Full Course Description
Transformative Nursing in the NICU: Trauma-Informed, Age-Appropriate Care
The NICU experience is at best traumatic. Despite the lifesaving nature of the services provided in this highly technologically driven setting, one must not lose sight of the primary purpose of healthcare. Healthcare is much more than a focus on survival. The fundamental purpose of healthcare is to enhance the quality of life by enhancing health. According to the WHO, health is not simply the absence of disease but a state of complete physical, mental, and social well-being. Transforming the experience of care in the NICU for babies and families begins with the individual healthcare professional. The evolution of neonatology and medicine at large has taken us further and further away from our shared humanity and into a place where our patients and even ourselves are reduced to parts and functions. Reconnecting with our own story, our values and beliefs creates a bridge that restores our collective consciousness. When we can see ourselves in others, we open the door for more compassionate and loving encounters. This new vision enables us to serve at our highest level, increasing our job satisfaction as we ease the suffering of others, which, in turn reduces our own experience of compassion fatigue and burnout. This session will present the biology of trauma and how these experiences can be mitigated and buffered through authentic caring relationships grounded by love.
Program Information
Objectives
- Determine the biology of early life adversity and toxic stress.
- Debate 3 long term consequences associated with early live adversity and toxic stress.
- Apply 3 best practices that mitigate the experience of early life adversity and toxic stress.
- Commit to one small first step towards becoming trauma informed.
Outline
Introduction
The Biology of Toxic Stress
- Fetal Development
- Developmental Trajectory
- Long Term Consequences
Moderators of Toxic Stress
- The Core Measures for Trauma Informed Developmental Care
- The Principles of Trauma Informed Care
- The Healing Power of Connection
The Power of Story
- Trauma Exposure Responses
- The Walking Wounded versus the Wounded Healer
- Unitary Caring Science
Conclusion Target Audience
- Lactation Consultants
- Nurses
- Nurse Practitioners
- Physical Therapists
- Physical Therapist Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech Language Pathologists
- Other Healthcare Professions
Copyright :
02/09/2023
The Preterm Brain: Development, Injury and Influence
The preterm brain is highly susceptible to injury and influence. Every interaction we have as providers can have significant influence on the long-term outcomes of this fragile population. Understanding development of the preterm brain, the pathophysiology of injury and infection, and the influence of our daily interactions will help practitioners deliver the highest quality care to the tiniest of patients.
Program Information
Objectives
- Determine normal development of the central nervous system from conception through 40-weeks gestation.
- Assess normal neurosensory development in the neonate, and implement three interventions to minimize effects of the NICU environment on the preterm infant.
- Formulate a list of the most common brain injuries seen in the preterm population.
- Evaluate evidence-based interventions to prevent brain injury in the preterm neonate.
Outline
Structural development of the fetal brain from conception to term
- Differences in brain complexity from 20-40 weeks
- Structural brain and neural definitions and functions
- Susceptibility to injury & infection
Sensory development of the brain and effects of outside influence due to preterm birth, injury, or illness
- Sensory systems
- Influence of pain on the preterm brain
- Developmental care
Preterm brain injury-Pathophysiology and prevention
- Intraventricular hemorrhage-stage classification and nuances of diagnosis
- Periventricular Leukomalacia-definition and recognition
- Post-hemorrhagic hydrocephalus-classification and treatment
- Infection-risks and strategies to prevent hospital-acquired infection
Target Audience
- Lactation Consultants
- Nurses
- Nurse Practitioners
- Physical Therapists
- Physical Therapist Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech Language Pathologists
- Other Healthcare Professions
Copyright :
02/09/2023
Shining a Spotlight on Feeding in the NICU and Beyond
Current evidence suggests 40% of infants who begin life in the NICU have feeding or growth problems within the first four years of life. And yet the focus within the NICU is often on simply getting the infant to eat well enough to go home. It is not enough to establish oral feedings in the NICU – professionals need to understand the ongoing development of feeding to support these infants and their families both in the hospital and after discharge. This session will review what is known about the normal development of eating as well as detail what the challenges are for infants and families after discharge. It will provide a model for understanding what needs to be done differently in the NICU to change the long-term feeding outcomes of these fragile infants, as well as suggestions for interventions.
Program Information
Objectives
- Analyze how classical conditioning relates to the development of feeding aversions.
- Apply two competencies for feeding, eating and nutrition in the NICU setting.
- Debate why infants have feeding/eating challenges after discharge from the NICU.
- Determine two behaviors that indicate an infant is not ready to engage in a feeding experience.
Outline
Struggles to establish safe, enjoyable feedings
- Current research on starting feedings early to decrease length of stay
- Research on feeding outcomes post-discharge
- Feeding and growth projections
Are we the etiology for the poor long-term outcomes post-discharge?
- A shift in the focus of feeding experiences in the NICU
- Changes to feeding after discharge
- Education
Published resources to guide professional practice
- Best practices
- Standards and competencies
- Limitations to current research
Target Audience
- Lactation Consultants
- Nurses
- Nurse Practitioners
- Physical Therapists
- Physical Therapist Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech Language Pathologists
- Other Healthcare Professions
Copyright :
02/09/2023
What is Behavioral Health in the NICU?
Very often when families learn that the newest member of their family needs time in the NICU, panic strikes. Research shows that infant medical severity has no influence over family mental health during a NICU stay. That means whether a neonate simply needs more time to grow and feed in the NICU, family members may experience diagnosable conditions such as Acute Stress Disorder, anxiety (or postpartum anxiety), major depressive Disorder, or even posttraumatic stress disorder (PTSD) related to their infant’s NICU hospitalization. These diagnoses have been shown to negatively impact infant outcomes resulting in longer NICU stays, limited skin-to-skin contact and even later developmental delays. In this session, you will improve your ability to accurately refer families for behavioral health services. Parental mental health, infant-bonding, and developmental care practices will be discussed so that you can help families gain positive health outcomes during their time in the NICU. Racial, cultural and linguistic considerations will be reviewed.
Program Information
Objectives
- Determine two cultural considerations when referring NICU patients and families for Behavioral and Mental Health Consults.
- Propose a definition for behavioral health in the NICU.
- Implement common assessment tools for screening NICU family mental health.
- Propose three ways that healthcare practitioners can support infant-parent bonding in the NICU.
Outline
What is Behavioral Health In the NICU?
- Define behavioral health in NICU settings
- Roles of psychology/counseling vs social work in many US hospital systems functions
- Brief introduction into infant mental health
What is the Impact of Behavioral Health in the NICU?
- Discuss infant outcomes
- Examine infant-parent relational bonding in the NICU
When to refer to Behavioral Health in the NICU?
- Explore common diagnostic outcomes for NICU families
- Examine signs of significant parental distress
- Brief review of select screening tools
Target Audience
- Lactation Consultants
- Nurses
- Nurse Practitioners
- Physical Therapists
- Physical Therapist Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech Language Pathologists
- Other Healthcare Professions
Copyright :
02/09/2023
Optimizing Ventilation of the Premature Infant
In the neonatal intensive care unit (NICU) the aim of any ventilation strategy is to support the neonate’s respiratory system during compromise while limiting any long-term damage to the lungs and the skin. In this session, we will review the many different ventilation modes and strategies that are available to assist with the optimization of non-invasive ventilation management.
Program Information
Objectives
- Using evidence, differentiate between the variety of ventilation modalities reviewed.
- Differentiate between flow-generated CPAP and bubble CPAP.
- Distinguish the various NIV interface options.
- Propose the device selection between different systems but the same modality.
Outline
Standard NC
High flow NC
- Review Vapotherm system
- Review Optiflow system
- Heating and Humidity
CPAP
- Flow generated
- Bubble
- Heating and Humidity
Non-Invasive Ventilation modes in various ventilators
- Review differences between a few ventilators and their NIV modes and how they work
- Review interfaces differences connected to ventilator
- Heating and Humidity
Complications Target Audience
- Lactation Consultants
- Nurses
- Nurse Practitioners
- Physical Therapists
- Physical Therapist Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech Language Pathologists
- Other Healthcare Professions
Copyright :
02/10/2023
Is My License on the Line? A Discussion of Legal Issues in the NICU
Everyone has heard stories in the news regarding formula recalls, lawsuits for NEC, birth injuries, infants with permanent brain damage and Cerebral palsy, and HIE. Nurses and healthcare workers are scared that they could be tried as a criminal if they make a mistake. This session will discuss legal issues pertinent to caring for patients in the neonatal intensive care setting, define negligence, and how caregivers of this vulnerable population can keep their patients and themselves safe.
Program Information
Objectives
- Advocate for standards of care and identify importance of adhering to policies and standard operating procedures for the neonatal population.
- Compose legal terminology and legal processes in a healthcare lawsuit.
- Analyze common errors and current lawsuits directly related to the neonatal population.
- Determine accountability for reporting medical errors.
Outline
Neonatal Nursing standards of care
- Professional practice for RNs, graduate RNs and advanced practice nurses
- Neonatal specialty
- Certification requirements and expectations
Legal thinking and descriptions
- Types of neonatal lawsuits
- How to determine negligence
- Anatomy of a deposition
Medical Errors in the NICU
- Most common errors
- Who is accountable for reporting
- Just Culture
- Reducing medical errors
Target Audience
- Lactation Consultants
- Nurses
- Nurse Practitioners
- Physical Therapists
- Physical Therapist Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech Language Pathologists
- Other Healthcare Professions
Copyright :
02/10/2023
Transition from NICU to Home
Evaluation of the fragile infant takes special skills and connection to family. There may be intensive treatments based on work – rest and goals established, to catch up milestones with their peers. Looking at the medical findings, scans, genetic tests, equipment needs will provide knowledge about what is happening on the outside. Neurological findings enlighten the therapist to what is working and what may need to be rewired for optimum function. Accommodations may need to be designed for special cases. Tracheostomies, feeding tubes and oxygen are a few items we must work around to encourage rolling, coming to sitting and other milestones.
Program Information
Objectives
- Create a list of findings to guide treatment and goal setting for the newborn.
- Evaluate motion, position tolerance, and symmetry of the infant and how it relates to occupation and participation.
- Apply knowledge to enhance progress toward developmental milestones.
Outline
From floating in amniotic fluid to gravity and ground: What to do when they are homeward bound
- History
- Neurological findings
- Genetics
Function
- Evaluate motor functions that are working
- Assess what is not working well
Asymmetry – face, neck, trunk, upper and lower extremities
Positional movements
- Tummy time
- Supine positions
- Side lying
- Accommodations for tracheostomy, oxygen, tube feeding equipment
Asymmetrical presentations
- Torticollis
- Scoliosis
- Tone
- Arm and leg lengths
Determine pain influence
- Methods of treatment
- Myofascial assistance
Building a home program for the newborn
- Activities to gently awaken the nervous system
- Positioning and movement
Target Audience
- Lactation Consultants
- Nurses
- Nurse Practitioners
- Physical Therapists
- Physical Therapist Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech Language Pathologists
- Other Healthcare Professions
Copyright :
02/10/2023
Health Equity in the NICU
When a baby is born prematurely and needs to be hospitalized in the NICU it is an overwhelming experience for families. And when families with premature babies come from multicultural backgrounds, this experience is often even more challenging. In this session, Ashley Randolph will talk about the unique needs of parents of color in the NICU, including how cultural factors impact how a family responds to the NICU experience. She will review how NICU professionals and families can establish a relationship with all families that is based on trust, mutual respect, and positive consistent communication. You will be introduced to the skills, tools, and resources to deliver more equitable care in the NICU.
Program Information
Objectives
- Identify common communication barriers between NICU parents and care providers.
- Provide specific strategies for promoting equity in the NICU.
- Prepare all for transition from NICU to home.
Outline
Health Literacy
- Assessing and addressing the cultural factors that impact how a family responds to NICU experience
- Addressing health literacy
- Minimize miscommunication
Environments that promote equity – Unique needs of parents of color
Language Barriers in the NICU
- Language and cultural barriers
- Developing a trusting environment between clinician families
- Positive consistent communication
- Cultural differences of families that may potentially affect care
Resources to Empower NICU Families
- Connecting caregivers with the necessary medical, community and benefit services
- Family Readiness
- Community Readiness
Target Audience
- Lactation Consultants
- Nurses
- Nurse Practitioners
- Physical Therapists
- Physical Therapist Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech Language Pathologists
- Other Healthcare Professions
Copyright :
02/10/2023
Neonatal Abstinence Syndrome Practice Essentials
Treating neonates with Neonatal Abstinence Syndrome has often involved the separation of the mother infant dyad and a NICU admission; something we know interrupts bonding and infant development.
In the last several years a new family centered model called Eat Sleep and Console (ESC)was developed. This model promotes maternal engagement, breastfeeding, the mother infant dyad rooming-in and a functional based assessment of infants. The approach is a substantial change from previous NICU care using primarily a pharmacological approach based on a scoring tool to treat and care for these babies. This session will review the history of treating substance exposed neonates, the development of the ESC model, and a functional approach to the assessment of a substance exposed infant.
Program Information
Objectives
- Differentiate between Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWs).
- Formulate the clinical presentation of a substance exposed infant.
- Differentiate the differences between the traditional scoring methodology and ESC.
- Assess the ability of a substance exposed neonate to effectively Eat, Sleep and Console.
- Integrate the parent/caregiver into the plan of care.
Outline
- What is NAS/NOWs
- Definitions
- Opioid Substances
- Non-Opioid Substances
- Etiology of NAS
- Signs and Symptoms
- Treatment and Intervention
- Non-Pharmacologic Management
- Pharmacologic Management
- ESC rationale and development
- ESC assessments
- Eating
- Sleeping
- Consoling
- Parent/Caregiver Presence
- Creating a supportive environment
- Parent presence
- Parent Teaching
- Recommendations
Target Audience
- Nurses
- Nurse Practitioners
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Speech Language Pathologists
- Other Professions
Copyright :
11/09/2022
Feeding Practices and Necrotizing Enterocolitis
Enteral feedings is the preferred method of nutrient delivery for preterm infants with evidence supporting significant nutritional and non-nutritional benefits. Practices vary in NICUs leaving best practice abroad. Barriers for initiating and advancing enteral feeds include provider fear of Necrotizing Enterocolitis (NEC), limited evidence, and excessive growth leading to high adiposity. This recorded session will demonstrate supporting evidence that enteral feedings, especially early enteral feedings, has an impact on the overall health, growth, and development of the preterm infant.
Additionally, NEC continues to remain an indicator for high mortality rates in preterm infants, despite ongoing research and advancements in neonatal care. Here we will review the current understanding of the disease, risk factors, pathophysiology, and its epidemiology. We will discuss management and prevention of NEC in addition to new emerging research.
Program Information
Objectives
- Determine the benefits of enteral feedings.
- Formulate safe feeding practices for preterm infants.
- Determine specific nutritional requirements.
- Analyze the pathophysiology of necrotizing enterocolitis (NEC).
- Distinguish signs and symptoms of NEC.
- Differentiate medical and surgical interventions for NEC.
- Assess for complications related to NEC.
Outline
- Nutritional Requirements for Preterm Infants
- Human Milk Vs Formula
- Nutrient per Kg
- Growth chart
- Benefits of Early Enteral Feedings
- When to start enteral feeds
- Stable infants
- High risk infants
- Colostrum as mouth care
- Advancing Feeds/Full Feeds
- Trophic feeds
- Assessing Feed Tolerance
- Rate of advancement
- Barriers
- Understanding best practice
- Infants with congenital abnormalities of the GI tract or following GI surgery
- Standardization of Practice across NICUs
- Etiology and Pathophysiology of NEC
- Multifactorial
- Prematurity
- Bacteria Flora
- Incidences
- Clinical indicators
- Subtle Indicators
- Feeding intolerance
- Delayed gastric emptying
- Abdominal distention
- Ileus
- Hematochezia
- Pneumatosis
- Systemic Signs
- Apnea
- Decreased tone
- Shock
- Cardiovascular response
- Laboratory Studies
- Metabolic acidosis
- Hyponatremia
- Thrombocytopenia
- Neutropenia
- Differential Diagnosis
- Malrotation
- UTI
- Meningitis
- Septicemia
- Hirschsprung’s Disease
- Diagnosis
- CBC, Chemistries, blood culture, blood gas
- Abdominal X-rays (AP and Lateral)
- Upper GI
- Abdominal Ultrasound
- Management and Surgical indicators
- Bell Stages of NEC
- NPO
- Antibiotics
- Vasopressors
- Volume expanders
- Parenteral nutrition
- Antifungals
- Central line access
- Prognosis and complications related to NEC
- Survival rate
- Long term complications
- Intestinal Strictures
- Short gut syndrome
- Prevention
- Prevent asphyxia
- Antenatal steroids
- Use of Human Milk
- prevent infection risks
- monitor feed tolerance
- Barriers
- Limitations of Research
- Understanding all potential risks and causative factors
Target Audience
- Nurses
- Nurse Practitioners
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Speech Language Pathologists
- Other Professions
Copyright :
11/17/2022
Neonatal Sepsis
One of the most common clinical issues you will encounter while working in the Neonatal Intensive Care Unit (NICU) is neonatal sepsis. Do you feel confident in identifying a neonate’s unique risk factors, along with recognizing the subtle signs and symptoms for neonatal sepsis? What about collecting and analyzing the relevant diagnostics, integrating multiple clinical interventions, and participating in infection prevention measures, all the while promoting family engagement to best manage these situations? Or would you like a refresher?
Whether you are a 20-year NICU veteran, transitioning to the NICU, or a new grad, this dynamic recording led by Mel Cook MSN, RNC-NIC, C-ELBW, PHN, DNP-c will equip you with the knowledge and confidence you need to effectively manage neonatal sepsis.
Program Information
Objectives
- Define the physiology of a neonate’s immune system.
- Identify a neonate’s risk factors.
- Characterize Early Onset Sepsis vs Late Onset Sepsis.
- Describe the clinical presentation of a septic neonate.
- Evaluate the diagnostics for neonatal sepsis.
- Discuss the clinical treatments for neonatal sepsis.
Outline
- What is Neonatal Sepsis
- Impact
- How the Immune System Works
- Innate Immune System
- Adaptive Immune System
- Routes of Transmission
- Congenital
- Perinatal
- Postnatal
- Risk Factors
- Maternal
- History and Delivery Summary
- TORCHS
- Toxoplasmosis
- Rubella
- Cytomegalovirus
- Herpes Simplex Virus
- Syphilis
- Neonatal
- Prematurity and Sepsis
- Infection Risks and Evidence-Based Infection Prevention Strategies
- Skin Integrity
- Respiratory Tract
- Gastrointestinal Tract
- Hospital
- Environmental Exposure
- Medical Interventions
- Early Onset Sepsis
- Definition
- Group B Streptococcus (GBS)
- Centers of Disease Control (CDC) Guidelines
- Risk Assessment
- Escherichia Coli (E. Coli)
- Late Onset Sepsis (LOS)
- Definition
- Coagulase-Negative Staphylococcus (Coag-Neg Staph)
- Care Bundle
- Infection Prevention
- Hand Hygiene
- NICU Environment
- Clinical Presentation
- Vital Signs
- Early Clinical Presentation
- Late Clinical Presentation
- Differential Diagnosis
- Diagnostics
- Blood Culture
- Complete Blood Count with Differential
- Absolute Neutrophil Count (ANC)
- I/T Ratio
- C-Reactive Protein (CRP)
- Lumbar Puncture
- 3 Case Studies
- Clinical Treatments
- Antibiotics
- Ampicillin
- Gentamicin
- Vancomycin
- Amphotericin B
- Ceftazidime
- Clindamycin
- Respiratory Support
- Conventional Mechanical Ventilation
- High Frequency Ventilation
- Continuous Positive Airway Pressure
- Nasal Cannula
- Hemodynamics
- Cardiac Output Equation
- Fluid Bolus
- Dopamine
- Dobutamine
- Epinephrine
- Family Perceptions
- Sepsis is Traumatic
- Family-Centered Care
- NICU Caregiver Considerations
Target Audience
- Nurses
- Nurse Practitioners
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Speech Language Pathologists
- Other Professions
Copyright :
11/23/2022
A Closer Look at ROP
Every year up to 16,000 premature infants in the born in the United States are affected by retinopathy of prematurity, or ROP. This eye disease is the leading cause of childhood blindness in the world. The complexity of ROP care requires effective coordination and communication between the entire healthcare team, including the patient’s family. As neonatal caregivers, we need to look at barriers to ROP care and follow-up through a health equity lens, then develop patient-centered solutions to prevent vision loss.
Program Information
Objectives
- Analyze the biologic basis for ROP.
- Debate barriers to ROP care and follow up.
- Formulate patient-oriented solutions to address potential gaps in health equity.
Outline
- History
- History of retinopathy of prematurity and
- How our understanding of it has evolved over time
- Diagnosis/Treatment
- Staging system
- Diagnosis and treatment of high-risk neonates
- Tracking
- Standardizing personnel and roles
- Monitoring post-discharge care
- Communication interventions
- Legal Issues
- Health equity and disparities
- Review barriers to ROP care and follow-up
- Describe patient-oriented solutions to overcome barriers
Target Audience
- Nurses
- Nurse Practitioners
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Speech Language Pathologists
- Other Professions
Copyright :
12/06/2022
Diagnosis to Transition: Comprehensive Management of Neonatal Heart Defects
In neonates, a comprehensive approach to the management of known or suspected cardiac defects is critical to ensuring diagnosis and management. In this session, both right and left heart lesions will be covered to include early recognition, initial resuscitation and stabilization, systematic evaluation, and knowledge of immediate and long-term management strategies. Be prepared to ensure the best possible patient outcomes.
Program Information
Objectives
- Outline the incidence and prevalence of neonatal cardiac defects.
- Describe nuances of transitional physiology in neonates.
- Detail initial resuscitation, stabilization, and evaluation strategies.
- Categorize critical congenital cardiac lesions and establish basic plans for immediate and long-term management.
Outline
- Incidence and prevalence of neonatal cardiac defects
- The rate of cardiac defects for live births in the United States per year
- The incidence and prevalence of critical cardiac defects
- Pre/post-natal diagnosis
- Nuances of transitional physiology in neonates
- Review fetal versus neonatal shunts
- Compare and contrast associated signs and symptoms
- Identify red flags
- Late presentation resuscitation, stabilization, and evaluation strategies
- Recognize clinical signs of late presentation
- Establish immediate goals of treatment and stabilization
- Review evaluation tools
- Critical congenital cardiac lesions
- Establish basic plans for immediate intervention including type and timing of surgical or catheter-based procedures
- Review lesion-specific pre/perioperative management
- Establish basic plans for long-term management and natural history of outcomes
Target Audience
- Nurses
- Nurse Practitioners
- Physician Assistants
- Other Professions
Copyright :
12/13/2022
Advanced Airway Placement for Neonates
Airway management for newborns is the most important part of resuscitation. In this recorded session, you will hear the evidence for placing advanced airways such as endotracheal tubes (ETT). Michelle Donahoo will review ETT using a standard laryngoscope and video laryngoscopy systems. Additionally, she will review laryngeal mask airways (LMA) which are becoming more popular for first-line advanced airways. An overview of the indications and contraindications of both advanced airways will be included.
Program Information
Objectives
- Differentiate between face mask ventilation and advanced airway verbalize indications, contraindications, and limitations for advanced airway devices.
- Demonstrate techniques associated with endotracheal intubation utilizing a standard laryngoscope.
- Demonstrate technique differences between a standard laryngoscope and video laryngoscope.
- Demonstrate placement of laryngeal mask airway.
- Integrate evidenced based practice related to intubation and laryngeal mask airway.
Outline
- ETT intubation procedure
- Standard laryngoscope
- Video laryngoscope
- LMA procedure
- Indications, limitations, contraindications
- Limitations of the research and potential risks
- Review of EBP for intubation training and competency
- Indications for advanced airway placement and initial management
- Indications
- Procedural tips
- Confirmation techniques
- Airway management utilizing ET intubation with standard laryngoscopy and video laryngoscopy
- Differences between laryngoscope and video laryngoscope
- Airway management utilizing LMA as a temporary airway
- Indications and limitations to LMA use
- Procedural steps
Target Audience
- Nurses
- Nurse Practitioners
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Speech Language Pathologists
- Other Professions
Copyright :
12/14/2022
Hypoglycemia and Hyperglycemia in the Neonate
Whether it is hypoglycemia or hyperglycemia in a neonate, it signals a failure of the normal transition from fetal to postnatal patterns of glucose homeostasis, and both can lead to complications and are important risk factors for mortality and morbidity in the neonatal period. In this session, Julia Muzzy Williamson will provide a comprehensive overview of both conditions, their complex etiologies, and the most current guidelines for management. Learn how to work within the interdisciplinary team to treat these challenging conditions and improve outcomes for these little patients.
Program Information
Objectives
- Differentiate between the pathophysiology of neonatal hyperglycemia and hypoglycemia.
- Develop a management approach for neonatal hyper/hypoglycemia.
- Determine the complications of neonatal hyper/hypoglycemia.
- Integrate current interprofessional guidelines to improve outcomes for patients with neonatal hyper/hypoglycemia.
Outline
- Hyperglycemia
- Etiology
- Prematurity and Intrauterine growth restriction
- Increased stress hormones
- Causes related to feeding/total parenteral nutrition (TPN)
- Sepsis
- Iatrogenic
- Transient neonatal diabetes mellitus
- Drugs
- Evaluation
- History and Physical
- Workup
- Glucose
- Electrolytes
- Differential Diagnoses
- Treatment and Management - Interdisciplinary
- Glucose Infusion Rate (GIR)
- Role of Insulin
- Hypoglycemia
- Etiology
- Insufficient glucose supply, with low glycogen or fat stores or poor mechanisms of glucose production
- Increased glucose utilization (excessive insulin production or increased metabolic demand)
- Failure of counter-regulatory mechanisms
- Evaluation
- History and Physical
- Workup
- Differential Diagnoses
- Treatment and Management - Interdisciplinary
- Early feeding
- Intravenous dextrose
- Second line - corticosteroids
Target Audience
- Nurses
- Nurse Practitioners
- Occupational Therapists
- Occupational Therapy Assistants
- Physical Therapists
- Physical Therapy Assistants
- Physician Assistants
- Speech Language Pathologists
- Other Professions
Copyright :
01/05/2023
Understanding the Complexity of Feeding & Eating
Many parents and professionals see eating as being an instinctive, automatic and easy task that comes naturally to children.
However, eating is actually the most complicated of human behaviors because it is the only body-based task humans do that involves all 7 areas of human function. Not only do each of these areas need to work correctly individually, but they also need to integrate and coordinate amongst, across and within all 7 areas in order to eat and grow well.
In this session, you’ll learn:
- To utilize an Iceberg analogy to help simplify the complexity of eating into an organized approach for assessments and treatment
- Prevalence of feeding problems to refute the myth that “All Children are Picky and all Children Outgrow This”
- Importance of matching skill to food choices
- Interventions to improve postural stability during mealtimes
- How to use the Pediatric Feeding Disorder (PFD) diagnosis
Join feeding and eating expert, Dr. Kay Toomey, in this two-hour workshop where she’ll share the complexity of feeding from a multidisciplinary perspective and outline the 7 areas necessary for thorough and accurate Feeding Assessments and Treatments.
Program Information
Objectives
- Assess the scope of the problem by outlining prevalence statistics.
- Create a conceptualization of feeding using an analogy of an Iceberg to understand how a feeding difficulty is what is seen, but that it is what is not seen that causes a child’s feeding/eating and growth to falter.
- Distinguish the 7 different areas of human function involved in being able to eat and grow well.
- Determine how to take a multidisciplinary viewpoint to feeding assessment and treatment.
Outline
Scope of the Problem
When Children Struggle to Eat
- Times of developmental shifts
- Skills needed
Why Children Struggle to Eat
Being Able to Eat & Grow Well - Seven Areas of Human Function
- Organs Systems
- Muscles
- Senses
- Learning
- Development
- Nutritional Status
- Environment
Pediatric Feeding Disorder
- A multidisciplinary approach
Target Audience
- Physical Therapists
- Physical Therapy Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech-Language Pathologists
- Chiropractors
Copyright :
09/13/2021
Neurochemistry & Self-Regulation: Strategies to Improve Behavior & Emotions
Knowing the correlation between neurochemistry and self-regulation will help you better develop appropriate interventions for challenging behaviors in children with Autism Spectrum Disorder (ASD), Sensory Processing Disorder (SPD), ADHD, anxiety, trauma, behavior/mood disorders, and learning disabilities.
Learn clinically proven neurological approaches to immediately improve behaviors, such as hyperactivity, aggression, frequent meltdowns, extreme sensory sensitivities, inattentiveness and more! Leave with access to simple screening tools to identify possible neurochemical differences and the knowledge to impact neurochemical change. Case studies and active participation in strategies to impact change will solidify your learning.
Program Information
Objectives
- Determine the primary roles of at least 5 important neurotransmitters and identify signs of neurotransmitter imbalance.
- Choose strategies based on the desired neurochemical changes needed as indicated by behaviors and emotional affect.
- Demonstrate the role of trauma and chronic stress on brain neurochemistry and the resulting impact on emotions and behaviors.
- Differentiate between the common neurochemical differences associated with diagnoses such as ADHD, anxiety, and ASD and understand the resulting impact on self-regulation.
Outline
Neurotransmitters
- 5 of the most important NTs
- Primary roles
- Function of neurons
- Major neurochemicals that impact self-reg
Addressing Neurotransmitter Imbalance
- Signs and symptoms
- How to increase or decrease major NTs
- Active participation in strategies to impact NT and enhance self-regulation
- Screening tools and intervention strategies
- Choose strategies based on desired neurochemical changes
Target Audience
- Physical Therapists
- Physical Therapy Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech/Language Pathologist
- Athletic Trainer
Copyright :
07/30/2020
Primitive Reflex Integration Through Neuroplasticity Treatment Techniques
Therapists frequently see primitive reflex patterns in pediatric cases. Sensory experiences govern primitive reflexes. When treatment is directed around the level of the lesion, integration begins. Rather than management of symptoms alone, neuroplasticity provides effective tools to place primitive reflex patterns in the background of the nervous system, allowing more voluntary movement.
Program Information
Objectives
- Distinguish where and why spastic patterns are demonstrated and how to apply neuroplasticity techniques
- Assess the neurological system of the pediatric patient to form a basis of therapeutic neuromotor rewiring around damaged areas
- Determine how to treat with neuroplasticity techniques to decrease the tone of spastic patterns to allow active movements
Outline
Function Related to Neurological Anatomy
- Brain and brain stem anatomy
- CNS lobes and layers related to function
- Why spastic patterns are demonstrated
- How to apply neuroplasticity techniques
Neurological System of the Pediatric Patient
- Neurological damage effects relating to specific regions of the brain and brain stem
- Instruction related to specific area of the CNS
- Demonstration of neurological patterns
- Form a basis of therapeutic neuromotor rewiring around damaged areas
Change Connections in the CNS
- Target brain regions to treat
- Neuroplasticity techniques to decrease the tone of spastic patterns and allow active movements
- Relate simple treatments for use in home programs
Target Audience
- Physical Therapists
- Occupational Therapists
- Athletic Trainers
- Speech/Language Pathologist
Copyright :
07/30/2020
Motor Skills Learning & Exploration: Early Intervention For Independence & Problem-Solving
Autonomy in movement is life changing – and you’re at the front lines, working to facilitate that change for your patients. Positively impact clinical outcomes with evidence-based therapeutic strategies to effectively examine and intervene. By identifying issues early on and addressing them, the brain’s plasticity allows the impact of your interventions to be much more comprehensive. You’ll be able to customize treatment plans for each child’s unique challenges and also offer solutions for their parents to integrate into their daily lives. Learn how to apply innovative techniques that completely redefine what’s possible for your patients’ independence and problem-solving.
Program Information
Objectives
- Integrate the principles of motor learning into early intervention practices to maximize potential for independent motor exploration.
- Design effective examination, intervention, and outcome measurement practices to guide evidence-based intervention practices and document progress toward outcomes.
- Prepare for the challenge of our contribution to the early diagnosis of cerebral palsy and identification of appropriate and timely intervention referrals.
Outline
Maximize potential for independent motor exploration
- Integrate principles of motor learning
- Interaction of Diagnosis
- Effective early intervention plans that promote motor learning/exploration
Framework for effective examination, intervention and outcome measurement
- International classification of function, disability and health (ICF)
- Observable and measurable outcomes
- Reliable and valid tools
- Task-specific practices to integrate into treatment plans
- Case study: down syndrome pairing movement and cognition for problem-solving
- Embrace technology
Contributing to the Early Diagnosis of Cerebral Palsy
- Context-focused therapy
- Early intervention of CP – certifications and examination tools
- Enhance motor learning and cognition
- Appropriate and timely intervention referrals
Target Audience
- Physical Therapists
- Physical Therapy Assistants
- Occupational Therapists
- Occupational Therapy Assistants
- Speech/Language Pathologist
- Athletic Trainer
Copyright :
07/29/2020
Bilingual Parent Coaching in Early Intervention Settings
Many bilingual families and therapists are struggling to navigate culture and language barriers as well as Early Intervention telehealth services. As daunting as these seem, there’s no need to worry!
Watch this exciting new session as Jennifer Gray demonstrates how to serve bilingual families in Early Intervention settings with proficiency. You will learn:
- An abundance of innovative technologies
- Materials that help bridge the gap
- Cultural and language considerations that make a difference
You’ll finish with the confidence to make informed decisions about how to work with bilingual families!
Program Information
Objectives
- Apply professional knowledge to child’s needs and modify it according to family culture, language, and desires for ethical service delivery in early intervention.
- Integrate a hybrid approach (in-person and telehealth settings) for bilingual and multicultural parent coaching and education.
- Possess and create developmentally and linguistically appropriate materials and resources to use the next day.
Outline
Parent and Therapist roles in Early Intervention Bilingual homes
- Different language, different culture, different expectations
- Terms to consider when describing yourself and your clients: Proficient, fluent, native, non-native, English Language Learner, Dual-language Learner, etc.
- Common hurdles and complaints
I am not Fluently Bilingual/Multilingual. What are My Options?
- Ethical considerations
- Use of interpreters (professional, friends of family, family members)
- Become the student investigator; be willing to learn; trust your skills
Parent Coaching
- Who is my client, the child or the family?
- Case examples with video demonstrations
- Prepare children and families for future language use
End the Blame Game
- Disability, difference, or disadvantage?
- Adapt the environment or the expectation?
- Prevent further need for interventions for the school-aged child
Do This not That
- Choose wisely: good sessions or better communication?
- Active engagement and home practice success
- Case studies, video examples, and discussion
Target Audience
- Speech-Language Pathologists
- Physical Therapists
- Occupational Therapists
- Behavior Therapists (and ABA)
- Teachers and Caregivers for the 0-3 population
Copyright :
11/20/2020
Adapting Pediatric Feeding Therapy for the Clinic, Home, School, and Online – Not Just the Kitchen Table
As feeding and swallow specialists, we are challenged with adapting our interventions to all the environments children eat in.
Join pediatric feeding expert, Angela Mansolillo, MA, CCC-SLP, BCS-S, as she shows you concrete strategies to customize your interventions for home, school, the sitter’s...and a hundred other places!
You will finish this recording armed with pediatric feeding strategies that will allow you to:
- Manage medical issues related to respiration, airway, and aspiration in non-medical environments
- Expand food repertoire wherever your client eat
- Design effective individual and group feeding environments in school settings
- Conduct tele-visits that really work
- And more!
Whether you currently work in pediatric feeding or are new to the field, Angela offers new tips and tools that make it easy to understand and easy to implement.
Program Information
Objectives
Upon completion of this program, participants will be able to:
- Determine the challenges and advantages of a variety of feeding environments including school, home, clinic, and online settings.
- Utilize two strategies to ensure safe feeding/swallowing in educational settings.
- Implement three strategies to facilitate carryover from medical/clinic to home feeding environments.
- Conduct effective tele-therapy sessions with children with feeding and swallowing disorders.
Outline
Feeding Environments
- Where, what, and with whom?
- Challenges and environments
There’s No Place Like Home
- Early Feeding Intervention at the kitchen table
School-Based Feeding Therapy
- Yes, it is educationally relevant
Medical Settings
- The challenge of carryover
Making Teletherapy Work
Target Audience
- Speech-Language Pathologists
- Occupational Therapists
- Occupational Therapy Assistants
- Early Intervention Specialists
- School clinicians
Copyright :
11/19/2020
Breastfeeding Success: Latch Secrets, Alternative Feeding Methods & Medication Safety
Over 80% of mothers say they want to breastfeed their babies – but by the time they leave the hospital almost 20% of those babies have already been given formula. Can we change that metric? Why do babies seem to refuse the breast, and what help can we offer?
Parents can feel confused, frustrated, and overwhelmed. They report that information has not been consistent amongst the nurses helping them. How can we change that? What can we do to help hit the reset button for babies who are neurologically disorganized and fighting the breast?
Begin your journey towards IBCLC certification with over 5 CE hours towards the 90 Lactation Education hours needed for the exam, based on the IBLCE Core Competencies!
Program Information
Objectives
- Apply the BASICS of breastfeeding assessment to deepen latch.
- Evaluate positioning for breastfeeding couplets based on infant preference and need.
- Analyze the hierarchy of pharmacokinetics to evaluate the safety of medications during breastfeeding.
- Determine available antidepressants for use during the postpartum and their safety for breastfeeding couplets.
- Appraise new research suggesting the role of insulin in milk production.
- Investigate D-MER and proposed role of oxytocin and dopamine in its etiology and severity.
- Apply an understanding of states of infant consciousness to feeding rhythms.
- Design a care plan utilizing feeding alternatives for babies struggling with latch in the first days postpartum.
Outline
Breastfeeding Latch, Suck & Positioning
- What is a good latch?
- The best position is the one that works
- Studies show families want hands-on, practical help with latch and positioning
- Physiologic breastfeeding (also called Baby-Led) encourages babies and moms to follow their instincts
- Steps to an effective feed
- BASICS can help staff and families assess and improve latch
- B = Belly to Belly
- A = Alignment
- S = Space
- I = In Close
- C = Cheeks and Chin
- S = Sucking and Swallowing
- What about babies who “fight the breast”?
- Assist with positional stability and teach the parent WHY the baby does what they do
- Maternal and infant conditions can affect latch and positioning
- Babies come with a history
- The role of birth, stimulation, medications
- Gestational age
- Neurologic disorganization
Self-Efficacy
- Pathways to self-efficacy
- Performance accomplishment
- Vicarious experiences
- Verbal persuasion
- Distressed behavior
- Babies who have been repeatedly pushed forcefully to the breast can learn it’s a place of discomfort, not comfort
- Feed in an alternate way
- Re-establish trust
- Back to the breast: Make it feel safe
- STS or not: “How do we fit together?”
- Mother keeps calm, follows infant lead
- Use your expertise only when needed
- GLOW authors suggest
- On days 2-3 share info about feeding cues and latch
- Supports lactogenesis II and the making of milk
- Supply will “take off like a rocket”
Alternative Feeding Methods
- What is normal weight loss?
- Start with hand expression
- Choose a safe way to get the milk into the baby – Global Media video
- Safe use of nipple shields
- Safe use of paced bottle feeding
- Push the reset button
- Teach parents about infant states of consciousness
Medication Safety
- Considerations for availability
- Molecular weight
- Lipid solubility
- Excretion of drugs including half life
- Oral bioavailability
- Timing in lactation
- Translating the theory into real life
- Hale’s Lactation Risk Categories
- Antidepressants
- Cannabis
- Cigarettes
- Alcohol
- SARS-COV2 vaccines and therapies
- Hormonal contraceptives
- Resources
- Infant Risk Center
- PLLR labeling
- References in print
Anatomy and Physiology Update
- 4-18 Ductal openings (previously thought 15-20)
- The ducts branch closer to the nipple – the lactiferous sinuses do not exist
- Ducts can be just below the skin surface, making them easily compressible
- Most glandular tissue is found within 30 mm (~1.2 inches) of the nipple
- Montgomery Glands are now called Areolar Glands
- Lactogenesis I (Secretory Differentiation)
- Lactogenesis II (Secretory Activation)
- Protracted nipples
- Inverted nipples (Grade 1 – 3)
- Baseline prolactin levels
- The role of insulin
- Is oxytocin always our friend?
- New research on Dysphoric Milk Ejection Reflex
Target Audience
- Nurses
- Nurse Practitioners
- Clinical Nurse Specialists
- Doulas
- Midwives
- Clinical Nurse Specialists
- Lactation Consultants
- Childbirth Educators
Copyright :
08/30/2022