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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.
Working with Difficult Individuals
There are many reasons that it can be difficult working with certain people. There may be communication breakdowns, personality clashes, or conflicting work habits. You may not like everyone you work with, but you do have to respect everyone. By learning ways to reduce conflicts, you’ll likely become more respected, too. In this course, you’ll learn strategies to calmly address misunderstandings before they become actual conflicts. Professional relationships can improve when you know how to deal with differences, communicate clearly, and listen respectfully.
Apply appropriate interventions to help manage high-risk or crucial situations that can lead to difficulties in communication and workflow with coworkers.
Minimizing Trips, Slips, and Falls
This course is about workplace slip, trip, and fall hazards. It alerts you to the serious consequences that can result even from a simple fall or a near fall and provides information about measures that can help you prevent these incidents and reduce potential injuries.
Identify common hazards that might lead to trips, slips, and falls.
Explain how to prevent injuries from trips, slips, and falls.
The Use of Root Cause Analysis
Within any healthcare organization, there are systems, policies, and procedures that can be improved or events that could have been prevented. A root cause analysis is a tool that helps healthcare organizations improve their systems by using a team process of discovery. When you understand how to use a root cause analysis, you can apply it to create better solutions, prevent adverse events, and create more effective and efficient systems. This course discusses what a root cause analysis is and how to use it.
Describe how a root cause analysis can be used proactively and reactively.
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.
Improving Nurse Retention
While much of the responsibility for nurse retention has been placed on the administration hierarchy, nurses themselves must take an active role in understanding why colleagues choose to remain in their jobs. Nurses play a vital role in developing and implementing strategies that create an engaging and rewarding work culture. Improving nurse retention also directly improves patient outcomes.
Discuss the benefits of retention on the quality of patient care and the reasons nurses leave an organization.
Recall strategies for retaining nurses in the workplace.
Change Management: Navigating Change
Supervisors and managers are challenged by change every day and must consistently demonstrate self-confidence to their teams in the face of these challenges. In this course, you will explore the characteristics, behaviors, and actions of being an effective “change agent,” (one who guides, supports, or leads change) which is a critical role in guiding your teams through change. The goal of this course is to provide managers and supervisors with an understanding of the common reasons for resistance to change and learn ways to counteract it.
Recognize the reasons people resist change and learn ways to overcome resistance.
Identify the characteristics, behaviors, and actions required to be an effective agent of change.
Learn communication actions to help people adapt to change.
An Overview of Trial of Labor After Cesarean Section
This course provides an overview about the safety of patients undergoing a trial of labor after cesarean (TOLAC) to attempt a vaginal birth after cesarean delivery (VBAC). Research evidence has influenced where VBACs are performed, which women are eligible and how the practice is conducted, including the safe use of induction/augmentation medications. The safety of VBAC for mother and newborn always remains the primary underlying principle that guides care.
Identify three risk factors and benefits associated with TOLAC and recommendations for safe TOLAC.
Recall essential components of nursing education, informed consent, safe medication administration, and fetal assessment related to TOLAC.