Course Syllabus ©National College of Midwifery 2012
01/2012
Course Title: Newborn Basic Skills
Credits: 1.0
Course Description: This course focuses on the basic professional skills needed to assess
the condition of the newborn. It includes gathering and recording information to develop an
individualized plan, the use of techniques, instruments, and equipment to monitor the growth
and development of the newborn. Skills are framed in the context of OSHA regulations as they
relate to the midwifery workplace, and the use of clean and aseptic technique and universal
precautions. This course uses current research in midwifery and obstetrics to broaden the
student’s understanding of the following NARM skills and MANA core competencies learned
under clinical supervision:
NARM Skills
I J. Provides education, counseling and/or referral, where appropriate for:
(19)-I J 10. Newborn care including normal/abnormal newborn activity, responses, vital signs,
appearance, behavior, etc.
II. General Healthcare Skills
(21)-II A. Demonstrates Universal Precautions
(22)-II B. Demonstrates the application of OSHA regulations as they relate to midwifery
workplace
(23)-II C. Demonstrates the application of aseptic technique
II D. Demonstrates the use of instruments and equipment including:
(25)-II D 2. Bag and mask resuscitator
(27)-II D 4. Bulb syringe
(28)-II D 5. Cord clamp and/or cord tape
(29)-II D 6. DeLee ® (or other tube/mouth suction device)
(32)-II D 9. Hemostats
(33)-II D 10. Infant airway
(34)-II D 11. Lancets
(35)-II D 12. Newborn and adult scale
(37)-II D 14. Needle and syringe
(38)-II D 15. Scissors (all kinds)
(41)-II D 18. Stethoscope
(43)-II D 20. Tape measure
(44)-II D 21. Thermometer
(49)-II E. Is trained in adult/infant CPR/neonatal resuscitation
III. Maternal Health Assessment
(92)-III M. Establishes and follows emergency contingency plans for mother and/or newborn
(109)-IV F 3. Monitoring respiratory and cardiac function
(110)-IV F 4. Responding appropriately to the need for newborn resuscitation
(111)-IV F 5. Clamping, cutting, and caring for the cord
VII. Well-Baby Care
(149)-VII A. Provides well-baby care 2-6 weeks
(150)-VII B. Assesses the general health and appearance of baby
MANA Core Competencies:
I. Guiding Principles of Practice.
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Course Syllabus ©National College of Midwifery 2012
01/2012
The midwife provides care according to the following principles:
1 J. Midwives synthesize clinical observations, theoretical knowledge, intuitive assessment and
spiritual awareness as components of a competent decision making process.
1 K. Midwives value continuity of care throughout the childbearing cycle and strive to maintain
continuous care within realistic limits.
1 L. Midwives understand that the parameters of “normal” vary widely and recognize that each
pregnancy and birth is unique.
II. General Knowledge and Skills
The midwife provides care incorporating certain concepts, skills and knowledge from a
variety of health and social sciences including, but not limited to:
2 C. Community standards of care for women and their developing infants during the
childbearing cycle, including midwifery and bio-technical medical standards and the rationale
for and limitations of such standards
2 G. The principles and appropriate application of clean and aseptic technique and universal
precautions
2 M. The ability to develop, implement and evaluate an individualized plan for midwifery care.
2 O. Knowledge and application of various health care modalities as they apply to the
childbearing cycle
IV. Care During Labor, Birth and Immediately Thereafter
The midwife provides health care, support, and information to women throughout labor,
birth and the hours immediately thereafter. She determines the need for consultation or
referral as appropriate. The midwife uses a foundation of knowledge and/or skill which
includes the following:
4 L. Understanding of and appropriate support for the newborn's transition during the first
minutes and hours following birth.
VI. Newborn Care
The entry-level midwife provides health care to the newborn during the postpartum
period and support and information to parents regarding newborn care. She determines
the need for consultation or referral as appropriate. The midwife uses a foundation of
knowledge and/or skill which includes the following:
6 A. Anatomy, physiology and support of the newborn’s adjustment during the first days and
weeks of life
6 B. Parameters and methods for evaluating newborn wellness including relevant historical
data and gestational age.
6 C. Nutritional needs of the newborn.
6 D. Community standards and state laws regarding indications for, administration of, and the
risks and benefits of prophylactic bio-technical treatments and screening tests commonly used
during the neonatal period.
6 E. Causes of, assessment of, appropriate treatment and emergency measures for neonatal
problems and abnormalities.
Learning Activities:
A. Student reads appropriate sections from the Learning Materials/Resources.
B. Student answers the questions listed in the Learning Objectives by researching the
Learning Materials/Resources for the course and correctly cites the sources and page
numbers for each of their answers.
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Course Syllabus ©National College of Midwifery 2012
01/2012
C. Student presents answers the questions listed in the Learning Objectives for review by
preceptor.
D. Student participates in preceptor elaboration/discussion of Learning Objectives.
E. In the case that the required texts are more than 5 years old, the student must research,
prepare & present a summary of current best midwifery care/practices appropriate to a
topic covered in this course from a current journal article/study, less than 5 years old.
F. Recommended Role-playing and/or Clinical Interactions
Note: The clinical requirement of NARM /Clinical Skills is completed at any time
throughout the ASM apprenticeship during actual clinical practice and is NOT a
requirement to complete this academic course.
Activities specific to NARM skills learned in this section:
1. Successfully complete a neonatal resuscitation course.
2. Practice assessing vital signs (with universal precautions) on a newborn baby, or
talk through what you would be doing, using a doll. Include an axillary temperature
measurement.
3. Practice doing basic measurements on a newborn, or a doll. Measure head and
chest circumference, length, and weight.
4. Practice finding brachial, femoral and apical pulses on a newborn or young baby.
5. Practice or role play your explanation to parents about how you would assess their
newborn’s reflexes. Practice gathering this information on a newborn.
6. Role play with your instructor or a student how you would clamp and cut the cord of
a newborn, using the instruments and methods that your preceptor uses (cord tie,
cord band or cord clamp.) Use universal precautions.
7. Role play or practice the steps of bathing and shampooing a newborn while
maintaining warmth. Role play or practice changing a diaper.
8. Role play with your instructor or a student how you would set up for and administer
an injection on a newborn, and dispose of needles appropriately.
9. Role play with your instructor or a student how you would harvest cord blood, if you
are able to obtain a kit and/or instructions from the cord blood company.
10. Role play or talk through with your instructor how you would obtain a capillary blood
sample from a newborn, using universal precautions.
11. Research online breastfeeding websites that show videos of successful latch and
positioning of the newborn. Practice showing a mother how to successfully position
and latch on her baby.
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Course Syllabus ©National College of Midwifery 2012
01/2012
Learning Materials / Resources:
Please use textbooks less than 5 years old or most recent edition.
1. Thureen, et al. Assessment and Care of the Well Newborn. 2nd ed. Elsevier Saunders.
2005.
2. Tharpe, Nell and Farley, Cindy. Clinical practice guidelines for midwifery and women’s
health. 3rd ed. Jones and Bartlett publishers. 2009
3. Fraser, DM, et al. Myles Textbook for Midwives. 15th ed. Churchill Livingstone Press.
2009.
4. Johnson, Ruth and Taylor, Wendy. Skills for Midwifery Practice. 3rd edition. Elsevier
Churchill Livingston. 2010.
5. Varney, Helen. Varney’s Midwifery. Fourth Edition. Jones and Bartlett Publishers. 2004
6. Frye, Anne. Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth
Practice, Vol. 2: Care of the Mother and Baby from the Onset of Labor Through the First
Hours After Birth. Labrys Press. 2004.
th
7. Weaver, Pam and Evans, Sharon K. Practical Skills Guide for Midwifery, 4 Edition.
Morningstar Publishing Co. Wasilla. 2007.
8. Mohrbacher, Nancy and Stock, Julie. The Breastfeeding Answer Book. Third Revised
Edition. La Leche League International. 2003
9. MEAC Abbreviated NARM Skills Form.
10. MANA Core Competencies for Midwives
11. Midwives Model of Care®.
12. Students must find 1 article/study less than 5 years old. Recommended internet links
as needed for latest developments in midwifery care:
The Cochrane Collaboration
EBSCO
National Library of Medicine
PubMed
Medline
SCIRUS
Medscape
World Health Organization
Evaluation Tools / Methods:
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Course Syllabus ©National College of Midwifery 2012
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Minimum passing grade for each course is a cumulative 80% / B-. Students and preceptors
are encouraged to work together until the student masters the information.
Final grade for the course is based on preceptor evaluation of the following:
A. Learning Objectives count for 80-90% of the final grade.
The preceptor evaluates each answer based on three elements:
1. Answers should reflect a thorough review of current literature regarding best
current practices in midwifery care.
2. Each answer should be formed in the student’s own words or paraphrased
from the text. The answer should be minimal, not a re-write of the entire text,
but enough to show appropriate comprehension of the learning objective.
3. Student identification of sources and page numbers for each of the Learning
Objectives. (Preceptor should do a random check to determine that sources
cited are correctly identified.)
B. Summary of current journal article / study counts for 10% of the final grade in the case that
other scholarly resources used are more than five years old.
C. Exam counts for 10% of the final grade.
Course credit:
One Academic credit equals approximately 15 hours of formal time plus 30 hours of additional
study or homework. Formal time is defined as the amount of time taken to answer the Learning
Objectives to the level of 80% and to complete any learning activities to the preceptor's
satisfaction, including any time spent face to face with the preceptor. Informal time includes
any time spent actively reading relevant sources and textbook/s, researching Learning
Objectives, and studying for examinations.
Learning Objectives:
A. The student must research, prepare & present a summary of an aspect of current best
midwifery care/practices appropriate a topic from this course from a current journal
article/study.
B. Student answers the questions below and cites the sources and page numbers.
1. Describe two methods for taking a newborn’s temperature.
2. What instruments are needed to take a newborn’s temperature?
3. Describe how to auscultate heart sounds in a newborn.
4. Describe how to evaluate breath sounds in the newborn.
5. What instruments are needed to evaluate breath and heart sounds in the newborn?
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Course Syllabus ©National College of Midwifery 2012
01/2012
6. Describe how to evaluate muscle tone in the newborn.
7. Describe the use of a bulb syringe in clearing an airway for the newborn.
8. When is the use of a bulb syringe indicated?
9. Describe the use of a Delee suction device in clearing an airway for the newborn.
10. When is the use of a Delee indicated?
11. Describe the various types of clamps that can be used to clamp the umbilical cord.
12. Describe the method of care for the umbilical cord that does not include cutting and
clamping.
13. Describe a method of tactile stimulation performed on the newborn.
14. Describe the instruments and supplies used in neonatal resuscitation.
15. Describe how to perform positive pressure ventilation on the newborn.
16. Describe how to perform chest compressions on the newborn.
17. Describe the method of initial evaluation for a newborn that needs resuscitation.
18. Describe the flow of evaluation and reassessment that is performed during resuscitation
to guide the order of procedures performed.
19. Discuss what actions should be taken for a newborn that does not respond positively to
resuscitation.
20. Describe a protocol for emergency transport of a newborn to a hospital facility.
21. Describe how head circumference of the infant is measured.
22. Describe how infant length is measured.
23. Describe how thoracic measurement of the newborn is performed.
24. Describe any other newborn measurements that might be performed on the newborn.
25. Describe how to weigh the newborn.
26. Describe how to perform an intramuscular injection on a newborn.
27. Describe how to harvest cord blood.
28. What instruments and supplies are needed to harvest cord blood?
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Course Syllabus ©National College of Midwifery 2012
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29. Describe how to determine a baby's blood oxygen saturation.
30. What instruments and supplies are needed to determine oxygen saturation in the
newborn?
31. Describe how to obtain a capillary blood sample from a newborn.
32. What instruments and supplies are needed when obtaining a capillary blood sample
from a newborn?
33. Describe how to bathe a newborn.
34. What instruments and supplies are needed to bathe a newborn?
35. Describe how to change the diaper of a newborn.
36. What instruments and supplies are needed to change a newborn’s diaper?
37. Describe the technique used to test for hip dysplasia in the newborn.
38. Describe how to perform a visual assessment of the newborn for jaundice.
39. Describe how to test for the moro reflex.
40. What response is expected for the moro reflex?
41. Describe how to test for a startle reflex in the newborn.
42. What response is expected for the startle reflex?
43. Describe how to test for the rooting reflex.
44. What response is expected for the rooting reflex?
45. Describe how to test the palmer grasp reflex.
46. What response is expected for the palmer grasp reflex?
47. Describe how to test the babinski reflex.
48. What response is expected for the babinski reflex?
49. Describe how to test the plantar reflex.
50. What response is expected for the planter reflex?
51. Describe how to test the stepping reflex.
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Course Syllabus ©National College of Midwifery 2012
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52. What response is expected for the stepping reflex?
53. Describe how to test the arm recoil reflex.
54. What response is expected for the arm recoil reflex?
55. Describe how to assess a newborn’s brachial pulses.
56. Describe how to assess a newborn’s femoral pulses.
57. Describe how to assess a newborn’s apical pulse.
58. Describe how universal precautions are practiced when examining the newborn.
59. Describe how the umbilical stump is cared for in the days following birth.
60. Describe how the umbilical stump is inspected for signs of infection or incomplete
healing.
61. Describe how the midwife can assess if the baby is latching onto the breast
successfully.
62. Describe how the midwife can assess if the baby is receiving adequate nutrition.
63. Describe how the midwife can demonstrate proper positioning of the newborn for
breastfeeding.
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