Super-Mentors to Train Multiple Neonatal Advanced Practice Providers: Pros and Cons.

BACKGROUND: Despite available training programs for neonatal advanced practice providers (Neo APP), including neonatal nurse practitioners and physician assistants, it is difficult to meet the demand for these providers. There are no publications regarding training models with greater than 1 Neo APP learner per mentor. PURPOSE: To create and measure outcomes of a 12-month program to educate Neo APP "Super-Mentors" able to train 2 Neo APP learners simultaneously. METHODS: Super-Mentors were selected and attended monthly classes to learn mentorship concepts and receive support. Learners received didactic content and support through a Fellowship program. Quantitative data regarding recruitment and retention, as well as Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS) results were compared pre- and postprogram. Qualitative satisfaction measures via survey from 21 stakeholders were analyzed through a phenomenological approach. RESULTS: Six Super-Mentors trained 14 Neo APPs, as compared to 7 in the previous year. One Neo APP left after training. Summative preprogram MNPJSS scores were better (5.1 ± 0.37) than postprogram (4.7 ± 0.47) ( P < .001). The most important preprogram subscale item was "vacation" versus "quality of assistive personnel" postprogram. Both pre- and postprogram scores reflected positive job satisfaction so differences may not be clinically significant. Qualitative program benefits included faster and increased onboarding, stronger relationships, and dedicated time. Challenges included role clarity among other stakeholders, learning culture, and spacial/technological logistics. IMPLICATIONS FOR PRACTICE: Super-Mentors can train twice the number of Neo APP learners, with optimal preparation and support of all stakeholders, adequate space, and appropriate technology.

Neonatal Nursing: Clinical Competencies and Education Guide, 8th edition.

This education guide provides a framework for educational content and skills verification for nurses who provide evidence-based care for newborns and infants.

Development of neonatal Apgar scoring training program utilizing contactless hand tracking in immersive virtual reality.

BACKGROUND: The rapid and accurate assessment of neonatal asphyxia is critical to preventing potentially fatal outcomes. Therefore, nursing students must acquire the skills to assess newborn conditions immediately after birth and implement appropriate interventions. Virtual reality (VR) simulation education has emerged as a promising tool for nursing education, offering repetitive and customizable clinical training while ensuring patient safety and overcoming spatiotemporal limitations. AIM: This study investigated the effects of a contactless hand-tracking-based immersive VR neonatal Apgar scoring program, adapted from experiential learning theory. DESIGN: A non-randomized controlled trial with a pre-post-test, quasi-experimental design was conducted. SETTINGS: The study was conducted at two nursing schools from July to October 2023. PARTICIPANTS: Participants comprised nursing students holding bachelor's degrees in nursing, with three or four years of experience and successful completion of a neonatal nursing theory course. Additionally, individuals with at least six months of experience working in a neonatal ward or delivery room before enrolling in nursing school were eligible. METHODS: The participants were divided into three groups: the VR group (n = 27) received contactless hand-tracking-based immersive VR neonatal Apgar scoring training; the simulation group (n = 28) received face-to-face Apgar scoring simulation training; and the control group (n = 26) received instruction on the Apgar scoring criteria. Changes in scores among the VR, simulation, and control groups were statistically compared using ANOVA with SPSS-WIN 27.0. RESULTS: The VR group exhibited significant improvements in knowledge, learning satisfaction, self-confidence, immersion, and motivation compared to the simulation and control groups. Moreover, satisfaction was significantly higher in the VR group than in the simulation group. CONCLUSIONS: The hand-tracking-based immersive VR neonatal Apgar scoring program represents an innovative and effective educational tool, prioritizing the privacy and rights of mothers and infants. It can potentially replace traditional delivery-room clinical training, which is observation-based and limited.

Promoting infant safe sleep practices among neonatal and paediatric nurses through simulation-based training program.

PURPOSE: To evaluate the effect of a Simulation-based training (SBT) program on neonatal and paediatric nurses' knowledge regarding infant safe sleep practices. BACKGROUND: Sudden infant death syndrome (SIDS) presents a major public health concern, preventable through the promotion of optimal safe sleep practices, particularly among neonatal and paediatric nurses. Despite its effectiveness in enhancing nurses' knowledge and clinical skills, SBT is not an adopted training method for nurses in Egypt. DESIGN AND METHODS: A single-group pre- and post-test design involved 57 nurses from Neonatal Intensive Care Unit, Paediatric Intensive Care Unit, and Paediatric In-patient Unit. The study consisted of two stages. In the first stage, knowledge assessment to identify deficiencies. The second stage, researchers developed four SBT scenarios. Two of these scenarios were recorded for training purposes, while the other two were intended for nurses to actively participate in. Data were collected from May 2022 to January 2023. RESULTS: A significant improvement in nurses' knowledge of infant safe sleep practices and SIDS prevention was observed (p = 0.000). Nurses expressed high satisfaction with the training program (mean score 45.035 ± 4.38). CONCLUSION: This study provides evidence that simulation-based training is an effective approach to promoting safe infant sleep practices among neonatal and paediatric nurses. PRACTICE IMPLICATIONS: Integrating SBT programs into nursing education can enhance nurses' knowledge and skills in infant-safe sleep practices, providing a realistic and interactive learning experience.

Baby Date: a mobile application for teaching nursing care to newborns in primary care.

OBJECTIVE: to develop and validate a mobile application for teaching undergraduates about the first nursing visit to a newborn in primary care. METHOD: methodological study with an Instructional Design framework; content drawn up from scientific documents on caring for newborns and their families, supported by the results of an integrative review on the subject. The Integrated Development Environment Android Studio 4.0.1 tool and the IntelliJ IDEA platform were used to build the digital technology. Experts validated content and students evaluated navigability. RESULTS: the final version of the mobile application contains 67 screens grouped into 12 sections with random access. The device is presented on the introductory screen; this is followed by content on the physical examination, neonatal screening, nutrition, oral health, the vaccination calendar, growth, development, danger signs, and accident prevention; at the end, there is a fact sheet and references. Audiovisual resources (texts, images, and videos) complement the application; experts presented a Content Validity Index (CVI) = 1.00; for nursing students all the items had a CVI = 1.00; only the item "layout and presentation" had a CVI = 0.95. CONCLUSION: the digital technology received a satisfactory evaluation from experts and students. It is innovative in child health care, with the potential to be used in the teaching-learning process of nursing students. BACKGROUND: (1) The mobile application provides content for newborn care in primary care. (2) The mobile application directs the nurse's consultation through evidence of care. (3) The mobile application can be used offline, offering knowledge at any time and place. (4) Navigation does not require a specific order, which gives the user freedom. (5) The mobile application promotes quality care in the first consultation with the newborn in primary care.

Trauma-Informed Care Education Initiative Explores Impact on Perinatal Nurse Secondary Traumatic Stress and Workforce Challenges.

BACKGROUND: Psychological trauma refers to long-lasting adverse effects on well-being precipitated by the experience of a distressing event or a combination of events. High rates of psychological birth trauma in patients contribute to secondary traumatic stress (STS) in perinatal nurses, creating workplace challenges and resulting in dissatisfaction, apathy, and attrition. Perinatal nurses experience high rates of STS, and researchers have called for a universal standard of trauma-informed care (TIC). However, there is a lack of published results on effectively creating TIC education in this nurse population. METHODS: A pre/posttest design evaluated an online pilot evidence-based practice project addressing a perinatal nurse education initiative on STS and its correlation with nurse attitudes toward TIC. Participants include perinatal nurses in the United States (n = 29). Two scales measured the program's effect on nurses: the Secondary Traumatic Stress Scale (STSS) and the Attitudes Related to Trauma-Informed Care (ARTIC) scale. RESULTS: A paired t test evaluating pre- and postprogram levels of the STSS showed a decrease in STS (t28 = -3.28, P = .003, Cohen's d = 0.609), the ARTIC scale results showed an increased receptiveness to TIC (t28 = 3.8, P < .001, Cohen's d = 0.706], and a not significant correlation was found between pretest STS and ARTIC scores (Spearman' ρ = -0.248, P = .194). CONCLUSION: This program supported a significant reduction in nurses' identification of STS. Future perinatal nurse education can expand to build a standard of TIC that is patient-centered and reduces nurse STS.

Targeted Neonatal Echocardiography Performed by Nurse Practitioners in the NICU: Attitudes and Perceptions of the Healthcare Team.

BACKGROUND: Targeted neonatal echocardiography (TNE) and hemodynamic consultation have typically been performed by physicians. The Stollery Children's Hospital neonatal intensive care unit (NICU) expanded their TNE training program to include neonatal nurse practitioners (NNPs), the first in North America. PURPOSE: This study examines the thoughts and perceptions of clinicians about the incorporation of NNPs providing TNE and hemodynamic consultation and investigates key facilitators and challenges for consideration when planning future training, expansion of service in Edmonton, or beyond. METHODS: In this descriptive study using qualitative methodology, purposive sampling was used to invite NICU clinicians to participate. Using a semistructured topic guide, a focus group and 2 individual interviews were conducted. RESULTS: Participants were supportive of NNPs. Advantages included increased access to service, acquisition and retention of skills, provision of patient-centered care, and leveraged interpersonal relationships in the decision-making process. Key aspects of program expansion included climate and culture of the NICU, presence of adequate patient volume, and resources to support training. IMPLICATIONS FOR PRACTICE AND RESEARCH: Support across disciplines and the collaborative working nature of the NICU are key factors in the success of the program's development and implementation. Benefits of having NNPs on the TNE team were clearly expressed. Benefits to the health system included rapid access to hemodynamic information allowing for care based on specific pathophysiology and additional local capacity to perform TNE and reducing demand on other trained providers. Additional research could consider parental views of NNPs performing TNE and hemodynamic consultation as well as the accuracy of diagnosis between the NNPs and physician group.

Growing the Neonatal Nurse Practitioner Workforce Through Mentoring: A Scoping Review.

OBJECTIVE: The purpose of this article is to highlight evidence specific to the neonatal nurse practitioner (NNP) workforce related to successful mentoring programs. Specifically, the authors of this article explored recent evidence of mentorship to improve job satisfaction and retention of the NNP workforce. BACKGROUND: NNPs are valuable members of neonatal healthcare team. Because of the aging NNP workforce, methods to recruit, train, mentor, develop, and retain new NNPs are imperative. METHODS: Using a quality appraisal tool from the PRISMA extension for scoping reviews, articles were identified through electronic database searches using search terms related to mentoring, nurse practitioners, recruitment, and retention. Studies published in English between 2013 and 2023 were included. Peer-reviewed quantitative and qualitative articles were synthesized and critically appraised by 4 reviewers. RESULTS: The authors identified 46 articles with a focus on mentoring in nursing of which 12 articles include mentoring for nurse practitioners. Research indicates that mentoring relationships are valuable in many healthcare roles and professions. Evidence is limited indicating the impact of mentoring in the highly specialized role of the NNP. CONCLUSION: Mentoring is an invaluable component of professional nursing and counters incivility while advancing competency, job satisfaction, and retention. Additional research is needed regarding NNP-specific mentoring programs.

Qualitative Study of Nurses' Experiences as They Learned to Provide Neonatal Palliative Care.

OBJECTIVE: To describe the experiences of nurses as they learned to provide palliative care in the NICU. DESIGN: Interpretive description. SETTING: Four NICUs in three Canadian provinces, including one rural center and three tertiary centers. PARTICIPANTS: Nine NICU nurses with 3 to 21 years of experience who provided neonatal palliative care. METHODS: We collected data using online interviews that we recorded and transcribed. We analyzed data using immersion, inductive coding, reflective memoing, and thematic analysis. RESULTS: Participants received little or no formal education in neonatal palliative care and instead learned to provide this care through observation and experience. Participants said it was important to find meaning in their work, which contributed to their motivation to learn to provide high-quality neonatal palliative care. Participants described challenges, including unit cultures in which early palliative care was not embraced. We identified three overarching themes that represented the participants' experiences: Meaning-Making in Neonatal Palliative Care, Challenges in Providing Neonatal Palliative Care, and Ill-Prepared to Provide Neonatal Palliative Care. CONCLUSION: Standardized education may improve the quality of care and nurses' experiences with neonatal palliative care. We recommend designing and evaluating a standardized curriculum on neonatal palliative care.

Neonatal Fragile Skin: Novel Use of Simulation to Improve Knowledge and Confidence for Neonatal Nurse Practitioner Students.

BACKGROUND: Infants with fragile skin pose challenges to neonatal providers, including the difficult nature of securing lifesaving devices. A paucity of information exists supporting best simulation practices in educating neonatal nurse practitioner (NNP) students on how to care for infants with fragile skin. PURPOSE: To evaluate whether simulation improved student knowledge and self-confidence related to caring for infants with fragile skin. METHODS: This quality improvement project included a pre/posttest survey with a sample of 14 NNP students. Participants practiced application of a multilayered dressing to secure a catheter to a neonatal manikin. Knowledge and self-confidence were measured before and after simulation. RESULTS: Correct responses on posttest survey knowledge items increased along with students' confidence ratings following simulation. Students reported high levels of satisfaction with the simulation experience. CONCLUSIONS: Simulation of caring for fragile skin allows NNP students the opportunity to improve self-confidence, knowledge, and performance of a necessary skill for NNPs.

Nurses' Knowledge, Communication Needs, and Future Directions in Neonatal Research: Results of an International Survey.

BACKGROUND: Preterm birth is a significant contributor to neonatal morbidity and mortality. Despite legislative efforts to increase pediatric drug development, neonatal clinical trials continue to be infrequent. The International Neonatal Consortium (INC) includes nurses as key stakeholders in their mission to accelerate safe and effective therapies for neonates. PURPOSE: INC developed a survey for nurses, physicians, and parents to explore communication practices and stakeholders' perceptions and knowledge regarding clinical trials in neonatal intensive care units (NICUs). METHODS: A stepwise consensus approach was used to solicit responses to an online survey. The convenience sample was drawn from INC organizations representing the stakeholder groups. Representatives from the National Association of Neonatal Nurses and the Council of International Neonatal Nurses, Inc, participated in all stages of the survey development process, results analysis, and publication of results. RESULTS: Participants included 188 nurses or nurse practitioners, mainly from the United States, Canada, the European Union, and Japan; 68% indicated some level of research involvement. Nurses expressed a lack of effective education to prepare them for participation in research. Results indicated a lack of a central information source for staff and systematic approaches to inform families of studies. The majority of nurses indicated they were not asked to provide input into clinical trials. Nurses were uncertain about research consent and result disclosure processes. IMPLICATIONS FOR PRACTICE AND RESEARCH: This study indicates the need to educate nurses in research, improve NICU research communication through standardized, systematic pathways, and leverage nurse involvement to enhance research communication.

Integrated Management of Neonatal and Childhood Illness Training in Lao PDR: A Pilot Study of an Adaptable Approach to Training and Supervision.

Integrated Management of Neonatal and Childhood Illness (IMNCI) has been part of the national strategy for child health in Lao Peoples Democratic Republic since 2003. The program, while running for an extended period, has faced multiple challenges including maintaining the teaching quality for the implementation of the IMNCI guidelines and a structure to enable and support healthcare workers trained to apply the training in their workplace. A revised training model that focused on building skills for teaching according to adult learning principles in a pool of facilitators, a practical and hands-on training workshop for healthcare workers, and the establishment of a program of health center supervision was developed and implemented in three provinces. Participants in the revised model reported increased confidence in implementing IMNCI guidelines, they demonstrated competence in the steps of IMNCI and on follow-up assessment at a supervision visit were found to have improved patient care through the measurement of pediatric case management scores. This study highlights the importance of a focus on education to ensure the translation of guidelines into practice and thereby lead to improvements in the quality of pediatric care. The IMNCI training approach is acceptable and valued by healthcare worker participants.

Effects of Virtual Reality Simulation Program Regarding High-risk Neonatal Infection Control on Nursing Students.

PURPOSE: Virtual reality simulation can give nursing students a safe clinical experience involving high-risk infants where access to neonatal intensive care units is limited. This study aimed to examine the effects of a virtual reality simulation program on Korean nursing students' knowledge, performance self-efficacy and learner satisfaction. METHODS: A nonequivalent control group design was applied. Senior nursing students were divided into an experimental group (n = 25) experiencing virtual reality simulation and routine neonatal intensive care unit practice and a control group (n = 25) having routine neonatal intensive care unit practice. The program consisted of three scenarios: basic care, feeding management and skin care and environmental management for prevention of neonatal infection. The total execution time for the three scenarios was 40 minutes. The simulation created immersive virtual reality experiences using a head-mounted display with hand-tracking technology. Data were collected from December 9, 2019, to January 17, 2020, and were analyzed using descriptive statistics and the t-test, paired t-tests, Mann-Whitney test and Wilcoxon signed-ranks test. RESULTS: Compared to the control group, the experimental group showed significantly greater improvements in high-risk neonatal infection control performance self-efficacy (t = -2.16, p = .018) and learner satisfaction (t = -5.59, p < .001). CONCLUSION: The virtual reality simulation program can expand the nursing students' practice experience in safe virtual spaces and enhance their performance self-efficacy and learning satisfaction.

Preparo de alta de famílias na promoção dos cuidados domiciliares do recém-nascido: revisão integrativa / Preparation of discharge of families in the promotion of the home care of the newborn: integrative review

Objetivo: Analisar evidências científicas da enfermagem acerca das melhores práticas relacionadas ao preparo de alta de famílias na promoção dos cuidados domiciliares do recém-nascido. Métodos: revisão integrativa da literatura realizada nos recursos informacionais LILACS, MEDLINE, BDENF, CINAHL e SCIELO, com utilização dos descritores controlados em português: "recém-nascido", "cuidado do lactente", "alta do paciente" e "enfermagem neonatal", e suas versões em inglês e espanhol, no recorte temporal de 2008 a 2018. Resultados: foram selecionados 14 estudos completos para análise interpretativa que permitiu a identificação de duas categorias: melhores práticas relacionadas ao preparo de alta de famílias de recém-nascidos e limitações no preparo de alta de famílias de recém-nascidos. Conclusão: evidenciaram-se distintas estratégias pedagógicas que podem ser desenvolvidas pela enfermagem junto aos familiares no processo de alta hospitalar, bem como a necessidade de sua efetiva aplicabilidade para a promoção dos cuidados domiciliares do recém-nascido com segurança e qualidade

Objetivo:Analizarla evidencia científica de enfermería sobre las mejores prácticas relacionadas con la preparación de las familias para recibir el alta en la promoción de la atención domiciliaria del recién nacido.Métodos: revisión integradora de la literatura realizada en los recursos de información LILACS, MEDLINE, BDENF, CINAHL y SciELO, usando descriptores controlados en portugués: "recién nacido", "cuidado del lactante", "alta del paciente" y "enfermería neonatal", y sus versiones en inglés y español, en el recorte temporal de 2008 a 2018. Resultados: se seleccionaron 14 estudios completos para análisis interpretativo que permitió la identificación de dos categorías: mejores prácticas relacionadas con la preparación de alta de familias de recién nacidos y limitaciones en la preparación de alta de familias de recién nacidos. Conclusión: se evidenció distintas estrategias pedagógicas que pueden ser desarrolladas por la enfermería junto a los familiares en el proceso de alta hospitalaria, así como la necesidad de su efectiva aplicabilidad para la promoción de los cuidados domiciliarios del recién nacido con seguridad y calidad

Objective: To analyzescientific evidence of nursing about the best practices related to preparing families to be discharged in the promotion of home care for the newborn.Methods: an integrative review of the literature on the information resources LILACS, MEDLINE, BDENF, CINAHL and SCIELO, using the descriptors controlled in Portuguese: "newborn", "infant care", "patient discharge" and "neonatal nursing" , and its versions in English and Spanish, in the time cut from 2008 to 2018. Results: 14 complete studies were selected for interpretative analysis that allowed the identification of two categories: best practices related to the preparation of discharge of newborn families and limitations in the preparation of discharge of newborn families. Conclusion: different pedagogical strategies that could be developed by nursing with family members in the hospital discharge process were evidenced, as well as the need for their effective applicability to the promotion of home care of the newborn with safety and quality

Innovative Approach to Procedure Skills: A Nurse Practitioner Educator's Response to COVID-19.

BACKGROUND: The The Neonatal Nurse Practitioner program at The Ohio State University transitioned from a traditional face-to-face program to a distance-enhanced hybrid model providing course content online with campus visits for procedural skills and simulation in 2017. Although the 2020 COVID-19 pandemic necessitated cancellation of all in-person events across the university, the neonatal nurse practitioner students' learning needs remained the same. METHOD: The onsite experience was redesigned for virtual delivery. Procedural content was accomplished through student-led small-group collaborative critical thinking activities surrounding procedural complications, and other faculty-led scenario discussions. RESULTS: Students collaborated for a Complications Rounds activity (1-day) that promoted learning about procedural skills from a global perspective including safe techniques, monitoring, risks, and troubleshooting complications. CONCLUSION: Procedural content can be achieved when in-person learning is not possible. The Complications Rounds approach can mitigate delays or gaps in practical experiences. Examining complications in-depth increases preparedness, promoting greater awareness of harm prevention when these present in future practice. [J Nurs Educ. 2020;59(12):692-696.].