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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.
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.
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.
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.
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.
An Overview of Substance Use Disorders
Substance use is a growing problem across populations. As a helping professional, you need a basic understanding of how substance use affects your clients. This information will help you to provide support and resources to help clients seek treatment and recovery. In this course, you will explore substance use disorders, how they develop, and their impact on individuals. The course also explains your role as a paraprofessional when working with individuals with substance use disorders. You will be provided an overview of evidence-based interventions and the types of substance use treatment programs available, when additional treatment may be necessary. Detailed examples will help you to apply this information in your own work. The goal of this course is to provide paraprofessionals and peer support specialists in health and human service settings with information on substance use disorders and evidence-based interventions.
Explain what a substance use disorder is, how it develops, and how it impacts individuals.
Identify strategies that paraprofessionals can use when working with individuals diagnosed with substance use disorders to encourage behavior change.
Describe the types of treatment that exist for people diagnosed with substance use disorders.
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.
Assessment and Intervention for Confabulation
Healthcare workers will often interact with patients who make up stories or memories that are inaccurate, sometimes wildly so. These patients are not lying, they are confabulating. A nurse who knows how to manage confabulation can help these patients. With proper interventions, most patients can stop confabulating or learn to manage the condition. This course will give you a solid foundation of knowledge about and skills to handle confabulation by explaining what it is, who does it, what causes it, and how to manage it.
The goal of this course is to inform nurses in the acute care setting about confabulation and how to assess and manage patients with confabulation.
Recall the types of confabulation and the pathophysiology of confabulation.
Identify two methods of assessing confabulation.
Apply several approaches for managing confabulation.
Infection Prevention Strategies for Healthcare Professionals
Healthcare professionals are responsible for implementing infection prevention techniques. This course reviews how pathogenic organisms spread in healthcare settings, infection prevention strategies for healthcare professionals, and occupational health strategies to control the spread of infectious and communicable diseases.
The goal of this course is to provide nursing and medical assistant professionals in the healthcare setting with a general overview of infection prevention strategies.
Indicate how pathogenic organisms may be spread in healthcare settings.
Recall infection prevention strategies healthcare professionals should employ in the work setting.
List occupational health strategies specific to preventing human immunodeficiency virus (HIV), hepatitis B virus, and tuberculosis (TB) in healthcare providers, and resources for evaluation of healthcare professionals infected with these organisms.
IV Therapy Complications
Nurses deliver infusion therapy to millions of patients in hospitals, home healthcare settings, long-term care facilities, outpatient clinics, and physicians’ offices annually. Nursing professionals perform many daily activities involving peripheral catheter insertion and safe delivery of intravenous (IV) fluids and medications. The use of vascular access devices and IV therapy are commonplace in the acute care setting. With that said, clinicians must take caution due to the potentially serious and fatal complications that can occur from inappropriate IV fluid or drug delivery. Patient safety requires that nurses institute safeguards to avoid complications associated with IV treatment.
Discuss the maintenance and complications of peripheral IV (PIV) therapy.
Identify drugs that can cause tissue damage if extravasation occurs.
Recall the components for documenting a peripheral IV insertion.
Management of Needlestick Injuries
Needlestick injuries continue to pose a threat to all healthcare professionals (HCPs). While HIV was once the most concerning organism, today, hepatitis B and C take precedence (King & Strony, 2022). Regardless of circumstances, more than 90% of sharps injuries are preventable (International Safety Center [ISC], n.d.). Therefore, all healthcare clinicians must be diligent to avoid injury even in busy and stressful working conditions. This module will review the current literature on managing the most common bloodborne pathogens (BBP) transmitted by needlestick injuries and evaluating post-exposure prophylaxis.
Discuss procedures to follow after a needlestick or sharps injury.
Identify factors that can lead to a needlestick or sharps injury.
Identify factors that can prevent a needlestick or sharps injury.
The Impact of Psychedelics
This course will provide healthcare professionals in the acute care setting with an introduction to the use of psychedelics for the treatment of behavioral health conditions. Healthcare professionals will learn about the types of agents used, their indications, benefits, and their associated risks and side effects.
The goal of this course is to provide health care professionals in the acute care setting with an introductory review of novel therapeutic agents used to treat behavioral health conditions.
Recall how psychedelics are used to treat behavioral health disorders and how they impact symptoms of behavioral health disorder.
Identify the potential risks and side effects of psychedelics.
Recognize whether an individual is a good candidate for psychedelic treatment for behavioral health symptoms.
Controlled Substances: Chronic Pain Management
Chronic pain is a common condition for which healthcare providers often prescribe controlled substances, such as opioids. Prescription opioids can alleviate pain in certain patients, but the risk of misuse, abuse, and overdose means providers need to evaluate the risks and benefits for each patient. This course will educate healthcare providers on the role of prescription opioids along with other therapies for chronic pain, using recommendations from current national guidelines.
The goal of this course is to educate healthcare providers on methods for the safe and responsible use of controlled substances for the management of chronic pain.
Indicate treatment options for patients with chronic pain.
Identify safe strategies to initiate or change opioid analgesics.
Name patient factors and characteristics that can make prescribing opioids unsafe.
Culture and Pain Management: Cultural Competence
Health inequities in pain management are prevalent across different healthcare settings. The cultural, ethnic, and social differences influence patients’ and providers’ perceptions and responses to pain. Several studies report higher incidences of pain, disability, and suffering in women and people of color compared to non-Hispanic White people. This course covers influential sociocultural factors grouped into the patient, the provider, and systemic factors. This course helps healthcare professionals become familiar with cultural differences associated with pain perceptions and management. Pain variables such as culture, religion or ethnicity are not part of standardized pain scales. Healthcare workers need to provide culturally competent care to their patients by asking about specific practices, beliefs, and values regarding pain that impacts the patient’s quality of life.
The goal of this course is to provide nurses, physicians, and social workers with an overview of cultural sensitivity in the management of pain.
Identify cultural factors influencing the patient’s perception and expression of pain.
Recall strategies for reducing barriers in pain assessment and promoting management decisions to respond to a patient’s pain in a culturally sensitive manner.
Central Arterial Aneurysms: Types and Management
Aneurysms can be deadly and can come on suddenly. Knowing what to do to help your patient with an aneurysm could be the difference between life and death for them. Early detection and management are the best tools to prevent a fatal outcome. Healthcare professionals should know what an aneurysm is, which of their patients are at highest risk, the signs and symptoms of an aneurysm, and how to manage an emergency rupture. This course focuses on central arterial aneurysms of the abdominal and thoracic aorta.
Recall concepts associated with vascular physiology and types of aneurysms.
Recognize clinical manifestations of central arterial aneurysms and associated risk factors.
Apply common techniques for managing patients with abdominal and thoracic aneurysms, pseudoaneurysms, and dissections.
Opioid Prescribing, Chronic Pain, and Opioid Use Disorder
The emphasis on pain management to improve quality of life and function has contributed to a significant increase in opioid prescriptions. As such, there has been a concurrent increase in risk of misuse and abuse. While opioids are highly effective for pain relief, closer attention to the risk versus benefit analysis has led to guidelines that prefer nonpharmacologic and nonopioid pharmacologic therapy over opioids, especially for chronic pain. Clinicians must carefully monitor the patient and be alert for signs that risks outweigh benefits of opioids. This course will address issues related to opioid prescribing, chronic pain, and opioid use disorder.
Discuss considerations and guidelines for prescribing controlled substances.
Describe patient evaluation and education for a safe and effective pain treatment plan.
Wellness Strategies that Support Addiction Recovery
Substance use is linked to millions of deaths worldwide each year (Ritchie & Roser, 2019). Supporting individuals’ long-term recovery from substance use can help save lives. Recovery is a lifelong process that aims to keep an individual substance-free while improving their overall quality of life. Wellness strategies enhance recovery outcomes by focusing on optimal health across all dimensions of an individual’s life.
Discuss how wellness approaches can positively impact recovery from substance use disorders.
Recognize the eight dimensions of wellness.
Identify wellness strategies to facilitate long-term recovery from substance use disorders.
An Update on Bariatric Surgery
The goal of this course is to equip nurses in the acute care setting with knowledge of the different bariatric surgical options and the psychosocial, metabolic, and physiological issues that patients may encounter before and after bariatric surgery.
Recall the different bariatric surgical options available for patients with obesity.
Identify psychosocial and quality-of-life issues affecting patients before bariatric surgery.
Recognize metabolic, physiological, and psychological changes that can occur in patients after bariatric surgery and the role nurses have in their care.
Managing Coagulopathies
The focus of this course is coagulopathies. In general, the term coagulopathy refers to bleeding disorders. This course will provide a review of the components of a clot. It will also provide you with valuable information about how to care for those with coagulopathies such as immune thrombocytopenia (ITP), disseminated intravascular coagulopathy (DIC), heparin-induced thrombocytopenia (HIT), and warfarin-induced coagulopathy.
The goal of this course is to provide nurses in the critical care setting with a general overview of coagulopathies, including the recognition and nursing management of ITP, DIC, HIT, and warfarin-induced coagulopathy.
Describe the etiology and presentation of DIC, ITP, HIT, and warfarin-induced coagulopathy.
Identify proper nursing care for those with DIC, ITP, HIT, and warfarin-induced coagulopathies.
Identify emergency findings in those with coagulopathies and discuss the appropriate nursing interventions.
Recognizing and Treating Stroke
By understanding the causes of stroke and how to treat and prevent it, you can make a significant difference in the lives of those you care for. This course will help you identify the symptoms of a stroke and provide you with the necessary knowledge to provide care during and after the stroke.
Recall the pathophysiology of a stroke.
Recognize at least three interventions for someone experiencing a stroke.
Identify strategies for achieving quality of life after a stroke.
Bowel Ischemia, Perforation, and Obstruction
Bowel ischemia, infarctions, perforations, and obstructions are serious conditions that require prompt recognition and interventions to prevent severe complications and death. There are several underlying conditions that predispose patients to these conditions, for which education and risk modifications are crucial.
The goal of this course is to equip nursing professionals in acute care with knowledge of risk factors, signs and symptoms, and management strategies for bowel ischemia, infarction, perforation, and obstruction.
Identify anatomical and physiological aspects of the intestines associated with bowel ischemia, infarctions, perforations, and obstructions.
Describe risk factors, causes, signs/symptoms, management, treatment, and complications of bowel ischemia, infarctions, perforations, and obstructions.