Syllabus

NM629 Skills for Nurse-Midwifery Care


Faculty

Course Coordinator

Tia Andrighetti, DNP, CNM

Nora Webster, DNP, CNM

Course Credit

(Didactic-Clinical)

1-0

Course Description

This course provides the student with the opportunity to learn and practice intrapartum, postpartum, and newborn skills in an on-campus didactic classroom and clinical laboratory. The intrapartum content includes beginning suturing skills, hand maneuvers for normal birth and third stage, and management of selected intrapartum complications and variations of normal. Students will begin to develop their clinical assessment skills related to normal postpartum clients as well as clients experiencing selected postpartum complications. Assessment of the newborn, including complete physical examination and selected complications, is presented.

Prerequisite

All core courses and NM specialty courses

Course Objectives

Upon successful completion of NM629 the learner will be able to:

Learning Outcome

Evidence of Student Learning

1.

Care for a woman during her vaginal birth experience, including anticipation of complications that may arise, detection of deviations from normal in a timely manner, and management of those complications, with implementation of relevant evidence for best practice throughout.

Student will describe basic vaginal birth techniques in classroom discussion and demonstrate appropriate hand skills during high fidelity simulations.

Students will demonstrate basic suturing techniques for a second-degree perineal laceration using foam and beef tongues.

Student will describe risk factors and prevention strategies in classroom discussion as well as demonstrate early detection and appropriate management of intrapartum complications during high fidelity simulations.

Student will demonstrate regard for patient educational level, culture, values, family situation and inclusion, and birth wishes.

Student will demonstrate patient advocacy for informed choice, participation in decision-making, and self-determination.

2.

Care for a woman during her postpartum period, including anticipation of complications that may arise, detection of deviations from normal in a timely manner, and management of those complications, with implementation of relevant evidence for best practice throughout.

Student will demonstrate normal postpartum care after a vaginal birth in classroom discussion and during high fidelity simulations.

Student will describe risk factors and prevention strategies in classroom discussion as well as demonstrate early detection and appropriate management of postpartum complications during role-play scenarios and high fidelity simulations.

Student will demonstrate regard for patient educational level, culture, values, family situation and inclusion, and preferences for care.

Student will demonstrate patient advocacy for informed choice, participation in decision-making, and self-determination.

3.

Care for newborn, including normal newborn exam based on current guidelines for care.

Student will demonstrate care of the normal newborn after a vaginal birth, including the first physical exam.

Student will demonstrate regard for parental educational level, culture, values, family situation and inclusion, and parental preferences for newborn care.

Student will demonstrate parental advocacy for informed choice, parental participation in decision-making, and family self-determination.

Core Competencies

AACN Criteria

Graduate Core Curriculum Content

1. Research
1. Assess current and relevant data needed to answer questions identified in one’s nursing practice.

2. Utilize new knowledge to analyze the outcomes of nursing interventions, to initiate change and to improve practice.

Advanced Practice Nursing Core Curriculum

1. Advanced Health/Physical Assessment
1. Demonstrate sound critical thinking and decision making.

ACNM Criteria

Core Competencies for Basic Midwifery Practice

Hallmarks of Midwifery

Recognition of pregnancy and birth as a normal physiologic and development process and advocacy of non-intervention in the absence of complications.

Empowerment of women as partners in health care.

Advocacy of informed choice, participatory decision-making, and the right to self-determination.

Therapeutic value of human presence.

Components of Care

Initiating management of specific complications, emergencies, and deviations from normal.

Applies knowledge of midwifery practice in the intrapartum period that includes:

Anatomy and physiology of the structures and processes of labor

Indicators of deviations from normal including complications and emergencies

Techniques for (I) administration of local anesthesia, (ii) vaginal delivery, (iii) third stage management, and (iv) performance and repair of episiotomy and repair of lacerations

Techniques for management of emergency complications and abnormal birth events

Components of Midwifery Care: Postpartum Care

Applies knowledge of midwifery practice in the postpartum period, which includes, but is not limited to, the following:

Management strategies and therapeutics to facilitate a healthy puerperium

Deviations from normal and appropriate interventions including management of complications and emergencies.

Management of discomforts of the puerperium.

Components of Midwifery Care: The Childbearing Family.

Newborn Care

Independently manages the care of the newborn during the first 28 days of life.

Applies knowledge of midwifery practice, which includes, but is not limited to, the following:

Effect of maternal/fetal risk factors on the newborn.

Evaluation of the newborn: physical and behavioral assessment and gestational age assessment.

Topical Outline and Time Frame

Topical Outline

In this course students will cover intrapartum, postpartum, and newborn care procedures and skills. The course consists of a pre-campus preparation component and the on-campus skills didactic and laboratory sessions. Preparation readings focus on the “how to” of procedures, and require repetition for understanding the sequence and technique as well as the rationale for each skill. On-campus coursework involves review and practice of skills for nurse-midwifery clinical practice.

Module 1: Intrapartum Care

Unit 1: Suturing

Unit 2: Cardinal Movements of Labor

Unit 3: Hand Maneuvers for Birth

Unit 4: Perineal Preservation, Indications for Episiotomy

Unit 5: Shoulder Dystocia

Unit 6: Management of Third Stage and Postpartum Hemorrhage

Module 2: Postpartum Care

Module 3: Newborn Care

Unit 1: Maternal and Newborn History

Unit 2: Newborn Physical Examination

Unit 3: Gestational Age Assessment

Unit 4: The Visit: The Efficient Practitioner

Time Frame

Pre-Campus Preparation

Module 1

Intrapartum Care: Review NM618 and NM622 course materials; specifically, review normal birth—cardinal movements and birth maneuvers (Remember your pelvis and fetus models? It’s time to dust them off!), perineal preservation, third stage management; review management of complications--shoulder dystocia and postpartum hemorrhage; suturing--read Varney chapter 79 (allow approximately 10 hours to review Varney and course articles)

Module 2

Postpartum Care: Review NM619 and NM623 course materials; PLEASE BRING your NM619 and NM623 course notes with you. If you are driving, you may want to bring postpartum texts for case scenario preparation

Module 3

Newborn Care: PLEASE NOTE: THIS IS ALL NEW MATERIAL FOR YOU. Watch newborn video and read Tappero text; practice head to toe newborn physical examination; readings and study guide questions (allow approximately 20 hours for video, Tappero)

On-Campus  Coursework

Day 1 pm

Suturing introduction: Knot-tying, step-by-step repair of second degree laceration/episiotomy on foam

Day 2 am

Newborn examination: Video, practice, check-off

Day 2 pm

Suturing practice continued
Review of normal birth
Normal birth simulation

Day 3 am

Review of shoulder dystocia
Shoulder dystocia simulation

Day 3 pm

Suturing finale: Repair of second degree laceration on beef tongue
Video fun

Day 4 am

Review of postpartum hemorrhage
Postpartum hemorrhage simulation

Day 4 pm

Postpartum case scenarios

Assignments and Grades

Grading Criteria

Mastery of all course objectives is required to pass the course

The following criteria are factored into your NM629 grade:

  1. Contributory class participation
  2. Beginning technical competence with hand skills
  3. Beginning competence with psychosocial and client teaching skills
  4. Class attendance

Grading Rubric

ACTIVITY

Total Points

Earned Points

POSTPARTUM

Class participation

15

13.5-15
Active participation during session; contributes to class learning.

12-13
Occasional participation; sometimes adds meaningful new inquiries and/or information.

0-11
Infrequent participation; comments have little or nothing to do with the content; most comments anecdotal, does not add meaningful new inquiries and/or information.

Clinical scenario

50

45-50
Accurate content, teaching complete. Appropriate diagnostics and management plan.

40-44
Accurate content, management plan incomplete.

0-39
Inaccurate or incomplete content. Inappropriate or incomplete management plan.

SOAP Note

10

9-10
SOAP note complete. Attempt at putting accurate content in correct places in note.

8-8.5
SOAP note complete. Minimal attempt at putting accurate content in correct places in note.

0-7
SOAP not complete or not turned in.

NEWBORN

Newborn teaching scenario

25

22.5-25
Utilized evidence-based information to provide appropriate parent teaching about newborn. Presented information in a professional manner

20-22
Generally used evidence-based information to provide appropriate parent teaching abut newborn OR presented information in a mostly professional manner.

0-19
Information presented was not  evidence-based AND/OR presented information in an unprofessional manner.

Newborn Exam Check off

100

90-100

80-89

0-79

INTRAPARTUM

Class attendance

50

45-50
On time

40-44
Late once

0-39
Late more than once

Class participation

100

90-100
Active participation at each session, contributes to class learning.

80-89
Occasional participation; sometimes adds meaningful new inquiries and/or information.

0-79
Infrequent participation; comments have little or nothing to do with the content; most comments anecdotal, does not add meaningful new inquiries and/or information.

Hand skills

150

Pass/Fail

 

 

  TOTAL SCORE
A = 450-500 points
B = 400-449 points

 


 


 


 

Required Textbooks

Tappero, E., Honeyfield, M.E. (2009). Physical assessment of the newborn (4th ed.). CA NICU ink. ISBN: 978-1-887571-17-3. (You will be reading most of this text. )

Varney H., Kriebs J., Gegor C. (2004). Varney’s Midwifery (4th ed.). MA: Jones and Bartlett Publishers. ISBN: 0-7637-1856-4.

Honor Code Policy

There are unique opportunities in the adult-learner, self-paced, distance model of education to demonstrate the highest standards of ethical behavior and conduct. There are also unique opportunities to violate these standards. FNU regards academic honesty and scholarly integrity to be essential to the education of our students; violations are not tolerated. No student shall claim credit for another’s work or accomplishments or use another’s ideas in a written paper or presentation without appropriate citations and references. Students may be dismissed for violation of FNU standards of conduct.

Violations of the expected standards of conduct include, but are not limited to, the following:

Cheating: Cheating is the attempt to gain improper advantage in an academic evaluation. Among the forms that this kind of dishonesty can take are: obtaining a copy of an examination before it is officially available, learning an examination question from another student before taking the examination, or consulting an unauthorized source during an examination. These sources could include electronic sources, paper sources, or human sources. Submitting part or all of work done by another student as one’s own work is also cheating. This also includes sharing your own work with other students in any form (via email, posting on the internet, etc.).

Plagiarism: Plagiarism is the representation of another person’s ideas or writing as one’s own. The most obvious form of this kind of dishonesty is the presentation of another person’s ideas as something one has written. Paraphrasing another’s writing without proper acknowledgment may also be considered plagiarism. See the Plagiarism Definition for further information and clarification. ( FNU Catalog)

Unprofessional Conduct: Including lying, misrepresenting the truth, and falsifying records.

Criminal Conduct: Such as stealing, drunkenness, or illegal drug use while on the Hyden Campus or in a clinical site.

It is the student’s responsibility to behave in an honorable and ethical manner.

It is also the student’s responsibility to report any suspected violation to a Student Council Representative.

Any student or faculty member may bring suspected honor code violations to the attention of the Associate Dean.
( FNU Catalog)

Plagiarism Definition

Plagiarism and breaches of academic standards are infractions of academic integrity, prohibited by the FNU Honor Code.

Plagiarism Includes:

1. Submitting a paper, examination, or assignment written by another.

2. Word-for-word copying (including cutting and pasting) portions of another’s writing from the World Wide Web, from hard copy text, from personal communication, without enclosing the copied passage in quotation marks and acknowledging the source in the appropriate APA reference format.

3. The use of a unique term or concept taken from another source without acknowledging that source.

4. The paraphrasing or abbreviated restating of someone else’s ideas without acknowledging that person.

5. Changing a few words in someone else’s sentence does not make it your own, even if the reference is provided at the end of the sentence. Either use quotes or synthesize the information and write your own completely new sentence with appropriate referencing.

6. Falsely citing a reference that was never actually consulted, or making up a citation. Functioning web links in assignments are important for this reason.

7. Falsely reporting data that was never actually collected or which showed contrary results.

9. Unacknowledged multiple authors or collaboration on a project or paper.