Newborn Nursery

Rotation Contact

Rotation Director - Carl Seashore, MD (carl_seashore@med.unc.edu)

Newborn Nursery Nurse Practitioners:

Emily Freeman, CPNP 
Emily.Freeman@unchealth.unc.edu 
pager 123- 8428

Jamie Haushalter, CPNP 
Jamie.Haushalter@unchealth.unc.edu 
pager 123-8425

Lara Reller, CPNP 
Lara.Reller@unchealth.unc.edu 
pager 123-8422

Ashley Wallace, FNP-C 
Ashley.Wallace@unchealth.unc.edu  
pager 123-8427

First Day Information

Meet with the NBN NPs at 7:00am in the NBN on the first day.  They will assign patients at that time.  The NBN is located on the 5th floor of the Women's Hospital.

Newborn Nursery Rotation Guide

"Welcome to the Newborn Nursery" Slideshow

Goals and Objectives

OVERALL EDUCATIONAL GOAL:
The purpose of this rotation is to provide the clinical experiences and didactic teaching which will enable residents to develop competence in the care of normal newborns. An understanding of maternal history, principles of infant feeding, common newborn problems, parent education in routine newborn care, and issues important to discharge planning are stressed.

OBJECTIVES:
Recognize the important factors in the maternal history and delivery process which affect the newborn. These factors include: pertinent social issues, chronic medical conditions in the mother (i.e., diabetes, seizure disorder, etc.); genetic risk factors, maternal/infant Rh/ABO status; maternal drug use; maternal infection (particularly, sexually transmitted diseases); type of delivery; APGAR scores, etc.

Develop competence in the examination of the newborn infant. This includes recognition of normal and abnormal physical characteristics and estimation of gestational age.

Develop the cognitive skills and practical experience needed to assist breast feeding mothers in initiating and maintaining successful breast feeding.

Develop a practical knowledge of the following topics and demonstrate competence in using such knowledge to counsel families about routine newborn care.

Prevention of cross infection in the nursery
Breast and bottle feeding
Parental counseling in routines of newborn care
Recognition of psychosocial factors that may affect maternal/infant interaction
Circumcision
Newborn screening

Recognize the following common problems in the newborn period and develop a diagnostic approach and management plan for each:

Prematurity and postmaturity
Respiratory distress
Jaundice
Suspicion and treatment of newborn infection
Maternal mental health issues that affect infant health (i.e. postpartum depression
Neonatal hypoglycemia and infant of diabetic mother
Maternal history of drug abuse
Congenital heart disease
Developmental dysplasia of the hip

Develop skills in arranging follow-up care particularly for infants with significant medical or psychosocial risks including an assessment for safety or the potential for violent exposure in the home environment. This includes working closely with the UNCH Social Workers to involve local support services for families (i.e., Child Service Coordinators, Social Service Departments, Health Departments, drug abuse treatment programs, and physicians).

EVALUATION:
Residents will be evaluated in the newborn nursery by direct observation of their performance. The supervising attending physicians and nurse practitioners will observe residents as they examine infants, interact with families, participate in clinical rounds, and document infant findings and progress. An online evaluation of each resident’s performance will be discussed with the resident.

LEARNING ACTIVITIES OF THE ROTATION:
The primary learning activity is participation in the admission, care, and discharge of infants in the UNC Newborn Nursery unit. Residents are expected to utilize the reference books in order to look up specific information about patient problems and to perform computer literature searches around more unusual problems. Residents will also be expected to prepare brief didactic sessions on specific issues and clinical problems encountered in the newborn nursery. There is a required curriculum in the newborn nursery. It will be completed independently online through the NBN Rotation webpage. Residents are expected to complete all learning modules and quizzes.

A small, but well stocked, library is part of the nursery and is used for conferences. Additional information, such as guidelines for patient care of infants with certain conditions or situations are also available on the web site. Student teaching is an important part of Newborn Nursery activities and residents play an active role in this. Rounds are held daily with the attendings, residents and students. These involve both a formal review of newborn issues as they relate to specific patients in the nursery but also discussions of the major topics of concern in newborn care.

Readings and Resources

EPIC and the NBN

Breastfeeding for Providers

Curriculum Materials

Newborn Care

Assessment of the Newborn Heart

Maternal Graves' Disease

Circumcision in the Newborn Male

Infants of Diabetic Mothers

The Late Preterm Infants

Neonatal Group B Streptococcal Infection

Breastfeeding Introduction

Part 1

Part 2

Free Online Breastfeeding Education

SIDS

Neonatal Dermatology

Neonatal Dermatology Guidelines

Neonatal Orthopedics

Hip Dysplasia

Hyperbilirubinemia

Assessment of Jaundice and Indications for Treatment in the Neonate

Hyperbilirubinemia Guidelines in Newborn Infants(algorithm). Alkalay, AL and Simmons, CF. Pediatrics, Mar 2005; 115: 824 - 825.

Mother-Baby Book

Maternal RPR Testing at Delivery

Newborn Follow-up in Clinic

Instructions for SpO2 Screening

Protocols

Infants Exposed to HIV

Prenatal Hydronephrosis Algorithm

Newborn Abstinence Syndrome: Guidelines and Algorithm

Comfort Care

Guidelines for phototherapy in hospitalized infants of 35 or more weeks' gestation

Hypoglycemia Algorithm

UNC Newborn Nursery Protocol of Infants with Maternal History of Herpes

UNC Early Onset Sepsis Protocol

Infant Drug Screening

Reasons to call NCCC

Additional Information

Attending Orientation

Circumcision Information

Circumcision Policy

Social Work Consults

The Horizons Program

The Center for Maternal and Infant Health