MS4 Catalog

Newborn Nursery

LOCATION: WVU Medicine Children's Hospital - Birthing Center
PRECEPTOR: Renee Saggio, MD
DURATION: 2 weeks
OFFERED: Intermittently
MAXIMUM ENROLLMENT: 1
STATUS: Elective

OBJECTIVES:

This rotation will give 4th year students the opportunity to experience additional hands-on care of the newborn as well as exposure to those infants requiring more than the usual newborn basics (hyperbilirubinemia, sepsis work-up, poor transition to postnatal life). This will include prenatal evaluations, birth parameters, a physical exam and day to day monitoring in addition to providing procedures and immunizations recommended by the American Academy of Pediatrics (AAP).

Patient Care:

  • Explain the fundamentals of the delivery of care for a healthy newborn and late pre-term infant.
  • Perform an assessment of the newborn including maternal history, physical exam and routine screening procedures.
  • Detail the importance of the prenatal office visits/ultrasounds and how maternal illness, vaccination status, and habits play a role in the overall wellbeing of the unborn child.
  • Provide an overview of the Neonatal Resuscitation Program (NRP) protocol, initial evaluation of the newborn and APGAR scoring.
  • Explain the importance of the transition period and being able to distinguish a well vs sick infant and when a transfer/referral to the Neonatal Intensive Care Unit (NICU) is warranted.

Medical Knowledge:

  • Identify the events neonates go through from birth until discharge including but not limited to APGAR scoring, feeding and growth and elimination patterns.
  • Explain the varied transitional period after birth including cardiopulmonary changes and appropriate monitoring of glucose, temperature, vital signs and behavior in this infant population.
  • Explain basic newborn screening and early procedures: Vitamin K, Erythromycin ophthalmic ointment, Hepatitis B vaccine, congenital hearing screen, congenital heart screen and WV State Newborn Screening and be familiar with the 32 conditions which can be identified.
  • Communicate to families evidenced-based recommendations so the families may make informed decisions about newborn care and vaccinations.
  • Communicate the rationale for screening and management of hypoglycemic newborns: routine glucometer screening; review of the definition of hypoglycemia.
  • Define the various order set protocols for those infants at risk for hypoglycemia – Small for Gestational Age (SGA), Large for Gestational Age (LGA), Infants of Diabetic mothers; Infants with 5-minute APGAR < 7.
  • Define the risks and effects of maternal infections (chorioamnionitis and Group B step colonization) and the mor common maternal sexually transmitted diseases (HSV, Chlamydia, Syphilis, HIV, Gonorrhea) on the newborn with diagnosis and treatment.

Communication Skills:

  • Communicate effectively with parents and family in a professional and caring manner that honors family values and enhances their parenting skills and confidence.
  • Display a professional manner with other members of the health care team including nursing staff, residents and faculty.

Professionalism:

  • Demonstrate prompt arrival for learning and be on time for all events; stay until the work is completed or dismissed by a member of the team.
  • Follow designated dress code as outlined in the WVU SOM guidelines, including wearing clean scrubs that are an option for day-to-day wear.
  • Demonstrate professional behavior with families in a way that is respectful of their beliefs, ethical principles and cultural identity. This should be done in a calm, non-judgmental manner and be considerate as we make plans and recommendations for the care of their newborn.

Systems-Based Practice: 

  • Explain the roles of other health care providers and their contributions to ensure the complete care of the newborn and their families. This includes dietary, pharmacy and in particular care management that continually updates us on the social status of the families available supplies and their ability to care for the infant in a safe environment.

METHODS TO ACHIEVE OBJECTIVES:

This is an in-person hospital-based rotation. Students will spend their time in the NBN workroom, NBN nursery and the postpartum areas of the 8th floor Birthing Center in the WVUCH in addition to the Post Partum unit on 6 SE of Ruby. They will participate in table discussions of the patients prior to room to room rounds. They will have the opportunity to carry several patients on their own. There are additional learning materials – lectures and slides on each of the monitors of the NBN workroom available for the students.

EXAMINATION PROCEDURES AND EVALUATION CRITERIA:

Formative Assessment:
Mid-rotation face to face evaluation will occur with the student to see how things are going with the student and the rotation. Adjustments will be made as necessary.

Summative Assessment: 
A formal standard 4th year medical student evaluation form which assesses all six competencies will be completed by the preceptor once the student completes the rotation.

PRIOR TO THE FIRST DAY OF THE ROTATION:

Please contact Dr. Renee Saggio, rbsaggio@hsc.wvu.edu at least 2 weeks prior to the start date of the rotation for reporting procedures.