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CEN: Psychosocial Emergencies
The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of psychosocial emergencies, their signs and symptoms, their management, and the nursing interventions that are needed.
The goal of this course is to review the knowledge domains specific to psychosocial emergencies included as a part of the Certified Emergency Nurse (CEN®) exam.
Recognize signs and symptoms of specific psychosocial emergencies.
Identify strategies to manage psychosocial emergencies.
CEN: Respiratory Emergencies
The Certified Emergency Nurse (CEN®) is required to demonstrate competency in the domain of emergency nursing which includes knowledge of respiratory emergencies, their signs and symptoms, their management, and the nursing interventions.
The goal of this course is to review the knowledge domains specific to respiratory emergencies included as a part of the Certified Emergency Nurse (CEN®) exam.
This course is not affiliated with the Board of Certification for Emergency Nursing (BCEN).
Identify signs and symptoms of life-threatening respiratory illnesses and injuries.
Analyze strategies to manage respiratory conditions and emergencies that present to the emergency department.
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.
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.
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.
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.
Collecting and Preserving Evidence in a Healthcare Setting
Whenever a crime occurs, evidence can be transferred among the perpetrator, victim, and the crime scene. Law enforcement personnel collect and preserve crime scene evidence. Healthcare professionals can simultaneously assist with a crime investigation and provide good healthcare to patients by collecting and preserving evidence from the patient’s body. It is imperative to understand that the collection and preservation of evidence from a patient should never compromise the patient’s safety, autonomy, or legal rights. This course provides an overview of interviewing, collecting, and preserving forensic evidence, toxicology, and documentation.
Recognize how nurses and other healthcare professionals can impact the outcome of criminal investigations.
Describe how to document information regarding the collection of evidence and forensic findings while providing patient-centered, high-quality healthcare.
Identify the measures necessary to preserve forensic evidence and maintain the proper chain of custody.
Communicating with Patients
Effective communication with patients and families is the foundation for a therapeutic, safe, and positive patient experience. The patient‘s experience of care is greatly influenced by what is communicated and observed. It is also a vital component of obtaining an accurate history and physical assessment, providing informed, comprehensive care, and educating patients and families to achieve optimal outcomes. The goal of this course is to provide information about how to effectively communicate with patients in healthcare settings.
Identify at least three specific elements of effective communication and how communication affects the patient and family experience.
Recall important components of cultural competence and inclusivity when communicating with patients and families.
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.
Cultural Perspectives in Childbearing
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.
Recall the relationship of culture, subculture, acculturation, assimilation, ethnocentrism, cultural relativism, and cultural humility to healthcare practice.
Recognize elements of cultural assessment and respectful maternity care that can improve quality of care and meet the unique needs of culturally diverse families.
Culture and Mental Health
Culture affects how individuals talk about and recognize their mental health symptoms. It also affects how providers conceptualize and work with individuals with diverse backgrounds. It is important to recognize how culture influences the ways individuals and providers approach mental health. Healthcare providers should be encouraged to use interventions and strategies that assist in delivering culturally competent care.
This course will examine the reasons for healthcare disparities among culturally diverse individuals, how both the cultural backgrounds of patients and their providers can impact patients’ mental health outcomes, and what kinds of actions providers can take to provide more effective care to patients of diverse cultures.
Distinguish between some of the different assumptions and values that mental health providers and individuals hold, which influence their approaches to mental health. Explain why patients of diverse cultures with mental health needs are encountering disparities. Select assessment and intervention strategies that promote culturally competent care.
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.
Culture and Women's Health
According to the U.S. Census Bureau, minority groups will outnumber what is now considered mainstream culture by the middle of this century. Healthcare professionals need to heighten their awareness about the importance of role, culture, and tradition in preventing and treating women’s unique healthcare problems. When there is a lack of cultural sensitivity in communication, patients are less likely to be content with their healthcare experience, increasing the likelihood of miscommunication and possible cultural disparities. These factors can also cause non-compliance with treatment, worse health outcomes, and a higher incidence of adverse events.
The goal of this course is to equip healthcare professionals with knowledge of the impact of culture on women’s health beliefs and practices and their responses to current approaches to care.
Recall different cultural practices that impact women in various stages of life. Identify two cultural practices that interfere with women’s health. Recognize ways to provide culturally competent care to women.
DEI: An Introduction to Multicultural Care
Increasing awareness of cultural diversification has challenged traditional institutions and practices. This includes the delivery of treatment services. Outcome studies have consistently demonstrated the need for change in the way that healthcare and other services operate. Awareness of and sensitivity to cultural issues are critical to establishing a positive relationship with the people you are serving and ensuring beneficial treatment outcomes.
Identify three primary reasons why a commitment to diversity, equity, and inclusion is critical for providing quality care and improving outcomes for individuals with behavioral health needs.
Summarize ways you can identify and mitigate the impact of bias in your professional interactions.
Indicate at least three approaches you can use to demonstrate cultural humility and a commitment to diversity, equity, and inclusion.
Discrimination in the Workplace for Supervisors
The U.S. Equal Employment Opportunity Commission (EEOC) is responsible for enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person's race, color, religion, sex, national origin, age, disability, or genetic information. The federal laws are very specific about the ways in which you, as an employer, are expected to select, promote, and accommodate your employees. You can be held liable for discrimination whether or not you intentionally discriminated against your employee, so it is imperative that you understand the federal laws prohibiting discrimination.
Identify at least five employment practices that may constitute discrimination. Identify at least three examples of “reasonable accommodation” of employees and “undue hardship” to an organization.
Documentation: The Legal Side
As a professional nurse, you are expected to be familiar with many aspects of care. You are not exempt from malpractice or negligence claims because you were following orders. You are responsible for assessing, planning, implementing, and evaluating appropriate nursing care. What you document can and does reflect the care provided and the outcomes of that care. Documentation that is factual, complete, timely, and detailed is required. In this course, you will learn about concepts and rules regarding documentation in the medical record. Legal aspects to be aware of while practicing will also be discussed. The goal of this course is to educate nursing professionals in post-acute care settings about the legal implications of documentation.
Discuss malpractice, negligence, and compensatory and punitive damages as they relate to healthcare. Explain four intentional torts that a healthcare professional may be held liable for. Describe four documentation techniques to use to avoid legal issues.
Domestic Violence Awareness for Healthcare Personnel
Nurses encounter victims of domestic violence or intimate partner violence regardless of where they work. Those who practice in offices, hospitals, clinics, homes, or facilities must be aware that living with domestic violence may be part of a person’s daily life. Even though education for healthcare professionals and routine screening in EDs is mandated, many abused people do not receive needed support. Nurses are able to recognize and help victims, yet do not necessarily receive education about domestic violence. This updated CE module provides information nurses need to increase their understanding of and provide support to people experiencing domestic and intimate partner violence.
Disclaimer: Images in this course depict violence that has been inflicted on children and adults. They may be disturbing to some learners.
List steps ensuring the safety of abused women who decide to leave an abusive environment Identify the role of intimate partner advocacy in helping victims or survivors to understand that physical, sexual, or emotional abuse is not their fault but an issue of power and control. Relate direct and indirect questions that broach the subject of violence and abuse with patients, partners, and family members to screen for abuse. Identify risk factors, signs, and symptoms associated with abuse and neglect across the lifespan.
Drug Diversion, SUD, and Pain Management
Safely managing pain for the people in your care requires you to be knowledgeable about pain management recommendations. It is important to understand the risk factors for misuse and substance use disorder (SUD) as well as the signs that someone has a SUD and how to treat it. Unfortunately, SUD is one of the drivers of drug diversion. Therefore, it is also critical that you understand drug diversion tactics and behaviors so you can help prevent it. The goal of this course is to educate healthcare providers in all settings on pain management and preventing substance use disorder and diversion.
Discuss drug diversion and related drug diversion behaviors and activities.
Identify various classifications of medications that are diverted or misused.
Describe screening and assessment tools helpful in identifying substance use disorders.
Recognize nonpharmacological and pharmacological treatments of substance use disorders.
Explain options for pain management.
Economic Stability: Social Determinants of Health
Economic stability is defined as a domain of social determinants of health in the Healthy People 2030 campaign. It relates to an individual’s ability to access resources such as food, adequate housing, and healthcare. Each component of economic stability, including poverty, employment, food security, and housing stability, is linked to individual health outcomes.
Describe the four components of economic stability.
Explain how economic stability affects health and health outcomes.
Identify strategies for helping patients overcome barriers to economic stability and how they positively impact health outcomes.
Emergency Department: HIPAA and CFR42
In an emergency department, information often flows amongst providers and patients quickly because of urgent, sometimes life-threatening, situations. Due to the volume of information being shared, as well as the need for it to be shared quickly and accurately, emergency department providers must be especially careful to safeguard patient information.
The goal of this course is to update nursing professionals in the acute care setting with basic information about the Health Insurance Portability and Accountability Act (HIPAA) and 42 CFR Part 2.
Identify information sharing standards under HIPAA and 42 CFR Part 2.
Define the concept of consent, when you must obtain it to share or receive information, and the types of information that may not be available to you.
Emergent Delivery of Infant
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.
Know the clinical presentation and physical exam findings associated with pregnancy.
Recognize the common complications associated with pregnancy. Plan the steps to prepare the process of delivery of a newborn.
Recognize common complications of delivery of a newborn.
EMTALA Requirements
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.
Define key terms and requirements associated with EMTALA.
Describe how EMTALA applies to certain situations.
Ethics for Licensed Professionals: 1 Hour
Ethics are a significant part of high-quality clinical practice. This one hour course presents ethical principles and responsibilities of healthcare professionals. The goal of this course is to provide healthcare professionals with an awareness of how ethics impact clinical practice and an approach for analyzing ethical issues in clinical practice.
Identify definitions, similarities, and differences of common ethics terminology and concepts.
Describe the four healthcare ethical principles and their implications for clinical practice.
Apply an ethical decision-making model to ethical issues and dilemmas.
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.
Forensic Evidence Collection
Forensic evidence connects the scene, the survivor, and the suspect together to assist the justice system in solving crimes. Crucial parts of evidence collection include knowing the correct procedures to preserve evidence and prevent contamination. Patients presenting to the emergency department with injuries requiring forensic evidence collection are often afraid and distressed. Healthcare professionals should know how to care for their emotional needs as well as their physical ones.
Identify the fundamentals of survivor-centered care. Recall important elements of documentation in forensic medical care. Define the essential components of forensic evidence collection.