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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.
The Dangers of Alarm Fatigue
This course provides nurses with information regarding safety concerns associated with alarm fatigue along with evidence-based research strategies to reduce the fatigue.
Describe the national patient safety goals set by The Joint Commission as they relate to alarm management.
Discuss evidence-based strategies to reduce alarm fatigue.
Social Determinants of Health: Education Access and Quality
Education access and quality is a pillar of the social determinants of health for Healthy People 2030 (U.S. Department of Health and Human Services, n.d.). This course outlines the effects of education on an individual’s health. The four components of education access and quality include early childhood education and development, high school graduation, enrollment in higher education, and language and literacy.
Identify the components of education access and quality and their effects on health.
Recall patient care and education related to education access and quality.
CEN: Communicable Diseases
he purpose of this course is to inform the emergency nurse of communicable diseases, including a comprehensive assessment and appropriate interventions.
Identify alterations in the biological, physiological, and psychological status of patients experiencing communicable disease emergencies.
Describe a comprehensive plan for the care of communicable disease conditions including diagnostic and treatment interventions, and patient education.
Bias in Healthcare
All healthcare professionals must be aware of bias and the challenges that bias can create in healthcare. This includes knowing some of the challenges people face with the healthcare system. In this course, you will learn best practices to help recognize and manage bias.
Define bias.
Identify how biases can affect healthcare.
Describe steps that can help decrease barriers created by bias.