Recent changes in Medicare policies that limit reimbursements for Hospital Acquired Conditions (HACs) in acute care hospitals and healthcare facilities have enhanced the need for proper education and training for healthcare providers.  Stage III and Stage IV pressure ulcers have been added to the list of Preventable Hospital Acquired Conditions no longer being reimbursed.  Proper Wound Care management and application of evidenced-based guidelines is essential to promote patient health and help protect facilities and healthcare professionals from costly claims and litigation.  Nursing Unlimited Wound Care Update class provides healthcare professionals with the knowledge to identify prevent and treat pressure ulcers using the most recent standards of care.  Proper care of Ostomies is also included.  Come join us for an informative multimedia presentation and skills demonstration using Nursing Unlimited’s proven methodology for “Stress Free” education.

TARGET AUDIENCE:

Healthcare professionals involved in providing wound care

OBJECTIVES:

1. Identify the three main layers of the skin and their components
2. Name the three types of wound healing
3. Describe the three phases of wound healing
4. Describe the etiology of pressure ulcers
5. List the six stages of pressure ulcers
6. Understand the role of the Braden Scale in prevention of pressure ulcers
7. Differentiate between Arterial and Venous ulcers
8. Differentiate between neuropathic and neuroischemic ulcers
9. Name three interventions to improve diabetic wound healing
10. Differentiate between colonization and infection of a wound
11. List the stages of skin tears and their treatment
12. Identify three types of ostomies
13. Identify at least 2 characteristics of a healthy stoma
14. Identify at least 2 characteristics of an unhealthy stoma
15. List 3 techniques applicable to all wounds
16. Describe the use of Negative Pressure Wound Therapy

The course fee is $100 for 6.1 contact hours.

Register Online Now!

Hotlines

National Domestic Violence Hotline 800-799-SAFE

(For speakers of English, Spanish, and Creole)

Florida Domestic Violence 800-500-1119

Domestic Violence Injunction 305-547-3170

Domestic Violence Shelter 305-758-2546

Florida Elder Helpline 800-963-5337

Legal Assistance

Legal Aid (divorce, child custody, support) 305-579-5733

Florida Bar Attorney Referral Service – 800-342-8060

State Attorney’s Office, Domestic Violence Unit 305-547-0150

Financial Assistance

Victim Assistance Program – 305-758-2546

Child Support Enforcement – 305-530-2600

Counseling

Family & Victim Services

(treatment for victims, children, & perpetrators) 305-571-7750

“Common Ground”

(educational support groups for women) 305-758-2546

Rape Treatment Center

(medical & crisis counseling) 305-585-7273

REFERENCE:

Burt, Martha R., Janine M. Zweig, Kathryn A. Schlichter, Stacy Kamya, Bonnie Datz, Adele V. Harrell, “Evaluation of the STOP Formula

Grants 2000 Report: The Violence Against Women Act of 1994″ March 15, 2000.

Evans, Patricia. Verbal Abuse: Survivors Speak Out . Hollbrook, Massachusetts; Bob Adams Inc. Publishing, 1993.

Gerard, M. (2000). Domestic violence: How to screen and intervene. RN , p. 52 – 56.

Gondolf, Edward W. Man Against Woman: What Every Woman Should Know About Violent Men . Blue Ridge Summit, Pennsylvania; Tab Books Inc., 1989.

Island, David & Letellier, Patrick. Men Who Beat the Men Who Love Them: Battered Gay Men & Domestic Violence . New York; Harrington Park Press, 1991.

Jones, Ann and Schechter, Susan. When Loves Goes Wrong: What To Do When You Can’t Do Anything Right . New York; Harper Collins, 1992.

Lobel, Kerry. Naming the Violence: Speaking Out About Lesbian Battering . Seattle; Seal Press, 1986.

Maltar, M. Domestic Violence: the Florida Requirement . ME Resource, Sacramento, CA, 2003

Miami-Dade Advocates for victims. (2000). Information guide for abused women, Miami-Dade Advocates , [Brochure]. Pohlmann, L., Frazee, S., & Cousin, M.

Nicarthy, Ginny. Getting Free: A Handbook for Women In Abusive Relationships . Seattle; Seal Press, 1987.

Paris, Susan. Mommy and Daddy are Fighting: A Book for Children About Family Violence . Seattle: Seal Press.

Renzetti, Claire. Violent Betrayal: Partner Abuse in Lesbian Relationships . Newbury Park, California: Sage, 1992.

Schornstein, Sherri L. Domestic Violence and Healthcare: What Every Professional Needs to Know . Sage, 1997.

White, Evelyn. Chain, Chain, Change: For Black Women Dealing with Physical and Emotional Abuse . Seattle: Seal Press, 1985.

www.batteredmen.com

www.batteredmenshelpline.org

www.batteredwomen.com

www.breakthecycle.org

www.buddybuddy.com

www.crisisprevention.com

www.dateviolence.org

www.elderabusecenter.org

www.endabuse.org

www.fcadv.org

www.glennsacks.com/nowhere_to_go.htm

www.growing.com

www.menstoppingviolence.org

www.menstuff.org

www.menweb.org

www.myfloridalegal.com/directory

www.ncvc.org

www.nccanch.acf.hhs.gov/

www.ndvh.org

www.rainbowdomesticviolence.itgo.com

www.safe4all.org

www.salon.com

www.thehelpline.net/abused.html

www.usda.gov

www.4woman.gov/violence

A. MYTHS ABOUT DOMESTIC VIOLENCE

B. SEXUAL ORIENTATION AND GENDER

C. THE COSTS OF DOMESTIC VIOLENCE

II. TYPES OF ABUSE

A. PHYSICAL

B. PSYCOLOGICAL

C. CHARACTERISTICS OF THE BATTERER

D. CHARACTERISTICS OF THE VICTIM

F. THE CYCLE OF VIOLENCE

G. “RED FLAGS” OF A BATTERING PERSONALITY

H. WHY VICTIMS STAY

III. HELPING AND REFERRING VICTIMS AND PERPETRATORS

A. HOW TO CONDUCT A DIAGNOSTIC INTERVIEW

B. SCREENING QUESTIONS FOR VICTIMS

C. SCREENING QUESTIONS FOR PERPETRATORS

D. HELP FOR BATTERERS

E. SAFETY TIPS FOR VICTIMS WHO LEAVE THEIR ABUSER

F. LEGAL PROTECTION FOR VICTIMS OF DOMESTIC VIOLENCE

IV. ELDER AND CHILD ABUSE

V. FLORIDA REPORTING REQUIREMENTS

This home study is intended to educate health care professionals on domestic violence issues as required by Florida state law, Section 456.031(1)(a), F.S.

Objectives:

Upon completion of this program the learner will be able to:

•  Describe the dynamics of an abusive and/or violent relationship.

•  Identify three “red flags” of a battering personality.

•  Identify three characteristics of the victim of domestic violence.

•  List three reasons that victims may stay in an abusive relationship.

•  Describe screening procedures used to identify and assist both victims and perpetrators of domestic violence.

•  Identify two legal protections available to victims of domestic violence.

•  List three community resources available to assist the victim, the perpetrator and the family.

I. WHAT IS DOMESTIC VIOLENCE?

Domestic violence is a crime in all fifty states. Florida law (741.28, F.S.) defines domestic violence as “any assault, aggravated assault, battery, aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking, false imprisonment, kidnapping, or any criminal offense resulting in physical injury or death of one family or household member by another who is or was residing in the same single dwelling unit”. Domestic violence may also be defined as a “pattern of controlling behavior by one person who has a personal, intimate or familial relationship with another.” (Governor’s Task Force on Domestic Violence, 2000).

The crime of assault is an intentional, unlawful threat, by word or act, to do violence to someone, coupled with an apparent ability to carry out such threat, creating a well-founded fear in the other person that violence is imminent. Aggravated assault is assault with a deadly weapon.

The offense of battery occurs when a person intentionally touches or strikes another person against their will or intentionally causes them bodily harm. Knowingly causing great bodily harm, permanent disability or disfigurement, using a deadly weapon, or committing battery against a pregnant victim is aggravated battery .

Anyone who willfully, maliciously and repeatedly follows or harasses another person, for no legitimate purpose, causing substantial emotional distress, commits the offense of stalking . Making a credible threat which causes someone to reasonably fear death or bodily injury either for themselves, their child, sibling, spouse, parent, or dependent, is aggravated stalking .

Kidnapping and false imprisonment mean forcibly, secretly, or by threat confining, abducting, or imprisoning another person against her or his will and without lawful authority.

Because violence inflicted by an intimate partner has traditionally been treated more leniently by law enforcement than violence inflicted by a stranger, domestic barterers are not always arrested.

On January 5, 2006, the President signed the “Violence Against Women” Reauthorization Act. This works though the use of STOP grants. As a result, “victims are safer, better supported by their communities, and treated more uniformly and sensitively by first-response workers.”

A. MYTHS ABOUT DOMESTIC VIOLENCE

Myths and misunderstandings about domestic violence abound. Although domestic violence occurs in approximately one out of three relationships , it remains one of the nation’s best-kept secrets. Domestic violence is the most under-reported crime in the country, with the actual incidence probably 10 times higher than reported. It remains a major health concern.

One prevalent myth is that perpetrators of domestic violence strike when angry and out of control. On the contrary, violence is an intentional choice, used to establish power and control in an intimate relationship. (Barterers manage not to beat their bosses or terrorize their friends when they are angry.) Domestic abuse is always about power and control . While the violence may not occur often, it is a constant underlying factor in the relationship. Although the first violent incident may not be severe, once battering begins, it tends to increase in severity and frequency, sometimes leading to permanent injury or death. The occasional slap or shove can evolve into a push down the stairs, a punch in the face or a kick in the stomach.

Another myth is that perpetrators are driven to violence by the behavior of their partners. In fact, perpetrators are unaffected by their partners’ efforts to change their behavior in order to appease them. The behavior the abuser chooses to target at any one time usually cannot be predicted by the partner, and this unpredictability is a major means for the banterer to maintain control.

Types of Rhythms Where Pacing Is Indicated
• Bradycardias that are unresponsive to drug therapy or are symptomatic
• 2nd degree heart block type II
• 3rd degree heart block

Clinical Note:
Atropine may be given to 2nd degree type II heart block or a narrow complex 3rd degree heart block as a trial but, when detected, the American Heart Association ACLS guidelines recommend that these dysrhythmias be managed by immediate application of the transcutaneous pacer and close observation of the patient for any signs of hemodynamic instability, e.g., shortness of breath – hypotension – altered level of consciousness – chest pain – pallor – nausea & vomiting – profuse sweating. If unstable and in 2nd degree heart block type II or 3rd degree heart block, then the pacer should be used to correct the rate only until transvenous pacing can be accomplished by a qualified person.

Remember from earlier in the reading that if a patient is bradycardic and hemodynamically unstable, as described in the previous paragraph, then transcutaneous pacing should be considered as a first line treatment.
Setting a transcutaneous pacemaker will be discussed in the electrical therapy station on day 1 of ACLS

Three Basic Rhythms
There are 3 categories of abnormal rhythms: too fast, too slow or none. Patients with any dysrhythmia may be stable, unstable or in cardiac arrest. Recognizing which type of patient you have will decide your treatment choices: medicine, electrical, and/or mechanical (BLS).

Too Fast
The first rhythm is too fast. Our goal is to slow it down. We have two methods to slow down a rhythm: electrical therapy and/or medicine. If the patient is hemodynamically stable, pharmacology should be the first line treatment. If our patient were hemodynamically unstable, synchronized cardioversion should be the first line treatment.

Too Slow
The second rhythm is too slow. Our goal is to speed it up. We have two methods of speeding up a rhythm: electrical therapy and/or medicine. If the patient is hemodynamically stable, pharmacology should be the first line treatment. If our patient were hemodynamically unstable, transcutaneous pacing should be the first line treatment.

None
Ventricular fibrillation, pulseless ventricular tachycardia, pulseless electrical activity and asystole are the dysrhythmias associated with cardiac arrest. As these are lethal dysrhythmias, management must be quick and aggressive.

Today, more people in the United States die from medical errors than from motor vehicle accidents, breast cancer or AIDS. While not all adverse patient outcomes are due to medical error, medical errors represent adverse outcomes that are preventable with our current state of medical knowledge. It is therefore imperative that all healthcare professionals recognize the factors contributing to the occurrence of medical errors, in order to develop more effective processes to prevent their occurrence. This course examines the systemic causes of medical errors and outlines steps that can be taken, both by institutions and by individual care providers, to reduce the incidence of errors. Attention is paid to the particular vulnerabilities of special patient populations, such as children, the elderly and psychiatric patients. This course meets the mandate of the Florida State legislature (Florida Statute 456.013) requiring training on the prevention of medical errors, and follows the curriculum guidelines of the Florida State Board of Nursing for the issuance of 2 contact hours needed for license renewal. Join us and participate in lively class discussions, sharing real-life experiences and solutions as you satisfy your re-licensure requirement.

Some of the Objectives Include:

1. Identify factors that contribute to the occurrence of medical errors.
2. Recognize error-prone situations.
3. Discuss processes and strategies to improve patient outcomes.
4. Recognize responsibilities for reporting medical errors.
5. Discuss the need for public education on the occurrence of medical error

Who Should Attend:
All RN’s & LPN’s

The course fee is $25 for 2 contact hours.

Don’t Forget Your CPR Update, HIV/AIDS Update and Domestic Violence
Mandatory Requirement.

Complete this class online now!

Since domestic violence occurs in approximately one out of three intimate relationships, both heterosexual and homosexual, chances are great that any healthcare provider will encounter both victims and perpetrators of domestic violence on a routine basis. Providers must realize that ignoring domestic violence is essentially an act of collusion with the perpetrator. The price of not intervening may be preventable death, serious injury or persistent mental and physical problems. The role of healthcare professionals is to be fully informed, clear in understanding the destructive nature of domestic violence and available over time to facilitate change. This course meets the mandate of the Florida legislature requiring training on domestic violence, and follows the curriculum guidelines of the Florida State Board of Nursing for issuance of 1 contact hour needed for license renewal. Experienced educators weed through the myths about domestic violence, offering real solutions for positive interventions. Join us for an informative and serious discussion of this problem as you satisfy your relicensure requirement.

Some of the Objectives Include:

1. Identify three “red flags” of a battering personality.
2. List three reasons that victims may stay in an abusive relationship.
3. Describe screening procedures used to identify and assist both victims and perpetrators of domestic violence.
4. List three community resources available to assist the victim, the perpetrator and the family.

Who Should Attend:

All persons required by Florida statute to take a Domestic Violence course

The course fee is $20 for 2 contact hours

Don’t Forget Your CPR Update, HIV/AIDS Update and Prevention Of Medical Errors
Mandatory Requirement.

This dynamic course meets state HIV and federal OSHA requirements regarding training for health care professionals. OSHA requires healthcare facilities to develop an internal Exposure Control Plan and to provide employees with specific training on the Bloodborne Pathogens Standard, the intent of which is to protect workers from potential workplace hazards.

The first one-hour segment of this course provides the learner with crucial information concerning bloodborne and airborne pathogens, including TB, and describes in detail the precautions necessary to minimize or eliminate occupational exposure to such pathogens.

The second segment of this course provides the student with a one-hour update on HIV/AIDS. Acquired Immunodeficiency Syndrome has killed more than 25 million people since it was first recognized in 1981, making it one of the most destructive epidemics in recorded history. Remarkable medical advances, including life-prolonging antiretroviral therapy, have allowed longer survival times, but AIDS is still among the leading causes of death globally. Take a look at the latest national and international statistics, advances in pharmacology, medical management, testing and a variety of other topics of compelling interest to the healthcare professional concerned about an epidemic that currently afflicts over 30 million worldwide.

Some of the Objectives Include:

• Describe Universal Precautions and their application to the healthcare arena.
• Define potentially infectious materials.
• Describe 3 items of personal protective equipment.
• List 4 components of an Exposure Control Plan.
• Describe modes of transmission of TB, HBV, HCV and HIV.
• List 4 symptoms of active TB infection.
• List 3 drugs commonly used in HIV treatment.
• Identify 3 of the most common transmission categories for HIV/AIDS.

Who Should Attend:

All persons required to take HIV / OSHA for employment/licensure purposes, as well as all medical professionals wanting an update on this epidemic.

The Course fee is $20 for 2 Contact Hours.

Don’t Forget Your CPR Update also Domestic Violence Mandatory Requirement
and Prevention Of Medical Errors Mandatory Requirement

Who Should Attend
The participant in this course is a healthcare provider based in a practice setting that requires ACLS knowledge and skills as a condition of employment. The 1-Day option is targeted to those experienced ACLS providers who routinely use ACLS in their practice setting as a part of their job duties. The 2-Day option is for all other providers.

Prerequisites
The choice of enrollment option is determined by proficiency in the subject matter. The participant is required to self assess their knowledge and skills at time of registration according to the criteria defined below.

• Performing BLS CPR skills using the most recent American Heart Association Guidelines
• Reading and interpreting ECGs
• Understanding ACLS drugs and treatment algorithms
• Performing the BLS Primary Survey and the ACLS Secondary Survey

Providers enrolling in the 1-Day option are required to be proficient in the criteria listed above.
Providers enrolling in the 2-Day option are expected to have a basic understanding of the criteria listed above.

Some of the Objectives Include
Upon successful completion of this course, the student should be able to:

• Recognize and initiate early management of peri-arrest conditions that may result in
cardiac arrest or complicate resuscitation outcome.
• Demonstrate proficiency in providing BLS care, including prioritizing chest compressions and
integrating AED use.
• Manage cardiac arrest until return of spontaneous circulation, transfer of care or termination of resuscitation
• Identify and treat ischemic chest pain and expedite the care of patients with acute coronary syndromes
• Recognize other life-threatening clinical situations, such as stroke, and provide effective initial care and transfer to reduce disability and death.
• Demonstrate effective communication as a member or leader of a resuscitation team and recognize the impact of team dynamics on overall team performance.

2-Day Option
The course fee for the 2-Day option is $200 for 9.2 contact hours and includes the Nursing Unlimited Homestudy Guide and ACLS Provider Manual from Nursing Unlimited’s Library (which is to be returned at the end of class, or may be purchased for $30).

1-Day Option
The fee for the 1-Day option is $140 for 6.9 contact hours and includes the Nursing Unlimited Homestudy Guide and ACLS Provider Manual from Nursing Unlimited’s Library (which is to be returned at the end of class, or may be purchased for $30).

If you are not practicing ACLS as a regular part of your professional role in your healthcare facility, it is recommended that you carefully read the pre-requisites to choose the correct course option.
Please remember to include $5.00 for shipping and handling.

If you do not feel comfortable reading and interpreting ECGs, understanding ACLS drugs or treatment algorithms please refer to our ACLS Preparation course CLICK HERE.

A current BLS for Healthcare Providers card is no longer a prerequisite for entry into the ACLS program; the AHA requires “BLS SKILLS”.  However, if your BLS card has expired or is about to expire and you wish to renew, we still offer BLS certification within the ACLS course for a discounted price of $25.

Register Online for 2-Day ACLS Class

Register Online for 1-Day ACLS Class