Training Offer

Standards in Neonatology and Perinatal Care

Specialized Area: Materno-Neonatal
Scientific Reference
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Luca Antonio Ramenghi
lucaramenghi@gaslini.org - international@gaslini.org
+39 010 5636.2878
Curriculum Vitae

  • General Information

    Purpose
    To support the training path of the client's neonatology and obstetric-gynecological staff to promote the development of the necessary skills to ensure safe care for newborns from birth to the early days of life, in accordance with internationally recognized quality care standards.
    Duration
    The duration of the training path can only be estimated following a site visit to observe the local context and the knowledge and skills of the operating staff.
    Target Audience
    Physicians, nurses, midwives, rehabilitation technicians, and neonatal transport service operators.
    Minimum Requirements for Participants
    Skills related to the academic degree held.
    Expected Outcomes
    Autonomy of healthcare personnel in providing perinatal care and neonatal care to both physiological and pathological newborns, from resuscitation maneuvers at birth to possible moderate-intensity care in the first hours/days of life.
    Outcome Indicators
    • Reduction of mortality and morbidity by gestational age in the period following the training intervention, through the correct application of clinical practices taught and adherence to provided protocols.
    • Increase in the territorial coverage of the potential neonatal transport service with an evaluation of the volumes managed.

  • Program

    Training Tools
    • Missions at the client hospital headquarters, each typically lasting between 7 and 14 days, involving senior medical and nursing staff from the Gaslini Institute, experts in the topics of the training path.
    • Residential training with internships at the Materno-Neonatal Department of the Gaslini Institute: periods of "observership" typically lasting between 30 and 45 days, with assigned tutors.
    • Remote training with webinars: educational activities led by senior faculty; second opinion for discussing complex cases: consultancy activities entrusted to senior physicians.
    4 Missions
    Mission 1
    • Investigative site visit of the local context in general, and more specifically, the case mix, available technological resources, personnel skills and competency levels, active clinical procedures and pathways, and specific needs of the local staff.
    Mission 2
    • Practical training on the technical skills that must be possessed and non-technical skills necessary for correct management of the work group and the patient. The preliminary theoretical training will also be provided remotely through e-learning and must be completed by the local staff before the practical training mission.
    Mission 3
    • After a period of 6 months, an evaluation mission aimed at quantifying the success of the previous educational intervention in terms of modifying daily clinical and managerial practices, as well as addressing any additional shortcomings identified. Implementation of contextual educational interventions aimed at addressing any shortcomings identified during follow-up or emerging during the course.
    Mission 4
    • 12-month follow-up and closure of outcome studies, organization of customer satisfaction questionnaire collection.
    1 Internship
    Internship 1
    • "Observership" at the Neonatal Intensive Care Unit of the Gaslini Institute for periods typically lasting 30 days (frequency to be established).
    14 Webinars
    Webinar 1:
    • Organizational aspects of perinatal and neonatal care: organization of the delivery room and its essential equipment; organization of an intensive/sub-intensive care unit and functional spaces.
    Webinar 2:
    • Hospital neonatal care.
    Webinar 3:
    • Principles and algorithm of Neonatal Resuscitation according to the ILCOR 2020 guidelines (AAP/AHA adaptation).
    Webinar 4:
    • Recognition of warning signs in a critical neonate and subsequent determination of the level of care.
    Webinar 5:
    • Management of critical neonates by systems: Respiration, Circulation, and Neurology.
    Webinar 6:
    • Principles of temperature control and monitoring of vital parameters both at birth and during subsequent care.
    Webinar 7:
    • Management of fluid therapy and enteral feeding in critical/premature neonates.
    Webinar 8:
    • Operation and use of major non-invasive respiratory support tools (CPAP, HFNC) and correct management of medical gases.
    Webinar 9:
    • Management of neonatal jaundice.
    Webinar 10:
    • Glycemic control and its protective effects on neurodevelopment.
    Webinar 11:
    • Management of infectious risk and antimicrobial therapy management.
    Webinar 12:
    • Elements of neonatal neurology (neonatal encephalopathy, seizures).
    Webinar 13:
    • Protocol for the administration of blood products and control of bleeding risk.
    Webinar 14:
    • Involvement of local staff in the International Neonatal Transport School organized by the Gaslini Institute.
    Second opinion
    As per the client's needs, typically bi-monthly.

  • Practical Training (Physicians)

    Methodological notes
    • Low-fidelity simulation focuses on knowledge and psychomotor skills; simulators used are part-task or box trainers, i.e., physical interfaces not necessarily realistic for performing technical skills.
    • Medium-fidelity simulation focuses on more complex knowledge and techniques; simulators used provide a more realistic substrate for pathologies and healthcare maneuvers but lack operator immersion (low level of realism).
    • High-fidelity simulation focuses on non-technical skills such as communication, decision-making, teamwork, clinical judgment, and leadership; in this case, simulators are technically realistic and offer an immersive environment where trainees work individually or in teams to perform scenarios with a high level of realism. This context includes the use of virtual reality and mixed reality.
    Execution of neonatal resuscitation maneuvers
    Delivery mode:
    • In-situ Simulation (use of medium-fidelity simulators, in collaboration with the Simulation Center and the Department of Bioengineering at the University of Genoa). To be evaluated, based on the resources applicable to the context, the possible introduction and use of high-fidelity simulators and virtual/mixed reality.
    Proper use of non-invasive respiratory support devices (CPAP, HFNC)
    Delivery mode:
    • On-site demonstration
    • Demonstrative videos (features, assembly and setting of machines, and selection of interfaces)
    Placement and Aseptic Management of Umbilical Venous Catheters (sterile placement technique, technique for opening/closing the catheter in sterility, and control of venous access position via ultrasound)
    Delivery mode:
    • On-site demonstration
    • Familiarization with positioning aids and the use of umbilical venous catheters Demonstrative videos (positioning technique)
    • Low-fidelity simulation
    • Practice on patients (with the use of ultrasound for catheter placement control), under expert supervision both in the host state and at Gaslini.
    PDA patency check using targeted echocardiography
    Delivery mode:
    • On-site demonstration
    • Demonstrative videos (probe positioning technique)
    • Practice on patients under expert supervision both in the host state and at Gaslini.
    Neonatal lung ultrasound
    Delivery mode:
    • On-site demonstration
    • Demonstrative videos (probe positioning technique and recognition of main ultrasound patterns and signs)
    • Practice on patients under expert supervision both in the host state and at Gaslini.
    Neonatal cerebral ultrasound for the detection of intracranial hemorrhages and gross malformations
    Delivery mode:
    • On-site demonstration
    • Demonstrative video (execution of essential scans)
    • Practice on patients under expert supervision both in the host state and at Gaslini.

  • Practical Training (Nurses)

    Execution of neonatal care maneuvers
    Delivery mode:
    • On-site demonstration
    • Demonstrative video (execution of essential scans)
    • Practice on patients under expert supervision both in the host state and at Gaslini.
    Use of Bilicheck and phototherapy
    Delivery mode:
    • On-site demonstration
    • Demonstrative video (execution of essential scans)
    • Practice on patients under expert supervision both in the host state and at Gaslini.
    Management of central and peripheral vascular accesses
    Delivery mode:
    • On-site demonstration
    • Familiarization with positioning aids and the use of umbilical venous catheters
    • Demonstrative video (execution of essential scans)
    • Practice on patients under expert supervision both in the host state and at Gaslini.
    Use of feeding devices for critical neonates
    Delivery mode:
    • On-site demonstration
    • Demonstrative video (execution of essential scans)
    Use and management of non-invasive ventilation interfaces
    Delivery mode:
    • On-site demonstration
    • Demonstrative video (execution of essential scans)

  • Educational Material

    Educational material used for training sessions, demonstrative videos, international guidelines, and protocols used at the Maternal-Neonatal Department of the Gaslini Institute.
    • Demonstrative Videos
    • Guidelines
    • Protocols
    • PPT Presentations

  • Learning Assessment

    • Assessment of theoretical knowledge through the administration of a multiple-choice questionnaire
    • Assessment of practical skills acquired by local staff during follow-up missions

  • Customer satisfaction

    • During the 6-12 month follow-up period, a customer satisfaction questionnaire will be prepared for local staff, the results of which will be evaluated as part of the training intervention.