Neonatology Online Course(s) & Continuing Education
Access the latest clinical skills and research for Neonatology for Maternal Health professional training. These Neonatology online courses provide practice-changing skills and valuable perspectives from leading global experts. This Neonatology education has been accredited for a variety of CEUs / CERPs and can be accessed on-demand, at your own pace.
‘He Fought Like a Lion’: Using Trauma Resolution Approaches to Support Professionals and Families with Babies in the Neonatal Intensive Care Unit
Kate White is and award-winning craniosacral and massage therapist, prenatal and early childhood educator. She is trained in somatic therapies, prenatal and perinatal health, lactation, brain development, infant mental health, and has specialized in mother-baby dyad care using somatic prevention and trauma healing approaches for nearly 20 years. She is a mother of two children, holds a BA and MA in Communication, is a Registered Craniosacral Therapist in the Biodynamic Craniosacral method and a Somatic Experiencing® Practitioner. Her work combines somatic therapy with brain development to help give families with babies and small children the best possible start. She is Founding Director of Education for the Association for Prenatal and Perinatal Psychology and Health from 2013 – 2018 where she managed a large online educational program for professionals. She currently co-directs this program, administering an online program for parents and parent professionals, runs a private practice and offers her own seminars through the Center for Prenatal and Perinatal Programs, ppncenter.com.
Topic: Best Practices in Prenatal and Perinatal Psychology and Somatic Health for Optimal Birth Outcomes - [View Abstract]
Topic: Integration of the Science of Safety and Resilience into Perinatal Care: A 5 Step Process - [View Abstract]
Topic: The Science of Safety and Trauma Specific Recognition to Improve Birth Outcomes: What Does It Mean for the Midwife? - [View Abstract]
Topic: “It Was Right but so Wrong:” Helping Families Make Sense of Difficult Births with Trauma Sensitive and Prenatal and Perinatal Healing Approaches - [View Abstract]
Having a baby in the Neonatal Intensive Care Unit is one of the most stressful life events for a parent. The nervous system of babies and parents can go into survival mode, disrupting normal development, especially attachment and bonding. This presentation will detail the nervous system’s response to overwhelming births so that parents and professionals can better understand how to support themselves, their partners, parents and babies. Strategies for self-care and skills for increasing nervous system capacity for greater health will be presented. A successful story of reducing prematurity in a birth center will be presented.
A Neuroprotective Approach to Reduce the Risk for Intraventricular Hemorrhage (IVH) In ELBW Neonates
Sandy Jose, DNP, APRN, NNP-BC is a board certified Neonatal Nurse Practitioner (NNP) in the Level IV Neonatal Intensive Care Unit (NICU) at Texas Children’s Hospital. She completed her NNP education at Rush University in Chicago and her DNP at UT Cizik School of Nursing in Houston. Her passion for quality improvement has helped improve neurodevelopmental outcomes for preterm neonates by reducing the risk for intraventricular hemorrhage (IVH) through the establishment of her “Mindful of Preemies” protocol. She was also a key stakeholder for the development of Neuro-Protective Guidelines for the Small Baby Unit (SBU) Program for Extremely Low Birth Weight (ELBW) neonates. In addition, she continues to actively participate in various QI initiatives within the NICU.
Intraventricular hemorrhage (IVH) is a devastating and debilitating diagnosis commonly seen in premature neonates. Statistics indicate that 45% of extremely premature infants with very low birth weight develop IVH within the first week of life. IVH is associated with numerous acute and long-term neurologic and psychiatric complications. Additionally, it has led to a progressive increase in hospital costs and length of hospitalization.
IVH is multifactorial, but it is primarily attributed to the intrinsic fragility of the germinal matrix vasculature from prematurity and disturbances in the cerebral blood flow (CBF) from commonly seen complications in premature neonates. Seminal research studies support neurodevelopmental positioning (NDP) of high-risk preterm infants as a postnatal preventive approach to reduce the risk for IVH. Hospitals with low IVH rates utilize NDP.
Naomi Bar-Yam, PhD, ACSW, has been working in maternal and child health for over 30 years as an educator, researcher, advocate, and writer. She is the immediate past president of the Human Milk Banking Association of North America (HMBANA) and the founding director of Mothers’ Milk Bank Northeast, which provides safe donor milk to hospitals and families throughout the northeastern US. An expert on access to perinatal health care and policies that support breastfeeding, she has been a consultant to the Centers for Disease Control (on a panel that created “The CDC Guide to Breastfeeding Interventions”), to the United States Breastfeeding Committee (developing an issue paper addressed to CEOs and legislators on breastfeeding and the workplace), and to the March of Dimes (developing educational material for women and families who are medically and socially vulnerable to high-risk pregnancy). She also developed a curriculum for hospital personnel about combining breastfeeding with their work. She reviews articles submitted to the Journal of Human Lactation, Breastfeeding Medicine, and other publications related to breastfeeding, milk banking, and access to perinatal child care. As Executive Director of Mothers’ Milk Bank Northeast, she is thoroughly versed in the technical, procedural, and ethical aspects of milk banking. She often speaks at professional conferences, hospital staff trainings, and grand rounds about milk banking and breastfeeding policies.
Topic: Ethical Concerns in Human Milk Exchange - [View Abstract]
Topic: Getting Milk to Babies: Social, medical, economic and commercial forces - [View Abstract]
Topic: The Whys and Hows of Using Banked Donor Milk - [View Abstract]
This talk uses research literature and hospital policies and programs to explore ways for families of babies in the NICU to be meaningful and active members of the NICU care team. We will look at a global snapshot of prematurity; define what a team is and who is on the NICU care team; and discuss the short- and long-term goals of the NICU care team, as well as many tools and strategies that team members and the team as a whole have at their disposal to reach those goals. Can be adapted for US or global audiences.
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Adverse Babyhood Experiences (ABEs): 10 Indicators of Risk for Infant and Maternal Complications that Highlight Opportunities for Prevention and Repair
Dr. Veronique Mead was a family physician and assistant professor with an obstetrical practice before leaving medicine because she felt she was causing harm. Retraining as a somatic therapist provided insights through a comprehensive understanding of trauma. She has been aggregating the large bodies of evidence revealing how adversity influences health for two decades.
Dr. Mead has developed Adverse Babyhood Experiences (ABEs) to identify risk factors for maternal and infant mortality and morbidity, chronic illness and other effects. ABEs focus on risk from preconception to a child’s 3rd birthday to emphasize how effects of trauma are influenced by epigenetic and other nonpsychological mechanisms. Her focus highlights how opportunities for prevention, healing and repair are greater than has been recognized. Dr. Mead is a speaker, educator, and writer who shares the science on her blog, Chronic Illness Trauma Studies.
Maternal mortality rates are improving around the world but preventable deaths remain unacceptably high, such as in the US where rates are the highest of any developed country, continue to increase, and are associated with severe racial disparities.
Adverse babyhood experiences (ABEs) are a new construct identifying 10 categories of adversity that increase risk for complications and death in mothers and infants. In this emerging era of trauma-informed care, ABEs provide opportunities to optimize resilience through practical strategies for prevention, treatment and repair. ABEs serve as indicators of risk for low birth weight, preterm birth, neonatal intensive care, and chronic illness later in life, among other poor outcomes for infants; and for miscarriage, still birth, other complications and negative outcomes for mothers, including postpartum depression, which is a leading cause of maternal death. ABEs further the science of adverse childhood experiences to highlight a distinct group of risk factors occurring prior to a child’s 3rd birthday.
Attendees will be able to identify early indicators of risk in babies and parents; understand how effects of trauma occur through epigenetics and are not psychological; learn of practices for reducing risk in the sensitive periods before and after birth, and for repairing effects of ABEs later in life; and part with knowledge to inform choices in management and treatment interventions that optimize clinical outcomes.
Dr. Tinisha Lambeth is the Neonatal Quality Improvement Coordinator and an Assistant Professor of Pediatrics at Wake Forest School of Medicine. She coordinates quality improvement at Novant Health Forsyth Medical Center NICU as well. She is a Neonatal Nurse Practitioner and received her MSN (2004) & DNP (2014) from Duke University School of Nursing. Over the past 8 years, Tinisha has presented quality improvement work locally, nationally, & internationally. She has co-authored three publications, on the topics of cytomegalovirus, golden hour and the association of different feeding types with necrotizing enterocolitis and growth in premature infants.
Early- and late-onset sepsis is a significant cause of morbidity and mortality in neonates. However, prolonged antibiotic administration alters the microbiome and increases the risk of necrotizing enterocolitis, sepsis, and death in very low birth weight infants and in late preterm and term infants adverse effects include ototoxicity, nephrotoxicity, increased bacterial resistance, and unnecessary costs. Empiric antibiotic therapy for early-onset sepsis and routine Vancomycin usage for late-onset sepsis was a common practice for neonates at this neonatal intensive care unit. Also, antibiotic stewardship in early- and late-onset sepsis management in the NICU posed unique challenges due to variability in provider practices. In this presentation the Model for Improvement quality improvement methodology and three quality improvement projects with a global aim to reduce antibiotic usage will be presented.
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Antibiotics in the NICU: Practical Understanding of Bugs & Drugs
I have been working in the neonatal area for about 40 years. I received my BSN from Grand Valley State University in Grand Rapids, Michigan. I began working in the NICU right after graduation at Bronson Methodist Hospital in Kalamazoo, MI. I then moved to Detroit and worked at Henry Ford Hospital for 7 years as an RN, Perinatal Educator, Clinical Nurse Specialist, and NNP. I completed my MSN at Wayne State University. I was the first NNP in Michigan, and after leaving Henry Ford, I started working at St. Joseph’s Hospital in Ann Arbor. We moved to Arizona in 1985. I worked at St. Joseph’s Hospital & Medical Center in Phoenix and Banner Desert Medical Center in Mesa (including time at other Banner facilities at Baywood, Mesa Lutheran, and Thunderbird). I completed my PhD at the University of Arizona in Tucson in 2005, and moved to Omaha, NE to begin teaching in the NNP program at Creighton University. I have continued to work most weekends in the NICUs at Methodist Women’s Hospital, Creighton University Medical Center, Lakeside Hospital, and Bergan Mercy Medical Center (CHI Health). I love both teaching and the clinical aspects of the NNP role. I love working with students and helping them “get” the connection between physiology and the disease. I also get a “kick” out of attending deliveries, bagging infants, and intubating them!! I love that adrenaline rush! I also enjoy biking, reading a good novel, and enjoy roller blading (until I broke my leg 4 years ago). I have been pretty cautious with my roller skating since then. I have two sons – one in college and one who recently graduated from college and is working in downtown San Francisco. My husband and I love to travel (when I get time off) and have done some kayaking on the beautiful Nebraska lakes.
This talk will discuss the bacteria seen in the NICU and the groups of antibiotics that are used to treat them, differentiating between empiric therapy and directed therapy. The antibiotics covered will be penicillins, cephalosporins, aminoglycosides, macrolides, carbapenems and vancomycin. Antibiotic resistance patterms and possible new therapies will also be discussed.
Dr. Elizabeth Sharpe is a neonatal nurse practitioner and vascular access specialist with over 25 years of experience in Level II and Level III NICUs. She is an Associate Professor Clinical Nursing at The Ohio State University and Specialty Track Director of the Neonatal Nurse Practitioner Specialty in the Master of Science Graduate Nursing Program. Her unique contributions focus on education, vascular access, simulation, and harm prevention. She is the coauthor of the National Association of Neonatal Nurses (NANN) Guideline for Practice: Neonatal Peripherally Inserted Central Catheters, 3rd Edition, and has authored numerous publications. Dr. Sharpe has served two terms on the Board of Directors of the National Association of Neonatal Nurses (NANN.org) and currently serves as the NANN liaison to the Council of International Neonatal Nurses. She was honored to be named the 1st Janet Pettit Scholar by the Association for Vascular Access (avainfo.org) and a Fellow of the American Association of Nurse Practitioners and the National Academies of Practice.
Our special babies present unique challenges in vascular access. This presentation will highlight different methods of vascular access in neonates and infants including anatomy, therapy and patient characteristics. This will provide baseline information regarding guidelines for proper placement of umbilical catheters, surgically-inserted, peripherally inserted central catheters (PICC), midline and peripheral intravenous catheter. This is essential to building the knowledge base of new nurses and will update advanced neonatal nurses.
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Assisting Late Preterm Dyads Achieve Breastfeeding/Chestfeeding Success
Angela Lober has been an educator and clinician for over 19 years. She has been an Internationally Board Certified Lactation Consultant since 2005 providing evidence-based care within an academic medical center and within her community. Angela is the Director of the Arizona State University Lactation Education Programs offering on-line and academic elective on breastfeeding and lactation. She completed her PhD at Arizona State University's College of Nursing and Healthcare Innovation focused on the breastfeeding complexities of late preterm infants.
Late preterm infants struggle with feeding challenges. Due to the oscillating nature of breastfeeding progress in the late preterm population coupled with the innate issues of prematurity, families need support to navigate waters toward breastfeeding success. A model for evidence-based education and breastfeeding assessment will be presented to support infant development and empower mothers to achieve their breastfeeding goals.
Attachment and Neurodevelopmental Outcomes in Premature Infants: The Role of Interpersonal Neurobiology in the NICU
Kara Wahlin is a licensed marriage and family therapist and art therapist who resides in the Coachella Valley of southern California. After going through the preterm birth of her twin sons William and Elliott, and the subsequent loss of William, Kara made the promise to dedicate her clinical work to helping other families coping with the trauma and loss often wrought by the NICU experience. She developed the website NICU Healing in order to provide free information, couples and individual therapy, and online support to NICU families. Kara uses strengths-based, neuroloscientifically-informed and creative practices to empower her clients to picking up the pieces of their lives and moving forward with their new life stories. She speaks frequently at conferences discussing best clinical practices, and writes for her own as well as other blogs about new ways of coping with mental health issues that come up after traumatic experiences. In her free time, Kara and her son Elliott are art machines and expert hikers, and also spend their time at home with their menagerie of small animals.
Evidence has shown that attachment between a primary caregiver and their preterm infant can change the neurodevelopmental outcomes for the infant later in life. Attachment can be seen as a living organism between parent/caregiver and child, and with encouraged development and growth, the attachment relationship can have profound effects, even in the context of the most difficult of circumstances and medical diagnoses. The more NICU caregivers know how to encourage attachment, the likelier a family system will need less medical/psychological intervention after discharge from the hospital.
Automated Control of Inspired Oxygen…. Is it the Future of Oxygen Therapy in Preterm Infants?
Dr. Souvik Mitra is an Assistant Professor and neonatologist at the Division of Neonatal Perinatal Medicine, Department of Pediatrics, Dalhousie University, Halifax, Canada. He completed his medical school and pediatric residency from Calcutta Medical College, India. Dr Mitra went on to complete his neonatal fellowship at McMaster University, Hamilton, Canada and is currently pursuing his Masters in Clinical Epidemiology from the same institution. Cerebral oxygenation and cardiovascular physiology in premature infants are his primary clinical research interests. He also has extensive epidemiological research experience having published a number of systematic reviews and meta-analyses. He has shared his research through webinars across Canada and the United States as well as through platform presentations at various international conferences. He has special expertise in targeted neonatal echocardiography and is a member of the Pan-American Hemodynamics (TnECHO) Collaborative.
There is increasing evidence that optimizing time spent within targeted oxygen saturation limits improves clinical outcomes in premature infants. Recent randomized clinical trials show that preterm infants who spend more time above the target saturation range tend to have increased retinopathy of prematurity and bronchopulmonary dysplasia, while those infants who spend a considerable time below the target range tend to have more necrotizing enterocolitis and death. Hence it is imperative that we find out the best way to optimize oxygen saturation targeting in preterm infants. Education programs followed by implementation of oxygen titration guidelines for the bedside nursing staff have been shown to have some benefit. However, the ever-increasing NICU workload often makes it impossible for nurses to adhere to strict oxygen titration guidelines. Automated control of inspired oxygen may provide some respite to the nurses as this recent technology has not only been shown to reduce nursing workload but also to improve oxygen saturation targeting in preterm infants. This is an exciting new innovation which, with more refinement in technology and practice, has the potential of becoming the standard of NICU care in future.
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