STATE OF CALIFORNIA - STATE AND CONSUMER SERVICES AGENCY Arnold Schwarzenegger, Governor

n~~DepartlNnlcI

ConsumerAffairs

BOARD OF REGISTERED NURSINGPOBox 944210, Sacramento, CA 94244-2100

TOO (916) 322-1700Telephone (916) 322-3350

www.m.ca.govRuth Ann Teny, MPH, RN

Executive Officer

COURSE INFORMATION(Califomia Code of Regulations, Title 16. Section 1456)

Please Type or Print All EntriesPROVIDER/BUSINESS NAME: National Institute of Family and Life Advocates (NIFLA)

1. TITLE: Limited Obstetrical Ultrasound: The Role of the Nurse in the 2. DATE(S) TO BE OFFERED:Pregnancy Helo Medical Clinic continuing (see attached)

3. OBJECTIVES (Behavioral Terminology):(see attached)

4. OVERVIEW/DESCRIPTION:A course designed to assist nurses with various levels of competency to form a foundation of basicobstetrical knowledge and to gain the skills necessary to perform limited obstetrical ultrasounds withspecial emphasis on first trimester pregnancies.

5. TYPE OF OFFERING (Academic, Workshop, In-service, Independent study, etc.):Workshop

6. TEACHING METHODS:

Didactic, Clinical Practice

7. NUMBER OF CONTACT HOURS: * 18.8

8. CONTENT (Outline Form):

(see attached)

9. METHOD OF EVALUATION WHEN REQUIRED:

Final Exam

" Independent study providers describe methodology used to determine number of contact hours.

nII II THE ROLE OF THE NURSE

IN THEPREGNANCY HELP MEDICAL CLINIC

~~ATI()f~A.LINSfiTUTE (IfIAI ..1i!_Y~. LIF [ADVOC.", TES

Course Objectives

Upon completion of this course the nurse will be able to:

I) Determine the indications for limited ultrasound examinations in thepregnancy help clinic setting.

2) Provide appropriate patient education regarding the limited ultrasoundprocedure, its purpose and its limitations.

3) Understand and apply the basic principles of ultrasound physics,instrumentation and imaging techniques.

4) Document ultrasound fmdings in the patient's record and communicatefindings to responsible health care provider.

5) Identify the policies, procedures and protocols necessary to provideexcellence in nursing care.

6) Evaluate the patient's response to ultrasound findings and implementappropriate nursing intervention based on that response.

THE ROLE OF THE NURSEIN THE

PREGNANCY HELP MEDICAL CLINIC

Course Outline

1. Introductiona. Our missionb. Our goalc. Our heartd. Legal Guidelines

I. The use of ultrasound for women in crisis pregnancies(I) NE Journal of Medicine, 2117/83, "Maternal Bonding in Early

Fetal Ultrasound Examination."2. Federal Drug Administration ruling on "entertainment ultrasound."

(1) FDA letter 8/1/94(2) AlUM, Fall 1994, Vol. 3, No.4 "Sound News Quarterly"

3. Provision of ultrasound services in the practice of medicine(1) AIUM Official Statement(2) Definition of a Medical Clinic

4. Reveiw of recent guidelines from AIUM, ACOG and ACR5. Indications for limited obstetrical ultrasound - AIUM guidelines6. Who should perform the limited ultrasound examination

II. Nursing Accountabilitya. Policies, procedures, protocolsb. Standards of practicec. Reporting protocold. Documentation in the form of written reporte. Techniques of image archivingf. Lines of authority and responsibilityg. Handling a questionable scan

m. Nursing Assessmenta. Psychologicalb. Physiologicalc. Socialogicald. Developmentale. Culturalf. Spiritual

IV. Philosophical Foundation in the Medical Clinic Modela. Referrals and resourcesb. Medical specialistsc. Birth control policyd. Medical history and exame. Medical intake vs. client intakef. Verification of pregnancyg. Medical team concepth. Follow-up1. Understanding abortion techniques (Laminaria)

V. Ultrasound Physics/Probes and Instrumentationa. Sound wave propogationb. Transducer function

1. Frequency2. Penetration3. Resolution

c. Time-gain compensationd. Artifactse. Proficiency in imaging techniquesf. Safety

VI. Limited Ultrasound in Pregnancya. Methods

1. Transabdominal2. Transvaginal

b. Normal pelvic anatomyc. Ultrasound-related pelvic pathologyd. Embryonic and fetal development in the first trimestere. First trimester biometryf. Documenting fetal heart rateg. Ultrasound in early pregnancy failureh. First trimester ultrasound-related pahtophysiology1. Ectopic pregnancyJ. Second and third trimester fetal biometryk. Second trimester ultrasound images1. Evaluating multiple gestations

VII. Obstetrical Fundamentals for the RNa. First trimester nursing as a specialtyb. Rh factor in miscarriage/abortionc. STD testing and abortiond. RCG levelse. Birth control methods and the effects on pregnancyf. The effects of drugs during pregnancyg. Other causes of amenorrhea

VITI. Ultrasound Basicsa. Three levels of ultrasoundb. Scope of limited ultrasound in the pregnancy clinicc. Preparing for the transvaginal exam - the patient and the probed. Cleaning and disinfecting the vaginal probee. Preparing for the transabdominal examf. Cleaning the transabdominal probeg. Scanning techniques - fmding the leading edgeh. Avoiding musculoskeletal injuries (MSI)1. Basic are of the ultrasound equipment

IX. Hands-On ScanningX. Final Exam

._- - ._- ------

STATE OF CALIFORNIA - STATE AND CONSUMER SERVICES AGENCY Arnold Schwarzenegger, Governor

SWeolCaIiIomia[)epMInenl of

ConsumerAffairs

BOARDOF REGISTEREDNURSINGPOBox 944210, Sacramento,CA 94244-2100

TOO (916) 322-1700Telephone (916) 322-3350

www.m.ca.govRuthAnn Terry, MPH, RN

ExecutiveOfficer

INSTRUCTOR INFORMATION(Califomia Code of Regulations, Title16, Section 1457)

Please Type or Print All Entries

1. NAME: 2a. LICENSENUMBER: 42270

Thomas A. Glessner, JD 2b. Date of Expiration: annual renewal

2c. Type of License: Attorney

3. EDUCAnON:

College/University Major Degree Area of Preparation Year Degree Granted

Univ.ofWashington Political Science B.A. Pre-law 1974

Univ. of Washington Law J.D. Law 1977

4. EXPERIENCE:(Start with most recent experience)

Agency Position ClinicalArea From ToMoIYr MolYr

NIFLA President, General Counsel legal counsel 01193 present

Christian Action Council President CEO/legal counsel 12/87 01/93

5. TEACHINGEXPERIENCE:

Titleof Course Description Location Month/Year

Legal Issues & Guidelines (as stated) Nationally (10+ states) 1995 - presentin Limited Obstetrical Ultrasc und

Legal Basics of Converting "How- Tos" of becoming Nationally (10+ states) 1995 - presenta Center to a Medtcal Cumc a MedIcal Chruc

6. Have you ever had a course in Principles of Adult Education? vesDNo[KJ

Ifyes, give dates: __________________________________________________________

NOTE: Ifcourse has more than one instructor,please copy this form,as a separate formis necessary for each instructor.

CEPApp (rev 05/04) Page6of7

STATE OF CALIFORNIA - STATE AND CONSUMER SERVICES AGENCY Arnold Schwarzenegger, Governor

SIoIe 01CaIiIomiaDepaltnentof

ConsumerAffairs

BOARD OF REGISTERED NURSINGPOBox 944210, Sacramento, CA 94244-2100

TOO (916) 322-1700Telephone (916) 322-3350

www.m.ca.govRuth Ann Terry, MPH, RN

Executive Officer

INSTRUCTOR INFORMATION(Califomia Code of Regulations,TItle 16, Section 1457)

Please Type or Print All Entries

1, NAME: 2a. UCENSE NUMBER: 6467

Connie Ambrecht 2b. Date of Expiration: annual renewal

2c. Type of License: ARDMS

3. EDUCATION:

College/University Major Degree Area of Preparation Year Degree Granted

St. Louis CollegeHospital Rad. Tech. Certificate General Radiology 1976

Masters Divinity School Counseling B.A. Counseling 2006

4. EXPERIENCE: (Start with most recent experience)

Agency Position Clinical Area From ToMolYr MolYr

SonographyNow PresidentlInstructor OB/GYNMedical Clinics 2002 present

NIFLA Instructor/Counsel V/S PhysicslHands-on 2000 present

Wellstar Hospital Staff Sonographer OB, GYN, ABD, Sm. Pts. 1991 2004

Piedmont Hospital Staff Sonographer OB, GYN, ABD, Sm. Pts. 1990 2000

Ballas Radiology Lead Sonographer OB, GYN, ABD, Sm. Pts. 1980 1988

5. TEACHING EXPERIENCE:

Title of Course Description Location MonthiYear

SonographyNow Hands-on on-site training Various locations 40+ wks/yr

NIFLA PhysicslHands-ontrng. National (varies) l Ox/yr

Piedmont Hospital ClinicalInstructor Atlanta not certain

BallasRadiology ClinicalInstructor St. Louis 1985-1987

St. Louis College ClinicalInstructor St. Louis 1982-1985

6. Have you ever had a course in Principles of Adult Education? YeSDNo[]

If yes, give dates: ______________________________________________ ._______ --------

NOTE: If course has more than one instructor, please copy this form, as a separate form is necessary for each instructor.

CEP App (rev 05/04) Page6of7

n.~Of~c=::,..~dConsumerAffairs

BOARDOF REGISTEREDNURSINGPOBox 944210, Sacramento, CA 94244-2100

TOD (916) 322-1700Telephone (916) 322-3350

WWW.m.ca.govRuth Ann Terry, MPH, RN

Executive Officer

STATE OF CALIFORNIA - STATE AND CONSUMER SERVICES AGENCY Arnold Schwarzenegger, Governor

INSTRUCTOR INFORMATION(California Code of Regulations. Title16. Section 1457)

Please Type or Print All Entries

1. NAME: 2a. UCENSE NUMBER:078041590 R1'

Audrey Stout, RN, RDMS 2b. Date of Expiration: 9/101062c. Type of License: Registered Nurse

3. EDUCATION:College/University Major Degree Area of Preparation Year Degree Granted

Portland Community Coll. Nursing Associate Nursing 1978

Univ. of Arkansas Home Economics none Home Economics (3 vears)

Kennisaw State Univ. Nursing none Nursing (BSN) (moved)

Preceptorship in Ultrasonoj raphy U/S OBlUltrasound 2000

4. EXPERIENCE:(Start with most recent experience)

Agency Position ClinicalArea From ToMoNr MoNr

NIFLA National Nurse Manager Nursing & Ultrasound 01/00 present

Sonoaranhv Now On-Site Instructor Ltd. Obstetrical Ultraound 10104 present

Sandy Pregnancy Rsrc. Ctr. Nurse Manager Medical Clinic 06/03 08/05

Cobb Pregnancy Resource Ct Nurse Manager Medical Clinic 06/00 06/02

N.W. Womens Care Ultrasonographer OB/GYN 12/00 06/02

5. TEACHINGEXPERIENCE:Titleof Course Description Location Month/Year

NIFLA (lnst. in Ltd. OB U/SIn~Jp'~u U~V~JUp oc reacn

National (varies) IOx/vrnursmg sections of curriculunSonography Now Hands-on on-site training Various Locations ongoing

6. Have you ever had a course in Principles of Adult Education? YeSDNo[!]

Ifyes, give dates: ______________________________________________________ --------

NOTE: Ifcourse has more than one instructor,please copy this form,as a separate formis necessary for each instructor.

CEP App (rev 05/04) Page 6ot7

STATE OF CALIFORNIA - STATE AND CONSUMER SERVICES AGENCY Arnold Schwarzenegger, Governor

BOARDOF REGISTEREDNURSINGPOBox 944210, Sacramento, CA 94244-2100

TOO (916) 322-1700Telephone (916) 322-3350

www.m.ca.govRuth Ann Terry, MPH, RN

Executive Officer

SWeolCaIiIomiaOepoItnent of

ConsumerAffairs

INSTRUCTOR INFORMATION(Califomia Code of Regulations, Title16, Section 1457)

Please Typeor Print All Entries

1. NAME: 2a. LICENSENUMBER: 6617

Jessica M. Davis 2b. Date ofExpiration: N/A2c. Type of License: ARDMS

3. EDUCATION:College/University Major Degree Area of Preparation Year Degree Granted

Vniv. ofNC - Chapel Hill Radiological Scien es B.S. 1979

4. EXPERIENCE:(Start with most recent experience)Agency Position ClinicalArea From To

MolYr MolYr

Medical Sonozranhv II ..1 ident Contractor OR/GYN & Vascular Imaoir Q 03/01

Hlth East Outer Banks Med ( tr Sonozranher OB/GYN & Vascular Imazir ,g

Albermarle Radiologist Sonographer OB/GYN & Vascular Imagir ,g5. TEACHINGEXPERIENCE:

TitleofCourse Description Location MonthlYear

NlFLA (Inst. in Ltd. OB VIS nhvsics/scanning National (varies) 5x/vrSonozranhv Now Hands-on on-site traininz VariousT • IQ

Medical Sonozranhv Pro gran Instructor/Director Pitt Comm. ColI.-Greenville NC 01/86 - 12/88

Radiologic Sciences Deot. Chair Pitt Comm. ColI.-Greenville NC 01190 - 12/94

6. Have you ever had a course in Principles of Adult Education? YeS~NoDIfyes, give dates: ____ 19].&.._______________________________________________________

NOTE: Ifcourse has more than one instructor,please copy this form,as a separate form is necessary for each instructor.

CEP App (rev 05/04) Page 6of7

STATE OF CALIFORNIA - STATE AND CONSUMER SERVICES AGENCY Arnold Schwarzenegger, Governor

BOARD OF REGISTERED NURSINGPOBox 944210, Sacramento, CA 94244-2100

TDD (916) 322-1700Telephone (916) 322-3350

www.m.C8.govRuthAnn Terry, MPH, RN

Executive Officer

SWeolCoIiIamoao.p_nlof

ConsumerAffairs

INSTRUCTOR INFORMATION(California Code of Regulations, Title 16, Section 1457)

Please Type or Print All Entries

1. NAME: 2a. LICENSE NUMBER: 36750

Byron C. Calhoun, MD, FACOG, FACS 2b. Date of Expiration: 5121/07

2c. Type of License: Medical Doctor

3. EDUCATION:

College/University Major Degree Area of Preparation Year Degree Granted

Univ. of Iowa Med. Sch. Medicine M.D. Medicine 1983

Univ. ofMissouri-Columbi OB/GYN Residency OB/GYN 1987

Oregon Health Science Uni J. Fellowship Maternal-Fetal Medici ~e 1989

Regis University Business MBA Business 2004

4. EXPERIENCE: (Start with most recent experience)

Agency Position Clinical Area From ToMolYr MolYr

Acnvery pracucmg maternal- etai mecicme, perrormmg Qla~nosnc oostemcai unrasounoand narticioatine in nrenatal d iaznosis counseling. ongoingNIFLA National Medical Advisor OB/GYN - Ultrasound 2001 presentAm Assn or t:ro-~lt~_l}t:~stetncians& Gvnecolozists AAPLOG President ongoing

Crisis Preg. Ctr. Rockford, II Medical Advisor OB/GYN - Ultrasound 01103 OliOS

5. TEACHING EXPERIENCE:

Title of Course Description Location MonthNear

Obstetrics & Gynecology Visiting Clinical Professor Univ. of Illinois at Chicago present

Obstetrics & Gynecology Adiunct Professor Midwestern Univ.-Chicago present

Obstetrics & Gynecology Adjunct Associate Professor Uniformed Services Univ. presentof Health Sciences

6. Have you ever had a course in Principles of Adult Education? YeSDNo[K]

If yes, give dates: ____________________________________________________________

NOTE: If course has more than one instructor, please copy this form, as a separate form is necessary for each instructor.

CEP App (rev 05/04) Page 6017

2006Institute in LimitedObstetrical Ultrasound

NIFLAPO Box 42060FredericksburgVirginia 22404540.372.3930

Fax 540.372.3929www.nifla.org

For Nurses, Medical Personnel and Executive Directors of Pregnancy Help Medical Clinics

"The quality of theInstructors Is first ..... "-Beth DiemertHeartbeat International

PURPOSE OF COURSEThis course is designed to equip the leadership and staff ofpregnancy help medical clinics to achieve excellence in theprovision of ultrasoundservices to clients.

COURSE DESCRIPTIONThis is a three-day coursewith two tracks, medical and management, to address both medicaland administrative concerns. On day one, both tracks meet together. Days two and three focuson workshops designed specifically for each track.

WHO SHOULD ATTEND?Clinical Directors, Executive Directors,Board Members and CEOsWorkshops include: fundraising ideas, clientmarketing, recruitment and supervision ofmedical teams, clinical infrastructures,corporate strategies, policies and procedures,and risk management issues.

RNa, LPNs, Medical Directors, Mid-Wivesand Nurse Practitioners _ ~Workshops include: legal guidelines, obstetrical ~.fundamentals, nursing accountability, ultrasound physics,ultrasound instrumentation, documenting fetal cardiac activityand documenting fetal biometry.And best of all, there ishands-on, live OB scanning in different stages of pregnancy.

"Ifound the COUlHsuccinct and Nay tounderstand, even for nu.... not accustomedto the 08 field.The Instructors 'bent overbackwards' In every WII'J to make ItenJoyableand unclel'stanclable. A+.It

-Cathie Greer. RNGainesville. GA

MEDICAL COURSE CONTENTThis course follOWSthe guidelines from the Association of Women'sHealth, Obstetric and Neonatal Nurses (AWHONN) and the AmericanCollege of Obstetricians and Gynecologists (ACOG) for training in limitedobstetrical ultrasound. Provider approved by the California Board ofRegistered Nursing, Provider# xxxxxx for 18.8Contact Hours.

Note: The Basic Course is the beginningof ultrasound training for nurses tobecome competent in their scanning abilities. NIFLA recommends that after thistraining, an additional 50-75 supervised scans should be performed by eachnurse. Information on on-site and other training opportunities is presented ateach course.

THE FACULTYThomas Glessner, JD - Founder and President of NIFLA. A leading national legal expert inthe pro-life medical clinic movement.Byron Calhoun, MD - Medical Director. NIFLA. President of the American Association ofPro-Life Obstetricians and Gynecologists (AAPLOG) and a board certified OBIGYNspecializing in Matemal-Fetal Medicine.Connie Ambrecht, RT, RDMS - President of Sonography Now. Has provided sonographytraining and services for over 25 years.Audrey Stout, RN, RDMS - Nurse Manager Consultant, NIFLA. Extensive experience inOBIGYN sonography.Beth Chase - Executive Director. Medical Advancement. NIFLA. Over 15years CEOexperience in clinic conversion and leadership.Dorothy Wallis, M.Div - President. Caring to Love Ministries (Louisiana). Worlcswithcenters nationwide to facilitate conversion to medical clinics.Anne O'Connor, JD - General Counsel. NIFLA. Provides legal and organizational auditservices for NlFLA members.Patty Meadows, ROMS - A sonographer since 1992 and outstanding trainer of nurses toperform ultrasound exams in the pregnancy help medical setting.

"I can't imagine IIIIYOM convertingto medical without th.. cou..... It-Jane Maxfield. ExecutIve DlractorPregnancy Resource CenterLake Ray Hubbard

Endorsed by

American Associationof Pro-Ufe

Obstetricians andGynecologists(AAPLOG)

CAREItNE1:

2006 INSTITUTE IN LIMITED OBSTETRICAL ULTRASOUNDREGISTRATION FORM

Please select one:o February 9-11 Torrance, CA NurseslDirectorso March 2-4 Dallas, TX NurseslDirectorso April 6-8 Atlanta, GA Nurses/Directorso May 4-6 Kansas City, MO NurseslDirectorso June 1-3 Chicago,IL NurseslDirectorso August 10-12 Seattle, WA NurseslDirectorso September 7-9 Torrance, CA NurseslDirectorso October 5-7 Nashville, TN NurseslDirectorso November 2-4 Torrance, CA Nurses/Directorso December 7-9 Richmond, VA NurseslDirectors

Name of Center: ---------------------------------------------------Person(s) Attending: _________________________________ RN# _

DirectorDNurseD

_________________________________ RN# __Nurse D DirectorD

_________________________________ RN# _

Address:

Nurse D Director D

City: ___________________________ State: .Zip: _

Phone #: ('--_~) __ Email Address: ---------------------------Membership Status (check one)

o NIFLA Membero Non-NIFLA Membero TLCCenter

Registration Fees$650 per NIFLA Member attendee$750 per Non Member attendeeIncluded in TLC Contract

Fee includes breaJifast, lunch and breaks each day. Dinner. transportation and accommodationsto be paid by attendee. Full information will be mailed upon receipt of paid registration.

Please send registration to:NIFLAPO Box 42060Fredericksburg, VA 22404Phone: (540) 372-3930Fax: (540) 372-3929Email: adrnih@23fl4tpr( Z J:j:J QUe?

Payment Enclosed!Attached:o Check #o AMEXIV-IS-AlM--C-#--Exp. Date __ / __Billing Address: _

City: St: _ Zip: _

Cancellation .f.QHc!Y~'!~egis'lN'IttP'I~ be transferred to afuture course, or 1)fee refunded less $50handling charg~' l/tWo w.eekS:or 'mOtJ{1:i~forefirst day of course; 2) ¥2 of fee refunded if two weeks or lessbefore first day of cQurse. -