File - Christina Rust, DNP, MSN, RNC-OB, C-EFM

Community Partnership for Level III NICU Skills
Angela A. LaRuffa, RN, MSN, CCRC, Education Specialist II, Newborn Intensive Care Unit , Cincinnati Children’s Hospital
Christina Rust, RN, MSN, RNC-OB, C-EFM, Nursing Educator, Maternal Child Health, Saint Elizabeth Healthcare
Magnet™ Concepts
Next Steps
St. Elizabeth Healthcare - Edgewood is preparing
to transition from a Level II to a Level III NICU.
The overall aim was to increase knowledge,
confidence and skills for the RNs’ in training.
• Individualized education plan provided orientation
focused on the specific needs and skill level of
each nurse
SEH Edgewood and CCHMC are Magnet ™ facilities
working collaboratively to promote Magnet™ model
components as essential elements of this program.
Continue collaborative relationship between
hospitals to provide updated evidence-based
education for staff.
Some of the components include:
• NICU Nurses have increased knowledge,
confidence and clinical skills to care for high risk
Update policies and procedures to reflect care for
Level III babies.
Monitor quality performance data to identify
improvements in practice by participating in the
Vermont Oxford Network.
• Infants receive care based on developmentally
sound concepts (NIDCAP Program) which also
supports kangaroo care/ skin-to-skin contact.
Establish multi-disciplinary patient care rounds to
facilitate improved communication regarding plan
of care.
• NICU infants born between 28 and 32 weeks stay
at their birth hospital, allowing for easier mother,
baby and family bonding.
Establish a simulation lab to provide simulation
experiences for new and experienced staff.
Incorporate St. Elizabeth Respiratory Therapists,
Occupational Therapists, Physical Therapists and
Neonatal Nurse Practitioners in Level III NICU
Develop low fidelity simulation scenarios for on
unit training and skills practice.
Share educational resources for NICU RN
The proposed Level III NICU will provide
ventilation and other services to babies born
between 28 and 32 weeks gestation.
Institutions who are seeking certification as a
Level III NICU have identified educational needs in
terms of skills, training and equipment to support
Level III services.
1. Transformational Leadership
• Leadership collaboration across state lines,
Management and Nurse Educators work with
contract development, initial needs
assessment, implementation and evaluation
2. Structural Empowerment
• Commitment to the community to keep
babies with their mothers in their own
community when possible
This level of educational preparation necessitates
a strong, collaborative, working relationship with
a Level III NICU in an academic setting.
The program was developed by Nursing Leadership,
Management and Nurse Educators from St. Elizabeth
Healthcare (SEH) Edgewood - Maternal Child Health
Division and Cincinnati Children’s Hospital Medical
Center NICU (CCHMC).
Exemplary Professional Practice
Sharing professional model of care
Nurses as Teachers
Consultation and Resources
Quality of Care
• Focus on best interest of infants and not
competition between facilities
• 9 Registered Nurses
• Range of 7 to 32 years of Level I, II or III NICU
• Promotes breastfeeding.
New Knowledge, Innovations and Improvements
• Supports family-centered care.
• Educational collaboration across state lines
has long been a community standard in the
Tristate area.
Model for Educational Program
• Standardized, quality, evidence-based Level III
NICU care
The training program was a blended learning
experience with online and classroom education
along with clinical time in the CCHMC NICU.
Education Evaluation
Survey outcomes provided high ratings for
staff satisfaction in communication skills,
clinical skills and confidence levels.
Cincinnati Children’s Hospital Medical Center
Whitney Brady, RN, MSN - Clinical Director, Tammy Casper,
RN, MSN, MEd, Linda Lacina, RN, MSN(c), Rachel Wilson, RN,
BSN - Education Specialists, Suzanne Fraiche, RN, BSN –
Clinical Manager, and all of the Preceptors of the Newborn
Intensive Care Unit.
During the 160 hours of hands-on training at
CCHMC, the RNs’ were under the direct
supervision of a preceptor who were clinically
advanced RN in the NICU.
Tiffany Pendergrass, RN, BSN, Simulation Center and Anne
Longo, RN, PhD and Rhonda Cooper, RN, BSN Center for
Professional Excellence.
Weekly meetings took place with the NICU
Educator to discuss individualized learning
experiences for each RN, including observations
with Respiratory Therapy, Unit Charge Nurse,
Speech Pathologist and time with specially
trained PICC (peripherally inserted central
catheter) nurses.
St. Elizabeth Healthcare
Jane Swaim, RN, MSN - Vice President of Nursing , Laurie
Conkright, RN, MSN – System Director, Maternal Child Health,
Tracy Burch RN, BSN, MSN(c) and Teri Wilde, RN, MSN, MHA –
Nurse Managers and all of the RN participants in the training
Newborn Individualized Developmental Care and
Assessment Program (NIDCAP) theory, principles
and techniques introduced at CCHMC and
reinforced with programs at SEH.
As a final evaluation, simulation was completed to
practice interaction, communication and clinical
skills without compromising the safety of real
NICU patients.
Gaberson, K.B. & Oermann, E.H. (Editors). (2007). Clinical teaching strategies in nursing. New York,
NY: Springer Publications.
Pilcher, J. (2011, May/June). Incorporating Best practices and evidence-based learning strategies
into a NICU residency program. Neonatal Network, 30(3), 189-195.
“Being around the preemie infants and
caring for ventilated infants has
made me less fearful of them” - RN trainee.
Pilcher, J. & Bedford, L. (Nov/Dec). Educational strategies in the NICU. Podcasts, webcasts, SIMS,
and more: New and innovative ways for nurses to learn. Neonatal Network. 29(6), 396-399.
The Advisory Board (2009). Strategies for transitioning from a level II to a level III NICU; Original
inquiry brief. The Advisory Board Marketing and Planning Leadership Council, 1-14. Retrieved from:
Wielenga, J.M. Smit, B.J., Unk, K.A., Mainous, R.O. (2008). A survey of job satisfaction among
nursing staff before and after introduction of the NIDCAP model of care in a level III NICU in
Netherlands. Newborn individualized developmental care and assessment. Advances in Neonatal
Care, 8(4), 237-245.
Zigmont, J.J., Kappus, L.J., & Sudikoff, S.N. (2011). The 3D model of debriefing, discovering and
deepening. Seminars in Perinatology, 35(2), 52-58.

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