Facilitated newborn care for nursing course

Facilitated new born care

1. ARMY COLLEGE OF NURSING MICROTEACHING SUBJECT : CHILD HEALTH NURSING TOPIC : FACILITY BASED NEWBORN CARE SUBMITTED TO : MRS. PRIYANKA DEVI (ASS. PROFESSOR, ACN) SUBMITTED BY : VAISHNAVI MISHRA BSc (N) SEM 6 57

2. FACILITY BASED NEWBORNS CARE (FBNC) Facility based newborns care encompasses care at peripheral health posts such as SC, PHCs and DH . As a first step towards successful achieving the target, the GOI, has targeted the PHCs for round the clock deliveries and is continuously upgrading the health facilities in terms of neonatal care .

3. CONTD... With the aim of strengthen FBNC under NRHM , facility based programme established special newborn care units for sick newborn . Keeping in view the acute shortage of specialist (paediatric) at facilities, it becomes important to built skills of the health staff at these facilities to manage newborn.

4. FBNC TRAINING : What it is and how does it help The goal of newborn training is to improve the skills of health workers so that they can save newborn lives . The training is based on participatory approach combining classroom sessions with hands-on clinical sessions .

5. The training package includes : Training module for doctors and nurses which addresses most of the common issues related to newborn care , Following upgraded protocol for neonatal resuscitation for doctors and nurses . Facilitators module for the trainers conducting these trainings.

6. TRAINING DAYS Training is for 4 days, and most of the time is spent in a health care facility building skills by " hands-on training" and remaining 50% in classroom sessions . Facilitators demonstrate the skills first, then participants are made to practice those skills on manikins. All doctors and nurses working in SNCUs and NBSUs should have undergone the four-days FBNC training.

7. Four-day training is followed by 14 days observership at the recognised state/national hospital.

8. INSTRUCTIONAL MATERIALS NEEDED

9. MAIN COMPONENTS OF FNBC NEWBORN CARE CORNERS(NBCC) SPECIAL NEWBORN CARE UNIT(SNCU) NEWBORN STABILIZATION UNIT(NBSU)

10. FBNC SETUP At district hospitals and medical college hospitals In all labor rooms and OTs (PHC/CHC/TH/DH) At all taluk hospitals and some CHCs 37 SNCUs 166 NBSUs 1083 NBCCs

11. NEWBORN CARE CORNERS

12. (NBCC) NBCC is required to provide support to newborns required resuscitation services and/or assistance at the time of birth. It is a space within the delivery system in any health facility where immediate care is provided to all newborns at birth. This area is mandatory for all health facilities where deliveries are conducted.

13. NEWBORN CARE CORNERS ESSENTIALS A draught free, warm room with temperature >25 ºC A clean, dry and warm delivery surface A radiant warmer/overhead lamp Two clean, warm towels/clothes A folded piece/roller of cloth A newborn size self inflating bag Infant masks in two sizes : ‘1’ for normal weight baby and ‘0’ for small baby A suction device Oxygen A clock (with second hand)

14. NEWBORN STABILIZATION UNITS

15. (NBSU) NBSU is a facility within or in close proximity of the maternity ward where sick and low birth weight newborns can be cared for during short periods. The training here is given about : Assessment and management of newborn with emergency signs Resuscitation at initial time Referral and transport of sick babies and communication with the family Assessment of newborn for admission in NBSU Supportive care

16. Contd.... Management of sepsis Management of neonatal jaundice

17. SPECIAL NEWBORN CARE UNIT

18. (SNCU) SNCU is a neonatal unit in the vicinity of the labor room which will provide special care (all care except assissted ventilation and major surgery) for sick newborns. Any facility with more than 3000 delivery should have an SNCU (most district hospitals and some sub-district hospitals would fulfil this criteria). The SCBU provides the level of care for babies born after 32 weeks. This may include : Monitoring breathing and heart rate. G iving milk through a tube into the stomach.

19. DIFFERENCE BETWEEN NICU AND SNCU Neonatal Intensive Care Units (NICUs) provide care for babies who need special treatment for critical illnesses in the first few weeks and months of life. Special Care Nurseries (SCNs) look after premature babies, babies who have a low birth weight or need care for neonatal health issues.

20. CONTENT OF CARE AT SNCU SPECIAL NEWBORN CARE FOR SMALL OR SICK NEWBORNS KMC for small babies – starting immediately after birth Breastfeeding – including breast milk by cup and nasogastric tube Thermal care IV care Respiratory support – CPAP, safe administration of oxygen Prevention, detection and management of infection Detection and management of jaundice, anaemia, apnoea, seizures Detection and referral management of birth defects

21. SUMMARIZATION INTRODUCTION TO FBNC FBNC TRAINING TRAINING DAYS INSTRUCTIONAL MATERIALS, SESSIONS MATERIAL MAIN COMPONENTS OF FBNC DIFFERENCE BETWEEN NICU AND SNCU