0483_SHU_Postpartum Transition in Practice - December 2024 Class
Description:
This program is designed for novice or experienced RNs who are new to the Postpartum specialty. The 4-day program consists of didactic, skills, and high-fidelity simulation in our 5-bed simulation lab. Using AWHONN principles as a framework and evidence-based content, this program offers the basic foundation necessary to transition into practice as a Postpartum RN.
Target Audience
Nurse, Registered (RN)
Learning Objectives
Following this activity, learners will be able to perform the following functions in the areas listed.
Family Centered Care
• Describe the core principles of family-centered care and their importance in postpartum nursing.
• Demonstrate the ability to assess family dynamics and support systems in the postpartum period.
• Explain the roles and responsibilities of parents in the postpartum period, including physical and emotional adjustments.
• Identify common challenges faced by new parents and strategies to support their adaptation to parenthood.
Review of Systems
• Describe the normal physiological changes that occur in the postpartum period, including uterine involution, lochia changes, and hormonal fluctuations.
• Analyze the physiological adaptations that facilitate maternal recovery, including changes in cardiovascular, respiratory, and musculoskeletal systems.
• Apply knowledge of postpartum pathophysiology to develop appropriate nursing interventions and care plans for postpartum women.
PP Assessment
• Identify normal versus abnormal findings during the postpartum assessment and their clinical significance.
• Demonstrate the skills needed to perform a thorough physical assessment of postpartum patients, focusing on vital signs, uterine involution, lochia, and perineal healing.
• Explain the significance of a head-to-toe physical assessment in postpartum care, including the identification of normal recovery patterns and early detection of complication.
Handoff
• Explain the significance of effective handoff communication in ensuring continuity of care, patient safety, and minimizing the risk of errors in the postpartum setting.
• Demonstrate proficiency in using standardized handoff tools (e.g., SBAR: Situation, Background, Assessment, Recommendation) to organize and communicate essential patient information.
• Reflect on personal handoff experiences to identify strengths and areas for improvement, seeking feedback from peers to enhance communication skills.
Vaginal Care
• Perform thorough postpartum assessments, focusing on vital signs, uterine firmness, perineal healing, and signs of potential complications (e.g., infection, hemorrhage).
• Promote early ambulation and physical activity for postpartum patients, explaining the benefits for recovery and prevention of complications such as thromboembolism.
• Accurately document all assessments, interventions, and patient education in the medical record, ensuring clear communication among healthcare team members.
• Identify common sources of pain and discomfort in postpartum patients and implement appropriate pain management strategies, including pharmacological and non-pharmacological interventions.
PP C/S Care
• Describe the physiological changes and recovery process following a cesarean section, including incision healing, uterine involution, and pain management.
• Perform thorough assessments of postpartum patients after a cesarean delivery, focusing on vital signs, incision site condition, abdominal assessment, and overall recovery.
• Encourage safe ambulation and mobility for cesarean patients, explaining the importance of early movement for recovery and prevention of complications.
IV Starts
• Assess and select an appropriate venipuncture site based on patient factors, vein visibility, and accessibility.
• Recognize and manage potential complications associated with IV insertion, such as infiltration, phlebitis, and air embolism.
• Participate in hands-on practice sessions using simulation or manikins to develop proficiency and confidence in IV insertion techniques.
Foley Catheters
• Participate in hands-on practice sessions using simulation or manikins to develop proficiency and confidence in Foley catheter insertion techniques.
• Describe the relevant anatomy and physiology of the urinary system to understand catheter placement and function.
• Demonstrate the step-by-step technique for inserting a Foley catheter, including: preparing the patient and environment, positioning the patient appropriately for insertion.
• Cleaning the insertion site using aseptic technique.
• Inserting the catheter to the correct depth and securing it properly.
Post Birth Warning Signs
• Recognize and list the critical warning signs that may indicate complications in postpartum patients, including:heavy vaginal bleeding (hemorrhage), severe abdominal pain, signs of infection (fever, foul-smelling lochia), symptoms of deep vein thrombosis (DVT) or pulmonary embolism (leg swelling, chest pain, shortness of breath), emotional distress (anxiety, depression).
• Develop effective communication strategies to educate postpartum patients and their families about warning signs to watch for after discharge.
• Outline appropriate nursing interventions and actions to take when warning signs are identified, including when to escalate care or refer to a healthcare provider.
Hemorrhage & QBL
• Identify clinical signs and symptoms of postpartum hemorrhage, such as changes in vital signs, amount and characteristics of bleeding, and uterine tone.
• Explain the concept of quantitative blood loss (QBL) and its importance in assessing the severity of postpartum hemorrhage.
• Outline immediate nursing interventions for managing postpartum hemorrhage, including fundal massage, medication administration (e.g., oxytocin), and fluid resuscitation.
Blood Administration
• Identify the criteria for blood transfusions in postpartum patients, including signs of postpartum hemorrhage, anemia, and the patient’s hemoglobin levels.
• Explain the institutional policies and evidence-based guidelines for blood transfusion, including pre-transfusion checks and consent processes.
• Conduct a thorough assessment of the patient prior to transfusion, including reviewing medical history, current medications, vital signs, and laboratory results.
• Demonstrate the proper techniques for preparing and verifying blood products for transfusion, including checking blood type and crossmatch results against the patient’s identification.
• Identify the signs and symptoms of potential transfusion reactions (e.g., fever, chills, itching, shortness of breath) and demonstrate appropriate nursing interventions in response.
IV Iron Administration
• Explain the indications for IV iron transfusions in postpartum patients, particularly in the context of treating iron deficiency anemia due to postpartum hemorrhage or insufficient oral iron intake.
• Identify contraindications for IV iron therapy, such as known hypersensitivity to iron preparations, and recognize patient factors that may require special considerations.
• Describe the various types of IV iron formulations (e.g., iron sucrose, ferric gluconate, ferric carboxymaltose) and their respective dosing regimens, including differences in administration rates and side effects.
• Demonstrate the proper techniques for preparing the IV iron product for administration, including checking compatibility, diluting if necessary, and selecting appropriate IV access.
• Recognize potential adverse reactions associated with IV iron transfusions, such as allergic reactions, hypotension, and infusion site reactions, and demonstrate appropriate nursing interventions.
Jada System
• Describe the components and functioning of the Jada Vacuum System, including its purpose in managing postpartum hemorrhage and uterine atony.
• Explain the mechanism by which the Jada Vacuum System helps control bleeding, including its role in providing uterine compression and facilitating uterine involution.
Postpartum Complications
• Identify the key signs and symptoms associated with each postpartum complication, enabling early detection and timely intervention.
• Identify signs of postpartum infections, such as endometritis and wound infections, and demonstrate appropriate nursing interventions, including antibiotic administration and monitoring.
• Apply evidence-based protocols for the prevention and management of postpartum complications, ensuring adherence to best practices in clinical care.
Sepsis
• Describe what sepsis is, including the criteria for its diagnosis and the differences between sepsis, severe sepsis, and septic shock.
• Identify the specific risk factors for developing sepsis in postpartum patients, including cesarean delivery, prolonged labor, and existing maternal health conditions.
• Recognize the early signs and symptoms of sepsis in postpartum patients, such as fever, tachycardia, hypotension, altered mental status, and signs of infection.
• Discuss the importance of early intervention in sepsis management and outline the initial nursing interventions, such as initiating sepsis protocols, obtaining cultures, and administering IV fluids and antibiotics.
• Recognize potential complications associated with sepsis, including organ dysfunction and the need for advanced interventions, and demonstrate appropriate nursing responses.
• Accurately document assessments, interventions, and patient responses in the medical record, ensuring clear communication with the healthcare team.
Preeclampsia
• Recognize the clinical signs and symptoms of preeclampsia, including hypertension, proteinuria, edema, and symptoms of severe preeclampsia (e.g., headache, visual disturbances).
• Outline appropriate nursing interventions for managing patients with preeclampsia, including monitoring vital signs, administering medications (e.g., antihypertensives, magnesium sulfate), and educating patients about signs of worsening conditions.
• Apply evidence-based guidelines for the management and follow-up of patients with preeclampsia in the postpartum period.
Magnesium Sulfate Administration
• Describe the indications for administering magnesium sulfate in postpartum patients, including its use for preventing and treating eclampsia and managing severe hypertension.
• Conduct comprehensive assessments of the patient prior to administration, including baseline vital signs, neurological status, and renal function.
• Execute the steps for safe administration of magnesium sulfate, including IV infusion techniques and monitoring for adverse effects.
• Identify therapeutic effects, such as seizure prevention, and monitor for potential adverse reactions, including respiratory depression, hypotension, and signs of magnesium toxicity.
• Identify therapeutic effects, such as seizure prevention, and monitor for potential adverse reactions, including respiratory depression, hypotension, and signs of magnesium toxicity.
Deep Tendon Reflexes
• Identify specific scenarios in which assessing deep tendon reflexes is indicated for postpartum patients, such as evaluating for signs of magnesium toxicity or neurological deficits.
• Demonstrate proper patient positioning and preparation techniques to ensure a comfortable and accurate reflex assessment.
Cultural Considerations
• Identify the diverse cultural backgrounds of postpartum patients and their unique beliefs, practices, and values related to childbirth, postpartum recovery, and infant care.
• Recognize potential barriers to care that may arise from cultural differences, including language barriers, differing health beliefs, and access to resources.
• Demonstrate skills for conducting culturally sensitive assessments that respect patients’ cultural backgrounds, preferences, and needs.
Tox Screening
• Identify specific situations and risk factors that warrant toxicology screenings, such as maternal substance use history, clinical signs of withdrawal in infants, or concerns about environmental exposure.
• Describe the various methods of toxicology screening available (e.g., urine, blood, meconium) and their respective advantages and limitations.
• Develop strategies for effectively communicating the purpose and process of toxicology screenings to mothers and their families, addressing any concerns or questions.
Child Abuse
• Understand the physical, emotional, and behavioral indicators of child abuse in infants and children, including neglect, physical abuse, sexual abuse, and emotional maltreatment.
• Learn the legal requirements and ethical considerations for reporting suspected child abuse, including understanding mandated reporting laws and the importance of timely reporting.
• Recognize the role of interdisciplinary teams in addressing child abuse, including collaboration with social workers, pediatricians, and law enforcement.
PP Mood Disorders
• Understand the different types of postpartum mood disorders, including postpartum depression (PPD), postpartum anxiety, postpartum psychosis, and baby blues.
• Learn to identify the signs and symptoms of postpartum mood disorders in new mothers, including emotional, physical, and behavioral indicators.
• Develop skills in conducting effective screenings and assessments for postpartum mood disorders using validated tools and questionnaires.
• Understand the importance of interdisciplinary collaboration in managing postpartum mood disorders, including working with mental health professionals.
Selfcare & Compassion Fatigue
• Identify the signs and symptoms of compassion fatigue, including emotional exhaustion, decreased empathy, irritability, and reduced job satisfaction.
• Emphasize the importance of self-care in maintaining mental and emotional well-being, and its role in preventing compassion fatigue.
• Encourage the establishment of peer support networks and debriefing sessions to share experiences and provide mutual support among colleagues.
Newborn Care & Assessment
• Learn to assess and monitor newborn vital signs, growth parameters, and overall health, recognizing early signs of potential complications.
• Teach parents about daily newborn care routines, including bathing, diapering, cord care, and maintaining hygiene.
• Identify normal newborn behaviors, such as feeding cues, sleep patterns, and reflexes, to provide appropriate guidance to parents.
Newborn Handling & Swaddling
• Learn proper techniques for safely handling and positioning newborns, including supporting the head and neck, and transitioning between different holds.
Heel Sticks
• Familiarize with the anatomy of the infant’s heel, including the location of blood vessels and the safest sites for heel sticks to minimize discomfort and complications.
• Understand and implement proper infection control measures, including hand hygiene, use of gloves, and cleaning the heel site prior to the procedure.
• Develop the ability to explain the procedure and its purpose to parents, addressing their concerns and providing reassurance.
IM Injections
• Recognize the clinical reasons for administering IM injections in newborns, such as vaccination, administration of vitamin K, or antibiotics.
• Familiarize with the anatomy of newborn muscles, including appropriate injection sites (e.g., vastus lateralis) and their landmarks to ensure safe and effective administration.
• Master the proper techniques for preparing and administering IM injections, including selecting the appropriate needle size, and angle of injection.
• Encourage a supportive and calm environment for both the newborn and the parents during the procedure to enhance overall comfort and cooperation.
Newborn Abnormalities
• Recognize and describe common congenital and acquired abnormalities in newborns, including conditions such as congenital heart defects, cleft lip and/or palate, and neurological disorders.
Neonatal Complications
• Recognize and describe common neonatal complications, such as respiratory distress syndrome, jaundice, infections, and feeding difficulties.
• Develop skills to perform comprehensive assessments of neonates, recognizing signs and symptoms indicative of potential complications.
• Learn to accurately monitor vital signs, growth parameters, and laboratory values to detect changes that may indicate complications.
Neonatal Hypoglycemia
• Identify the clinical signs and symptoms of hypoglycemia in neonates, such as jitteriness, lethargy, poor feeding, and respiratory distress.
• Familiarize with the recommended screening protocols for at-risk infants, including when and how often to monitor blood glucose levels.
• Learn to navigate and apply institutional policies and algorithms for the identification, assessment, and management of neonatal hypoglycemia.
• Understand the appropriate interventions for managing hypoglycemia, including feeding protocols, oral glucose administration, and ongoing monitoring.
Newborn Respiratory Distress
• Identify the clinical signs of respiratory distress in newborns, including tachypnea, retractions, grunting, nasal flaring, and cyanosis.
• Develop skills to perform thorough respiratory assessments, including auscultation of lung sounds, monitoring respiratory rate, and evaluating overall oxygenation.
• Learn to accurately monitor vital signs, including heart rate, respiratory rate, and oxygen saturation levels using pulse oximetry.
• Recognize the importance of interdisciplinary collaboration in the management of respiratory distress, including working with pediatricians, respiratory therapists, and nursing staff.
Newborn Screening
• Learn the recommended guidelines and protocols for conducting each type of screening, including timing and methods used.
• Develop skills to effectively communicate the importance and procedures of each screening to parents, addressing their concerns and ensuring they understand follow-up processes.
Perinatal Loss
• Develop skills to offer empathetic and sensitive care to grieving parents, ensuring that they feel heard, supported, and respected throughout the process.
• Learn effective communication techniques for discussing perinatal loss with parents, including how to deliver bad news compassionately and answer questions.
• Understand how to guide parents in making informed decisions regarding their care and the care of their baby, including options for memorialization and post-mortem care.
• Familiarize with available resources, including grief support groups, counseling services, and literature for families dealing with perinatal loss.
Hyperbilirubinemia
• Define hyperbilirubinemia and recognize its causes, including physiological and pathological factors, and the significance of bilirubin levels in newborns.
• Familiarize with risk factors associated with hyperbilirubinemia, such as prematurity, blood type incompatibility, and breastfeeding issues.
• Learn to identify clinical signs of hyperbilirubinemia, including jaundice, lethargy, poor feeding, and changes in stool color.
• Develop skills to assess bilirubin levels using appropriate methods, including transcutaneous bilirubinometers and serum bilirubin tests.
• Learn the management protocols for hyperbilirubinemia, including monitoring bilirubin levels, determining treatment thresholds, and when to initiate treatment.
Transition to Parenthood
• Develop skills to assess the individual support needs of new parents, including emotional, informational, and practical assistance, and identify potential barriers to support.
• Develop effective communication skills to engage with new parents, addressing their concerns, answering questions, and providing reassurance during the transition.
• Educate parents on newborn care, infant development, and parenting strategies, ensuring they have accurate and relevant information to make informed decisions.
Breastfeeding
• Recognize the nutritional, immunological, and emotional benefits of exclusive breastfeeding for both infants and mothers.
• Master various breastfeeding positions (e.g., cradle hold, football hold, side-lying) to help mothers find comfortable and effective ways to breastfeed.
• Develop skills to assess and support a proper latch, including techniques for helping mothers achieve a good latch and identifying signs of an ineffective latch.
• Understand the importance of exclusive breastfeeding for the first six months of life and communicate the recommendations from health organizations.
• Learn the guidelines for safely preparing and storing infant formula, including hygiene practices and understanding the differences between breastmilk and formula.
• Familiarize with the different types of breast pumps, how to properly use and clean them, and the benefits of expressing milk for both feeding and comfort.
• Understand the guidelines for the use of donor breastmilk, including safety considerations and resources for accessing human milk banks.
• Recognize common breastfeeding challenges, such as sore nipples, engorgement, low milk supply, and difficulties with feeding, and learn strategies to address these issues.
Discharge Education
• Recognize the clinical criteria for safe discharge of both the mother and newborn, including assessment of vital signs, physical recovery, and newborn health.
• Educate parents on postpartum care for the mother, including signs of complications (e.g., infection, hemorrhage), self-care practices, and emotional well-being.
• Be able to teach parents essential newborn care practices, including bathing, diapering, feeding, and safe sleep recommendations.
• Emphasize the importance of scheduling and attending postpartum and pediatric follow-up appointments, explaining what to expect during these visits.
Assembly Bills 1195 & 241- Culturally Appropriate Care which is Free of Implicit Biases:
Saluja, B., & Bryant, Z. (2021). How implicit bias contributes to racial disparities in maternal morbidity and mortality in the United States. Journal of Womens Health, 30(2), 270–273. https://doi.org/10.1089/jwh.2020.8874
Lakine-Harden, R. (2022). Implicit Bias Training for Perinatal Nursing (Doctoral dissertation, University of Missouri-Saint Louis).
Reed, L., Bellflower, B., Anderson, J. N., Bowdre, T. L., Fouquier, K., Nellis, K., & Rhoads, S. (2022). Rethinking nursing education and curriculum using a racial equity lens. Journal of Nursing Education, 61(8), 493-496.
Disclosure of Financial or In-Kind Commercial Support & Conflict of Interest
No one involved in the planning or presentation of this educational activity have any relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. No financial or in-kind commercial support was received to produce or promote this educational activity.
– Provider Designee/Verification: Kerri Maya, PhD(c), MSL, RN, NPD-BC
Accreditation:
In support of improving patient care, Sutter Health, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), the American Nurses Credentialing Center (ANCC), and the Association of Social Work Boards (ASWB) to provide continuing education for the healthcare team.
Credit Designation Statement
Sutter Health designates this LIVE activity for a maximum of 28.75 continuing professional development contact hours for nurses. Learners should claim only the credit commensurate with the extent of their participation in the activity.
Attendance & Credit Claiming
Enter the 6-letter attendance verification code when prompted in the Attendance Course Object within the course outline. Please review the course instructions for pictorials of the steps to take when registering for the course.