Report: Promoting Clinical Skills in Neonatal Care for Junior Nurses

This report examines the promotion of clinical skills for junior nurses in neonatal care, focusing on an NHS setting. It begins with an abstract and introduction outlining the project's background, overview, and justification for the study. A comprehensive literature review explores the role of junior nurses, challenges they face, and the clinical skills required, alongside ways to enhance these skills. The methodology section details the aim, objectives, study design (exploratory), time schedule, literature search strategy, data collection methods, and data analysis techniques. It also addresses research limitations and ethical considerations. A feasibility study assesses resource needs and budget considerations. The report concludes with a discussion of the potential impact of the project and includes a list of references. The core focus is on identifying and recommending strategies to improve the clinical competencies of junior nurses in the neonatal care unit, which is critical for the well-being of premature or ill infants.

A report to promote better clinical
skills of neonatal care for junior nurse

TABLE OF CONTENTSs
TITLE..............................................................................................................................................1
ABSTRACT....................................................................................................................................1
INTRODUCTION...........................................................................................................................1
Background..................................................................................................................................1
Project overview..........................................................................................................................2
Justification..................................................................................................................................2
LITERATURE REVIEW................................................................................................................3
Role of Junior nurse in neonatal care..........................................................................................3
Challenges faced by Junior nurses of neonatal care....................................................................4
Clinical skills required by a junior nurse for neonatal care.........................................................5
Ways in which clinical skills of neonatal care for junior nurse can be promoted.......................6
METHODOLOGY..........................................................................................................................7
Aim and objectives of project......................................................................................................7
Study design and time schedule...................................................................................................8
Literature search Strategy............................................................................................................9
Data collection...........................................................................................................................10
Data analysis..............................................................................................................................11
Research Limitations.................................................................................................................11
Ethical issues and considerations...............................................................................................12
FEASIBILITY STUDY.................................................................................................................12
Resources required and budget considerations..........................................................................12
IMPACT........................................................................................................................................12
REREFENCES..............................................................................................................................15

TITLE
Title of this project is “A report to promote better clinical skills of neonatal care for
junior nurse”.
ABSTRACT
Neonatal care unit is a kind of intensive care unit for premature or ill infants or babies up
to 2 years of age. This care unit most of the time take care of babies for first 28 days if they are
seriously ill or are facing some kind of health issues. Junior nurses working within this care unit
need to have various kinds of clinical skills and need to have complete knowledge about their
roles and responsibilities towards the babies admitted into neonatal care unit because most of the
babies admitted in this care unit are in vulnerable and critical condition. Any kind of mistake or
carelessness can cost increase life threatening risk for babies or infants admitted in this care unit.
The following project will aim to analyse ways in which clinical skills of neonatal care for junior
nurse can be promoted. A case study of NHS neonatal care unit. This aim will be achieved with
the help of three main objectives. Main objectives of this project are: to evaluate role of junior
nurses working within neonatal care, to identify clinical skills required by them and third is to
recommend ways in which clinical skills of neonatal care for junior nurse can be promoted. All
the three main objectives of following project will be achieved though secondary data analysis
using qualitative methods. This project will be utilizing exploratory study design as it is one of
the most suitable study design method that can be used for qualitative study for collection and
analysis of secondary data. For achieving pre-defined main objectives of project, literature search
strategy was developed in which literature for secondary data collection and analysis key words
were defined, inclusion and exclusion criteria was set with the help of which articles/ research
papers etc. were collected.
Key words: neonatal care, clinical skills, neonatal nurses, junior nurses’ skills
INTRODUCTION
Background
Neonatal care is an intensive care unit which is specialized in providing care of ill or
premature new born babies or infants. New natal care unit take care of infants or babies for first
28 days of life. Neonatal care is also known as specialized nurseries. Nurses or professional
practitioners who work in neonatal care deal with newly born infant babies so they need to be
specialized in their field because mostly premature babies or infants needed to be taken care of
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very carefully as they are in most vulnerable and critical stage (Soroush, Zargham-Boroujeni and
Namnabati, 2016). Especially junior nurses working in neonatal care unit are responsible for
taking care of premature or ill babies or infants carefully by continuously monitoring them,
change their feeding tubes, checking vital signs and many more. Any kind of carelessness or
mistake can cost new born babies with their lives. They are also responsible for conducting any
kind of test upon ill or premature babies and if they are in critical condition then junior nurses are
responsible for taking care of such babies in a proper and appropriate manner.
Project overview
The project will focus upon different ways though which clinical skills of neonatal care
for junior nurse can be promoted or it can also be said that this project will aim in analysing
ways of promotion of clinical skills in junior nurses or of neonatal care of NHS. In order to
achieve this aim role of Junior nurse in neonatal care will be explained and discussed in detail
manner. Other than this, project will also focus upon why there is a need to develop clinical
skills in junior nurses of neonatal care unit, challenges faced by Junior nurses of neonatal care in
providing care to premature or ill infants or babies. This project will also help in identifying
different kinds of clinical skills required by a junior nurse for neonatal care. Detail discussion
and focus upon this objective will help in identifying different ways in which clinical skills of
neonatal care for junior nurse can be promoted. For achieving defined aim and objectives,
secondary data will be collected so that detail information can be collected about skills required
by junior nurses for taking care of neonatal care unit babies in a proper manner and different
ways can be identified through which clinical skills within junior nurses can be explored. With
the help of literature review ways though which required clinical skills within junior nurses can
be promoted will be investigated in this project.
Justification
There are many different reasons because of which this topic has been selected. Neonatal
care unit deals with taking care of premature or ill babies or infants. They are required to be
handled and taken care off very carefully. If junior nurses are not skilled enough to take care of
then it can put lives of premature or ill babies or infants in danger. Junior nurses are not only
responsible of taking care of babies but they are also responsible for monitoring them, changing
their feeling tubes etc. so that risk associated with lives of premature or ill babies or infants can
be reduced (Soroush, Zargham-Boroujeni and Namnabati, 2016). For this it is important to study
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about ways though which clinical skills within junior nurses of neonatal care unit can be
promoted.
LITERATURE REVIEW
Role of Junior nurse in neonatal care
According to the view of Wi and Kang, (2016) Junior nurses plays a vital role in providing
care to new born infants born so that different variety of problems faced by them can be dealt
with like prematurity, birth defects, infection, cardiac malformations, surgical problems and
many more. Junior nurses need to work with new born babies in order to take care of them. this
is majorly because new born babies are often sick and can experience different kinds of problems
for several months just after birth. The main primary role of Junior nurses of Neonatal care unit
is to take care of infants up to 2 years of age. So that their health condition can be improved and
they can be discharged from hospital. Wi and Kang, (2016) further explains that, Most of the
junior nurses are responsible for taking care of newly born babies just after their birth until they
are discharged from hospital, only in few cases when newly born infants are in critical condition
and require long tern treatment only then senior nurses are involved in taking care of them. Most
of the Junior nurse’s work at level of neonatal care unit i.e. in special baby care unit. At this level
junior nurses take care of babies who need more care as compared to healthy babies. But babies
at this level are much more stable and mature. Level one neonatal care unit is also known as
Special care baby Unit (SCBU).
As per the view of Jakšová, Sikorová and Hladík, (2016) Junior nurses working at Special
care baby Unit are responsible for providing and changing feeding tube, perform oxygen therapy,
provide antibiotics to babies for treating their infection and many more. Junior nurses of level
one Neonatal care unit take care of four babies at a time. Junior nurses need to continuously
monitor health condition, heart rate of babies at this level and perform diagnostic procedures so
that any kind of complications, allergies or any other kind of issues can be identified at early
stages as soon as possible (Tarjoman and et. al., 2019). They are also responsible for performing
different kinds of therapeutic procedures with newly born infants in order to bring implement
within their health. Other than this one of the major roles of Junior nurses of neonatal care unit is
to assist neonatal senior nurses and practitioners in providing complicated treatment or carrying
out typical therapist or procedures upon premature infants. Jakšová, Sikorová and Hladík, (2016)
further elaborates that, Duties of junior nurses in this care unit is more serious as they work in
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life-sustaining care for the new babies. They are also responsible for maintaining and updating
records of patient’s care, educate parents with essential home procedures. Monitor their
breathing, vital signs, lung development and provide life sustaining nutrients to the baby. They
also play a vital role in administrating provision of appropriate medicines to the babies and if
there is any kind of change within their condition then they are responsible for reporting it to
senior nurses or senior physicians so that changes within current care plan can be brought within
babies.
Challenges faced by Junior nurses of neonatal care
As explained by Ohnstad and Solberg, (2017) Junior nurses of neonatal care not only
need to establish their relationship with new born babies but their also need to establish their
relationship with their parents and family members. They need to provide comfort to their
families as well so that seek comfort within them and can feel relaxed that their babies will be
treated well and taken care off in an appropriate manner. But it is one of the main challenges
which is faced by Junior nurses of neonatal care unit. This is mainly because many times it
becomes quite difficult for Junior nurses to provide comfort to parents of premature babies and
gain their trust in provision of required for babies. Many times, due to this challenge they feel
irritated, anxious and depressed as well. This challenge is mainly faced by nurses Due to their
lack of experience and lack of convincing skills. Ohnstad and Solberg, (2017) further expands
that another challenge which is faced by Junior nurses of neonatal care unit is alarm fatigue i.e.
junior nurses working in this critical care unit need to work for long working hours. They need to
be completely attentive in order to provide appropriate create to babies. They are also surrounded
by multiple alarm soundings in order to guide nurse (Purdy and et. al., 2017). Junior nurses need
to be completely attentive and sensitive to those alarm sounds so that proper care can be
provided to premature infants or babies. Many times, due to these alarm systems and long
working hours well- being of junior nurses can be impacted drastically.
Kim and et. al., (2019) has further explained that, neonatal care unit structure is another
challenge which is faced by junior nurses. Structural standard of neonatal care unit and
equipment’s used in this intensive care unit are completely different as compared to other care
units. In fact, procedure and standards are a bit complex as this care unit deal with survival of ill
or premature infants or babies. It is important for neonatal care unit to develop and maintain
conditions for proper growth and development of infant and babies in this unit. Kim and et. al.,
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(2019) further says that, it is important to provide excellent and proper training and orientation to
junior nurses working in neonatal care unit so that they can maintain proper environment of
neonatal care and can adopt all the standards and procedure of this care unit. Not providing
proper and appropriate training to Junior nurses can create new challenges for them and can
make it a bit difficult for them to adopt themselves in the working environment of neonatal
intensive care unit as they won’t be able to adjust themselves in the working environment of this
care unit in a proper manner. Other than this many times junior nurses are not provided with
proper guidance or expertise. This inadequate expertise can create many different kinds of
challenges for them and as a result their efficiency and effectivity are reduced because of which
care provided by them to premature babies can be impacted. These are some of the most
important challenges that are majorly faced by Junior nurses of neonatal care.
Clinical skills required by a junior nurse for neonatal care
According to the view of Cooper and et. al., (2019) there are various kinds of clinical skills
that are required by a junior nurse in order to provide appropriate and effective care to patients of
neonatal care unit. These clinical skills help junior nurses to bring improvement within their
performance so that they can provide excellent and appropriate desired care to premature or ill
babies in order to increase their survival chances and reduce risk chances in a proper manner.
Clinical investigation is one of the most important type of clinical skill which is required by a
junior nurse working in neonatal care unit. Clinical investigation clinical skill helps the nurses to
investigate medical condition of babies admitted in neonatal care unit, assess they safety
conditions and also investigate effectiveness of medical deicide used within their treatment.
Clinical investigation helps junior nurses to provide appropriate care to babies in neonatal care. It
further helps them to ensure their safety so that effectivity of treatment and care can be
enhanced. Cooper and et. al., (2019) also says that, it is important for junior nurses to have
clinical investigation clinical skills so that effectiveness of care provided to premature or ill
babies can be increased so tat life threatening issues or problems associated with such infants can
be reduced. Another important clinical skill which is required by junior nurses of neonatal care
unit is clinical reasoning. It is one of the most important and crucial skill which is required to be
present within junior nurses. This skill helps junior nurses for interpreting clinical findings so
that interpreting of clinical findings and diagnostic reasoning can be done (Beck and et. al.,
2017). It is important of junior nurses to develop this skill because it helps them in stabilization
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of neonatal so that if there is requirement of transferring neonatal from place to another then it
can be done without risking their lives.
As per the view of Mirlashari and et. al., (2016) there are many clinical skills that are
required to be developed by junior nurses of neonatal care. Each of these skills have their own
importance and is used for different kinds of safety and care of babies. One of those skills is
effective communication. Effective communication for junior nurses is important critical skill
which is required to be developed and enhanced by them. Effective communication skills help
them to maintain effective relationship with parents and family members of the baby so that
current condition, type of treatment and therapies that are being or will be provided to the baby.
Effective communication skill helps them to maintain positive and effective communication with
family members. Mirlashari and et. al., (2016) also explains that are there are many other
important clinical skills required to be developed by junior nurses of neonatal care like team
work, professionalism, procedural perfection. These skills help in ensuring that treatment
provided to premature or ill infants is perfect and appropriate so that positive outcomes can be
achieved and health of infant babies in neonatal care can be improved. Procedural perfection
skills help in ensuring that all the procedure for care and treatment of babies in neonatal care are
performed in an effective and accurate manner.
Ways in which clinical skills of neonatal care for junior nurse can be promoted
As explained by Li, (2016) there are different kinds of ways though which clinical skills
of neonatal care for junior nurses can be promoted. One of the most effective way though which
clinical skills can be promoted is by providing training to junior nurses. Provision of training not
only helps in enhancing current clinical skills but also helps junior nurses in learning new other
required clinical skills through which they can enhance their overall quality of care that they
provide appropriate care and treatment to patients. Training and development activities also
helps junior nurses to identify skills that they need to work upon so that they can bring
improvement within their performance and can provide excellent cate to patients of neonatal
care. Li, (2016) further elaborates that, Provision of constructive and regular feedback to junior
nurses can also help in promoting clinical skills within nurses. Constructive and regular feedback
will allow senior nurses or practitioners to help junior nurses to identify clinical skills that are
required to be improved or learned by them. Feedbacks is one of the most appropriate and
accurate way though which clinical skills within junior nurses can be promoted. It can also help
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junior nurses in realizing importance of clinical skills and ways in which those skills can help
them in proving excellent care to neonatal. It further helps them in understanding types of
clinical skills and their importance in achieving positive outcome can be achieved and effectivity
of treatment and therapies provided to premature or ill babies can be improved.
Lejonqvist, Eriksson and Meretoja, (2016) has further explained that, other than training
and feedback there are many other kinds of ways though which clinical experience of neonatal
care for junior nurse can be promoted. Self- directed learning is another way though which
clinical skills within junior nurses can be promoted. This can be done by encouraging junior
nurses so that they can take initiates so that they can further diagnose their learning needs and
formulate their learning goals. Self- directed learning is one of the most appropriate way though
which junior nurse can be encouraged so that they work upon their identifying different kinds of
clinical skills needs they need to learn. This will not only help them in identification of need and
requirement of clinical skill but it will further help them to identify appropriate learning methods
though they can learn and enhance their clinical skills. Lejonqvist, Eriksson and Meretoja, (2016)
says that adequate expertise or supervision of senior nurses can also help junior nurses in
promotion of clinical skills. Expert supervision helps junior nurses to practically learn
importance and ways in which different clinical skills can enhance quality of care of positive
outcomes. NHS has their own neonatal care unit where they deliver best neonatal care for all
babies as well as to their families. They focus upon development of requited clinical skills within
their nurses and doctors so that babies and their parents can be treated at right time, by right staff
members at right time so that positive outcome can be achieved. For this they provide different
kinds of training to their nurses, provide time to time feedback about their care and performance
so that they can identify skills that are required to be developed by them.
METHODOLOGY
Aim and objectives of project
This study will majorly focus upon exploring role of junior nurses who work within
neonatal care unit so that different kinds of ways though which their clinical skills can be
promoted can be identified. For this challenges that are being faced by junior nurses working
this care unit has also been identified so that by identifying ways to overcome those challenges,
clinical skills in Junior nurses can be promoted. So, it can be said that main aim of this project is
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“To analyse ways in which clinical skills of neonatal care for junior nurse can be promoted. A
case study of NHS neonatal care unit”.
Objectives of this project have been developed in such a manner so that aim of the project
can be achieved in a proper manner. Achievement of desired objectives will help in identification
of ways though which clinical skills of neonatal care for junior nurse can be promoted. All the
main objectives of the project will be achieved with the secondary data analysis.
Some of the main objectives of this project are:
 To evaluate role of Junior nurse in neonatal care.
 To identify clinical skills required by a junior nurse for neonatal care.
 To recommend ways in which clinical skills of neonatal care for junior nurse can be
promoted.
Main research questions of this study are as follows:
 What is the role of Junior nurse in neonatal care?
 What are the main clinical skills required by a junior nurse for neonatal care?
 What are the recommended ways in which clinical skills of neonatal care for junior nurse can
be promoted?
Study design and time schedule
Study design can be defied as a set of procedures or methods that can be used to collected
and analyse data on variables that are specified within a particular research problem (Gericke,
Kramer and Roschuni, 2016). There are many different kinds of study design that can be used for
collection and analysis of data on variables so that main research questions can be answered.
Some of the main type of study design methods are: exploratory design method, descriptive
design method, casual design method and mixed design method. Exploratory study design
provides a general insight of the situation, Descriptive study design helps in describing specific
elements of research area, causal study design helps in study cause and effect relationship within
the research study. Whereas mixed method utilizes both qualitative and quantitative methods.
For this project exploratory study design has been chosen that utilizes only qualitative methods.
Using exploratory study design data will be collected from secondary sources like Books,
Journals, articles and many more so that role of junior nurses within neonatal care unit can be
identified, clinical skills required by them, challenges faced by them. Analysis of this data
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though informal qualitative analysis, main research questions can be answered i.e. to identify
ways through which clinical skills of neonatal care for junior nurse can be promoted.
Time schedule in which project will be completed is 10 weeks. In first 2 weeks research
proposal will be prepared and after approval only research protocol will start.
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Research
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Research
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Introduction
Literature
Review
Methodology
Feasibility
study
Impact
Submission
Literature search Strategy
For this project secondary qualitative data analysis has been focused upon and for this
narrative literature each strategy has been developed. Literature search strategy for this project
will be done in five steps: first step is to identify main key search terms using which articles,
research papers etc. will be searched (Eriksen and Frandsen, 2018). Second step is to identify
search engine though which literature will be identified. Third is to identify inclusion and
exclusion criteria on the basis of which article/ research papers etc. will be selected. Fourth step
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is to check contribution of selected paper in the research area. Final step is to check date of
publication of selected paper i.e. most recent research or publication should be preferred.
Literature search was mostly done though online sources. Database though which
secondary articles and research papers will be selected is though Google Scholar. There are
many other databases though which secondary data can be selected but Google scholar is one of
the most appropriate databases though which any kind of secondary data can be selected. For
section of literature key words will be used and though Boolean operations combination of key
words will be used for selection of literature. Sone of the main and important key words used for
searching appropriate literature of the research project are: neonatal care, clinical skills, neonatal
nurses, junior nurses’ skills. Literature search for secondary qualitative research project will be
done on the basis of sone pre- defined inclusion and exclusion criteria.
Inclusion criteria: Articles or papers that includes role of junior nurses in neonatal care unit.
Papers that focuses upon identification of clinical skills required by junior nurses working in
neonatal care. Other than this, All the papers that are less than 5 years old will be selected.
Papers related to neonatal care are published in English and have an appropriate or authorized
published sources will be selected.
Exclusion criteria: papers in language other than English will not be selected, Articles that will
not focus upon neonatal care will also not be selected.
Data collection
Data collection methods are one of the most important methods of a research study. It
helps in identifying methods though which required data for research study can be collected so
that it can be analysed and research questions can be answered in a proper manner (Mkandawire,
2019). There are two main types of data collection methods: primary and secondary data
collection methods. Primary data is a kind of data which is collected for the first time by the
researcher and is collected though survey, interview etc. Whereas, Secondary data is a kind of
data that has already been published and is collected from sources such as Books, Journals,
articles, newspapers, government publications and many more. For this research project
secondary data will be collected for answering research questions in a proper and appropriate
manner. Collection of secondary data will help in identifying ways though which clinical skills
of neonatal care for junior nurse can be promoted by identifying role of junior nurses in neonatal
care, clinical skills required them. Secondary data will help in developing a base of research
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