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Clinical Management of Category III Fetal Heart Rate Tracings
The National Institute of Child Health and Human Development (NICHD) workgroup standard for fetal heart rate monitoring assessment and categorization, first proposed in 1997 and subsequently updated in 2008 was meant to promote commonality of FHR tracing nomenclature and interpretation. Based on these recommendations, a three-tiered categorization pattern based on the visual assessment of the fetal heart rate pattern was adopted. This module aims to review and apply essential FHR content in several clinical scenarios to highlight an important Clinical Pearl: The Category III tracing is a rare intrapartum FHR pattern that is highly associated with fetal acidemia and adverse neonatal outcomes.
Consistently apply 1997 and 2008 NICHD definitions and terminology when describing intrapartum fetal heart rate patterns.
Identify intrapartum fetal heart rate tracings using the 2008 NICHD 3-tiered system.
Recognize the fetal heart rate characteristics that define a Category III pattern.
Review the diagnostic imprecision and clinical significance of minimal fetal heart rate variability.
Social Determinants of Maternal-Fetal Health
The goal of this course is to educate nurses and physicians about key social determinants of health (SDOH) and health disparities affecting maternal and fetal outcomes.
Identify at least four social determinants/disparities of health impacting maternal-fetal health outcomes.
Describe at least two clinical and/or social support interventions to be used in clinical practice to decrease bias regarding social determinants and improve maternal-fetal health outcomes.
Clinical Management of Uterine Atony
A case of obstetrical hemorrhage due to uterine atony, requiring medical and surgical interventions and blood component replacement therapy is presented. Emphasis: A review of obstetrical hemorrhage, etiologies, and treatments is provided. The importance of early recognition and response to excessive blood loss is stressed. Medical and surgical interventions for uterine atony are reviewed. Current recommendations for blood component replacement therapy for massive hemorrhage are discussed.
List common risk factors for OH.
Review medical treatments for uterine atony.
Identify pre-surgical and surgical treatments for uterine atony.
Describe blood component therapy for massive hemorrhage.
Fetal Heart Tracing Pattern Evolution
Intrapartum fetal heart rate monitoring is an integral part of modern day obstetrics and when properly interpreted, may provide valuable insight into the fetal metabolic state. During labor, the physiologic stress posed by regular uterine contractions and maternal expulsive efforts may adversely impact the fetal acid-base status, leading to changes in the fetal heart rate pattern.
This module aims to review and apply essential FHR content in several clinical scenarios to highlight an important Clinical Pearl: Management of the laboring patient requires that the FHR pattern trends are interpreted in context with the clinical scenario and progress of labor.
Consistently apply 1997 and 2008 NICHD definitions when describing intrapartum fetal heart rate patterns.
Identify the importance of FHR variability evolution when assessing the FHR pattern.
Review the importance of FHR tracing trend assessment when managing the abnormal intrapartum FHR tracing.
Recognize the importance of clinical scenario, FHR pattern evolution, and stage of labor when managing the Category II tracing in labor.
Obstetric Hemorrhage: Mitigating Risk to Improve Outcomes
Two cases are presented. Risk factors, including recurring and nonrecurring, for obstetrical hemorrhage, are reviewed. Delivery preparations and preventative strategies are discussed. Methodologies that better quantify blood loss, allowing for earlier recognition of excessive blood loss, are presented. Management of the patient experiencing obstetric hemorrhage, including a review of current guidelines for blood component replacement therapy, are reviewed.
List recurring and nonrecurring risk factors for obstetrical hemorrhage. List the four Ts of OH.
Identify low, medium and high risk patients for OH.
Review blood component therapy for large volume blood loss.
Practice Scenarios for Social Determinants of Health
The Healthy People 2030 campaign categorizes social determinants of health (SDOH) into five domains and each one has an impact on health outcomes and informs best practices in the delivery of healthcare (U.S. Department of Health and Human Services, n.d.). This course provides practice scenarios for use of a rapid assessment tool for screening patients for social determinants that impact their health.
Describe social determinants of health, including the five domains within each of them.
Discuss the use of rapid assessment tools for understanding patients’ barriers and risks to optimal health associated with social/environmental conditions where people live, work, and play.
Economic Stability: Social Determinants of Health
Economic stability is defined as a domain of social determinants of health in the Healthy People 2030 campaign. It relates to an individual’s ability to access resources such as food, adequate housing, and healthcare. Each component of economic stability, including poverty, employment, food security, and housing stability, is linked to individual health outcomes.
Describe the four components of economic stability.
Explain how economic stability affects health and health outcomes.
Identify strategies for helping patients overcome barriers to economic stability and how they positively impact health outcomes.
Emergent Delivery of Infant
The management of the female who presents to the emergency department (ED) in active labor is stressful and overwhelming. Ideally, the ED has a plan in place, based on hospital resources, for the imminent delivery of a newborn. Decisions regarding delivery in the ED or transferring the patient to labor and delivery are based on a variety of factors. Knowledge of the possible complications of delivery will provide anticipatory guidance to improve maternal and fetal outcomes.
Know the clinical presentation and physical exam findings associated with pregnancy.
Recognize the common complications associated with pregnancy. Plan the steps to prepare the process of delivery of a newborn.
Recognize common complications of delivery of a newborn.
Preventing Medical Errors: Culture of Safety
Medical errors and substandard care occur often in today’s complex healthcare organizations. Errors are usually due to multiple factors at the system-level rather than a single factor from an individual. Healthcare organizations that are committed to patient safety are high-reliability organizations. These organizations remain alert for ways to protect patients from harm even though they have few adverse events. This course will offer suggestions for reducing medical errors and maintaining a culture of safety.
Describe how the culture of healthcare organizations and the roles of healthcare professionals affect patient safety.
Identify three examples of medical errors and how they may occur.
Social Determinants of Health: Healthcare Access and Quality
Nearly 10% of U.S. population does not have health insurance (U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion [ODPHP], n.d.a). Healthy People 2030 is a national population and public health initiative endorsed by top U.S. government health agencies, setting health goals for the U.S. healthcare system to improve the overall wellbeing of patients in their communities. This course provides an in-depth and interactive analysis of one of the five Healthy People 2030’s domains of social determinants of health (SDOH), healthcare access and quality, and its impact on patient outcomes.
Review what SDOH are and how they impact both healthcare access and quality of care.
Identify barriers to healthcare access and care quality, how these barriers negatively impact patient outcomes, and some strategic interventions to improve these patient outcomes.
Neonatal Respiratory Emergencies
Neonatal emergencies are frightening and challenging to almost all acute care providers. Recognizing the presentation of common neonatal respiratory emergencies is essential to acute care providers. This issue will focus on the neonate and provide a succinct review of respiratory emergencies pertinent to clinical practice and board preparation/review.
The goal of this course is to present healthcare providers in the acute care setting with a succinct review of neonatal respiratory emergencies.
Know the anatomy and pathophysiology relevant to emergency management of neonatal respiratory emergencies.
Know the indications and contraindications for acute management options for neonatal respiratory emergencies.
Plan the key steps and know the potential pitfalls in the acute management of neonatal respiratory emergencies.
Recognize the complications associated with the acute management of neonatal respiratory emergencies.
Shoulder Dystocia: Teamwork and Training
This content is intended for all members of the obstetric team and is based on the educational theory that team performance is enhanced when all members of the team have the same understanding of the task and procedure to be performed.
Enhance situational awareness for patients at increased risks for shoulder dystocia (SD). Design a team-based SD simulation drill. Improve obstetrical team performance through enhanced cooperation in deliveries complicated by SD. Review methods to enhance communications with teams.
Clinical Management of Category II Fetal Heart Tracing
Three different obstetrical scenarios, complicated by a Category II Fetal Heart Rate pattern, are presented to illustrate the importance of clinical context when formulating management plans. Emphasis, characteristics, and potential etiologies of Category II fetal heart rate tracings are reviewed. Management of the patient with a Category II fetal heart rate pattern is discussed, with special emphasis on the importance of the clinical context and fetal heart rate pattern evolution.
Describe characteristics of Category II FHR tracings.
Identify common etiologies for Category II FHR tracings during labor.
Examine clinical interventions for Category II FHR tracings.
Review the etiology-based management of Category II FHR tracings.
Opioid Use During Pregnancy
Americans are using opioids at an alarming rate, whether through prescriptions or illegal means. Parallel to this problem is the use of opioids during pregnancy.
The goal for this course is to present RNs, PAs, physicians, and entry-level drug and alcohol counselors in inpatient or outpatient settings with best practices for identifying and managing pregnant women who are using opioids.
Recognize the risks and complications related to opioid use disorder during pregnancy.
Identify evidence-based treatment recommendations for opioid use disorder during pregnancy.
The Role of Risk Management: A Quality Perspective
The role of risk management has a significant impact on the quality outcomes of acute care organizations. It includes systems and validated processes aimed at assessing and developing interventions to mitigate risk factors and optimize quality outcomes. HCPs are stakeholders in the risk management process and can benefit from understanding risk management strategies and objectives. In this course, you will learn about risk management in the acute care setting.
The goal of this course is to provide healthcare professionals in acute care settings with information to enhance their understanding of the role they play in risk management along with proven strategies for ensuring quality outcomes in their professional practice in acute care settings.
Identify the importance of risk management, the processes, and tools used in risk management in the acute care setting.
Identify at least two concrete strategies for enhancing quality outcomes.
Understanding Human Trafficking
Human trafficking victims are often concealed by their traffickers; however, studies show that many victims interact with healthcare professionals while they are being victimized. This places healthcare professionals in a unique position to recognize the signs and risk factors of human trafficking and take steps if they suspect a person may be a victim of human trafficking.
The goal of this course is to provide healthcare staff with critical steps to recognize and respond to human trafficking.
Identify the two major types of human trafficking.
Explain how force, coercion, and fraud relate to human trafficking.
Discuss federal laws regarding human trafficking.
Describe at least three barriers to identifying human trafficking.
Identify at least three signs that someone may be a trafficking victim.
Discuss steps to take if you suspect a person is being trafficked.
Acute Stroke and the Latest Information
In patients with symptoms of acute stroke, early recognition and interventions have been identified as critical factors in stroke outcomes. Evidence-based care can identify, manage, and prevent stroke-related complications. Nurses and physicians must understand stroke management to prevent disability and death. This course aims to present the most up-to-date practices for managing patients with acute stroke.
Discuss current diagnostic practices in patients with acute stroke.
Recall best practice protocols for early identification of acute stroke.
Stroke: Recognition and Management
This course equips healthcare professionals with essential knowledge and skills to promptly and effectively manage stroke in the acute care setting. Participants will gain insight into how to recognize an acute stroke and the initial steps to take for emergency treatment of stroke. In addition, learners will know the different acute treatment options for ischemic and hemorrhagic stroke as well as patient care for acute stroke.
Recall the benchmark diagnosis and treatment times for acute stroke.
Differentiate the treatment of ischemic stroke and hemorrhagic stroke.
Indicate interventions in the care of a patient presenting with an acute stroke.
A Review of Traumatic Brain Injury (TBI)
A traumatic brain injury (TBI) is a complex condition that may have short- or long-term effects on a patient. TBIs have a wide array of associated symptoms and disabilities. These may have a significant impact on the lives of patients and their families. Healthcare professionals should be ready to rapidly assess patients with TBIs so that they can be treated promptly.
This course provides strategies to enhance the knowledge and skills of physicians, registered nurses, and physician assistants in recognizing, assessing, and managing traumatic brain injuries, contributing to improved patient outcomes and interdisciplinary collaboration.
Indicate how to assess and diagnose traumatic brain injuries, using both clinical examination and diagnostic tools, recognizing the signs and symptoms that distinguish mild, moderate, and severe TBI.
Apply management strategies for TBI, including immediate interventions, pharmacological treatments, and monitoring techniques, to optimize patient care from acute to rehabilitative stages.
Discuss the importance of using a multidisciplinary approach in the management of TBI to support recovery, minimize complications, and facilitate patient and family education.
Psychopharmacology in the Emergency Department
As a healthcare professional transporting patients to the ED, you may serve patients with symptoms indicative of behavioral health disorders, such as depressive, bipolar, and anxiety disorders. In some situations, the ED provider must administer psychiatric medications. However, if possible, it is prudent to defer their use until the patient is admitted to an inpatient mental health facility or seen as an outpatient. In many instances, the reason for presentation in the ED is an adverse reaction to psychiatric medications.
Identify some of the most common medications in each major category, their indications, and their usage in treating mental health disorders.
Recall adverse reactions to psychiatric medications.
Social Determinants of Health: Neighborhood and Built Environment
The physical environment in which individuals live has a direct impact on their health and wellness and their ability to access healthcare. Healthy People 2030 identifies neighborhoods and the built environment as a domain of the social determinants of health tied to health outcomes. This course provides an in-depth analysis of this domain and how it affects the health and well-being of patient populations. The four components of neighborhood and built environment include access to healthy foods, quality of housing, crime and violence, and environmental conditions. Clinicians can leverage this knowledge to improve treatment planning for patients and health outcomes.
Identify the four components of neighborhood and built environment domain of social determinants of health.
Recall how neighborhood and the built environment affect overall health outcomes.
Define how clinicians can address issues related to the neighborhood and built environment.
A Look at Malignant Hyperthermia
Malignant hyperthermia (MH) is a life-threatening syndrome associated with an anesthetic trigger. Awareness of MH by all perioperative team members, from those working in the preoperative holding area to those in the Post Anesthesia Care Unit (PACU), is important in preventing negative patient outcomes.
Define risk factors for MH and preventive measures for improving patient outcomes.
Identify the signs and symptoms of MH along with diagnostic and genetic considerations.
Describe the best practices for managing and treating MH.
Medication Error Prevention
Medication errors and substandard care occur often in today’s complex healthcare organizations. High-reliability organizations remain alert to potential errors and ways in which they can be prevented, regardless of how few adverse events occur. Healthcare organizations with a culture for patient safety focus on identifying the cause of errors and applicable prevention strategies rather than blaming or punishing the people involved in an error. Organizations that focus on patient safety in this manner have higher rates of error reporting and are better positioned to address problems at the systems level.
The goal of this course is to educate healthcare professionals about approaches to prevent medication errors.
Discuss how a culture of patient safety influences reporting and resolving errors.
Define the types of medical errors and their impact on healthcare.
Explain strategies to reduce medication errors.
Ethics for Licensed Professionals: 1 Hour
Ethics are a significant part of high-quality clinical practice. This one hour course presents ethical principles and responsibilities of healthcare professionals. The goal of this course is to provide healthcare professionals with an awareness of how ethics impact clinical practice and an approach for analyzing ethical issues in clinical practice.
Identify definitions, similarities, and differences of common ethics terminology and concepts.
Describe the four healthcare ethical principles and their implications for clinical practice.
Apply an ethical decision-making model to ethical issues and dilemmas.
Sexual Assault and Rape for Healthcare Professionals
Survivors of rape and sexual assault will experience a variety of physical and emotional comorbidities as a direct result of their experience. This means survivors will enter the healthcare system through a variety of specialty clinics in addition to their primary care provider. It is important healthcare providers of all disciplines, be familiar with the signs that a patient may have been raped or sexually assaulted in their past. This course will provide the legal aspects of rape and sexual assault, the emotional and physical trauma associated with the experience, and how to identify and care for survivors.
Recall important aspects of sexual assault and its impact on the survivor.
Indicate the role of the healthcare provider in identifying and caring for survivors of sexual assault.