Instructional Strategies
Formal and informal
lectures
Competencies
Addressed
Direct
observation of
patient care
Competencies
Addressed
X MK X ICS
XP
X PC
� PBLI X SBP
Verbal feedback
on rounds
Normal Newborn Nursery (MBU) Rotation Curriculum
Goal 7: Recognize and manage jaundice in the newborn period.
Objectives
1.
2.
3.
4.
5.
6.
Interpret maternal history for factors contributing to jaundice (Rh, blood type,
gestational age, infection, family history of jaundice in infants, etc.).
Interpret infant's history for possible etiologies of jaundice (e.g., infrequent or
ineffective feeding, poor urine or stool output, acholic stool, blood type, risk factors
for infection, metabolic disease).
Perform a physical exam to assess for jaundice or other evidence of hepatic
dysfunction (e.g., skin color, sclerae, bruising, cephalhematoma, organomegaly).
Obtain laboratory tests judiciously for management of the jaundiced infant and
correctly interpret test results to evaluate jaundice in the clinical setting.
Counsel parents about types of jaundice (physiologic, insufficient breastfeeding,
breast milk, hemolytic, etc.) and their natural history, counsel parents about when to
be concerned about jaundice.
Discuss the current AAP practice parameters regarding diagnosis and management
of the jaundiced infant, including reference to normative data based on age in hours
, the indications for phototherapy and exchange transfusions and describe the use
of phototherapy in both the hospital and the home and explain risks (e.g.,
dehydration, eye injury, and disruption of breastfeeding routines).
Instructional Strategies
Direct Patient Care
Learner
Evaluation
Resident global
evaluation
Daily patient care rounds
Formal and informal
lectures
Rotation readings
Direct
observation of
patient care
Competencies
Addressed
X MK X ICS
XP
X PC
� PBLI X SBP
Verbal feedback
on rounds
Normal Newborn Nursery (MBU) Rotation Curriculum