MIDW335 - Babies Needing Extra Care

Year

Credit points

Campus offering

Prerequisites

MIDW217 Midwifery Care of the Woman with Complex Needs AND (MIDW201 Clinical Midwifery Practice 3 OR MIDW224 Midwifery Professional Practice 4 )

Teaching organisation

Unit rationale, description and aim

This unit focuses on the care of neonates with complex needs, leading to admission to a Special Care Nursery or requiring higher level care in a postnatal unit, as the profession strives to keep mothers and their neonates together. The issues confronting the neonate and family during this period and the role of the midwife in facilitating health and wellbeing of the neonate and family are addressed. Ethico-legal issues involved in caring for a neonate with complex needs are explored in the context of professional midwifery practice. This unit is required by students to assist their consolidation of midwifery knowledge and skills, specifically in relation to evidence-based care for neonates with complex care needs.  

This aim of this unit is to support students in the development of knowledge and skills regarding the role of the midwife in provision of care to neonates requiring complex care, and in promoting family-centred developmental care through enhancement of the Special Care Nursery environment. 

We recognise that people who access maternity care may have diverse gender identities, that those who do can experience marginalisation and oppression, and that using appropriate terminology can help with these community members’ recognition and visibility, acknowledge the variety of pregnancy and birth experiences people may have, and respect individuals’ preferences. To reflect this, terms such as ‘pregnant person’, ‘birthing person’, ‘childbearing people’, ‘parent’ and ‘chestfeeding’ may be used in the midwifery courses at ACU in addition to ‘woman’, ‘mother’, ‘maternity’, ‘maternal’ and ‘breastfeeding’, which are used not to exclude those who do not identify as a woman, but in recognition that women continue to be marginalised and oppressed in many places around the world and to respect their own individual preferences.  

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Analyse the impact of the Special Care Nursery environment upon the neonate and family; (GA8) 

LO2 - Differentiate the role of the midwife within the context of the Special Care Nursery multidisciplinary team; (GA7) 

LO3 - Support the family to be self-determining in making informed decisions regarding care of their neonate including ethico-legal issues; (GA3, GA9) 

LO4 - Utilise reflective practice, information and communication technologies to effectively complement learning and self-care; (GA4, GA10) 

LO5 - Apply the principles of teamwork and self-management when planning, implementing and evaluating family-centred care and/or clinical responsibilities; (GA7) 

LO6 - Plan and evaluate safe, family-centred, culturally competent, evidence-based care for the neonate and their family in a Special Care Nursery or postnatal ward through demonstration of the knowledge of underlying pathophysiology of admission condition. (GA1, GA5) 

Graduate attributes

Each unit in your course contributes in some way to the development of the ACU Graduate Attributes which you should demonstrate by the time you complete your course. All Australian universities have their expected graduate attributes. ACU’s Graduate Attributes have a greater emphasis on ethical behaviour and community responsibility than those of many other universities. All of your units will enable you to develop some attributes.

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media 

GA10 - utilise information and communication and other relevant technologies effectively.

NMBA Midwife Standards for Practice 

NMBA (2018) Midwife Standards for Practice developed in this unit are: 

Content

Topics will include: 

Legal and professional practice 

• Scope of practice 
• Consultation and collaboration 
• Documentation and use of health informatics and health technologies 
• Medication knowledge and administration 
• Assertive communication skills 

Midwifery knowledge and practice 

• Fetal and neonatal growth and development  
• Assessment of the newborn  
• Gestational assessment 
• Developmental care 
• Parental contact, promoting bonding and attachment 
• The neonate with complex needs 
• Pre-term  
• Intrauterine growth restriction 
• Diseases related to respiratory distress  
• Macrosomia 
• Congenital malformations and genetic disorders 
• Metabolic disturbances 
• Neonatal abstinence syndrome 
• Jaundice 
• Infection 
• Neurological disorders 
• Anaemia 
• Care of the neonate with complex needs 
• Resuscitation 
• Temperature regulation 
• Oxygenation 
• Metabolic homeostasis 
• Pain management 
• Care of the family 
• Education 
• Support and counselling 
• Grief and loss 
• Transition to parenthood  
• Fluid and electrolyte needs of babies  
• Nutrition 
• Elimination 
• Calculating fluid requirements 
• Gavage feeding  
• Intravenous feeding 
• Supplemental feedings 
• Breastfeeding 
• Neonatal emergency transport service 
• Referral, stabilisation and retrieval of the sick or pre-term neonate 

Midwifery as primary health care 

• Referral to community agencies and support networks 
• Cultural safety 

Reflective and ethical practice 

• Ethico-legal issues 
• Informed consent  
• Saving very premature babies 
• Palliative care 
• Self-care 

Learning and teaching strategy and rationale

Modes of delivery in this unit are intensive, supplemented with online modules. Consistent with adult learning principles, the teaching and learning strategies used within these modes of delivery will provide students with foundational knowledge and skills relevant to professional midwifery practice. These strategies will provide flexibility for students’ attendance at clinical placements, and also support students in meeting the aim, learning outcomes and graduate attributes of the unit and the broader course learning outcomes. Learning and teaching strategies will reflect respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers.  Scenario-based learning, case-based learning, problem-based learning and inquiry-based learning are all used to support the development of students' independent learning ability. 

Students exiting university need significant life-long learning skills to deliver sound, ongoing, evidence-based graduate practice as a member of the professional workforce. To embed life-long learning skills, students must demonstrate high level reflective capacity to identify what is being done well and what requires additional work in progressing toward required learning outcomes. Located in the third year of the programme, this theory unit includes intensive face-to-face teaching hours,  and an increased online component of learning. The online component delivers interactive and student-driven learning sessions to extend the community of learners, and increase their self-reliance, critical reflection and debate - skills for life-long learning.   

Assessment strategy and rationale

A range of assessment procedures consistent with University assessment requirements will be used to meet the unit learning outcomes and develop graduate attributes.  

The written assignment provides students with the opportunity to explore the evidence based practice which impacts the unwell neonate and family, including ethical considerations. Group work, inclusive of an oral presentation, will encourage students to be active in their learning and promote communication skills essential for collaborative practice within the midwifery profession. The examination enables students to demonstrate overall knowledge and understanding of content in the unit. 

These assessments are required to build student knowledge and skills which, by the conclusion of this programme, will enable the student to graduate as a safe and effective midwife.  

Overview of assessments

Representative texts and references

Australian College of Midwives [ACM]. (2021). National Midwifery Guidelines for Consultation and Referral (4th ed.). Australian College of Midwives. 

Davies, L., & McDonald, S. (Eds.). (2020). Examination of the Newborn and Neonatal Health: A Multidimensional Approach (2nd ed.). Elsevier. 

Gardner, S. L., Carter, B.S., Enzman-Hines, M., & Niermeyer, S. (2020). Merenstein & Gardner's Handbook of Neonatal Intensive Care (9th ed.). Elsevier.

Johnson, R., & Taylor, W., De-Vitry Smith, S., Bayes, S. (2018). Skills for Midwifery Practice Australian & New Zealand Edition (1st ed.). Elsevier. 

MacDonald, S., & Johnson, G. (Eds.). (2017). Mayes' Midwifery (15th edition.). Elsevier. 

Meeks, M., Hallsworth, M., & Yeo, H. (Eds.). (2013). Nursing the Neonate (2nd ed.). Wiley.

Sinha, S., Miall, L., & Jardine, L. (2017) Essential Neonatal Medicine (6th ed.). Wiley-Blackwell. 

Wylie, L. & Bryce, H. (2016) The Midwives' Guide to Key Medical Conditions. (2nd ed.). Elsevier.