POSITION STATEMENTS
WHAT IS NEONATAL NURSING
VIOLENCE AGAINST WOMEN, CHILDREN AND FAMILIES
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35% of women worldwide have experienced either intimate partner violence or non-partner sexual violence in their lifetime. This is more than 1 in 3 women worldwide -
42% of women experience injuries either physically or sexually by a partner -
38% of all murders of women globally were committed by an intimate partner
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2 x more likely to experience depression -
2 x more likely to have alcohol use disorders -
1.5 x more likely to acquire HIV and sexually transmitted disease -
16% more likely to have a premature or low-birthweight baby
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Nobody has the right to physically hurt another person and this includes children(3); -
Nobody has the right to have sexual contact with another person without that person’s permission(3); -
Nobody has the right to use intimidation or threats to control another person(3); -
Everybody has the right to live in a healthy family relationship based around trust and respect. A place they can feel safe and valued, no matter which country they come from(12); -
Women and Children Violence is unacceptable and impacts our most vulnerable. There is a need to make changes, to stand up and be counted and not accept family violence as something that is behind closed doors(3); -
It is up to every individual, community, society and country to engage others to speak up and support programmes that will allow women to say no more and teach parents about healthy relationships(9, 13).
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United Nations. Transforming out world: The 2030 Agenda for Sustainable Development. A/RES/70/1 https://sdgs.un.org/2030agenda [Accessed February 27, 2021]. -
Every Women Every Child (2015). Global Strategy for Women’s, Children’s and Adolescents’ Health, 2016-2030. Survive, Thrive, Transform http://www.everywomaneverychild.org/commitments/make-a-commitment. [Accessed October 23, 2015]. -
Ministry of Social Development (2015). Family Violence is not OK. http://www.areyouok.org.nz/ [Accessed October 23, 2015]. -
World Health Organization (2013). Global and regional estimates of violence against women. Prevalence and health effects of intimate partner violence and non-partner sexual violence http://www.who.int/reproductivehealth/publications/violence/9789241564625/en/ [Accessed October 23, 2015]. -
World Health Organization (2014). Child maltreatment fact sheet 150 http://www.who.int/mediacentre/factsheets/fs150/en/ [Accessed October 23, 2015]. -
The Body Shop International and UNICEF (2006). Behind Closed Doors:The Impact of Domestic Violence on Children http://www.unicef.org/media/files/BehindClosedDoors.pdf [Accessed October 23, 2015]. -
Nobilo H (2014). The experience of poverty for infants and young children. https://brainwave.org.nz/article/the-experience-of-poverty-for-infants-and-young-children/ [Accessed February 27, 2021]. -
Altarac M, Strobino D. Abuse during pregnancy and stress because of abuse during pregnancy and birthweight. Journal of the American Medical Women’s Association. 2002;57(4):208-14. -
Benoit D. Infant-parent attachment: Definition, types, antecedents, measurement and outcome. Paediatrics & Child Health. 2004;9(8): 541–45. -
Larson CP. Poverty during pregnancy: Its effects on child health outcomes. Paediatrics & Child Health. 2007;12(8):673–77. -
Perry B. Childhood Experience and the Expression of Genetic Potential: What Childhood Neglect Tells Us About Nature and Nurture. Brain and Mind. 2002;3:79-100. -
Revilla L (2014). Characteristics of family relationships. / www.livestrong.com/article/55800-characteristics-family-relationship/ [Accessed October 23, 2015]. -
World Health Organization (2014). Global status report on violence prevention 2014. http://www.who.int/violence_injury_prevention/violence/status_report/2014/en/. [Accessed october 23, 2015].
CARE OF THE WELL TERM INFANT
COUNCIL OF INTERNATIONAL NEONATAL NURSES, Inc. (COINN)
Position Statement
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Infant’s nursery course was uncomplicated after vaginal delivery. -
Gestational Age (GA) is 38-42 weeks. -
Infants should be in stable condition for at least 12 hours prior to discharge. (Respiratory Rate-RR less than 60 per minute, Heart Rate-HR 100-160 per minute, Temperature-T 36.5- 37.5 degrees C or 97.7-99.5 degrees F in an open crib with appropriate clothing. -
Has urinated and passed one stool. -
Free from abnormal physical assessment findings, (or follow up plan made for non-emergent abnormal findings). -
At least 2 successful feedings evidenced by coordinated suck, swallow and breathing. -
No evidence of significant jaundice at less than 24 hours of age (transcutaneous Bilirubin/serum bilirubin should be done before discharge). -
To prevent complications associated with severe indirect hyperbilirubinemia, plans should be made for a follow up evaluation within a 24-48 hours based on the bilirubin level at discharge. Care should be given especially for Low Birth Weight, Small for Gestational Age or infants with Coombs’s positive, breastfeeding infants and infants of first time mothers.
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Free from history of abuse or neglect or domestic violence, parent with mental illness. -
Presence of family support for the mother. -
Presence of a fixed home environment with heat, water and essential supply. -
Identify community support as needed to address concerns.
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Prevention of hypothermia. -
Basic hygiene including bathing, cord care, diaper change. -
Breast feeding, and also proper preparation for formula. -
Importance of follow up care and definite plan for the next follow up. -
Basic safety and prevention of Sudden Infant Death Syndrome (SIDS) (back to sleep, no soft bedding or excessive blankets). -
Newborn safety including car seat safety, smoke fire alarms for home, danger of second hand smoking, and any other environmental hazards (i.e. a need for boiling water for formula preparation). -
Preventive measures against infection (avoid public in flu season, hand washing for the care providers, avoid crowd during newborn period). -
Immunization schedule should be reviewed and need for follow up according to the recommended schedule by follow up health professional and country. (Hepatitis B, Mumps, Measles, and Rubella (MMR), Haemophilus influenza type b-Haemophilus influenza (b-HIB), Pneumococcal conjugate, Polio, Rotavirus and other). -
Proper use of thermometer for axillary temperature. Education to identify risk factors given in #6 and number for clinic to call to report change in jaundice, any lethargy and poor feeding, development of respiratory distress or fever greater than 38 degrees C or 100.4 degrees F (axillary, oral thermometer). -
Depending on the time of discharge, the bilirubin level, and other factors identified should be included in the decision for the timing of the follow up and the first appointment should be made and parent is aware of it before discharge. To avoid sever hyperbilirubinemia, follow up within 48-72 hours should be considered. The baby that has had early discharge (24 hours) should be assessed at 48 hours then 3 to 5 days after discharge, 2 weeks, and every 2-3 months for first 6 months.
Loftin, R. W., Habli, M., Snyder, C. C., Cormier, C. M., Lewis, D. F., & DeFranco, E. A. (2010). Late Preterm Birth. Reviews in Obstetrics and Gynecology, 3(1), 10–19.
The Royal Children Hospital’s Melbourne (2017). Neonatal and Infant skin care. Retrieved from:
https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Neonatal___infant_skin_care/
UNICEF. (2016). The neonatal period the most vulnerable time for a child.
Retrieved from: https://data.unicef.org/topic/child-survival/neonatal-mortality/#
United Nations Sustainable Development Goals (SDG). (2015).
Retrieved from: http://www.un.org/sustainabledevelopment/sustainable-development-goals/
World Health Organization (2012). Born to soon: The global action report on preterm births. Retrieved from:
http://www.who.int/pmnch/media/news/2012/preterm_birth_report/en/index3.html
World Health Organization (2016). Newborns, reducing mortality.
Retrieved from: http://www.who.int/mediacentre/factsheets/fs333/en/
NEONATAL NURSING EDUCATION
COUNCIL OF INTERNATIONAL NEONATAL NURSES, Inc. (COINN)
Position Statement
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COINN (Council of International Neonatal Nurses, Inc) believes that the survival and long-term outcomes for high-risk and/or sick newborns depends on the provision of skilled nursing care. -
COINN (Council of International Neonatal Nurses, Inc) supports the provision of neonatal nursing education that is resourced, evidence-based, focused on developing skills and a theoretical basis for practice, and delivered by appropriately qualified educators and clinicians. -
COINN (Council of International Neonatal Nurses, Inc) recognizes that different models of education must be available that take into account local capacity and requirements. -
Although differences exist within local and national organizations as to what constitutes basic, essential, and advanced care of the newborn, COINN (Council of International Neonatal Nurses, Inc) believes that neonatal nurses need skills to resuscitate newborns, and to care for preterm, small for gestational age, low birth weight, sick and critically ill newborns. COINN (Council of International Neonatal Nurses, Inc) acknowledges that, in some countries, the ability to educate neonatal nurses is hampered by limited resources - personnel, financial, and equipment. However, COINN (Council of International Neonatal Nurses, Inc) believes that in order to reduce newborn mortality and morbidity, neonatal nursing education is essential. Support and assistance for neonatal nursing training is required from health professionals, hospital management, academic institutions and regional and national governments in all countries. COINN (Council of International Neonatal Nurses, Inc) is committed to facilitating the education of neonatal nurses worldwide.
CARE OF THE LATE-TERM INFANT
POSITION STATEMENT ON CARE OF THE LATE PRETERM INFANT
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A late preterm infant 34 0/7‐36 6/7 weeks’ gestation after the onset of the mother’s Last Menstrual Period‐LMP is physiologically and metabolically immature. The limited compensatory response to the external stressors must be recognized and should be cared for as immature regardless of the weight. -
The presence, at every delivery, of a nurse/doctor trained in neonatal resuscitation (skilled neonatal attendant) dedicated solely to care for the baby. Availability of an oxygen source, suction, bag and mask set up is essential. -
Provision of adequate thermal environment such as warmer. -
Immediate assessment of the newborn’s health status by a trained professional after delivery as drying, stimulation, and suctioning is provided for during the transition. -
On‐going maintenance of an appropriate thermal environment by placing a cap, light clothing and bundling, or skin to skin with mother. Temperature instability is one of the frequent diagnosis for the late preterm infant. Keep in mind that cold stress alone could lead to peripheral and pulmonary vascular constriction, hypoglycemia, or death if not minimized or prevented. -
Formal admission of individual infant as an individual patient to receive identification number. -
Recording of the newborn’s condition including gestational age, physical exam and vital signs at birth. -
Identify and document other risk factors besides late preterm at this time. These factors may include but are not limited to: Small for Gestational Age‐SGA, Infant of a Diabetic Mother‐IDM, maternal smoking, substance exposure, genetic anomalies, low Apgar score at 5 minutes and prenatal laboratory values for Syphilis, Hepatitis B, Human Immunodeficiency Virus‐HIV, Rubella status, and Herpes Simplex Virus (HSV). Make an appropriate reporting to the doctor of these findings. -
Give Vitamin K to prevent Vitamin K dependent Hemorrhagic disease and eye prophylaxis against gonococal ophthalmia within 1 hour after birth. -
Continued monitoring of vital signs, skin color, respiratory pattern, tone, peripheral circulation, level of consciousness and activity every 30 minutes until over all status is stable for 2 hours. -
During this time and throughout the hospital stay, family‐centered care practice such as on‐ going contact with the mother is encouraged for breast feeding initiation and bonding. However, excessive handling of the infant is not encouraged for the late preterm infant has limited compensatory mechanism for external stimulation. Excessive stimulation leads to excessive use of glucose, tiring and not being able to feed. -
Offer feeding as soon as possible. Glucose check within an hour is recommended for hypoglycemia is another frequently diagnosed condition. If the infant is unable to suck swallow and breathe effectively, physicians/doctors or nurse practitioners must be notified immediately to avoid hypoglycemia, dehydration, aspiration and other complications. -
Keep in mind that preterm infants’ serum glucose hits nadir (low point) at 1‐2 hour after birth. Each nursery‘s glucose protocol must be followed for continued glucose check. -
Continued observation for potential complications by assessing for the following,
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Temperature instability, -
Change in activity, -
Poor feeding, -
Poor skin color, -
Abnormal cardiac or respiratory rate and rhythm, -
Apnea, -
Abdominal distension or bilious vomiting, -
Excessive lethargy and sleeping, -
Delayed stooling or voiding, -
The importance of these changes in assessment findings should also be communicated to the parents while rooming‐in so that a trained staff is notified of any change, -
Trained staff should observe the infant periodically in mother’s room while rooming in according the institutional protocol, -
Infant with these findings should be evaluated by the medical team for specialized care may be necessary to properly care for the infant in a timely manner.
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Proper cord care, -
Hygiene practices for diaper change, -
Hand washing, -
Clean technique for breast feeding and formula preparation, -
Limiting visitors during the influenza season, -
Bathing instructions.
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Feeding competency with 24 hours of successful feeding with demonstration of coordinated suck, swallow and breathing. -
Thermoregulation ability. -
Free from abnormal physical exam findings, (or immediate follow up plan available for a non emergent abnormal finding). -
Infants should be in stable condition for at least 12 hours prior to discharge. (Respiratory Rate less than 60/minutes, Heart Rate 100‐160/minutes, Temperature 36.5‐37.4 degrees C or 97‐98.6 degrees F in an open crib with appropriate clothing. -
At least one spontaneous stooling. -
To avoid severe hyperbilirubinemia, appropriate follow up plan is made based on the bilirubin level that should be checked on the day of discharge. -
Mother has been educated and demonstrated the understanding of feeding plan, hygiene, importance of follow up, recognition for status change including severe jaundice, dehydration, sepsis, thermoregulation, clothing, and safety issues (see 21). -
Absence of social risk factors that endanger the infant. Availability of a safety plan for the infant if there is risk factor. (see 21) -
Infant has demonstrated ability to tolerate car seat challenge without apnea, bradycardia or decreased oxygen saturation or skin color change. -
Follow the policy of the state or country regarding the genetic or metabolic screening. Perform the screening after full feeding is achieved. If one was done before 24 hours of initiation of feeding, another screening is needed at a follow up. The plan must be in place before discharge and should be communicated to the follow up professional. -
Infant passed Hearing screening or if did not pass, plan is made to repeat the screening. -
Infant’s weight loss must be assessed. Weight loss of more than 2‐3% per day or maximum of 7% by the time of discharge calls for an evaluation by a medical professional. Dehydration must be considered and feeding ability and volume of feeding must be carefully assessed before discharge decision is made.
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Prevention of hypothermia, -
Basic hygiene including bathing, cord care, diaper change, -
Current feeding plan, -
Comfortable and proficient with breast feeding, and also proper prep for formula, -
Importance of follow up care and definite plan for the next follow up, -
Newborn safety such as car seat, smoke fire alarms at home, danger of second hand smoking, and any other environmental hazards present, -
Prevention of SIDS (back to sleep, no soft pillows and excessive blankets), -
Appropriate layers of clothing for the infant, -
Preventive measures against infection (avoid public in flu season, hand -
washing for the family, avoid crowd during newborn period), -
Proper use of thermometer for axillary temperature, -
Administering any medication such as multivitamin or iron -
Education to identify risk factors given in #13 and provision of number/clinic -
name/doctor’s office contact information to call to report change of status, -
Contact for emergency needs is reviewed.
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Increase in severity of Jaundice, -
Lethargy and poor feeding -
Vomiting, -
Poor skin color, -
Fever greater than 38 degrees C or 100.4 degrees F or below 36 degrees C or 96.8 degrees F, -
Respiratory distress–emergency, -
Apnea‐emergency.
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United Nations Millennium Development Goals. (2009). Available: http://www.un.org/millenniumgoals/. -
March of Dimes (MOD). (2006). Late Preterm Birth: Every Week Matters. Available: http://www.marchofdimes.com/files/MP_Late_Preterm_Birth‐Every_Week_Matters_3‐24‐06.pdf. -
Lawn, J.E., Cousens, S., Zupen, J., for Lancet Neonatal Survival Steering Team. (2005). Neonatal Survival 1. 4 million neonatal deaths: When? Where? Why? Lancet, 365, 821‐822. -
The Millennium Development Goal Report 2009. Available: http://www.un.org/millenniumgoals/pdf/MDG_Report_2009_ENG.pdf -
March of Dimes. (MOD). Late preterm births. 1990‐2006. Available http://www.marchofdimes.com/peristats/level1.aspxdv=ls®=99&top=3&stop=240&lev=1& slev=1&obj=1 -
Engle, WA, Tomashek, KM, William, C, and the Committee on Fetus and Newborn.(2007). Late Preterm Infants: A population at risk. Pediatrics, 120(6). 1390‐1401. -
Global death toll: 1 million premature babies every year. White Plains, NY: March of Dimes (MOD). Available: http://www.eurekalert.org/pub_releases/2009‐10/modf‐gdt100209.php. -
American Academy of Pediatrics (AAP) and American College of Obstetricians and Gynecologists* (ACOG). (2007). Guidelines for perinatal care. 6th ed., Elk Grove Village, IL: AAP/ACOG. *now named the American Congress of Obstetricians and Gynecologists. -
Kruse, L. (2009). Late Preterm Infant Clinical Guideline. Oklahoma City, OK: University of Oklahoma Medical and the Oklahoma Healthy Mothers, Healthy Babies Coalition Infant Alliance. -
American Academy of Pediatrics (AAP). Committee on infectious diseases. Policy statement modified recommendations for use of palivizumab for prevention of respiratory syncytial virus infections. Published online Sept 7, 2009. Available: https://pediatrics.aappublications.org Dec 3, 2009. -
Bartels, N.G., Mleczko, A., Schink, T., Proquitte, H., Wauer, R.R., & Blume‐Peytavi, U. (2009). Influence of bathing or washing on skin barrier function in newborns during the first four weeks of life. Skin Pharmacology and Physiology, 22(5), 248‐257. -
Walker, L., Downe, S., & Gomez, L. (2005). Skin care in well term newborn: Two systematic reviews. Birth, 32(3), 224‐228.
January 2010
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Representing over 50 countries and 15,000 nurses.
ETHICAL MIGRATION OF NEONATAL NURSES
COUNCIL OF INTERNATIONAL NEONATAL NURSES, Inc. (COINN)
Position Statement
health workers. Given the growing global nursing shortage as documented by the ICN and other such organisations, the problem of bartering or trading nurses for profit is going to increase as well. Ideally westernised countries should be able to manage their workforce effectively and not be reliant on other countries. However, COINN (Council of International Neonatal Nurses, Inc) recognises that short term migration may be needed to meet the maternal child health care needs. This migration must be done with consideration of the potential “brain drain” from the country sending the nurses and the need for transition training in the country to which the nurse is migrating. When this migration is necessary there should be a limit on the number of nurses migrating, countries from which migration is acceptable and duration of time during which this migration is permitted so that this migration is not at the behest of a shortfall. Retention strategies should be employed so that nurses have incentives to stay in their own countries rather than migrate. These strategies could include but are not limited to: better working conditions, decreased number of hours, better patient to nurse ratios and better compensation – wages and benefits.
CHILD, HEALTH, POVERTY AND BREASTFEEDING
COUNCIL OF INTERNATIONAL NEONATAL NURSES, Inc. (COINN)
Position Statement
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The Council of International Neonatal Nurses, Inc. (COINN) recognizes the critical contributions made by breastfeeding, breast milk, and mother-baby bonding, to not only enhance developmental outcomes but also child survival. Intergenerational cycles of poverty and health inequalities are also factors linked to not breastfeeding the infant. The highest risk of death is during the neonatal period. Positive survival and health outcomes result from relatively simple and safe measures such as breastfeeding. -
Keeping mothers and infants together as much as possible, providing breastfeeding counselling, assisting mothers to provide breast milk for their preterm unwell babies and supporting breastfeeding initiation, exclusivity and continuance, even in the workplace, are essential components for child survival. Supportive health care practices, such as these, are a prerequisite to reach optimal breastfeeding goals. -
That all infants should be exclusively breastfeed for a minimum of 6 months. -
Mothers living with HIV should breastfeed for at least 12 months and may continue to breastfeed for 24 months or beyond (similar to the general population) while being fully supported with ART adherence (WHO, 2016). -
Mothers known to be living with HIV should only give commercial infant formula as a replacement to their HIV-uninfected infant or infant who are of unknown HIV status if specific conditions are met: there is assured safe water and sanitation in the household and community; the mother or caregiver can reliably provide sufficient infant formula to support normal growth and development of the infant; the mother or caregiver can prepare the formula cleanly and frequently enough to ensure there is a low risk of diarrhea or malnutrition; the mother or caregiver can give infant formula exclusively for the first 6 months; the family supports the practice; the mother or caregiver can access health care that offers comprehensive child health services (WHO, 2016). -
In situations where the HIV positive mother chooses to give mixed feedings it is recommended that she is on ARV medication and preferable breastfeed exclusively for minimum of 6 months. -
Research appears to indicate that this abrupt weaning even in HIV positive women may lead to adverse neonatal/infant outcomes. -
National and local health authorities should actively coordinate and implement services at health facilities, workplaces, communities and homes to promote and protect that ensure the right of for HIV positive mothers to breastfeed. -
During emergency situations and in the presence of an orphaned infant attempts should be made to administer HIV-negative donor human milk. -
In situations where the mother’s own milk is not available, the best option is donor human milk. While pasteurized donor milk from a regulated milk bank is preferred, it is often not available during a disaster. If formula is given, recommend ready-to-feed standard formula. Use concentrated or powdered formula only if bottled or boiled water is available. -
In emergency situations it may be preferable to re-initiate lactation in mothers who have been weaned over artificial feeding with infant formula. (United States Breastfeeding Committee, 2011; WHO Regional Office for Europe, 1997). -
COINN (Council of International Neonatal Nurses, Inc) supports the International Code of Marketing of Breastmilk Substitutes and subsequent, relevant World Health Assembly resolution.
2. Globally neonates (first 28 days of life) have the highest risk of death but a mortality gap exists between developing and developed countries, especially for countries experiencing conflicts or crises.
3. Infants born in less developed countries, who are not breastfed, have a six-fold greater risk of dying from infectious diseases in the first two months of life than those who are breastfed.
4. The Global Strategy on Infant and Young Child Feeding confirms that breastfeeding is a public health priority globally.
5. Initiation and support of breastfeeding are essential components of infant care in all settings including the woman’s workplace.
6. Protection and support of mother-baby bonding and breastfeeding, beginning shortly after birth, or as soon after birth as possible, [including situations where babies are born preterm or unwell and admitted to a neonatal or special care unit] are essential components for increased child survival.
7. Breastfeeding and breast milk provide optimal, species specific, nutrition and are an essential component of any program to improve child health.
8. Breastfeeding and breast milk save lives by protecting babies from infection and by modulation of the immature immune systems of babies.
9. The use of any breast milk substitutes in emergencies is a risk factor for neonates and infants due to unhygienic conditions, lack of water or clean water and lack of knowledge about safe preparation of these products.
10. “The world cannot afford to continue to lose one of its most valuable resources - its children." Carole Kenner (2007)
http://www.coinnurses.org/news/savings_children_lives.htm.
SOCIAL MEDIA POLICY
COUNCIL OF INTERNATIONAL NEONATAL NURSES, Inc. (COINN) Policy
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Twitter -
Facebook -
Google+ -
WordPress/Blogger -
You Tube/Vimeo -
iTunes/Podcasting -
Instagram -
WhatsApp
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Integrity: COINN (Council of International Neonatal Nurses, Inc) will not knowingly post incorrect, defamatory or misleading information about its own work, the work of other organizations, or individuals. In addition, it will post in accordance with the organization’s Copyright and Privacy policies. -
Professionalism: COINN’s (Council of International Neonatal Nurses, Inc) social media represents the organization as a whole and should seek to maintain a professional and uniform tone. Elected members and volunteers may, from time to time and as appropriate, post on behalf of COINN (Council of International Neonatal Nurses, Inc) using its online profiles, but the impression should remain one of a singular organization rather than a group of individuals. -
Information Sharing: COINN (Council of International Neonatal Nurses, Inc) encourages the sharing and reposting of online information that is relevant, appropriate to its aims and of interest to its members.
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Members should be aware of the effect their actions may have on their images, as well as COINN’s (Council of International Neonatal Nurses, Inc) image. The information that employees post or publish may be public information for a long time. -
Members should be aware that COINN (Council of International Neonatal Nurses, Inc) may observe content and information made available by members through social media. Members should use their best judgment in posting material that is neither inappropriate nor harmful to COINN (Council of International Neonatal Nurses, Inc), its leaders or customers. -
Although not an exclusive list, some specific examples of prohibited social media conduct include posting commentary, content, or images that are defamatory, pornographic, proprietary, harassing, libellous, or that can create a hostile environment. -
Members are not to publish, post or release any information that is considered confidential or not public. -
Social media networks, blogs and other types of online content sometimes generate press and media attention or legal questions. Members should refer these inquiries to the COINN (Council of International Neonatal Nurses, Inc) board. -
If members find encounter a situation while using social media that threatens to become antagonistic, members should disengage from the dialogue in a polite manner and seek the advice of a board member. -
Members should get appropriate permission before you refer to or post images of current or former members, vendors or suppliers. Additionally, members should get appropriate permission to use a third party's copyrights, copyrighted material, trademarks, service marks or other intellectual property.
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Ensuring appropriate and timely action is taken to correct or remove inappropriate posts (including defamatory and/or illegal content) and in minimizing the risk of a repeat incident. -
Ensuring that appropriate and timely action is taken in repairing relations with any persons or organizations offended by an inappropriate post. -
Moderating and monitoring public response to social media, such as blog comments and Facebook replies, to ensure that trolling and spamming does not occur, to remove offensive or inappropriate replies, or caution offensive posters, and to reply to any further requests for information generated by the post topic.
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Is the information I am posting, or reposting, likely to be of interest to COINN’s (Council of International Neonatal Nurses, Inc) members and stakeholders? Is the information in keeping with the interests of the organization and its constituted aims? -
Could the post be construed as an attack on another individual, organization or project? -
Would COINN’s (Council of International Neonatal Nurses, Inc) donors be happy to read the post? -
If there is a link attached to the post, does the link work, and have I read the information it links to and judged it to be an appropriate source? -
If reposting information, is the original poster an individual or organization that COINN (Council of International Neonatal Nurses, Inc) would be happy to associate itself with? -
Are the tone and the content of the post in keeping with other posts made by COINN (Council of International Neonatal Nurses, Inc)? Does it maintain the organization’s overall tone?
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The offending post should be removed. -
Where necessary an apology should be issued, either publicly or to the individual or organization involved. -
The origin of the offending post should be explored and steps taken to prevent a similar incident occurring in the future.
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Excessive or inappropriate use of swearing. -
Defamatory, slanderous or aggressive attacks on COINN (Council of International Neonatal Nurses, Inc), other individuals, organizations, projects or public figures. -
Breach of copyrighted material not within reasonable use, in the public domain, or available under Creative Commons license. -
Breach of data protection or privacy laws including but not limited to use of an institution’s or patient’s family’s name or picture without consent. -
Repetitive advertisements. -
Topics which fall outside the realms of interest to members and stakeholders, and which do not appear to be within the context of a legitimate discussion or enquiry.
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Remove the post as soon as possible. -
If possible/appropriate, contact the poster privately to explain why you have removed the post and highlighting COINN’s (Council of International Neonatal Nurses, Inc) posting guidelines.
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Remove the post as soon as possible. -
Ban or block the poster to prevent them from posting again.
RESEARCH PARTICIPATION POLICY
COUNCIL OF INTERNATIONAL NEONATAL NURSES, Inc. (COINN)
Position Statement
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COINN (Council of International Neonatal Nurses, Inc) supports the Declaration of Helsinki agreement that states neonates belong to a vulnerable group and encourage research to be done only if it cannot be carried out on a non-vulnerable group. -
COINN (Council of International Neonatal Nurses, Inc) supports research that is built on trust and openness. -
COINN (Council of International Neonatal Nurses, Inc) supports research that has been approved by RECs/IRBs for the protection of the neonate and family
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respects the unique needs of the neonate. -
recognizes the role of the parents or care giver. -
takes into consideration the immediate and long-term welfare of the neonate.
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To perform research in an ethical and morally appropriate manner. -
To lead, support, and promote high quality research that is of strategic importance to both COINN (Council of International Neonatal Nurses, Inc) and neonatal nursing worldwide. -
To lead, support and promote world-class nursing and multidisciplinary research programs that support effective models of evidence-based healthcare and development of a highly skilled health workforce. -
To strengthen the integration of research findings into clinical practice, education programs and heath care policy by effective knowledge implementation strategies. -
To increase research capacity by offering expert research guidance, mentoring, identifying, and supporting emerging research leaders. -
To expand collaborations with National and International partners from academic, industry, consumer and government sectors. -
To disseminate quality neonatal research and resultant change of practice to enhance the care of neonates and families worldwide.
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In almost all circumstances the researchers should try to identify all ancillary conditions prior to commencing with the research. -
Identified ancillary conditions should have a plan of care developed before the research is begun. -
Possess the expertise sufficient to meet the need identified in a safe and effective manner. -
Possess the ability to apply that expertise without incurring inordinate costs. -
In the absence of other individuals or organizations that are able to meet the need, such as the local health system the researcher will attempt to address the issue.
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Member participation in research is voluntary. -
Should a member NOT wish to be sent information or invitations to participate in research, please notify the secretary of COINN (Council of International Neonatal Nurses, Inc) at ceo@coinnurses.org
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When the COINN (Council of International Neonatal Nurses, Inc) board receives a request from researchers to access COINN (Council of International Neonatal Nurses, Inc) members to participate in research, the board assesses each research project individually. -
Should COINN (Council of International Neonatal Nurses, Inc) agree to a research request, COINN (Council of International Neonatal Nurses, Inc) will either distribute the information and invitation to members or formalize an agreement with the researcher regarding the privacy and use of member details for the purpose of distributing research invitations. -
Confidentiality of member’s details is maintained at all times. -
Should a member NOT wish to be sent information or invitations to participate in research, please notify the secretary of COINN (Council of International Neonatal Nurses, Inc) at ceo@coinnurses.org
BREASTFEEDING
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Promotion, protection and support for breastfeeding at local, national and international levels. -
Increased global attention, media coverage and funding for breast feeding initiatives acknowledging, highlighting and supporting the critical role breastfeeding plays in reducing child deaths and providing short and long term benefits for maternal health. -
Promotion of The International Code of Marketing of Breastmilk Substitutes and subsequent, relevant, World Health Assembly resolutions. -
Support the UNICEF and World Health Organization Baby-Friendly Hospital and Community Initiative. -
The provision of paid maternity leave in line with the International Labour Organization (ILO) minimum recommendations and workplace breastfeeding initiative. -
Professional and lay support for breastfeeding mothers, including:
KANGAROO MOTHER CARE
COUNCIL OF INTERNATIONAL NEONATAL NURSES , Inc. (COINN)
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Kangaroo position, or continuous skin-to-skin contact between infant and mother or another caregiver. -
Exclusive breastfeeding, or feeding with breastmilk, when possible. -
Timely discharge from hospital with close follow-up.
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Kangaroo mother care is recommended for the routine care of newborns weighing 2000 grams or less at birth, and should be initiated in health-care facilities as soon as the newborns are clinically stable. -
Newborns weighing 2000 grams or less at birth should be provided as close to continuous kangaroo mother care as possible. -
Intermittent kangaroo mother care, rather than conventional care, is recommended for newborns weighing 2000 grams or less at birth, if continuous kangaroo mother care is not possible.
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Stablised preterm or low birthweight baby admitted to a neonatal intensive care unit or special care baby unit. -
Full term, well baby. -
To assist with maternal attachment when separation of mother and baby has occurred. -
To support lactation and establish breastfeeding.
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Medically unwell, unstable baby who may be ventilated, have pneumothoraxes, or be extremely low birthweight. -
Immediate post-surgical baby.
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Mother, or another caregiver. -
A comfortable reclining chair, if possible. -
Optional carrying sling or kangaroo wrap. -
Blanket to cover the baby’s back. -
Infant hat or cap. -
Adequately trained personnel with special skills to monitor mother and infant. -
Supportive environment. -
Privacy screens when practiced in open units, if possible.
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KMC is safe. -
KMC is beneficial. -
The baby will stay warm. -
KMC will stabilize heart and respiratory rate and increase oxygenation levels. -
Enhances lactation, breastfeeding, and immunological effects.
EDUCATION COMMITTEE TERMS OF REFERENCE
COUNCIL OF INTERNATIONAL NEONATAL NURSES, Inc. (COINN)
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To provide a forum for the discussion of current and common issues surrounding the development and deliverance of neonatal education, on a local, national and international scale -
To share ideas, innovations and projects surrounding neonatal education to enable members to learn from each other -
To encourage the development and/or to assist in the adaptation of, programs and educational material that are relevant and feasible across the spectrum of country’s/region’s available resources -
To share expertise and to lend support to anyone undertaking education or research projects within the field of neonatal care -
To foster and support multi-centre interdisciplinary collaboration in neonatal education and research, especially on an international level -
To raise the profile of neonatal education and research locally, nationally and internationally -
To raise the profile of COINN (Council of International Neonatal Nurses, Inc) and the COINN (Council of International Neonatal Nurses, Inc) Education Committee by having a presence/ representation at relevant conferences and meetings
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One Chair -
One Co-Chair -
Members from a minimum of six different countries/regions -
Administrative assistance will be provided by COINN (Council of International Neonatal Nurses, Inc) with respect to the provision of communication resources/forums and other resources as able
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To work collaboratively to determine educational priorities by gathering information from stakeholders -
To develop short term and long term goals for the ongoing development of educational resources and projects, in conjunction with the goals and direction of the COINN (Council of International Neonatal Nurses, Inc) Executive Board -
To develop and maintain a work plan that clearly states the inputs, outputs, and measurable outcomes expected to ensure the goals set by the COINN (Council of International Neonatal Nurses, Inc) Educational Committee are being met -
In order to ensure accountability and transparency, the COINN (Council of International Neonatal Nurses, Inc) Education Committee will produce a report outlining their projects and progress, which will be presented to the COINN (Council of International Neonatal Nurses, Inc) Executive Board twice a year -
To maintain an awareness of the educational issues and opportunities available, and to disseminate this information as needed -
To offer recommendations to the COINN (Council of International Neonatal Nurses, Inc) Executive Board, as needed -
To draft and write educational resources/documents/policies, for the COINN (Council of International Neonatal Nurses, Inc) Executive Board to review
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The COINN (Council of International Neonatal Nurses, Inc) Education Committee will meet every second month (6 times/year) by teleconference/online forum, as organized by the Chair. -
The COINN (Council of International Neonatal Nurses, Inc) Education Committee may request an optional face-to-face, with the location, date and time to be determined by the Committee in consultation with COINN (Council of International Neonatal Nurses, Inc) Executive Board. -
Meetings that fall outside of the regularly scheduled meetings may be conducted, as requested by the Chair, for urgent and time sensitive matters.
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Representation from a minimum of six (6) different countries/regions is preferred (excluding the Chair) up to a maximum of ten (10) different countries/regions
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Though the Committee is open to all members of the neonatal healthcare team, a maximum of 20 people should be considered in order to facilitate participation -
Whenever possible, a mixture of clinical/bedside nurses, educators, nurse practitioners and adjunct team members, is desired -
When deemed appropriate, the COINN (Council of International Neonatal Nurses, Inc) Education Committee may invite others to meet with the Committee, through the Chair, on a consulting basis in order to either supplement the work being done by the Committee, or to provide subject matter expert input, for a limited term
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One term of appointment is deemed to be a period of two years. A member’s Term of Appointment ends when a new member is appointed to replace the out-going member.
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COINN (Council of International Neonatal Nurses, Inc) Education Committee members are expected to serve one term to a maximum of two terms. -
To ensure continuity of business, the COINN (Council of International Neonatal Nurses, Inc) Executive Board requests that no more than 50% of COINN (Council of International Neonatal Nurses, Inc) Education Committee members’ Terms of Appointment be slated to end in any given year.
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Two months prior to the end of a member’s term, the COINN (Council of International Neonatal Nurses, Inc) Executive Committee may elect to issue a general call for new members via its website inviting interested and eligible nurses to apply to serve as new volunteer COINN (Council of International Neonatal Nurses, Inc) Education Committee members -
Review of applicants and subsequent selection of prospective new members will be done by the continuing members of the COINN (Council of International Neonatal Nurses, Inc) Education Committee in consultation with the COINN (Council of International Neonatal Nurses, Inc) Executive Board
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The costs associated with the telephone/on-line meetings will be borne by COINN (Council of International Neonatal Nurses, Inc) -
All other incidental expenses such as photocopy requirements and paper, will be borne by the COINN (Council of International Neonatal Nurses, Inc) Education Committee members, unless prior arrangements have been made with the COINN (Council of International Neonatal Nurses, Inc) Executive Board
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The COINN (Council of International Neonatal Nurses, Inc) Education Committee may develop its own goals, plans, and work schedule to achieve its mandate/work, in consultation with the COINN (Council of International Neonatal Nurses, Inc) Executive Board. Annually in September, the Committee will review its goals, plans, operations and achievements in relation to its Terms of Reference and Mandate in order to make or recommend adjustments where needed. This process will ensure the work of the Committee is aligned with the vision and work of the COINN (Council of International Neonatal Nurses, Inc) Executive Board -
The Terms of Reference will be reviewed every 3 years by the Committee, and amended as needed.