OBJECTIVES: Participants in the Instructor course will:

Transcription

1 OBJECTIVES: Participants in the Instructor course will: PRESENTED BY:

2 (see next page) or download from Once your application has been approved, you will be sent information to register for the course. Following successful completion of the NRP Instructor course & Team Teach of an NRP Provider course supervised by an NRP Instructor Trainer (IT) participants are eligible to register with the Canadian Pediatric Society as an NRP Instructor. Following the Team Teach, the new Instructor must remit a completed Instructor Registration Form and fee of $ to the CPS to obtain instructor status. Instructors MUST be registered with the Canadian Pediatric Society. Course Fees: $ $21.25 GST = $ (Includes the NRP Instructor Manual (5th. ed) $ $17.50 GST = $ (Does not inlcude the NRP Instructor Manual - all registrants must have access to the manual For further information contact: Roxanne Laforge, Coordinator, Perinatal Education Program Phone: (306) Fax: (306) [email protected] For more information about the Perinatal Education Program visit our website

3 Neonatal Resuscitation Program Instructor Course Application Form September 17 & 18, 2015 Thank you for your interest in becoming a Neonatal Resuscitation Program Instructor! The Canadian Pediatric Society has established eligibility criteria for becoming registered as an NRP Instructor in Canada. The Neonatal Resuscitation Program (NRP) Advisory Committee of Saskatchewan works with interested individuals to ensure that eligibility criteria have been met prior to formal registration and attendance at the NRP Instructor course. The application form includes 3 pages as follows: Information we require to confirm your eligibility (p. 1) Overview of your experience in neonatal care and professional development (p. 2) Institutional Support Form completed and signed by your manager establishing support for NRP and in your role as NRP Instructor in your organization (p.3) Once these forms are complete, please send to: Roxanne Laforge Coordinator Perinatal Education Program Chair NRP Advisory Committee of SK. Division of Continuing Medical Education, College of Medicine Continuing Education & Development for Nurses, College of Nursing Mailing Address: University of Saskatchewan Box RPO University Saskatoon, SK S7N 4J8 Phone: Fax: E mail: [email protected] First Name Last Name Mailing Address: City: Prov. Postal Code: E mail Address Mandatory for all course correspondence Phone Number I am currently licensed as an: RN RN (NP) / RN (NNP) RM RRT MD Family Physician MD Peds. General Practice MD Peds Neonatology I have a minimum of 2 years experience as an NRP Provider I have attached a copy (or sent an electronic image) of my most recent NRP Provider course card which includes Lesson 1 9 and Advanced Megacode. Your last course must have been in the last 2 years. If your Provider card is not available, documentation from your Instructor which includes the date of your most recent course and includes the lessons and level of Megacode completed will be accepted.. I have completed the Provider Course On Line exam (Lessons 1 9) in the last 12 months. Please attach your On line Verification Certificate. Does not apply. My last Provider course was taken within the last 12 months. It has been more than 12 months since taking the exam. I need to take the exam and understand that verification of successful completion will be required prior to the course.

4 Page 2 Please describe your experience in caring for neonates and in performing/assisting with neonatal resuscitation at birth and/or the immediate post birth period. (NOTE: Relevant experience in neonatal care is a requirement for becoming an NRP Instructor). Describe your current area of clinical practice and how it relates to your interest in becoming an Instructor of NRP. How do you see your role as an NRP Instructor contributing to the development and mentorship of health professionals in your facility? In addition to teaching NRP courses, in what way have you planned to maintain currency in neonatal resuscitation practices and education?

5 Page 3 INSTITUTIONAL SUPPORT NRP Instructor Course Please have the following completed by your Administrator or Manager. I am writing this letter in support of s request to become an NRP Instructor for Name of Applicant Facility / Health Region. I am confident that will: (Name of the applicant) Implement NRP programming in our institution in accordance with national guidelines Mentor and be a resource for NRP Providers/Instructors within our institution and region Demonstrate the requisite knowledge, skills and confidence to work with members of the interprofessional team Emphasize to Provider course participants that courses provide skills practice and context but does not confer certification nor indicate competency I am aware that support may be requested to cover the cost of the workshop fee, course materials (NRP Instructor Manual) and/or registration with the Canadian Paediatrics Society. I acknowledge that institutional support is integral to the success of NRP programming and education and our institution is committed to providing support for ongoing NRP activities including resources, equipment, space and/or professional support for NRP education in your organization. Should you have any questions do not hesitate to contact me at or [email protected] Name (please print) Signature Organizational Title ( ) Phone E mail Date Please send completed forms to Roxanne Laforge, Coordinator, Perinatal Education Program as specified on page 1. When your application is reviewed, you will be contacted by e mail regarding your application and directed to register for the course. Please ensure adequate time for review of your application and to prepare for the course.