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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.
Employee Wellness: Emotional Awareness
You have probably heard about an “IQ” score that measures intelligence, but have you ever heard of “emotional intelligence” or EQ? Emotional intelligence is your ability to understand, express, and manage your emotions, as well as your insight into what the people around you are feeling. EQ can add to your quality of life and contribute to career success. In this course, you’ll learn about developing emotional awareness, which is the foundation of emotional intelligence.
Describe emotional intelligence.
Explain how to recognize your feelings and the feelings of others.
Communication Essentials: Effective Listening
Listening skills are an often-undeveloped component of effective communication. Leaders and managers with strong listening skills build more productive and engaged teams with increased effectiveness. In this course, you will learn how managers and leaders can listen actively to build stronger teams and increase their impact. You will also learn the importance of establishing common ground and practicing empathy as you apply the techniques for becoming a better listener.
The goal of this course is to provide managers and leaders with the awareness and skills to be effective communicators.
Discuss best practice techniques for improving your active listening skills.
Describe at least two benefits of active listening.
Maintaining Professional Boundaries
As a healthcare professional, you may find yourself in situations where issues with professional boundaries develop. Some boundary violations can be quite serious for you, your team members, your organization, and the people you provide care for. For this reason, it is important for you to be aware of these risks.
You should understand the difference between a boundary crossing and a boundary violation. You must also be able to recognize situations that may lead to a boundary crossing or violation and know how to prevent problems.
The goal of this course is to share with general staff in any setting the basics of how to maintain professional boundaries.
Describe the difference between a boundary crossing and a boundary violation.
Recognize common situations that may lead to a boundary crossing or violation.
Identify ways to prevent boundary crossings and violations.
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.
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.
Care Teams: Depression and Anxiety
The goal of this course is to provide nurses and prescribing providers (physicians) in all healthcare settings with best practices to improve their care team approach to patients with depression and anxiety.
Recall care team best practices, including collaboration, communication, and roles.
Identify how care team best practices can improve outcomes for patients with depression and anxiety.