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NICU Rotation Curriculum
Goal: Understand the pediatrician's role in and become an active advocate for programs to reduce morbidity and mortality from high-risk pregnancies.
Objectives
Achievement
Instructional
Learner
Competencies
at Learner
Strategies
Evaluation
Addressed
Level
1.
Identify and describe strategies to reduce fetal and neonatal mortality,
PGY-1
Family-centered
Global Rotation
X MK � ICS
including use of group B strep prophylaxis and perinatal steroids.
patient care rounds
Evaluation
�P
X PC
Formal and informal Immediate
� PBLI � SBP
lectures
feedback on
rounds
Rotation readings
Goal: Assess, resuscitate and stabilize critically ill neonates..
Objectives
1.
Explain and perform steps in resuscitation and stabilization, particularly
airway management, vascular access, volume resuscitation, indications for and
techniques of chest compressions, resuscitative pharmacology and
management of meconium deliveries.
Achievement
at Learner
Level
PGY-1
Instructional
Strategies
Lead the resuscitation team at level 1 and 2 neonatal resuscitations.
PGY-2
3.
Lead the resuscitation team at level >3 neonatal resuscitations.
PGY-3
Competencies
Addressed
NRP
NRP certification
X MK
X ICS
Direct Patient Care
Direct
observation of
patient care
XP
X PC
Video debriefings
2.
Learner
Evaluation
� PBLI X SBP
Behavioral
Assessment Tool
Goal: Provide excellent Patient Care through the evaluation and management of common signs , symptoms and conditions associate of disease in premature and ill
newborns.
Objectives
Achievement at
Instructional
Learner
Competencies
Learner Level
Strategies
Evaluation
Addressed
1. Evaluate and manage, with consultation if indicated, patients with signs and
PGY-1
Direct Patient Care
Global rotation
X MK
� ICS
symptoms that commonly present to the NICU (see attached for signs and
evaluation
�P
X PC
symptoms).
Daily patient care
rounds
Direct
X PBLI � SBP
2.
Recognize and manage, with consultation as indicated, patients
PGY-1
observation of
with conditions that commonly present to the NICU (see attached for
patient care
conditions)
Clinical Rounds
3. Use a logical and appropriate clinical approach to the care of hospitalized
PGY-2
NICU Curriculum
patients, applying principles of evidence-based decision-making and problem
solving.
4.
Provide family-centered patient care that is developmentally and age
appropriate, compassionate, and effective for the treatment of health problems
and the promotion of health.
PGY-1
5.
Understand the scope of established and evolving biomedical, clinical,
epidemiological and social-behavioral knowledge needed by a
pediatrician; demonstrate the ability to acquire, critically interpret and
apply this knowledge in patient care.
PGY-3
Direct
observation of
patient care
orders
Goal: Understand the appropriate utilization of physiologic monitoring, special technology and therapeutic modalities commonly used in the care of the fetus and
newborn.
Objectives
Achievement
Instructional
Learner
Competencies
at Learner
Strategies
Evaluation
Addressed
Level
1.
Use appropriate monitoring techniques in the NICU, including
PGY-1
Direct patient care
Rotation
X MK � ICS
oxygen administration (guided by oximetry), positive pressure
evaluation
XP
X PC
ventilation, phototherapy, parenteral and enteral nutrition, sedation,
Daily inpatient
blood and blood product transfusions, antibiotics.
rounds
Clinical rounds
X PBLI � SBP
2.
Use more advanced monitoring techniques in the NICU,
PGY-2
Formal and informal
including nitric oxide therapy (understanding of use only), vasoactive
lectures
drugs (pressors and inotropes), and ventilator management.
3.
Describe home medical equipment and services needed for
oxygen-dependent and technology-dependent graduates of the NICU
(oxygen, apnea monitor, ventilator, home hyperalimentation).
PGY-2
4.
Discuss indications, contraindications and complications of
various advanced monitoring techniques. Demonstrate proper use of
techniques for neonates of varying gestational ages. Interpret and
respond appropriately to results of monitoring based on method used,
age and clinical situation.
PGY-3
5.
Demonstrate the skills for assessing and managing pain. Use ageappropriate pain scales in assessment. Describe indications for use
and side effects of common narcotic and non-narcotic analgesics.
Administer medications to control pain in appropriate dose, frequency
and route.
PGY-1
NICU Curriculum
Goal: When appropriate, describe and competently perform the technical /therapeutic procedures and diagnostic /screening procedures commonly used in the
NICU.
Objectives
Achievement
Instructional
Learner
Competencies
at Learner
Strategies
Evaluation
Addressed
Level
1. Competently perform umbilical artery and vein catheter placement,
PGY-1
Direct patient care
Direct
X MK � ICS
positive pressure ventilation, pain management, lumbar puncture, IV
observation
�P
X PC
placement, suctioning of nose and oropharynx, and endotracheal
NRP
intubation/suction in level 1 or 2 deliveries or under controlled situations.
Resident Global
� PBLI � SBP
Assessment
2. Competently perform exchange transfusion, endotracheal
PGY-2
intubation/suction in level 3 or higher deliveries or under non-controlled
NRP certification
situations, and deliver medication via endotracheal tube.
Procedure log
3.
Effectively supervise the above procedures for more junior learners.
PGY-3
Goal: Demonstrate high standards of professional competence in Systems-Based Practice while working with patients in the NICU.
Objectives
Achievement at
Instructional
Learner
Learner Level
Strategies
Evaluation
1. Understand the practice of high quality health care and advocate for
PGY-1
Involvement in
Direct
patients within the context of the health care system.
process
observation
improvement (PI)
2. Identify key aspects of health care systems, cost control, billing, and
PGY-2
projects
Resident Global
reimbursement in the hospital inpatient setting. When providing care in the
Assessment
inpatient setting, consider cost and resource allocation without
Interactions/rounds
compromising quality of care.
with discharge
planners
3. Take steps to avoid medical errors by recognizing the limits of one's
PGY-1
knowledge and expertise; work with the health care team to recognize and
Exposure to Patient
address systems errors.
Safety Net reporting
Competencies
Addressed
X MK
X ICS
XP
X PC
X PBLI
X SBP
NICU Curriculum