Clinical Specialists Consulting,

Transcription

1 Clinical Specialists Consulting, Inc 745 Kingston Drive Virginia Beach, VA Phone & Fax: (757)

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3 About Our Company Clinical Specialists Consulting, Inc (CSC) welcomes your business. Our company was founded in 1993 as a provider of multidisciplinary healthcare education and consulting services nationwide. All providers of direct and indirect patient care in the area of perinatal health enhance knowledge and skill through CSC services. Our clients include individual practitioners (registered nurses, certified nurse midwives, residents, physicians, and perinatologists) and independent hospitals or hospital systems. CSC is a consumer advocate for pregnant mothers, fetuses, and neonates. We uphold strict standards and guidelines with our education and consulting products to meet state, national, and international criteria. CSC has developed and offered numerous educational programs to over 10,000 providers nationwide. Our staff has devoted more than 500,000 hours to research, analysis, and development of our products. As our national Health Care Delivery System continuously changes, CSC offers new and innovative approaches to meet the standards of care for the promotion of patient safety. Our GOAL/Mission: To decrease morbidity and mortality in the maternal, fetal, and neonatal populations through evidenced-based education and consulting services; hence, increasing patient safety to all perinatal populations. Our Mission Objectives our as follows: Provide outstanding evidence-based educational offerings, products, and consultation services for all health care providers and consumers in the area of Perinatal Health. abcdefm tm The TEXTBook, Electronic Fetal Monitoring (2006), authors Curran & Torgersen, is the ONLY textbook available with the national NICHD guidelines & terminology cover-to-cover; it sold out at the 2006 National AWHONN Convention. All CSC Speakers are nationally recognized veteran practitioners and clinical experts in the field of perinatal nursing, medicine, and medical-legal consulting. CSC Educational Offerings are offered as half, one, or multi-day opportunities. Each course offers continuing educational credits with the opportunity for certification & competency analysis assessments of staff attendees. Decrease the overall financial burden on our Health Care Delivery System through fiscally responsible education and consulting endeavors. CSC Co-Sponsorship Program offers a full spectrum of educational offerings well below the national attendance rate. CSC offers Split-Revenue Options to subsidize programs. Build Your Own Programs offers the ability to meet the individualized educational needs of a hospital or hospital system. Designing your own educational program is a CSC option. Exhibit honesty and integrity to all internal and external customers as a means to foster trust and growth in all of our working relationships CSC Co-Sponsorship Programs offer hospitals & hospital systems the opportunity to become a community provider of continuing education. This increases exposure to current and potential clients and clinical associates in the field of perinatal healthcare. CSC staff are available to discuss your current health care education and consultation needs. Please call (757) or visit our website at to define your professional health care objectives. We look forward to assisting your staff in decreasing maternal, fetal, and neonatal morbidity & mortality through patient-focused education and consulting opportunities.

4 OB CORE: 1-2 week or day option for continuing education focused for new employees, orientation, and enhancement of veteran practioners skills. Numerous CSC Courses are offered consecutively or periodically to supplement clinical practicum skills. OB CORE: Advanced Principals 1 week/5 days of CSC Enhancement Courses to provide advanced training and critical thinking to all nurses providing the patients perinatal care.

5 OB Critical Care & Transport Course Critical Decisions, Assessment, & Transport of the Maternal-Fetal *1-3 Course Options Three of Three Option; 8:00a-4:30p 3: Critical Care Plans for the Pregnant Patient Cardiogenic Shock in OB American Heart Classification of Disease Myocardial Infarction Congenital Anomalies Peripartial Cardiomyopathy Cardiac Transplant Septic Shock in OB Pyelonephritis Acute vs Chronic Renal Failure Intrauterine Fetal Demise OB Trauma: Foreign Body Hypovolemic Shock in OB Previa Placental Abruption Uterine Rupture Post Partum Hemorrhage: PPH OB Trauma: Gun Shot, MVA Disseminated Intravascular Coagulation Acute Respiratory Distress Syndrome during Gestation Pulmonary Embolus Pulmonary Edema Amniotic Fluid Embolus Cerebral & Cardiac Resuscitation Fetal Code Blue FHR Maternal BCLS ACLS Perimortem Cesarean Section Multisystem Organ Dysfunction & Failure Post Test (if applicable) CONTACT HOUR: 7.4 per or 22.2 Total 3

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8 Table of Contents CSC Co-Sponsor How to Become a Co-Sponsor CSC Speaker Comments Master List Course Compendium ABCDEFM: Menu of Electronic Fetal Monitoring Courses ABCEDEFM Critical Core Concepts Advanced Course - 2 Advanced 1 Advanced Update Master Course Core Courses Critical Concepts in Perinatal Nursing Perinatal Emergencies & Strategies Perinatal Survivor Island OB Trauma and Safety Enhancement Courses L&D to ICU Critical Care Strategies and Challenges Medical Legal Challenges in Pernatal Care Perinatial Quality + Safety = Risk Reduction Code Blue: FHR One Code Blue: FHR Two Labor and Birth Critical Concepts in Management Obstetrical Emergency Skills and Drills Mentor Me: How to be a preceptor & Manage New Employees Charge Nurse Survival Guide OB Legalities Mock Trial Multi- Courses OB Critical Care and Transport Course

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10 OB Critical Care & Transport Course Critical Decisions, Assessment, & Transport of the Maternal-Fetal *1-3 Course Options Two of Three Option; 8:00a-4:30p Current OB Population Trends High Risk Populations on the Rise: Advanced Maternal Age Obesity Multiple Gestations Medical Complications Medical Complications of Pregnancy CHTN Asthma DM: Hypo/Hyper/DKA 2: Obstetrical Populations at Risk Preterm Rupture, Dilation, or Delivery Systemic Inflammatory Response Syndrome in OB Lupus Erythematosis Preeclampsia HELLP Syndrome Hepatic Rupture Acute Fatty Liver 3

11 OB Critical Care & Transport Course Critical Decisions, Assessment, & Transport of the Maternal-Fetal *1-3 Course Options One of Three Option; 8:00a-4:30p 1: Essentials in Perinatal Assessment and Transport Standards in Physical Assessment Criteria for Triage Assessments Criteria for Admit Assessments Recommendations per ACOG, AWHONN, ASA, AAP, NRP Physical Adaptations & Pathological Responses to Pregnancy Maternal : Systems Approach Fetal: Gestational Age Approach HR Physical Assessment of the OB Patient Maternal: Assessment Criteria Equipment: Stethoscope, Dynamap, Pulse Oximeter, Central Venous Pressure Catheter, Arterial Line Fetal: Assessment Criteria Equipment: EFM Ultrasound Advanced Testing & Laboratory Analysis MRI, CT, X-Ray in the OB Patient Overview of General Medical, Trauma, Preeclamptic Lab Tests Perinatal Transport Community-based Maternal Neonatal Interdepartmental Antepartum & LD Critical Care Unit Collaborative Communication & Documentation 3

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14 WHAT is a CSC Co-Sponsor? HOW does a hospital become a CSC Co-Sponsor? WHAT are the BENEFITS to becoming a CSC Co-Sponsor? CSC, Inc is recognized as one of the top evidence-based providers of perinatal continuing education nationwide. All of our advanced practice speakers are expert clinicians in the field of perinatal and high risk obstetrics. Our Course Compendium outlines our half, one, and multi-day course options. CSC Co-Sponsorship is an agreement between CSC, Inc and any perinatal facility/hospital/institution/system who would like to offer nationally recognized continuing education speakers and programs onsite. The Co-Sponsorship is a way to meet local, regional, and national continuing education, quality assurance, and patient safety initiatives through certification and competency analysis. CALL OUR OFFICE TODAY TO BECOME A CO-SPONSOR TODAY! CSC Co-Sponsorship BENEFITS: Excellent Source of Evidence-based Continuing Education All speakers are expert clinicians and educators All courses are updated every two years with current research Offers collaborative practice environment between practitioners Easy & Affordable You Pick the date and CSC comes on site Options for Revenue Sharing Yes, you can Make $$$ and it could be FREE Early marketing + Large Attendance = FREE Course Pre/Post Testing, Certification,& Competency Analysis Options Pick an option to meet annual employee requirements or national standards by AWHONN, ACOG, ASPAN, ASA, or JCAHO Become a Community Continuing Education Provider Offers an opportunity to RECRUIT NEW STAFF Continuing Education Credits Provided & CME Support Available

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18 BYOP: Build Your Own Program CSC Offers the BYOP Program to all perinatal providers with an interest for specialized educational opportunities. Clients my select a total of (7) seven topic from any CSC program to create an individualized one day program. This option assists clients to meet the annual education requirements for all perinatal care providers. Call CSC at (757) directly to discuss BYOP options today! Flexibility Individualized Education Annual Requirements Met Post Testing Options and Competency Analysis Available

19 CSC Speakers CSC s team of perinatal consultants include a variety of experts: Physicians, Lawyers, and Advanced Practice Nurses. Each individual clinician is a nationally recognized expert in their field. All maintain a clinical practice while participating in speaking engagements and consulting nationwide. Carol A. Curran RNC, MS, OGNP Perinatal Nurse Consultant Primary Speaker 19 Year Veteran Labor & Delivery RN Recognized as a OB Critical Care Educator Nationwide Fetal Heart Rate Monitoring Certification Instructor Perinatal Quality & Safety Consultant Obstetrical Medical-Legal Consultant Peer Reviewed Author Keiko Torgersen RNC, MS Perinatal Nurse Consultant Speaker 27 Year Veteran Labor & Delivery RN Retired Colonel in the U.S. Airforce Nationwide Fetal Heart Rate Monitoring Certification Instructor Obstetrical Medical-Legal Consultant Peer Reviewed Author

20 Comments from CSC Conference Attendees. May 2007 Course: tm : Advanced-1D Electronic Fetal Monitoring Carol, I didn t get a chance to thank you personally for the great job you did. You are an incredibly dynamic and entertaining speaker. The material you covered was also very informative and timely to my practice. Thank you again. I hope you come again in the future to educate all those who missed this session. Sincerely, Tim MD April 2007 Course: tm : Advanced-2D Electronic Fetal Monitoring Wow! Thanks! It has been over 10 years since my inpatient OB course. The reintroduction of information was exceptional! Glad you were here! RN-Elmendorf, AFB Best course I have ever been to! My knowledge was greatly increased and I will definitely be changing my ways of documentation and practice because of this class. Thank you1 RN-Elmendorf, AFB January 2007 Course: tm : Update Thank you for the update on the NICHD guidelines utilized in the United States as compared to European criteria. This was a great opportunity to increase our expertise as we educate and train in the U.S. RN-Gothenburg, Sweden November 2006 Course: Code Blue FHR I loved this course. Your power point slides had great pictures of ultrasound, abnormal placentas, and other great data. Overall, I enjoyed the ability to gain knowledge and then practice on day two with the hands-on skills drills. This was wonderful and the speaker made it fun. She kept my attention for two days! RN-Denver, CO October 2006 Course: OB Critical Care & Transport Course Excellent! I like to know hard concepts and the speaker made them simple with her descriptions. She kept my attention all 3 days. This course would be beneficial for all of our nurses, at all skills levels. RN-St. Louis, MO Get her back again! The speaker was a fountain of knowledge! Please send me her brain-phenomenal! Thank you for coming to MO. RN-St. Louis, MO May 2004 Course: Perinatal Emergencies 2 weeks after the course: I wanted to let the speaker know how her teaching impacted my care. I recently had a patient arrive in triage who has abruptio placentae. Prior to the class, I am not sure I would have been as alert to the patient s signs and symptoms. But I remembered things from class and I alerted the perinatal team and we got the patient in for an emergency cesarean section in less than 9 minutes!!! We were all pleased. Mother and baby are fine! RN-Plantation, FL February 2001 Course: Labor to Birth-Critical Concepts in Management I am a fairly new RN in labor and delivery and this was the best education I have received on L&D topics since my hire. This was a wealth of knowledge and I feel more competent than I did yesterday. I can t wait to go to work try out my new skills. Great speaker, I wish she worked with us! RN-San Antonio, TX Exceptional speaker! Wonderful information-i like the evidence-based data, I can use with the rest of my staff and physicians. As an 18 year veteran L&D nurse, I learned several new concepts and skills, this was great! The speaker had a great way of incorporating real stories into the presentation RN-San Antonio, TX

21 OB Legalities Mock Trial: How to Utilize Offensive Strategies in a Defensive Environment Two of Two Program; 8:00a-4:30p Jury Selection: Who, Why,& How Attorneys Discuss the Strategies to Pick the Perfect Juror and Jury Plaintiff v. Defense Roles and Strategies Discuss the Primary Roles, Objectives, and Legal Strategies for each side of a Medical Legal Case Deposition Role Play Watch as a National Expert is Deposed in preparation for the Mock Trial Case The MOCK TRIAL: The Legal System in Action Observe the Legal System in Action as Plaintiff and Defense Attorneys Act Out and Actual Obstetrical Malpractice Legal Case; Witness the Testimony of National Experts by Both Sides Cross Examination Witnesses, Objections, and Burden of Proof are All Explored During the Process Closing Statements Summations of Strategy Jury Deliberation Nine Jurors (Attendees) will Decide the Fate of the Obstetrical Defendants The VERDICT Mock & Actual Obstetrical Legal Outcomes are Discussed Medical-Legal Panel Discussion An Open Forum with the Mock Trial Participants: Attorneys, Experts, Defendants, Plaintiff, Jurors CONTACT HOURS: 14.8 Total 2

22 OB Legalities Mock Trial: How to Utilize Offensive Strategies in a Defensive Environment One of Two Program; 8:00a-4:30p History and Statistical Significance of OB Medical Malpractice CSC explains why Obstetrics is one of the most litigious fields in Medical-malpractice Malpractice Mayhem CSC reviews the four elements of the medical-malpractice process with a special focus on Nursing Breech of Duty. Current roles and responsibilities of the high risk perinatal and neonatal nurse will be explored OB Standards of Care to Live By CSC defines the obstetrical local, state, and national Standards of Care pertinent to defining perinatal practice. A special focus on high-risk aspects of inpatient care will be addressed. OB and The Law: Process, Players, & Pitfalls CSC will review the steps of the medical-malpractice process. The art and science of a deposition and aspects of a trial will be explored. How nurses can succeed at being deposed and on The Stand during trial. OB Medical Malpractice: Bumbles, Blunders, & Bloopers Through a case study approach, CNSA reveals real-life Perinatal Medical Malpractice cases for both defense and plaintiff verdicts. Following case presentations, group interaction and discussion, participants will render their own verdict s. Oxytocin Perinatal Asphyxia Chain of Command OB Medical Malpractice: Bumbles, Blunders, & Bloopers (Part 2) Through a case study approach, CNSA reveals real-life Perinatal Medical Malpractice cases for both defense and plaintiff verdicts. Offensive Strategies for OB Management and Nursing to Decrease Defensive Litigation CSC offers numerous nursing strategies to play offensively as a member of the Defense Team Documentation Communication Administration Competency Maintenance/Evaluation 2

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26 Course Compendium abcdefm Electronic Fetal Monitoring Course MENU (*ALL Courses support NICHD Terminology &Guidelines) abcdefmsm: Critical Core Concepts in EFM (2 ) abcdefmsm: The Advanced Course-2D EFM (2 ) abcdefmsm: Advanced-1D EFM (1 ) abcdefmsm: The MASTER Course-EFM (2 ) abcdefmsm : Advanced Update (4Hr) (CME supported) CORE Courses Critical Concepts in Perinatal Nursing: AP, IP, & PP Perinatal Emergencies & Strategies OB Trauma & Safety..Outrageous Case Studies from the Field Perinatal Survivor Island: Who Stays? Who Goes...Home?: Advanced Principles in Physical Assessment ENHANCEMENT Courses L& D to ICU: Critical Care Strategies & Challenges Medical-Legal Challenges in Perinatal Care OB Emergencies Skills & Drills Perinatal Quality + Safety = Risk Reduction: How to Best Care for Mothers & Babies CODE BLUE FHR L&D: Evidenced-Based Practice for Fetal Sentinel Events Labor to Birth: Critical Concepts in Management Mentor Me : How to Be a Preceptor & Manage New Employees through the Orientation Process Charge Nurse Survival Guide: Team-Focused Critical Thinking OB Legalities: A Mock Trial Multi- Courses Critical Care Obstetrics & Transport (3 Course) OB Core: Critical Concepts (1 week or 2 week option/10-14days) OB Core: Advanced Principles (1 week/3-6days) *Time schedules of each course are subject to change in order to meet the individual needs of the clients..

27 The Perinatal Charge Nurse Survival Guide: Roles, Responsibilities, & Reality Critical Thinking in Perinatal Healthcare Discuss How to Utilize & Mentor Critical Thinking into Practice Explain Contingency Plan Development & Implementation Practice: Explore & Group Discussion on Perinatal Dilemmas: When to Change Nurse-Patient Assignments? MD unavailable or nonresponsive? Dissatisfied Customers: Patients? Family Members? Physicians? Patient Acuity exceeding Staffing &/or Staff Competency? Patient Acuity exceeds Physician Level of Care? Patient receives wrong/poor/delayed care? Communication: Chain of Command V. Clinical Consults Outline a Standard Algorithm for Chain of Command Differentiate between Patient Safety or Clinical Advcocacy Practice: Role Play: MD v. Nse: Maternal-Fetal Safety Scenario Nse v. CNM: Clinical Advocacy Scenario Mgr v. Nse: Incident Report Scenario Objectivity in Documentation Discuss the Nurse s Role in Informed Consent Explore Administrative and Medical-Legal Aspects of Incident Reporting Offer Recommendations to Improve Documentation of Patient Log Books, Patient Care Assignment Sheets, & Interdepartmental Issues. Practice: How to Write an Objective Consult? Medical-Legal Implications on Perinatal Care Review the Statistical Significance of Perinatal & Neonatal Malpratice List several Charge Nurse techniques, skills, and behaviors to Positively Reduce Medical Legal Risk Practice: Review a Perinatal Medical Legal Case Study Professional Code of Conduct, Standards, & Ethics Define Standard of Care for Perinatal & Neonatal Healthcare Explore How to Mentor Professional Behavior Discuss Current and Future Areas of Interest in Perinatal Ethics Post-Test (if requested) Offered as a One or Two Format: Small Group Break Out Practice Sessions are included in 2 Format. CONTACT HOURS: 7.4 per or14.8 Total 1 or 2

28 The Perinatal Charge Nurse Survival Guide: Roles, Responsibilities, & Reality Course Outline8:00a-4:30p/ *Course may be offered in a Generalized Charge Nurse Format* Roles & Responsibilities: Administrative & Clinical Define the Job Description of a Charge Nurse: Credentials, Requirements, & Responsibilities Define Organizational Skills & Methodology Administrative Clinical Patient Care Rounds Resource Allocation I: Staffing & Orientation Discuss & Define Competency Outline Pro/Con of Each Staffer Full-time/Part-time/Flexi-PRN Float Agency Orientees Preceptors Assistive Personnel LPN UAP Outline Varied Staffing Models Explore Issues of Delegation Practice: Staffer-Patient Mix-Matching Resource Allocation II: Triage & Transfer Define Triage Outline Types of Triage & Indications for Each Internal External Explore Implications for Transfer & Receiving Perinatal/Neonatal Patients Practice: Triage 10: Priortize 10 Antepartum, Intrapartum, Postpartum, or Neonatal Patients per each participant specialty 1 or 2

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32 SM Critical CORE Concepts Electronic Fetal Monitoring Session Objectives ( 1) 8:30a - 4:00p: Upon completion of this session, the attendee will be able to: The Historical Perspective of EFM Review key historical events regarding the worldwide evolution of EFM Recognize EFM pioneers of fetal heart rate monitoring and implications for practical use Instrumentation Methodology Review current options for interpretation of fetal heart rate data: External & Internal Doppler Electronic Fetal Monitor External Internal Explain methodology & technology regarding equipment function Discuss the risks and benefits of each method Maternal, Placental & Uterine Anatomy & Physiology Outline key concepts in maternal adaptations to pregnancy Review the embryonic development & core functions of the human placenta Discuss physiological adaptations of the uterus to pregnancy, labor, & birth Fetal Anatomy & Physiology Review embryonic development of the human fetus Discuss the physiological adaptations for fetal growth Explore fetal tolerance & intolerance to hypoxia Essentials of Interpretation Define NICHD Guidelines & Terminology for EFM Explore the ABC s and s of EFM interpretation Explain the components of a complete fetal assessment Recognize Risky Fetus Nursing Interventions Apply critical concepts regarding invasive & noninvasive interventions for specific FHR patterns & fetal responses 2

33 Mentor Me Program How to Be a Preceptor & Grow Your Own Perinatal Nurses Course Format: DIDACTIC 8:00a-4:30p DAY 1- Mentor Philosophy, Role Definition, and Functions Adult Learning Techniques and Methodology Teaching the Art & Science of Nursing (Orientation Process) Behavioral Objectives: Basics for Preceptors Internal and External Resources Competency Analysis and Interpretation Conflict Resolution (Chain of Command) Communication Techniques DAY 2- Critical Thinking Skills & Techniques Liability in OB Professional Code of Conduct Testing and Skills Check-off Closing remarks/test scores/comp. Evaluation Certificates CONTACT HOURS: 7.4 One day or 14.8 Two day Two day: Includes Practicum Sessions for each Topic 1 or 2

34 Obstetrical Emergency Skills & Drills A Systematic Multidisciplinary TEAM Focused Approach Course Format: Didactic & Skills Course Length: 8:00a-4:30p Certificates Awarded: Contract Hour & Competency Analysis Shoulder Dystocia Physiology & Pathophysiology Management Options Personnel Equipment/Maneuvers Practicum: Skills & Drills Critique Hemorrhage Physiology & Pathophysiology Management Options Personnel Equipment/Maneuvers Practicum: Skills & Drills Critique Code Blue FHR Physiology & Pathophysiology Management Options Personnel Equipment/Maneuvers Practicum: Skills & Drills Acute, Subacute, & Chronic FHR Critique Perimortem Cesarean Section Physiology & Pathophysiology Management Options Personnel Equipment/Maneuvers Practicum: Skills & Drills Critique Each of the Four OB Emergencies consists of two Phases of Learning: Didactic: 60minutes Each learner gains evidence-based knowledge regarding current physiology and management guidelines promoting patient safety + Practicum: minutes At the completion of each OB Emergency Didactic Phase, Critical Thinking & Skills Techniques are assessed by expert clinicians in the form of Drills & Algorhythms CONTACT HOURS: 7.4 or 8.0 with Post Testing 1

35 SM: Critical CORE Concepts Electronic Fetal Monitoring Session Objectives ( 2) 8:30a - 4:00p: Upon completion of this session, the attendee will be able to: Interpretation Practice Session Review and discuss EFM Case Study Homework Return demonstration of EFM interpretation and documentation Documentation Explore current standards of care criteria for EFM Compare variations in EFM documentation techniques Review Documentation Etiquette to decrease Risk Return demonstration of accurate and concise EFM documentation Communication Explain SBAR critical components through case examples Master strong communication skills for positive collegial relations Antepartal Fetal Surveillance List various methods & implications for perinatal practice Fetal Movement Counts (FMC) Nonstress Test (NST) Oxytocin Challenge Test (OCT) Biophysical Profile Test (BPP) Define testing criteria for select perinatal populations Acknowledge the advantages and disadvantages of each method Case Study Fetal Surveillance: Putting the Skills Together Explore a variety of EFM variants through numerous case study scenarios Reassuring EFM Nonreassuring EFM Review & Testing Review course data regarding physiology, interpretation, documentation, & communication Completes the CSC abcdefm Posttest Certification EXAM with a passing grade of 85% or greater Completes On-Site Competency-Analysis: Optional CONTACT HOURS: 12.8 Total EFM Certificate with Post Test 2

36 SM: The ADVANCED COURSE 1 8:30-4:00p: Critical Concepts for a Strong Foundation Lunch Standards of Care in Fetal Assessment Clinical Application in Obstetrics Reduction in Antepartal Fetal Deaths Antepartal Fetal Surveillance Fetal Neurologic or Cardiac Dysfunction IU Hypoxia/UPI (50% Accuracy) Recognizing the At-Risk Maternal-Fetal Unit Standards of Care and Protocols: AWHONN, ACOG, NICHD, AAP, NRP Physiologic Response to Pregnancy, Labor, & Birth: Tolerance v. Intolerance Maternal Physiologic Adaptations to Pregnancy Uterine Physiology: Normal v. Abnormal Placental Physiology: Normal v. Abnormal Fetal Physiology: Tolerance & Intolerance Instrumentation: Options for Fetal Assessment Methods & Mechanics of Equipment External Options: Doppler, EFM Internal Options: FSE/IFE, IUPC The Practitioner: Scope of Practice Interventions Technology & Techniques: Pros v. Cons Pattern Definition, Recognition, Evaluation & Intervention Reassuring v. Nonreassuring: How Do You Define: Baseline Characteristics Periodic/Nonperiodic Changes Gestational Age Dependent Accelerations & Decelerations Apply EFM Core Values in EFM Interpretation and Maternal-Fetal Physiology *Individual Practice Sessions *Small Group Discussion *Strip Review & Analysis Collaborative Communication & Precise Documentation Pathways to Improve Communication & Promote Collaborative Practice Nursing Consultation SBAR Critical Components Documentation Essentials: Styles & Techniques 2

37 Labor to Birth: Critical Concepts in Management: Advanced Skills & Techniques to Optimize Maternal-Fetal-Neonatal Outcomes in the 21 st Century One or Two Options, 8:00a-4:30p, Two Topics include: Second Stage Labor Management: Options to Maximize Maternal-Fetal Oxygenation To Push or Not to Push, Is That a Valid Question? Shoulder Dystocia: Nursing Management Options to Decrease Neonatal Morbidity Is Fundal Pressure EVER an Appropriate Nursing Intervention??? Then what other options doe we have What is the OB Nurse s Role in the Operative Vaginal Delivery? Vacuum or Forceps: Strategies to Optimize Maternal-Fetal-Neonatal Outcomes through Collaborative Practice Selecting Plan B: Elective Vs Emergent Cesarean Section Risk Explore Current Trends in Obstetrical Practice Increasing the Rates of Election Inductions; What is Riskier: Elective or Emergent? Who Benefits and who is At Risk? Crisis in the Third Stage: Accreta & Uterine Inversion Prompt Nursing and Medical Interventions may Decrease Morbidity Associated with These Intrapartum Disasters Post Partum Hemorrhage: One of the Leading Causes of Obstetrical Mortality Don t Let Your Patient Die a Slow Death; Know the Warning Signs of PPH CONTACT HOURS: 7.4 per or 14.8 Total 1 or 2

38 Labor to Birth: Critical Concepts in Management: Advanced Skills & Techniques to Optimize Maternal-Fetal-Neonatal Outcomes in the 21 st Century One or Two Options, 8:00a-4:30p, One Topics include: Physiology & Pathophysiology of Labor: Don t Let Labor Dystocia Become Nursing Dystocia; Understanding the science behind labor and dysfunctional patterns ABC s of Cervical Ripening, Augmentation & Induction Agents: A Risk/Benefit Analysis of Nonpharmacologic & Pharmacologic Agents. How does Oxytocin really work? How much is needed? Tachysystole or Hyperstimulation? What is an optimal dose for optimal uterine results? Cytotec: A little pill with a big effect. Foley Catheters: Do they really open a cervix? Vaginal Birth After Cesarean: The Special Needs of a Scarred Uterus: Nursing Challenges and Strategies to Decrease the Incidence of Uterine Rupture During the Intrapartum Period; what everyone should be looking for Epidural Anesthesia: How Does It Truly Effect Labor? A Review of Current Literature on the Impact of Epidurals During Intrapartum: Do they impact labor progression or enhance it? Meconium Stained Amniotic Fluid: Implications for Fetal & Neonatal Outcomes Meconium is not Just Green, it is LETHAL!: When, Why, & How to interpret for optimal neonatal outcomes what does the evidence show? Fetal Intolerance of Labor: When Is Enough, Enough? An Evidenced-Based Case Study Approach to Evaluate the Effects of Acute & Chronic Hypoxia on the Fetus During Labor CONTACT HOURS: 7.4 per or 14.8 Total 1 or 2

39 SM: The ADVANCED COURSE 2D Lunch 2 (8:00-4:30p): Applications in Practice: Advanced Techniques & Complex Cases Challenging Case Studies in EFM Apply EFM Core Values in EFM Interpretation and Maternal-Fetal Physiology Induction of Labor Multiple Gestations Second Stage Labor Management Antenatal Assessment Techniques Antepartal Assessment Fetal Movement Counts Electronic Fetal Monitoring: NST, CST, OCT Ultrasound: Doppler Flow, 3D, 4D AFI, BPP, Modified BPP Vibroacoustic Stimulation Testing: VST Outline Clinical Indications & Define Limitations EFM Strip: An Acid-Base Monitor of the Fetus Outline Implications & Application of Data during Intrapartum The ABC s of ABG s: Arterial Blood Gases Alternative Therapies for Interpretation Complex Patterns in the High Risk Fetus Cases from the Field Explore Complex Patterns associated with Maternal-Fetal Pathology in the Maternal-Fetal Unit: Hyperstimulation Syndrome Placental Abruption Shoulder Dystocia Uterine Rupture Fetal Demise Fetal Dysrhythmia Outline a Maternal-Fetal Care Plan to include Interventions for Optimal Outcomes through Case Study Analysis Legal Intention, Quality Assurance & Clinical Responsibilities Define Standard of Care in Obstetrics Outline the Clinical Scope of Practice Responsibilities Regarding EFM Local, State, and National Guidelines Post test/certification: Optional (*Passing Grade= 85% or >) 2 CONTACT HOURS: 12.8 Total with EFM Certificate of Completion with Post Test

40 SM: Advanced-1 Course Duration: 8:00a-4:30p NICHD Guidelines & Terminology: Key Components Implications for perinatal teams has changed reviews new research and developments in the field of advanced electronic fetal monitoring and diagnostic methodology for the early diagnosis of fetal intolerance How Maternal Physiologic Compromise Influences the FHR Maternal & fetal adaptations to pregnancy, labor, and birth reveal a baseline measure for maternal-fetal tolerance. Risk factors and morbidity may significantly affect fetal tolerance and decrease endurance. Identifying patient populations at risk are focused. EFM Evolution: Acute-Subacute- Chronic Implications for Intervention CSC discusses current theory in the advanced interpretation of EFM to establish a common language among attendees and within the population of obstetrical nurses The FHR as an ABG: Blood Gas Analysis.Methods for Interpretation CSC evaluates all aspects of noninvasive and invasive blood gas analysis, rationale for discrepancies in values, and current interpretation guidelines as they apply to NICHD LUNCH The ABC s & s of Interpretation: Reassuring vs. Nonreassuring CSC s algorhythm for Interpretation success and enhanced specificity is outlined and accompanied by critical thinking skill sets. Reassuring and nonreassuring FHR interpretation is addressed from an acid-base perspective. Prompt intervention for nonreassuring uterine or FHR data is a must for the Perinatal Team. Options for interventions for various uterine and FHR characteristics and patterns are discussed. Case Studies from the FIELD: How to Enhance Maternal-Fetal-Neonatal Patient Safety (1:45-3:00p) CSC incorporates a variety of high risk & dysfunctional FHR obstetric medical-legal case studies to enhance EFM critical thinking skills surrounding advanced EFM techniques, skills, & interpretation. EFM Patient Safety & OB Medical Legal Risk Reduction CSC explains the astonishing increase in obstetrical medical malpractice claims in the 21 st Century and areas of improvement for nurses practicing in the field of maternal-fetal-neonatal healthcare. The TOP 3 OB medical malpractice issues are addressed and risk reduction measures are outlined. The importance of team practice in obstetrical healthcare is highlighted. Pre/Posttest or Certification Option Optional Multiple-choice Question Test with Certification & Competency-Analysis Included. CONTACT HOURS: 7.4 per day 8.0 with Post Testing 1

41 CODE BLUE: FHR Evidence Based Practice for Fetal Sentinel Events DAY TWO of the Two Course: 8:00a-4:30p OB Maternal Sentinel Events Hemorrhage, Amniotic Fluid Embolus, Perimortem Cesarean Section OB Ethics & Medical-Legal Implications Decision-to-Incision: Does Fetal Pathology and Current Standards of Care Support 30 Minutes? Code Blue FHR: L&D Who is on the Code Blue FHR Team? Delegation and Collaboration of All Maternal-Fetal Phases I-IV What is a Code Blue FHR in Labor and Delivery? Outline and Define Procedural Skills for Fetal Phases I-III and Maternal Phases IV-V When Do You Call a Code Blue FHR? Define NRFHR Parameters per National and International Guidelines How Do You Call a Code Blue FHR? Options for Delegation of Information for In-House and Outside Personnel are Explored Where Do You Document a Code Blue FHR? Documentation of the Maternal-Fetal Resuscitative Process are Examined Why Do You Practice a Code Blue FHR? Outline and Discuss an Annual Competency Program for Mock Code Blue FHR Drills Code Blue FHR: MOCK CODE How to Organize a MOCK Code Blue FHR? Options for Organization and Development of Training and Competency Maintenance for Level I-III Care Facilities for All Levels of Practitioners: Physicians, Nursing, OR/PACU, and Neonatal Practice a MOCK Code Blue FHR Participants will Perform a MOCK Code Blue FHR from Incident to Decision to Incision MOCK Code Blue FHR: Critique of Process Analysis and Evaluation via Open Discussion 2 CONTACT HOURS: 7.4 per or 14.8 Total

42 CODE BLUE: FHR Evidence Based Practice for Fetal Sentinel Events One of the Two Course: 8:00a-4:30p Statistical Significance of Perinatal Asphyxia & Neonatal Encephalopathy Explore the Definition and Statistical Significance of Perinatal Asphyxia, Fetal Sentinel Events, Hypoxic Ischemic Encephalopathy, Neonatal Encephalopathy, and Cerebral Palsy Fetal Intolerance Explore Objective Forms of Analysis of Fetal Intolerance to Pregnancy, Labor, and Birth as Defined by National and International Authorities and Evidenced-based Literature Neonatal Intolerance Explore Objective Forms of Analysis of Neonatal Intolerance to Extrauterine Life as Defined by: Advanced Diagnostic Testing and Evidenced-based Literature Adult Vs Fetal Compensatory Mechanisms How Does the Human Body Respond to Suboptimal Cardiac Output Across the Lifespan? Comparisons of Physiology, EFM, Apgar Scoring, and Glascow Coma Scoring is Applied Incidents & Accidents: Causation of a Code Blue FHR Defining the Implications of Acute Vs Chronic Nonreassuring FHR Causation: Maternal-Fetal-Uteroplacental Insufficiency-Cord-Medications Incidents: Socioeconomic-Antepartal Maternal/Fetal Risk Factors-Intrapartal Conditions Accidents: Cord Prolapse-Uterine Rupture-Shoulder Dystocia-Vasa Previa/Fetal Exsanguination CONTACT HOURS: 7.4 per day or 14.8 Total 2

43 SM: Advanced Update CSC Format # 1: Advanced Practice RN Speaker (MS, MSN, PhD) CSC Format # 2: MD Speaker & Adv RN Speaker (Obstetrician or Perinatologist) CSC Format # 3: MD Speaker, Adv RN, & Attorney (OB Medical Malpractice JD) Course Outline & Objectives: *May be provided as a four hour weekend breakfast meeting or after hours dinner meeting Program Objectives: Improve the knowledge base and practical skills of advanced practice obstetrical practitioners (CNM, Residents, Physicians) regarding electronic fetal monitoring in the areas of fetal physiology & pathophysiology, accurate interpretation, prompt communication, and thorough documentation Decrease maternal-fetal-neonatal morbidity and mortality specifically targeting the consumers of the Cosponsoring Hospital Optimize maternal-fetal-neonatal short and long-term outcomes Minimize obstetrical medical-legal malpractice events Goals of EFM Therapy & Data Collection Review a brief historical perspective of EFM Analyze the statistical significance of fetal death and cerebral palsy rates of occurrence NICHD Guidelines & Terminology Review Case Study Analysis in EFM: The Maternal-Fetal Interaction MD Speaker, National Perinatal CNS, or Perinatologist Discuss current options for medical management for the nonreassuring fetal state Correlate oxygenated and hypoxic fetal states with proper EFM interpretation Improve advanced EFM interpretation of the maternal-fetal unit Break Current Practice in Antepartum & Intrapartum Fetal Testing MD Speaker, National Perinatal CNS, or Perinatologist Describe various AP & IP Testing procedures and their applicable inclusion into perinatal care Outline criteria for reassuring and nonreassuring findings for various testing procedures Predict fetal outcomes following several case studies involving both AP & IP testing procedures Medical-Legal Issues in Obstetrical Practice National Perinatal CNS or Medical Malpractice Defense Attorney Discuss the overall historical perspective of medical-legal issues in obstetrical practice. Analyze the legal components of an obstetrical birth injury case Interpret the goals of the OB defendant and the plaintiff involved in medical-legal malpractice. Offer 10 solutions to decrease obstetrical litigation CME OPTION: 4Hr Category I Credit or 4 Contact Hours 1/2

44 1 (8:00a-4:30p): SM: The MASTER Course Electronic Fetal Monitoring Mastering EFM in Practice: Pearls from a Pro Address cognitive, critical thinking, and organizational skills attributable to patient assessment, interpretation, physiology, intervention effectiveness, deterioration progression, offensive communication, team-focused, and understanding the ability to abort an unsuccessful fetal care plan. Overview of EFM Evidence: What we know now that we did not know then. An Extensive Evaluation of the Evolution of EFM Evidence-based Literature; a worldwide perspective Toxic Uterine Compartments: Top 3 Causes of Perinatal Mortality The leading causes of perinatal mortality are preeclampsia, embolism, and hemorrhage. Early identification of patients at risk for severe morbidity are identified and implications for the fetus are outlined. Critical Concepts in Maternal Host Oxygen Transport Advanced principles in maternal adaptations & morbidity on cardiac output, oxygen transport, demand, and oxygen delivery are discussed. Interventions to optimize oxygen delivery while limiting maternal demand are evaluated. Maternal Adaptations Toxic Uterine Compartments: Top 3 Causes of Maternal Death Cardiac Output Principles Oxygen Transport & Delivery as Applied to the Demands of Pregnancy List Interventions to Optimize Delivery while Limiting Demand Add Case Studies *** Regulatory Mechanisms influencing Oxygen Transport to the Uterus Placental pathology significantly reduces oxygen transport to the fetus. As CO2 builds in the fetal compartment, respiratory acidosis develops. Placental and umbilical cord abnormalities are explored for implications on maternal and fetal plans of care. Fetal Regulatory Mechanisms influencing Oxygen Delivery Understanding physiologic principles in fetal development enhance the learner s ability to decipher neurologic & hormonal regulatory mechanisms of the fetal heart. Fetal heart rate modulation and physiologic implications are explained in depth. Hemodynamics of the FHR: Is it only a Pulse? Direct measurements of fetal vital signs are limited to the FHR: pulse. Understanding fluctuations as the evolve into various periodic and nonperiodic patterns are key components of mastery Evolution of the FHR: Acute vs. Chronic Hypoxia.Case Studies from the Field Progressive deterioration of the fetal heart may be slow and incidioius leading to a misdiagnosis. Both acute and chronic evolution are explored in a variety of case studies. Lessons learned CONTACT HOURS: 14.8 Total 2

45 CODE BLUE: FHR Evidence Based Practice for Fetal Sentinel Events ONE DAY ONLY: 8:00a-4:30p Fetal Intolerance & Neonatal Encephalopathy Historical Perspective and Current Trends in Electronic Fetal Monitoring, Cerebral Palsy Causation, and BCLS/ACLS Data Adult Vs Fetal Compensatory Mechanisms How Does the Human Body Respond to Suboptimal Cardiac Output Across the Lifespan? Comparisons of EFM, Apgar Scoring, and Glascow Coma Scoring is Applied Incidents & Causation of a Code Blue FHR Defining the Implications of Acute Vs Chronic Nonreassuring FHR Causation: Maternal-Fetal-Uteroplacental Insufficiency-Cord-Medications-Procedural Code Blue FHR: L&D Who is on the Code Blue FHR Team? Delegation and Collaboration of All Maternal-Fetal Phases I-IV What is a Code Blue FHR in Labor and Delivery? Outline and Define Procedural Skills for Fetal Phases I-III and Maternal Phases IV-V When Do You Call a Code Blue FHR? Define NRFHR Parameters per National and International Guidelines How Do You Call a Code Blue FHR? Options for Delegation of Information for In-House and Outside Personnel are Explored Where Do You Document a Code Blue FHR? Documentation of the Maternal-Fetal Resuscitative Process are Examined Why Do You Practice a Code Blue FHR? Outline and Discuss an Annual Competency Program for Mock Code Blue FHR Drills OB Ethics & Medical-Legal Implications Decision-to-Incision: Does Fetal Pathology and Current Standards of Care Support 30 Minutes? 1

46 Perinatal Quality + Safety = Risk Reduction: How to Best Care for Mothers & Babies One-day Option, 8:00a-4:30p: Risk: Who meets criteria?, What clinical scenarios warrant consults?, When to transfer?, & Why patient risk increases clinician and hospital risk? Maternal-Fetal Risk Status acts as a Thermometer to Population Outcomes. Flags & snags are Identified to Guide the Perinatal Team OB Triage: Who to Keep, Who to Send Home, & WHOM should perform the Assessment-ER vs OB Protocol recommendations from ACOG, AWHONN, ENA, & ACEP to Prioritize OB Criteria for Emergent, Urgent, & Routine Care..making the most out of a Patient Encounter 98% of OB Medical Malpractice involves Oxytocin: Stories form the War Zone Applying Uterine Physiology to Pharmacodynamics: Maximizing Drug Effects from Evidence-based Literature while promoting Fetal, Maternal, and Neonatal Safety Evolution of the FHR as a Risk Factor for OB Malpractice...Lessons Learned JCAHO Sentinel Event Survey shows evidence for the leading causes of perinatal mortality. How to Get a Clinician s Attention.. Methods for Verbal Expression Success! Tick-Tock.Decision-to-Incision vs. Fetal Intolerance: How Long SHOULD we take to perform an Emergent Cesarean Section? Fetal tolerance levels have been documented in the literature since the 1960 s yet Perinatal Behaviors remain Delayed. Discussions on How to improve the Perinatal Response Time during Acute Sentinel Events are explored. The #1 Killer of the Perinatal Population: MISCommunication JCAHO Sentinel Event Survey shows evidence for the leading causes of perinatal mortality. How to Get a Clinician s Attention.. Methods for Verbal Expression Success! Patient Safety Focused..Surviving a Near-Miss How to Promote a Patient Safety Initiative on a Case-by-Case Basis through Analysis and Reform 1 CONTACT HOURS 7.4 or 8.0 with Post Testing

47 SM: The MASTER Course 2 (8:00-4:30p): Electronic Fetal Monitoring Perinatal Asphyxia, Neonatal Encephalopathy, & Cerebral Palsy: Outcomes to Avoid International and national guidelines and recommendations on the definitions of perinatal asphyxia are compared. Each diagnosis is often present in obstetrical medical-legal malpractice cases. Implications on practice are discussed. Fetal Dysrhythmias: Lethal & Non-lethal Identification, pathophysiology, and current management strategies are outlined with the following dysrhythmias in the fetus: atrial flutter/fibrillation, supraventricular tachycardia, ventricular tachycardia, ventricular fibrilliation, pulseless electrical activity, congenital heart block, asystole Invasive & Noninvasive Interventions: What Does the EVIDENCE Show? Many intrauterine resuscitation techniques originally were not evidence based. Current literature exists as to the relevance of routine maneuvers on maternal, fetal, and neonatal outcomes. The following will be evaluated and compared: Scalp Stimulation to Scalp ph: Worldwide comparison IVF Bolus VS Analysis: What do they tell you *Maternal BP=Fetal BP Oxygen: Is it still OK to apply? Medications: E---BP Rx, Terb for tachsystole Rx, Turn off the Pit: When & For How LONG? Notify the Practitioner: MISCommunication is Killing Fetuses...Skills on How to Improve *** How to Utilize the FHR, Apgar, or Cord Blood as an Acid-Base Calculator Advanced FHR interpretation skills are outlined to explore the deterioration patterns of a fetus. Apgar scoring is compared to original intent and current standards of care. Biochemical acid-base principles are outlined in detail for mastery of interpretation in cord blood analysis. Challenges & Controversies in EFM..Case Studies to Despise & Energize! Critical care obstetrical cases are evaluated as a large group discussion. Physiology, pathophysiologic deterioration, FHR evolution, intervention effectiveness, team-focused strategies, medical-legal implications, and ultimate outcomes are discussed in a variety of case studies. Future Technologies: EFM & Adjunct Therapies EFM is not the only technology in fetal assessment. Worldwide application of numerous options have existed for decades, will any of them make it in America? FSpO2 What Happened???????? 4D Ultrasound Computer-assisted EFM Interpretation NIRS: Near Infrared Spectronometry STAN: ST Segment Analysis CONTACT HOUR S 14.8 Total 2

48 SM The TEXTBook: Electronic Fetal Monitoring Published in June 2006, this evidenced-based resource is the ONLY textbook in print applying NICHD terminology and guidelines cover-to-cover. Critical thinking techniques are incorporated into each chapter to guide multidisciplinary interpretation and intervention. Our textbook meets the national patient safety goal as the premier resource to enhance team work and effective communication among all perinatal providers. Primary Text Reviewer: Julian Parer, MD PhD, University of California, San Francisco & Chairman, : NICHD Research Planning Workshop- Electronic Fetal Monitoring: Research Guidelines for Interpretation Authors: Curran & Torgersen are nationally recognized leaders, researchers, and consultants on electronic fetal monitoring & medical legal implications Target Audience: Any perinatal practitioner responsible for interpretation of EFM to include: Nurses, Nurse Midwives, Residents, & Physicians The Pocket Guide: Electronic Fetal Monitoring As a supplemental tool to The TEXTBook, this quick reference guide offers core NICHD terminology and guidelines at your fingertips. The 14-card laminated reference includes additional topics to enhance skill and patient safety: NICHD Terminology, A-B-C s & s of EFM Interpretation, Classification of Reassuring vs. Nonreassuring, Interventions: UC & FHR, Code Blue FHR Guidelines, and Acid -Base Interpretation & Interventions. Order for all perinatal staff members (nursing staff, residents, nurse midwives, office staff, and physicians) to enhance communication and documentation consistency and increase patient safety Attach to each EFM (Antepartum Unit, Labor & Delivery, Antenatal Testing, OB Office, Emergency Department, & Operating Room) as a quick reference for all perinatal staff The CESG-I: Continuing Education Study Guide-I CE Study Guides are the current supplemental tool to our abcdefmtm productline. The CESG-I was developed for use with our abcdefmtm The TEXTBook. This tool is an excellent mechanism for competency assessment and knowledge retention regarding EFM techniques as they apply to the NICHD guidelines and terminology. CESG-I Certificate of 12.0 Contact Hours Certificate is issued to One Practitioner tm The CESG-I: Electronic Fetal Monitoring 12.0 Contact Hours Awarded CESG incorporates Post Testing & Competency Assessment of Key components of NICHD Terminology & Guidelines Supplement to the abcdefm tm: : The TEXTBook Mail the completed CESG to CSC for Full Credit Copyright CSC All rights reserved. Certification Certificate is Issued with a Post Test Score > 85% order now at

49 Medical Legal Challenges in Perinatal Care: How to Utilize Offensive Strategies in a Defensive Environment History and Statistical Significance of OB Medical Malpractice CSC explains why Obstetrics is one of the most litigious fields in Medical-malpractice Malpractice Mayhem CSC reviews the four elements of the medical-malpractice process with a special focus on Nursing Breech of Duty. Current roles and responsibilities of the high risk perinatal and neonatal nurse will be explored OB Standards of Care to Live By CSC defines the obstetrical local, state, and national Standards of Care pertinent to defining perinatal practice. A special focus on high-risk aspects of inpatient care will be addressed. OB and The Law: Process, Players, & Pitfalls CSC will review the steps of the medical-malpractice process. The art and science of a deposition and aspects of a trial will be explored. How practitioners can succeed at being deposed and as a witness at trial. OB Medical Malpractice: Bumbles, Blunders, & Bloopers Through a case study approach, CSC reveals real-life Perinatal Medical Malpractice cases for both defense and plaintiff verdicts. Following case presentations, group interaction and discussion, participants will render their own verdicts. Oxytocin Perinatal Asphyxia Chain of Command OB Medical Malpractice: Bumbles, Blunders, & Bloopers (Part 2) Through a case study approach, CSC reveals real-life Perinatal Medical Malpractice cases for both defense and plaintiff verdicts. Offensive Strategies for OB Management and Nursing to Decrease Defensive Litigation CSC offers numerous nursing strategies to play offensively as a member of the Defense Team Documentation Communication Administration Competency Maintenance/Evaluation CONTACT HOURS: 7.4 or 8.0 with Post Testing 1