Effectively Implementing Edition NRP

NRP Instructor CourseEffectively Implementing6th edition NRPLynn Dahlen BSN, RNC-NICDebbie Gleisberg BSN, RNC-NICNRP Regional TrainersThis session is designed for NRP RegionalTrainers and Hospital-Based Instructors whowish to discuss the implementation of the 6thedition of NRP. The presenters will review thecore elements and course requirements forProvider Courses. In addition, the session willinclude a facilitated discussion related tocourse planning, the online examination,organization of supplies, as well as ways toeffectively administer the performance skillsstation, integrated skills station, andsimulation/debriefing.Learning Objectives Identify components of an NRPProvider Course Formulate strategies for realisticsimulation based training Discuss effective administration of theperformance skills stations Describe the development of usefuldebriefing skills Discuss effective administration of theintegrated skills station checklist Identify resources for NRP theinstructorOrigins and GoalsOrigins and Goals Origin 1970’s – need to improve care ofnewborn with respiratory depressionrecognized by 1985 – AAP and AHA committed todeveloping a neonatal resuscitationtraining programWheaton Franciscan Healthcare St. Joseph 1987 – first NRP course was offered atthe AAP National Meeting. National faculty trained regional trainers ineach state Regional trainers then trained hospitalbased instructors 2.4 million providers 25,000 instructors 92 countries represented

NRP Instructor CourseGoalsGoals Goals of revised NRP educationmethodology Majority of instructor-participantinteraction focused on: hands on learning, immersive simulations and constructive debriefings To achieve this: Participants self-study text and/or DVD Instructor is available to assist learners Class time is used for review andpractice of technical skills andsimulation training Instructors no longer use slides andlecture during a course to repeatcontent from the textbookCore Elements of NRP ProviderCoursesProvider Courses Knowledge Textbook and online exam Skills Practice skills station Integrated skills station No differentiation between initial orrenewal courses The NRP instructor tailors the coreelements of each course to suit thelearning objectives of the learners Teamwork Simulation DebriefingNRP ProvidersProvider Course Components Minimum requirements: Self study the text and pass online exam Performance skills station (optional) Integrated skills station Simulation and debriefing Lessons 1-4 and 9 May take additional lessons asdetermined by professionalresponsibilities and/or hospital policy Each learner may receive credit forevery skill in course Doing a skill at a course does not certifythe learner to perform any resuscitationtechniqueWheaton Franciscan Healthcare St. Joseph

NRP Instructor CourseOnline ExamOnline Exam No hard copies any more! The 6th edition NRP online exam must bepassed by each course participant in the30 days before the NRP course Once the exam is started, learners have14 days to complete the exam Continuing education credit is offered tonurses, physicians, respiratory therapistsand EMS personnel HealthStream is the vendor for the 6thedition NRP online examination Fee varies depending on how manyexams are purchased and how the examis accessed If your institution uses HealthSteam,your learners may receive the exam inthe same way other hospital learningprograms are obtainedOnline ExamOnline Exam - Discussion If your institution is not a HealthStreamclient, you may purchase online exams ina small or large volume purchase HealthStream will set up a website foryour use How have you set up the online exam inyour institution? What challenges has the online exampresented? What is your pass rate? What if your staff fails the iscanhc You may allow learners to register or youmay register them Individuals may also purchase the onlineexam with a personal credit cardEquipment and SuppliesGetting Started: Organizingspace, equipment and suppliesWheaton Franciscan Healthcare St. Joseph Supplies listed on pp. 80-81 andpp.212-213 of NRP Instructor Manual Purchase or borrow? Reuse equipment (Et tubes) Expired drugs for medication station

NRP Instructor CourseEquipment and SuppliesEquipment and Supplies Standardize written course materials Make reusable notebooks for instructors Agenda (appendix D and pp.44-45) NRP Flow Diagram (p. 272) Provider Course Individual RecordingSheet (p. 41 and p.245) Integrated skills station checklist, basic oradvanced (App E) Provider course evaluation (App D) Confidentiality agreement (App F)Conference Room Setup Performance checklists NRP Revisions 2011: Brief Summary forBusy People Ready Set Go: NRP Instructor PrepSheet for Simulation and Debriefing Simulation Prep, tips and samplequestions NRP Instructor simulation and debriefingchecklistPerformance skills stations An opportunity to discuss, practice andreview technical skills OPTIONAL Most learners benefit from review oftechnical skills After review and practice, the learnerdemonstrates the skill in the context of abrief scenario starting with equipmentcheck and proceeding through stationsPerformance Skills StationDiscussion How have you utilized the performanceskills station? What items do you have at theperformance skills station?Wheaton Franciscan Healthcare St. JosephIntegrated Skills Station Evaluative component of the ProviderCourse REQUIRED Learner demonstrates technical skillsnecessary to resuscitate a newborn usingproper technique in the sequence of theNRP flow diagram without coaching orguidance

NRP Instructor CourseIntegrated Skills Station (ISS)Integrated Skills Station (ISS) Basic or Advanced Required component of every NRPProvider Course The instructor does not assist, coach, orinterrupt the learner during the ISSclinical scenarios Instructor may use one comprehensiveclinical scenario or a series of increasinglycomplex scenarios to allow the learner todemonstrate all the required skills Not formally “scored” Used to assess the learner’s readinessto proceed to the Simulation andDebriefing component of the course If the learner makes errors insequence, timing, or technicalperformance, the learners continues topractice in these areas and then triesthe Integrated Skills station againIntegrated Skills StationDiscussionSimulation and Debriefing What has been yourexperience with the integratedskills station been like? In July 2004, the Joint Commissionpublished a Sentinel event Alert, “whichinfluenced the ongoing evolution of NRP”.The report indicated that communicationplayed a role in nearly three-fourths of theperinatal death and injury cases reportedto the joint commission during thereported time period. As a result, the Joint commissionrecommended that organizations thatdeliver newborns conduct training to teachteamwork and communication.Simulation and DebriefingSimulation/Debriefing Focuses on improving communicationand teamwork REQUIRED Simulation based learning encourageslearners to “suspend disbelief” and actas they would in an actual resuscitation Allows learners to learn in a safeenvironment Encourages active engagement andreflection on actions Create a plausible scenario (most run 3-5minutes) Create a learning environment thatresembles the birth setting as closely aspossible Orient learners to supplies andequipment and how physiologicresponses are demonstrated Promote learning in a safe and supportiveenvironment where mistakes areconsidered part of the learning process!Wheaton Franciscan Healthcare St. Joseph

NRP Instructor CourseSimulationLearners during Simulation Training is dependent on goodmethodology, not technology! Sophisticated simulators are notnecessary – and they are #/shopMAINPRODUCTS Take responsibility for their learning Think, talk and DO Behave in scenarios as they wouldin real lifeSimulationVideotaping SimulationsI hear and I forget;I see and I remember;I do and I understand Are you planning to videotape thesimulations?Old Chinese proverbEffective DebriefingEffective Debriefing Debriefing is a team-centered discussion,not an instructor centered discussion.Learners talk mostly to each other (SELFDISCOVERY is KEY!) An effective debriefer facilitates thediscussion by asking questions, notmaking comments or giving feedback.Remember 3 questions: 1 statement An effective debriefer does not giveimmediate feedback or lecture to learnersabout what needs improvement The best debriefing allows learners tolink their simulation experience topersonal real-world experience An effective debriefing focuses onteamwork and communication. Thedebriefer guides learners into discussionthe Key Behavioral Skills which helpedthem manage or could have helpedthem manage the events of thescenarioWheaton Franciscan Healthcare St. Joseph

NRP Instructor CourseDebriefingDebriefing Ideally, conduct the debriefing in anarea somewhat removed from thescenario Arrange seating to be able to see thescreen if video is used and to promoteconversation Orient learners about how the instructorand learners are expected to participatein the debriefingEffective DebriefingEffective Debriefing Questions Debriefing questions encourage indepth discussion (as opposed toquestions which elicit yes-no answers) Use the “Ready Set Go” instructor Prepsheet as a guide (p. 136 of InstructorManual) Tell me in a few sentences whathappened to this baby? What did the group do well? Who was the leader? How did you know? What key behavioral skills did you use?When did you use (a key behavioralskill?) What could have gone better? What did you learn?DebriefingSimulation & DebriefingDiscussion Assume learners are intelligent, doingtheir best and striving to improve Maintain confidentiality Confidentiality agreement A learner’s performance is neverdiscussed outside the event Videotape is deleted after debriefing Aspects of a learner’s performance arenever used for an evaluation with asupervisorWheaton Franciscan Healthcare St. Joseph Please share yourexperience with simulationand debriefing

NRP Instructor CourseRostersResources Instructors must submit completedNRP Course rosters to the AAP within30 days after completion of theprogram See Appendix B in Instructor Manual Complete online at aap.org/nrp Log in as an instructor Explore the NRP website!!!!ResourcesMaintaining NRP Provider Status Share your views with other NRPinstructors Taking an NRP Provider Course every2 years Each institution determines its ownpolicy regarding what happens if aperson’s NRP provider status expires What does your institution do? NRP discussion groups:www.aap.org/nrp Receive the NRP Instructor Updatenewsletter, which is your primarysource of current NRP information. Be the first to receive broadcastinformation about new educationalprograms, administrative updates, newNRP course materials, programrevision information, and much more. NRP broadcast email list:www.aap.org/nrp NRP Instructor Update:www.aap.org/nrpMaintaining Instructor StatusSummary Each current NRP instructor must own acopy of the NRP Instructor DVD andcomplete post DVD education by March 16,2012 (was January 2012). Must teach or co-teach in at least 2courses in the 2 years their card is valid Beginning in January 2013, every NRPInstructor must take the NRP online exam,lessons 1-9 before their renewal date May take online every year at no charge Discussion of key learnings What questions do you have?Wheaton Franciscan Healthcare St. Joseph

NRP Instructor CourseAAP Contact Information Administered by the AAP Division of LifeSupport 8-1350www.aap.org/nrplifesupport@aap.orgWheaton Franciscan Healthcare St. JosephThank You!Lynn Dahlen BSN, RNC-NIC 608-392-3917Dahlen.Lynn@mayo.eduDebbie Gleisberg BSN, RNC-NIC414-447-2622Debra.Gleisberg@wfhc.org

NRP Flow Diagram (p. 272) Provider Course Individual Recording Sheet (p. 41 and p.245) Integrated skills station checklist, basic or advanced (App E) Provider course evaluation (App D) Confidentiality agreement (App F) Equipment and Supplies Make reusable notebooks for instructors Performance checklists NRP Revisions 2011: Brief Summary for .