CURRICULUM GUIDELINES
FOR
NEONATAL NURSE PRACTITIONER
EDUCATION PROGRAMS
National Association of Neonatal Nurses
4700 W. Lake Avenue
Glenview, IL 60025-1485
(800) 451-3795, (847) 375-3660
FAX: (888) 477-6266
www.NANN.org
Task Force Members
Terri A. Cavaliere, MS, RNC, NNP – Chair
Debra Sansoucie, EdD, RNC, NNP
Patricia Waltman, EdD, RNC, NNP
Victoria Chaffin Elliot, MSN, RNC, NNP
Alice Bohannon, PhD, ARNP *
Cheryl Ann Carlson, MS, RNC, NNP *
Jeanne M. Giebe, MSN, RNC, NNP *
Linda Juretschke, MSN, RNC, NNP *
Valerie K, Moniaci, MSN, RNC, NNP *
Linda Rath, MSN, RNC, NNP *
Carole Trotter, PhD, RNC, NNP - Consultant
* Denotes corresponding members
Board of Directors 2001-2002
Margaret Conway-Orgel, MSN, RNC, NNP-President
Catherine L. Witt, MS, RNC, NNP-President-Elect
Janet Pettit, MSN, RNC, NNP- Secretary
Suzanne Staebler, MSN, RNC, NNP-Treasurer
Beth Ann Allison, BSN, RNC-Director at Large
Robin Bissinger, MSN, RNC, NNP-Director at Large
Priscilla Frappier, MPH, RNC, NNP-Director at Large
Nona Peterson, MN, RNC-Director at Large
Margaret (Peggy) Gordin, MSN, RN, FAAN-Director at Large
Frances Strodtbeck, DNS, RNC, NNP, FAAN -Immediate Past President
Adopted by the NANN Board of Directors 2002.
National Association of Neonatal Nurses
4700 W. Lake Avenue
Glenview, IL 60025-1485
(800) 451-3795 or (847) 375-3660
FAX: (888) 477-6266
www.NANN.org
2
CURRICULUM GUIDELINES FOR
NEONATAL NURSE PRACTITIONER PROGRAMS
Introduction
It is the responsibility of the National Association of Neonatal Nurses (NANN), the
specialty organization for neonatal nurses, to define guidelines and standards for the
education of neonatal nurse practitioners (NNP). The education standards for NNP
programs are available on the NANN web site at www.nann.org. This document is the
updated curriculum guidelines for NNP programs. These guidelines should be used in
conjunction with other accreditation or review tools for the evaluation of NNP
educational programs or tracks. This would ensure that graduating NNPs receive
appropriate instruction to function at the novice-advanced beginner level. These
curriculum guidelines can also be used as a template for the development of new NNP
programs and as a self-study tool for existing NNP Programs. (NONPF, 1995)
Evolution of NNP Curriculum Guidelines
The neonatal nurse practitioner (NNP) role emerged in the 1970s and evolved along
with the changing status of women, the expanding role of nurses, the advanced
technology available for high risk neonates, and decreasing physician availability in
neonatal intensive care units. For more than 25 years, NNPs have demonstrated their
worth, not merely as physician extenders, but as competent, valuable practitioners in
their own right. This evolving role merges desirable characteristics of nursing, medicine,
and other disciplines to provide and direct expert care for neonates, their families and
their communities.
Currently, the NNP is defined as “A registered nurse (RN) who is an experienced,
expert neonatal nurse and has obtained a graduate degree in the nursing specialty (or
whose title/role has been grandfathered before January 1, 2000) with an emphasis in
managing the health care needs of newborns/infants and their families. The NNP
diagnoses and treats in collaboration with neonatalogists and other pediatric physicians.
The NNP makes independent and interdependent decisions in the assessment,
diagnosis, management, and evaluation of the health care needs of neonates and
infants. In addition, the NNP selects and performs clinically indicated advanced
diagnostic and therapeutic invasive procedures.” (NANN 1999)
In the current managed care environment, it is important to note that an additional
component of the NNP role is that of case manager. NNPs have been shown to
successfully address such case management issues as continuity of care, length of
stay, quality, efficiency, and cost-effectiveness. (NANN 1996) Further, studies have
shown a high level of satisfaction with NNPs among obstetricians, pediatricians, family
practitioners, registered nurses, and parents in regard to clinical skills, knowledge base,
and patient care. (Trotter & Danher 1994; Carzoli, Martinez-Cruz, Cuevas, Murphy &
Chiu 1994; Beal, Tiani, Saia & Rothstein 1999; Mitchell-DiCenso, Guyatt, Marrin,
Goeree, Willan, Southwell, Henson, Paes, Rosenbaum, Hunsberger & Baumann 1996;
3
Bissinger, Allred, Arford, Bellig 1997; Karlowicz & McMurray 2000; Aubrey & Yoxall
2001)
NNP education was initially accomplished through a combination of “on-the-job” training
and more formal education in certificate programs. Today NNP programs are
exclusively offered in university schools of nursing at the graduate level. According to
Berlin, Stennett and Bednash (2002), there are 327 nurse practitioner programs in the
United States and 826 specialty tracks in adult, family, pediatric, women’s health,
neonatal, acute care, and other areas.
NANN (1995B) announced its support of the master's degree as the minimum
requirement for entry into advanced nursing practice in the mid-1990s. "The lack of a
standard, minimum entry-level educational requirement for nurse practitioners is seen
as an obstacle to efforts to obtain third-party reimbursement, prescriptive privileges, and
independent statutory authority for the full scope of practice in many states; as a
credibility issue for 'advanced practice' by non-nursing groups such as physicians,
pharmacists, and health insurance companies; and as a significant source of concern
within nursing by regulatory and professional organizations such as the National Council
of State Boards of Nursing, the National League for Nursing, the American Nurses
Association, the American Association of Colleges in Nursing, and specialty
organizations such as NANN." (NANN 1995B)
Furthermore, in 1996, the Board of Directors of the National Certification Corporation for
Obstetric, Gynecologic and Neonatal Nursing Specialties (NCC), the certifying body for
NNPs, announced a change in its eligibility requirements for applicants for the NNP
examination. This change was made “in response to changes in the nursing profession
and in the regulatory climate”. (NCC 1999) By requiring graduate education in the
specialty area as an eligibility requirement for the NNP certification examination
beginning January 1, 2000, NCC moved NNP education into the mainstream of nursing
education.
The question of whether advanced practice nursing education belongs at the graduate
level is now moot. For this millennium the issue is ensuring the quality of both the
programs offering nurse practitioner preparation and the graduates of those programs.
Despite the fact that NNP education is now offered exclusively at the graduate level
and has become more comprehensive, there is little uniformity between programs in
such factors as pre-admission requirements, faculty and program director qualifications,
curricula, and length of preceptorship. Excellence and consistency in educational
preparation are essential if NNPs expect to remain a credible source of quality health
care.
In 1999, the NANN Board of Directors appointed a task force to examine and
standardize NNP education. The NNP Education Standards Task Force is the second
such task force commissioned by NANN. The work of the first task force resulted in the
publication of the first curriculum guidelines for NNP education programs. (NANN
4
1995A) This landmark document has been used by educators as a template for
developing and revising NNP programs at the certificate and graduate program levels.
In 1997, the National Task Force on Quality Nurse Practitioner Education published a
document entitled, Criteria for Evaluation of Nurse Practitioner Programs. (National
Task Force on Quality Nurse Practitioner Education 1997) With the goal of developing
“a model for evaluating the quality of nurse practitioner programs” (p.4), the document
was endorsed by 23 nursing and nurse practitioner organizations, including NANN and
NCC. One of the recommendations of this document is the separate evaluation of
each nurse practitioner (NP) track or major in institutions where there are multiple NP
tracks/majors. (p.5).
Shortly after this publication, the Consortium for Quality Nurse Practitioner Education
was formed to “identify mechanisms to improve evaluation of nurse practitioner
programs and to make recommendations regarding the national need for accreditation
of nurse practitioner programs”. (Consortium for Quality Nurse Practitioner Education
1999) The Consortium (1999) recommended the “integration of specific nurse
practitioner evaluation within nationally recognized accreditation processes for nursing
education”. These curriculum guidelines and the Education Standards for NNP
Programs (NANN 2002) are the foundations of NANN’s commitment to quality nurse
practitioner education.
Curriculum Content for NNP Programs
The recommended curriculum content for NNP education programs is divided into two
main content areas: professional role and professional practice. Each content area is
further divided into 14 content categories (seven each for professional role and
professional practice). The content areas and categories are listed in Table 1. Content
categories are identified by Roman numerals.
Table 1: NNP Curriculum Content Area and Categories
Content Area
Content Categories
Professional Role of NNP
I.
II.
III.
IV.
V.
VI.
VII.
Professional Role Development
Communication
Ethical and Legal Issues
Health Care Policy and Legislation
Management/Organization
Teaching/Education
Research
Professional NNP Practice
VIII.
Scientific Foundations for Practice
 Embryology
 Developmental Physiology
 Advanced Pharmacology
 Genetics
Advanced Physical Assessment
 Perinatal History
 Antepartum Complications
IX.
5


Intrapartum Conditions
Influence of Altered Environment on
the Newborn/infant/infants
 Gestational Age Assessment
 Newborn/infant Physical Examination
 Behavioral Assessment
 Developmental Assessment
X.
Clinical Laboratory and Diagnostic
Assessment
 Clinical Laboratory Tests
 Diagnostic Tests
 Diagnostic Procedures
XI.
General Management
 Thermoregulation
 Resuscitation & Stabilization
 Pain
XII.
Clinical Management (Embryology,
Pathophysiology, and Management)
 Cardiovascular System
 Pulmonary System
 Gastrointestinal System
 Nutrition
 Renal/Genitourinary System
 Fluids & Electrolytes
 Endocrine & Metabolic System
 Hematologic System &
Malignancies
 Immunologic System & Infectious
Diseases
 Skeletal System
 Neurobehavioral System
 Ears, Eyes, Nose, & Throat
 Integumentary
XIII. Sociocultural Assessment
 Cultural Competence
 Family Dynamics
XIV. Health Promotion and Disease Prevention
 Discharge Planning
 Primary Care of infants through the
first two (2) years of life
Essential Content & Competencies
Essential competencies and content are provided for each curriculum content category
in tables 2 and 3. Essential content is defined as curriculum content that must be
incorporated into the NNP program. Additional content may be added by individual
program faculty. Rationale statement(s) are presented for each content category.
6
Competency statements specific to the content category are listed in table 2 and 3.
These competencies reflect the content graduate programs must include to adequately
prepare NNPs for practice. Each educational institution should apply its own theoretical
framework and organizational structure in developing its curriculum.
Essential content is further defined in the curriculum topics section. This section
outlines essential course material and clinical experiences. A variety of teaching
strategies may be used in addressing this content. Additional clinical experiences may
be provided at the discretion of the faculty and/or preceptor based on the learning
needs of individual students.
Curriculum Design
The curriculum design of individual NNP programs is the prerogative of the program
faculty. While NANN supports the creativity of program faculty to design the NNP
curriculum, it is essential that the curriculum plan meet all current standards, evaluation
criteria, and guidelines. These criteria include state nursing board requirements,
advanced practice nursing standards (AACN 1976), nurse practitioner education
evaluation criteria (NONPF 2002), professional certification content requirements (NCC
2002), and specialty standards (NANN 2002).
Primary Care of Infants
Clinical and didactic content related to primary care of the infant during the first two
years of life should be included in the curriculum. This content would be offered in
addition to the required clinical and didactic hours required for NNP education. This
provides students with a broader, holistic base of function and enhances their role
diversity and career opportunities.
7
TABLE 2: ELABORATION OF CURRICULUM CONTENT FOR THE PROFESSIONAL ROLE OF THE NNP
I. Professional Role Development
Rationale
The NNP has a commitment to advance
the profession of nursing and the specialty
of Neonatology and to base professional
practice on a firm foundation of theory and
research. The NNP should have a clear
understanding of the theories and
processes necessary for development of
the professional role, including the
historical perspectives of the nurse
practitioner role and the requirements for
and regulation of advanced practice
nursing roles. The NNP functions not only
as a direct provider of care, but also
functions in a variety of non-provider roles
including teacher, researcher, advocate,
consultant, manager of systems and
leader. The transition into the new role of
the NNP occurs over time through
integration and enactment of a variety of
specific role behaviors into clinical
practice. In order to function in these roles,
the NNP must possess strong clinical
decision-making skills. These skills are
essential to the provision of care to infants
and families and to improving health care
delivery and outcomes of patient care. The
NNP is also responsible for maintaining
competence in the specialty area. Theory
and knowledge of health care and
management of vulnerable infants
increases at a rapid rate. Because
technology advances continuously, the
Competencies
1. Applies current scientific knowledge to
initiate change and improve care for
newborns/infants and their families.
5. Participates in professional activities
related to advanced nursing practice
8. Identifies and clarifies the role of the
NNP to the infant’s family, other health
care professionals and the community
12. Expands knowledge base and
maintains clinical competency through
continuing education activities and clinical
practice











Essential Content
Professional leadership
Role theory
Nursing theories
Advanced practice role
Role of the NNP
Historical perspectives
Scope of practice of NNP
Standards of practice
Credentialing and certification
Clinical decision-making/problem
solving
Professional scholarship
skills necessary to practice safely and
effectively must be reviewed and updated
regularly. The NNP collaborates with other
health care disciplines in the delivery of
care and must understand models and
processes for developing, implementing,
and evaluating collaborative practice
models. As an advanced practice nurse,
the NNP is expected to use and provide
consultation in such areas as clinical
practice, education, and management in
the specialty.
II. Communication
The ability to communicate skillfully is
pivotal to the role of the NNP in
establishing and maintaining interpersonal
relations with families and other health
care professionals. Professional behaviors
such as assertiveness, advocacy, and
skills in conflict resolution are necessary in
providing leadership in the provision of
health care and in the profession. In an
increasingly complex society, the NNP
must also be efficient in the use of
information processing systems to
document patient data as well as
communicate with other health
professions.
9. Establishes and maintains a
collaborative relationship with health care
colleagues
14. Advocates for infants and their families
27. Communicates with family members
regarding infant’s health care status and
needs
31. Presents and documents the
database, impression and plan of care
III. Ethical & Legal Issues
9







Communication theory
Collaboration
Conflict resolution
Assertiveness
Collaborative practice models
Informatics
Consultation
The NNP must:
 Possess an understanding of the
ethical and legal implications of
perinatal care and the scope of the
advanced practice role in the specialty
area.
 Possess skill in ethical decision
making and is expected to provide
counseling for families in situations
where ethical issues arise
 Participate in discussions of ethical
issues in health care as they affect the
needs and the care of infants and
families
6. Incorporates professional and legal
standards into practice


7. Participates in the ethical decision
making process in collaboration with
families and other health care
professionals






14. Advocates for infants and their families

Ethical decision making
Ethical issues – reproductive, prenatal,
neonatal, & infancy
Advocacy
Bioethics committees
Clinical research
Resource allocation
Genetic counseling
Legal issues impacting patient care &
professional practice
Informed consent
IV. Health Care Policy and Legislation
The NNP should have a comprehensive
understanding of health care policy,
legislation, and financing of health care
AND:
 Has the responsibility to analyze the
social, economic, and political
components of health care systems
that impact the planning and delivery
of health care.
 Initiates change and collaborates with
others to implement and evaluate
health care reform, incorporating
knowledge of social, economic, and
political forces.
 Has the responsibility to provide quality
cost-effective care.
4. Participates in the formulation of public
policies that affect advanced nursing
practice
6. Incorporates professional and legal
standards into practice
10. Participates at the local, state and/or
national level in the development of
legislative and health care policies that
affect the care of infants and families






Process of health care legislation
Maternal-child health legislation
Economics of health care
Third party reimbursement
Advanced practice
legislation/regulations
Advocacy



Models of planned change
Collaborative practice
Collaborative case management
15. Advocates for infants and their families
V. Management/Organization
The NNP must possess the knowledge
and skills to participate in the design and
implementation of care in a variety of
emerging and changing health care
1. Applies current scientific knowledge to
initiate change and improve care for
newborns/infants and their families.
10
systems, and to assume a leadership role
in the management of human, fiscal, and
physical health care resources. To provide
quality patient management, the NNP
must possess the skills to develop
protocols and systems for monitoring,
maintaining, and evaluating specified
standards. Knowledge of organizational
theory and management, resource
allocation and quality control enable the
NNP to secure adequate institutional
resources to meet patient management
goals and to work within the system to
establish the NNP role.
11. Participates in the continuous quality
improvement process for the care of
infants and families
Teaching is a fundamental activity of the
advanced practice nurse. The NNP is
responsible for assessing the educational
needs of families and functioning as a
clinical resource to staff and colleagues.
Knowledge of adult learning theory,
cultural diversity, instructional strategies
and technologies and current literature
provides a foundation for the NNP in
meeting these educational needs in a
culturally relevant manner. The NNP is
responsible for maintaining a current
knowledge base and clinical competence
through continuing education activities and
clinical practice.
5. Participates in professional activities
related to advanced nursing practice
A foundation in research prepares the
NNP to examine current practice and to
utilize new knowledge to provide high
quality health care, initiate change, and
1. Applies current scientific knowledge to
initiate change and improve care for
newborns/infants and their families.
13. Participates in self- and peer
evaluation to improve the quality of care
provided to infants and families
15. Applies appropriate theories from
nursing and related disciplines to provide
quality care to newborns/infants and their
families.









Reimbursement systems
Standards of practice
Cost, quality, outcome measures
Resource management
Continuous quality improvement
Evaluation models
Peer review
Organizational theory
Principles of management




Theories – motivational, change,
education, communication
Program planning
Instructional technology
Cultural competence




Research process
Critical evaluation of research findings
Research in vulnerable populations
Funding for research
34. Participates in the development,
review and evaluation of NNP protocols
VI. Teaching/Education
12. Expands knowledge base and
maintains clinical competence through
educational activities and clinical practice
27. Communicates with family members
regarding infant’s changing health care
status and needs.
VII. Research
11
improve nursing practice. The research
process provides the framework in which
the NNP evaluates management
strategies, integrates new modes of
therapy into practice, identifies clinically
relevant problems, and develops solutions
to these problems


2. Identifies potential areas for nursing
research in clinical practice.
Research dissemination
Institutional review boards
3. Demonstrates understanding of the
research process.
TABLE 2: ELABORATION OF CURRICULUM CONTENT FOR THE PROFESSIONAL PRACTICE OF THE NNP
Rationale
The biologic and social sciences provide
the foundation upon which the NNP
develops patient management plans
and evaluates the outcomes of
management interventions
VIII. Scientific Foundations for Practice
Competencies
15. Applies appropriate theories from
nursing and related disciplines to
provide quality care to infants and
families
16. Develops a comprehensive
database that includes pertinent history;
diagnostic tests; and physical,
behavioral, and developmental
assessments
18. Selects and interprets diagnostic
tests and procedures
19. Relates assessment findings to
underlying pathology or physiologic
changes
20. Establishes differential diagnoses
based on the assessment data
23. Plans, implements, and evaluates
12
Essential Content
A. Perinatal physiology
 Maternal physiology (physiologic
adaptation to pregnancy, pathologic
changes/disease in pregnancy, effects of
pre-existing disease)
 Fetal physiology
 Transitional changes
 Neonatal physiology
B. Pharmacology
 Principles of pharmacology
 Principles of drug
 administration
 Common drugs used in the
 newborn/infant
 Effects of drug use during
and lactation
pregnancy
C. Genetics

Principles of human genetics

Genetic testing and screening
pharmacologic therapies



Genetic abnormalities
Human Genome Project
Gene therapy
IX. General Assessment
Comprehensive assessment is the
foundation for the clinical decisionmaking required of the advanced
practice role. All components of
neonatal assessment are integral to the
development of differential diagnoses
and management plans for infants
16. Develops a comprehensive
database that includes pertinent history;
diagnostic tests; and physical,
behavioral, and developmental
assessments





17. Assesses family adaptation, coping
skills, and resources, and develops an
appropriate plan of care





19. Selects and interprets diagnostic
tests and procedures
Perinatal history
Antepartum conditions
Prenatal diagnostic testing
Intrapartum conditions
Influence of altered environment on the
newborn/infant
Gestational age assessment
Neonatal physical exam
Behavioral assessment
Developmental Assessment
Assessment of family adaptation, coping
skills and resources
24. Performs routine diagnostic and
therapeutic procedures according to
established protocol and current
standards for NNP practice
X. Clinical Laboratory and Diagnostic Assessments
The NNP is responsible for ordering
interpreting and directing care based on
clinical, laboratory, and diagnostic data.
Accurate and comprehensive
assessment requires a synthesis of data
gathered from the history, physical
examination, and laboratory and
diagnostic tests.
16. Develops a comprehensive
database that includes pertinent history;
diagnostic tests; and physical,
behavioral, and developmental
assessments
18. Selects and interprets diagnostic
tests and procedures
19. Relates assessment findings to
underlying pathology or physiologic
changes
24. Performs routine diagnostic and
13
A. Clinical laboratory tests
 Microbiologic
 Biochemical
 Hematologic
 Serologic
 Metabolic/Endocrine
 Immunologic
 Routine NB screening
 Other
B. Diagnostic tests
1. Types/techniques

Ultrasound
therapeutic procedures according to
established protocol and current
standards for NNP practice

CT

MRI/MRA/MRS

X-ray

EKG

EEG

Echocardiogram

Cardiac catheterization
2. Selection of diagnostic tests
 indications
 reliability
 advantages/disadvantages
 cost-effectiveness
3. Interpretation of results
C. Neonatal procedures
 Lumbar puncture
 Umbilical vessel catheterization
 Percutaneous arterial & venous
catheters
 Arterial puncture
 Venous phlebotomy
 Suprapubic bladder tap
 Bladder catheterization
 Intubation
 Ventilation
 Resuscitation
 Needle aspiration of pneumothorax
 Chest tube insertion/removal
XI. General Management
General principles of management have 16. Develops a comprehensive
consequences for all organ systems and database that includes pertinent history;
affect responses to therapy.
diagnostic tests; and physical,
behavioral, and developmental
Maintenance of a neutral thermal
assessments
environment is a key concept in
14
A. Thermoregulation

Factors affecting heat loss and
production

Mechanisms of heat loss

Temperature assessment techniques

Hypo-, hyperthermia
assuring adequate growth and
development of the newborn/infant
A thorough understanding of the
physiology of asphyxia is essential for
accurate and timely assessment and
intervention in emergency situations
19. Relates assessment findings to
underlying pathology or physiologic
changes
Pain, and the reaction to pain, impacts
the infant’s physiologic processes, as
well as future growth and development.
The NNP plays a pivotal role in
recognizing pain signals and
implementing therapies to optimize
outcome
21. Implements a comprehensive,
multidisciplinary plan of care that
incorporates cultural, ethnic, and
developmental variations
20. Establishes differential diagnoses
based on the assessment data
22. Establishes appropriate priorities of
care
23. Plans, implements, and evaluates
pharmacologic therapies
24. Performs routine diagnostic and
therapeutic procedures according to
established protocol and current
standards for NNP practice

Management techniques to minimize
heat loss or maintain body
temperature
B. Resuscitation and stabilization

Assessment of risk factors

Physiology of asphyxia

Indications for intubation, ventilation
and cardiac compressions (see also
section on neonatal procedures

Resuscitation equipment

Pharmacotherapeutics

Stabilization

Neonatal transport

NRP provider
C. Pain Management

Physiology of pain

Pain management
1. Non-pharmacologic
2. Pharmacologic
25. Initiates and performs necessary
measures to resuscitate and stabilize a
compromised infant.
26. Evaluates results of interventions
using accepted outcome criteria and
revise plan accordingly
XII. Clinical Management (Embryology, Pathophysiology and Management)
15
Clinical management of neonatal
patients requires a broad knowledge
base, which includes a thorough
understanding of embryology,
physiology, pathophysiology and
pharmacology. Diagnoses and
decisions regarding prevention,
intervention, and evaluation flow from
this knowledge base.
16. Develops a comprehensive
database that includes pertinent history;
diagnostic tests; and physical,
behavioral, and developmental
assessments
18. Selects and interprets diagnostic
tests and procedures
19. Relates assessment findings to
underlying pathology or physiologic
changes
20. Establishes differential diagnoses
based on the assessment data
21. Implements a comprehensive,
multidisciplinary plan of care that
incorporates cultural, ethnic, and
developmental variations
22. Establishes appropriate priorities of
care
23. Plans, implements, and evaluates
pharmacologic therapies
24. Performs routine diagnostic and
therapeutic procedures according to
established protocol and current
standards for NNP practice
25. Initiates and performs necessary
measures to resuscitate and stabilize a
compromised infant
16
A. Cardiovascular system

Embryology

Physiology

Fetal/transitional/neonatal circulation

Rhythm disturbances/EKG
interpretation

Myocardial dysfunction

Shock, hypo-, hypertension

Congenital heart disease
(pathophysiology, clinical
presentation, differential diagnosis,
medical management, pre- & postoperative management)
B. Pulmonary system

Embryology

Physiology (oxygenation/ventilation,
gas-exchange, acid-base balance)

Asphyxia

Pulmonary diseases
(pathophysiology, etiology, clinical
presentation, differential diagnosis, &
treatment)

Pulmonary radiology

Respiratory therapy
a.
physiologic principles
b.
physiologic monitoring
c.
continuous distending
pressure
d.
ventilation strategies
e.
ECMO

Respiratory pharmacology
C. Gastrointestinal system

Embryology
26. Evaluates results of interventions
using accepted outcome criteria and
revise plan accordingly
28. Consults with other health care
providers and agencies in providing
care to infants and families


29. Initiates referrals based on the
needs of infants and families
31. Presents and documents the
database, impression and plan of care
35. Collaborates with the family and
multidisciplinary health care team in
discharge planning and on-going
management of the infant in the
primary care setting
breast


D. Nutrition

Effects of maturational changes on
management of nutrition and feeding

Caloric and nutritional

requirements

Feeding methods
1. breast
2. bottle
3. gavage
4. gastrostomy
5. transpyloric
6. trophic feeding

Breast milk v formula
1.
composition
2.
benefits
3.
breast milk for preterm infants

17
Anatomy & physiology of
the GI tract
1.
structure and function
2.
hormonal influence
3.
motility
4.
digestion/absorption
Digestive & absorptive disorders
1. disorders of suck/swallow
2. motility
3. G/E reflux
4. malabsorption
5. diarrhea/short gut
Anomalies/obstruction
Necrotizing enterocolitis
Parenteral nutrition
1.
composition
2.
indications
3.
benefits


4.
complications
5.
monitoring
Dietary supplementation for
term and preterm infants
Dietary adjustments in special
circumstances
1.
cholestasis
2.
short gut syndrome
3.
osteopenia
4.
inborn errors of
metabolism
E. Renal and Genitourinary

Embryology and anatomy

Renal physiology

Evaluation of renal function

Urinary tract infections

Congenital anomalies

Functional abnormalities of

the renal system

Renal failure
1. predisposing factors & etiologies
2. pathophysiology
3. management
a. fluid & electrolytes
b. nutritional modification
c. drug modification
d. hemofiltration
e. dialysis
f. transplant
F. Fluid and electrolytes

Physiology
1.
electrolyte homeostasis
2.
body composition in fetal
3.
and neonatal periods
18
4.
5.
6.
transitional changes
insensible water loss
endocrine control
(mineralocorticoids, ADH,
calcitonin/PTH)
7.
renal function/physiology

Calcium & magnesium
homeostasis

Principles of fluid therapy
1. assessment of hydration
2. maintenance requirements
3. factors affecting total fluid
4.
requirements

Disorders of fluids & electrolytes

Immune/non-immune hydrops
G. Endocrine and Metabolic System

Neuroendocrine regulation

Carbohydrate metabolism

Infant of a diabetic mother

Adrenal disorders

Thyroid disorders

Inborn errors of metabolism

Newborn screening

Ambiguous genitalia, intersex
disorders
H. Hematologic System &
Malignancies

Development of the hematopoietic
system

Anemia

Polycythemia & hyperviscosity

Bilirubin
1. physiology of bilirubin
19
2.





production, metabolism, and
excretion
3. hyperbilirubinemia
4. breast milk jaundice
5. encephalopathy
Hepatic disorders
Coagulation
1. Physiology
2. Disorders of coagulation
Disorders of leukocytes
Blood transfusions &
blood products
Malignancies/neoplasms
I. Immunologic system
 Development of the immune
 system
 Function of the immune system
 Infectious diseases
 Evaluation of the infant
1. history
2. physical examination
3. laboratory data
4. other diagnostic tests
 Treatment
1. antimicrobial
2. adjunctive therapy

Infection with specific
microorganisms
J. Musculoskeletal System

Embryology

Congenital abnormalities

Birth injuries

Metabolic bone disease
20
K. Neurobehavioral System
 Development of the nervous
system
1.
embryology
2.
anatomy
3.
cerebral circulation

Birth injuries

Anomalies/defects of CNS & spine

Ischemic brain injury

Seizures

Intracranial hemorrhage

Disorders of movement & tone

Growth &d development

Developmentally supportive care

Developmental follow-up of infants
L. Eyes, Ears, Nose and Throat

Embryology and anatomy

Abnormalities of the airway
1.
congenital
2.
acquired

Auditory system
1.
physiology of hearing &
speech development
2.
speech & language alterations
3.
hearing screening methods
4.
abnormalities

Visual system
1.
physiology of vision & visual
development
2.
visual acuity
3.
visual screening
4.
pharmacotherapy
5.
abnormalities
6.
ROP (Pathophysiology,
management)
21
M. Integumentary System

Embryology

Anatomy/physiology

Terminology

Common variations

Skin disorders
XIII. Sociocultural Assessment
The NNP must be cognizant of
sociocultural factors that influence the
patient's/ family's response to care.
Acquisition of comprehensive
information of the patient and his family
will optimize outcomes. Knowledge of
family dynamics, crisis theory and
intervention, and the grieving process
provides a background for the NNP in
fulfilling the role of patient/family
advocate.
15. Applies appropriate theories from
nursing and related disciplines to
provide quality care to infants and
families
17. Assesses family adaptation, coping
skills and resources and develops an
appropriate plan of care
21. Implements a comprehensive,
multidisciplinary plan of care that
incorporates cultural, ethnic, and
developmental variations
22. Establishes appropriate priorities of
care
27. Communicates with family members
regarding infant’s health care status and
needs?
28. Consults with other health care
providers and agencies in providing
care to infants and families
30. Assesses educational needs of the
family and implements a culturally
sensitive teaching plan
22
A. Family assessment

Family function
1. roles
2. interactions
3. effect of childbearing

Social, cultural and spiritual
variations

Support systems
B.
Families in crisis
 Crisis theory
 Principles of intervention
 Crises of childbearing
1. sick/premature infant
2. chronically ill/ malformed
infant
3. death of an infant
 Grief
1. stages
2. factors influencing grieving
process
3. pathologic grief
4. sibling reactions
33. Provides anticipatory guidance to
families regarding infant growth and
development, physical and social
needs, and strategies for health
development
35. Collaborates with the family and
multidisciplinary health care team in
discharge planning and on-going
management of infants in the primary
care setting
XIV. Health Promotion and Disease Prevention
NNPs frequently provide services to
patients beyond the neonatal period.
Licensure/certification in many
jurisdictions allows the NNP to care for
patients through the first year of life.
Provision of curriculum content related
to provision of health care to the high
risk infant during the first year would
provide a broad, holistic base of
function.
15. Applies appropriate theories from
nursing and related disciplines to
provide quality care to infants and
families
17. Assesses family adaptation, coping
skills and resources and develops an
appropriate plan of care
21. Implements a comprehensive,
multidisciplinary plan of care that
incorporates cultural, ethnic, and
developmental variations
22. Establishes appropriate priorities of
care
27. Communicates with family members
regarding infant’s health care status and
needs
28. Consults with other health care
providers and agencies in providing
23
A. Discharge Planning

Discharge planning process

Technologically dependent

infants

Parent education
1.
emergency measures
2.
medical equipment
3.
disease-specific instructions
4.
well child care (normal
growth & development,
nutrition, dental health)

Community resources

Home care and follow-up
B. Primary care

Physical assessment

Immunization

Hearing screen

Eye exams

Neurologic follow-up

Developmental screening

Safety issues
care to infants and families
30. Assesses educational needs of the
family and implements a culturally
sensitive teaching plan
33. Provides anticipatory guidance to
families regarding infant growth and
development, physical and social
needs, and strategies
35. Collaborates with the family and
multidisciplinary health care team in
discharge planning and on-going
management of infants in the primary
care setting
24
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