A common neonatal nurse training curriculum


van den Hoogen A, Johnston L, Roehr CC, Gözen D, Mannix T, Kühn T, Panas M, Petty J, Schlembach D, Simeone N, Stoniene D, Tency I

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User group

Parents, healthcare professionals, professional societies, education providers, health services, and regulators of the profession

Statement of standard

All nurses providing care to infants and their families have access to and undergo education and training using a competency based curriculum and assessment framework.


For over thirty years several countries have recognised neonatal nursing as a specialty with either training in the neonatal unit, or at an academic institution, resulting in a neonatal diploma or master’s degree. (1) Infants in the NICU are among the most nurse-intensive patients. To intervene before the onset of life-threatening problems, nurses must make complex assessments, implement highly intensive therapies, and make immediate adjustments dependent on infant response. Maintaining optimal respiratory, cardiac, and feeding status may result in improved development and behavior, lower levels of morbidity, and shorter hospitalisation. (2,3)

In addition to staffing levels, neonatal outcomes have been shown to be associated with levels of patient volume, and training of medical and nursing staff. (4) In order to ensure that infants and families receive a standardised level of care, nurses should develop competencies through an integrated, developmental curriculum, both in university and practice settings.


  • More competent nurses are related to increased survival (5)
  • Significantly reduced rates of mortality and morbidity (4)
  • Improved nurse retention and satisfaction (6)
  • Consistency in quality of care delivery in neonatology (consensus)


Components of the standard

Component Grading of evidence Indicator of meeting the standard
For parents and family    
1. Parents contribute to the delivery of nurse education programmes. B (Low quality) Training documentation
For healthcare professionals    
2. Neonatal nurses are qualified in specialty as evidenced by the following criteria: B (Moderate quality) Certificates of award, professional portfolio
  Registered nurse, period of preceptorship or mentorship including defined foundation learning within the specialty, completion of a programme of post-registration (post-licensure) education which links the following theory and practice elements:    
  • Theory modules relating to the care of the neonate and their family within special care, high-dependency care and intensive care, delivered and assessed within a higher education institution.
  • Achievement of core skills set, undertaken with supervision of an experienced qualified neonatal nurse, assessed in practice and supported by evidence of learning.
  • Clinical decision-making skills.
For neonatal unit    
3. Infrastructure for educational programmes is provided. (see TEG NICU design) B (Moderate quality) Audit report
For hospital    
For professional societies    
4. Standards of care, including competencies at the local level are developed and regularly updated, disseminated, and promoted. (7) B (Low quality) Guideline
For education providers    
5. A (post) graduate programme focused on neonatal nursing, including the following domains is provided: neonatal physiology and pathophysiology, family-centred care, clinical practice, leadership and teamwork, professional development and research. (7) B (Moderate quality) Training documentation
For health service and regulators of the profession    
6. Common national training frameworks aligned with the relevant European Qualifications Framework are available and regularly updated. (8) B (High quality) Training documentation

Where to go

Further development Grading of evidence
For parents and family  
  • Parents are provided with the opportunity to review and revise neonatal nurse curricula.
B (Very low quality)
For healthcare professionals  
  • Undertake a minimum of 6 days per year of continuing professional development (CPD). (9)
B (Low quality)
For neonatal unit  
For hospital  
  • Support healthcare professionals to undertake CPD.
B (High quality)
For professional societies  
  • Develop, disseminate, and promote care competencies at regional, national, and international level. (7)
B (Very Low quality)
For education providers  
  • Provide specialty postgraduate programmes with a focus on neonatal care.
B (Very Low quality)
For health service and regulators of the profession  
  • International mutual recognition of specialty qualifications in neonatal nursing is facilitated.
B (Moderate quality)

Getting started

Initial steps
For parents and family
  • Parents are involved in the delivery of nurse education programmes.
For healthcare professionals
  • Attend specialty training through on the-job training or through professional education programmes.
For neonatal unit
For hospital
  • Support healthcare professionals to participate in neonatal nurse training.
  • Provide opportunities for on-the-job training, and experiential learning environments (clinical placements) for students undertaking professional education programmes.
For education providers
  • Include basic neonatal care content in undergraduate nursing and midwifery curriculum.
For health service and regulators of the profession
  • Develop and implement common training frameworks aligned with the relevant European Qualifications Framework. (8)


  1. Council of International Neonatal Nursing (COINN). Position Statement on Neonatal Nursing Education [Internet]. 2018 [cited 2018 May 15]. Available from:
  2. Lake ET, Staiger D, Horbar J, Cheung R, Kenny MJ, Patrick T, et al. Association Between Hospital Recognition for Nursing Excellence and Outcomes of Very Low-Birth-Weight Infants. JAMA. 2012 Apr 25;307(16):1709–16.
  3. Lake E, Patrick T, Rogowski J, Horbar J, Staiger D, Cheung R, et al. The Three Es: How Neonatal Staff Nurses’ Education, Experience, and Environments Affect Infant Outcomes. JOGNN. 2010;(39):S97–8.
  4. Grandi C, González A, Meritano J, Grupo colaborativo Neocosur. [Patient volume, medical and nursing staffing and its relationship with risk-adjusted outcomes of VLBW infants in 15 Neocosur neonatal network NICUs]. Arch Argent Pediatr. 2010 Dec;108(6):499–510.
  5. Hamilton KES, Redshaw ME, Tarnow‐Mordi W. Nurse staffing in relation to risk‐adjusted mortality in neonatal care. Arch Dis Child Fetal Neonatal Ed. 2007 Mar;92(2):F99–103.
  6. Cooper E. Creating a culture of professional development: a milestone pathway tool for registered nurses. J Contin Educ Nurs. 2009 Nov;40(11):501–8.
  7. Reid S. Australian Standards for Neonatal Nurses. Canberra: Australian College of Neonatal Nurses; 2012.
  8. Dury C, Hall C, Danan J-L, Mondoux J, Aguiar Barbieri-Figueiredo MC, Costa M a. M, et al. Specialist nurse in Europe: education, regulation and role. Int Nurs Rev. 2014 Dec;61(4):454–62.
  9. Royal College of Nursing. A joint statement on continuing professional development for health and social care practitioners [Internet]. 2007 [cited 2018 May 15]. Available from:

November 2018 / 1st edition / next revision: 2021

Recommended citation

EFCNI, van den Hoogen A, Johnston L et al., European Standards of Care for Newborn Health: A common neonatal nurse training curriculum. 2018.

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