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.

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.

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.

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.

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.

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.

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.

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.

As defined by the Association of periOperative Registered Nurses (AORN) (2019), the perioperative nurse’s goal is to help patients achieve or exceed the level of well-being they had at the pre-procedural baseline. The nurse is required to have the clinical knowledge, judgment, and clinical reasoning skills necessary to safely plan, deliver, and evaluate care for surgical patients.

The goal of this course is to equip perioperative nurses with knowledge of the nursing process and the roles and responsibilities within the perioperative team.

As the population of the U.S. soars in diversity, healthcare professionals must be prepared to care for childbearing families from many different cultures. All cultures and families should be given the same respect, be assured of the highest quality of care, have their religious, ethnic, and cultural values respected and integrated into their care, and have their physical and educational needs met in a way that honors their spiritual beliefs and individuality. Knowledge of the cultures one is serving and the influence they have on women’s perceptions of childbirth are important for achieving positive outcomes. Equally and perhaps more important is applying the principles of cultural humility to nursing care.

The goal of this continuing education course is to improve the ability of nurses and health educators in acute care settings to assess and meet the sociocultural needs of childbearing families of diverse cultural and social groups. 

Healthcare professionals often feel unprepared to ask about abuse or to counsel a pregnant woman who is being abused, although they are in a unique position to assess for IPV and to support women who experience it. As such, it is necessary for clinicians to skillfully screen for IPV and offer effective interventions when appropriate.

In this course, you will learn about pediatric anatomical and physiological differences, which will help you recognize normal variations throughout your assessment. Additionally, you will learn communication methods to help children feel more at ease during your assessment. Finally, you will understand essential warning signs that require immediate referral to additional medical professionals using the available resources and tools.

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.

Perioperative professionals must have a fundamental understanding of the anatomical, physiological, psychological, and emotional differences of children compared to adults and how these differences impact the care needs of pediatric patients in the perioperative period.

Obesity rates in the U.S. have risen to the level of an epidemic, as 1 in 3 adults are affected by this disease. Obesity is a disease that significantly affects a person’s health and is not simply due to poor diet and lack of exercise. This course introduces healthcare professionals to the causes, management, and treatment options for adult obesity.

The goal of this course is to familiarize healthcare professionals with the growing epidemic of obesity among adults in the U.S.

The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of gynecological and obstetrical conditions and diseases, their signs and symptoms, management, and applicable nursing interventions.

Septic arthritis is caused by infection and inflammation in the joint and can result in significant damage to the joints. Early recognition and treatment are critical to the preservation of joint function. This course will discuss how to quickly identify and treat septic arthritis.  

The goal of this course is to provide physicians, nursing professionals, and radiologic technologists with information about septic arthritis.

In the operating room, patient safety depends on high quality communication and shared knowledge among the surgical team. Several factors in this setting can contribute to communication failures like time constraints, shift changes, environmental barriers, the complex nature of surgical procedures, and clashing communication styles. All members of the surgical team must understand the risks to patient safety associated with communication failures, what information must be communicated and when, and how to use an assertive communication style.

The goal of this course is to equip nurses and CSTs with best practices for effectively communicating in the operating room. 

The OR is a complex environment. Highly trained individuals interact in a specialized setting with sophisticated and technically complicated devices, instruments, and equipment. There are also substantial differences among team members related to education, experience, skill level, influence, and formal and informal power. This course will inform nurses and surgical technologists of the evidence-based steps to take to create a culture of safety in the OR.

Proper surgical specimen handling is essential for patient safety. This course covers best practices for intraoperative personnel to prepare, label, and transfer specimens accurately. Adhering to these protocols ensures that specimens are identified and handled appropriately, minimizing the risk of harm to the patient.

This course provides OR nurses and surgical technologists with knowledge of best practices for specimen handling.

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.

Concussion is a form of mild traumatic brain injury that is common in children and adolescents. Despite increased awareness about the injury, concussion remains under-reported and under-diagnosed. Nurses and Radiology Technicians must be aware of the identification, diagnosis, and management of concussions in pediatric patients. 

The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted to prevent patient dumping by hospitals seeking to avoid unrecoverable costs of care for patients without insurance or the ability to pay for medical services. Language within the statute has led to inconsistencies in how it has been interpreted. Patient dumping and inappropriate medical screening examinations (MSEs) are the most common reasons for EMTALA violations (Ladd & Gupta, 2021). This course will describe how key terms are currently interpreted and how they apply to hospitals with a dedicated emergency department (ED). In addition, learners will have an opportunity to review cases where EMTALA violations were alleged and judgments applied by the courts. 

Mechanical ventilation is a cornerstone of critical care, offering life-saving therapy for patients experiencing respiratory failure for many disease processes. Before 2020, it was estimated that over 300,000 patients receive mechanical ventilation in the U.S. per year (NHSN, 2019). That number is now likely much higher considering the COVID-19 pandemic. 

Although it is a lifesaving intervention, patients who receive mechanical ventilation are at an increased risk for complications, such as ventilator-associated pneumonia, sepsis, volutrauma/barotrauma, acute respiratory distress syndrome (ARDS), and others. These complications may lead to longer ICU and hospital stays, increased risk of disability and death, and increased healthcare costs. For these reasons, clinicians at every level need to understand the concepts, theories, and practices guiding the management of patients receiving mechanical ventilation.