Patient Care & Procedural Skills

Withholding Life Sustaining Treatment, an Ethical Paradox

CMS is allowing reimbursement for healthcare providers who have stand-alone discussions with patients about their health care options near the end of life, including life-sustaining treatment. Lack of reimbursement has likely represented one barrier to these important discussions. Another obstacle…

Abnormal Uterine Bleeding

Abnormal Uterine Bleeding (AUB) accounts for nearly 30% of all visits to the gynecologist and 70% of all visits in the perimenopausal and postmenopausal years [ACOG, 2014]. Recent advancements in diagnostic modalities and new terminology warrant an up-date on this…

Opioid Mortality: What Prescribers Can Do

Deaths from opioid overdose have risen to epidemic levels, leading to a proliferation of many regulations and counter-measures, such as the pharmacy drug monitoring programs (PDMPs). This monograph will assess the effectiveness of these measures, review existing clinical practice guidelines,…

HIV Testing Guidelines (Part 2 of 2)

Since the CDC recommended expanded HIV testing, screening of patients for HIV will increase. In addition, with the approval by the FDA of rapid HIV tests and in-home HIV tests, screening will take place both in primary care and at-home…

HIV Testing Guidelines (Part 1 of 2)

Since the CDC recommended expanded HIV testing, screening of patients for HIV will increase. In addition, with the approval by the FDA of rapid HIV tests and in-home HIV tests, screening will take place both in primary care and at-home…

Electronic Fetal Monitoring Case Studies #4: Neonatal Encephalopathy

New guidelines outlined in the ACOG & AAP Task Force Report on Neonatal Encephalopathy (NNE) include scientific updates on specific fetal heart rate patterns, sentinel events, and newborn assessment indicators that may indicate an acute intrapartum hypoxic-ischemic injury that leads…

Electronic Fetal Monitoring Case Studies #3: Standard Terms & Guidelines

Over 90% of obstetric-related malpractice involves EFM negligence. EFM-related malpractice claims decrease in facilities that adopt, implement, and consistently use standardized EFM terms and guidelines. Universal adoption of standardized nomenclature by every practitioner skilled in EFM is a national goal….

Electronic Fetal Monitoring Case Studies #2: EFM Triage

The majority of obstetric triage encounters include an assessment of both mother and fetus but under certain conditions, clinical data may be unavailable. EFM triage is a skill of necessity that includes a brief and rapid assessment of fetal heart…

Psychotropic Medication Management in Primary Care

Four out of five prescriptions for psychotropic medications in the US are prescribed by primary care providers. Psychotropic medications have a relatively high rate of adverse side effects, and are an increasing source of claims for medical malpractice. Clinical practice…