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A clinical assessment tool for midwives undertaking the Newborn Infant Physical Examination

02 May 2017
5 min read
Volume 25 · Issue 5


The role of midwives has evolved over the last two decades, and in the United Kingdom midwives and advanced neonatal nurse practitioners undertake roles that traditionally were undertaken by junior doctors. The Newborn Infant Physical Examination (NIPE) is performed within the first 72 hours of birth (Lanlehin, 2011), and enables midwives to provide a holistic assessment of neonates and their mothers, as well as confirming normality, identifying abnormalities, and providing early intervention for at risk neonates.

The aim of this paper is to discuss the usefulness of the Newborn and Infant Assessment Tool (NIAT) which was originally used as an oral assessment tool for a health professional undertaking the NIPE course. However, it became clear over the course of 10 years that not only is this a framework for assessing students' application of theoretical knowledge to practice scenarios, it is also an assessment tool that can be used by trained midwives, medical staff, and student nurses to enhance clinical decision-making when faced with an unwell baby.

The purpose of the Newborn and Infant Physical Examination (NIPE) is to identify and refer all children born with congenital abnormalities of the eyes, heart, hips, and testes, where these are detectable, within 72 hours of birth. A second physical examination is performed later to identify abnormalities that may become detectable by 6–8 weeks of age, thereby reducing morbidity and mortality. NIPE screening includes a holistic ‘top-to-toe’ physical examination of a newborn (UK National Screening Committee, 2008). Once the NIPE is completed, parents should be informed of the outcome of normality or any abnormality, including any explanation of the referral process if required. They should also be informed that the infant examination will be undertaken at 6–8 weeks of age, as some conditions can develop or become apparent later (Public Health England, 2016). The Public Health England standard (2016) clearly focuses on patient safety and the referral process. The UK National Screening Committee standards (2008), on the other hand, stipulate the practitioners' learning needs and clinical competency requirements. One could argue that both standards complement each other, but from an educator's standpoint the 2008 NIPE standards are more explicit in terms of training needs and competency requirements for NIPE trained professionals.

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