On-Demand Portion
Course curriculum for the
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01
Welcome!
Show details- How To Take This Course, Including Ordering Your Supply Kit, and Scheduling Your Final Exam
- Before we go on...
- 1.1 Introduction
- 1.2 Language Matters
- Quiz 1
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02
Equipment and Safety
Show details- 2.1 Choosing The Right Instruments
- Q&A Why Russian forceps?
- Quiz 2.1
- Bonus Section: Article on Left-handed Surgical Instruments
- Bonus Section: Review of Instruments for Left-handed Midwives
- 2.2 Proper Instrument Techniques
- Visit our Supply Store (Optional resource)
- Q&A: Why The Needle Spins
- Quiz 2.2
- 2.3 Choosing The Right Suture
- Quiz 2.3
- 2.4 Other Supplies
- Q&A Lube on Suture
- Quiz 2.4
- 2.5 Safety and Sterilization
- Q&A How Do You Pack Your Instruments?
- Q&A How Long Do Instruments STAY Sterile?
- A Guide to Your Supply Kit
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03
Before The Repair
Show details- 3.1 Mapping and Tear Prevention
- Quiz 3.1
- 3.2 Exam and Assessment Prep
- Q&A Positioning the Client
- Q&A Anesthetic Prior to Exam
- Quiz 3.2
- 3.3 Initial Exam and Assessment
- Quiz 3.3
- 3.4 Degree Determinations
- Q&A Depth of Tear
- Quiz 3.4
- 3.5 OASIS Assessment
- Q&A Dovetail Clarification
- Quiz 3.5
- Printable PDF: Methods for Assessing Anal and Rectal Injury (OASIS)
- 3.6 Planning the Repair
- Printable PDF: Suturing Do's and Don'ts
- Quiz 3.6
- 3.7 To Suture or Not To Suture?
- Q&A To Suture or Not? Herbs for Healing?
- Overview of Research on Suturing vs Not Outcomes
- Bonus Section: Articles and Studies on Outcomes of Suturing vs Not
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04
Anesthetics
Show details- 4.1 General Considerations for Anesthetic
- Quiz 4.1
- 4.2 Considerations for Lidocaine
- Q&A Allergic Reaction to Lidocaine
- Quiz 4.2
- Printable PDF: Lidocaine Reference Card
- 4.3 Considerations for Ester Anesthetics
- Quiz 4.3
- 4.4 Methods of Anesthetic Administration
- 4.5 Tissue Adhesive
- Quiz 4.5
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05
Knot and Stitch Techniques
Show details- How To Use This Section
- 5.1 Talkthrough: From Anchoring Knot to End Knot
- Q&A Why does the cross-over stitch NOT cross the wound?
- Quiz 5.1
- 5.2 Medical Model Walkthrough: Anchoring Knot/Surgeons Knot/Instrument Tie
- 5.3 Medical Model Walkthrough: Two Layer Suturing of the Vaginal Floor
- 5.4 Medical Model Walkthrough: Subcuticular Running Mattress to End Knot
- 5.5 Talkthrough: Labial Repairs
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06
Practice Makes Perfect Suture-Along (Supply kit needed!)
Show details- 6.1 Practice Makes Perfect: How to Use the Supplies
- 6.2 Practice Makes Perfect: Curving, Curving, Curving
- 6.3 Practice Makes Perfect: 1 cm Down, and Straight Across
- 6.4 The Optical Illusion
- 6.5 Practice Foam Walkthrough: Interrupted Stitches and Basic Technique Tips
- Q&A Interrupted Stitches
- 6.6 Practice Foam Walkthrough Part 1: Assessment and Anchoring Knot
- Q&A Anchor Knot Placement Explanation
- 6.7 Practice Foam Walkthrough Part 2: Anchor Knot to End Knot of Double Layer Sutures
- Bonus Section: Walkthrough of LEFTIE Suturing
- Close-up of End Knot
- 6.8 Practice Foam Walkthrough: Locked Blanket
- Retrieving a Lost Needle
- Q&A Swelling, Adjusting Tension, and Timing of Repair
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07
Documentation & Aftercare
Show details- 7.1 Charting
- Printable PDF: OASIS Assessment Informed Choice Template
- Printable PDF: Checklist for Charting Postpartum Genital Injury Repair
- Printable PDF: Client Informed Choice Suturing
- Q&A Using Herbs and Bee Things
- Q&A Soothing Itching
- Q&A Detecting Infection and Follow-up Care
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08
Tests, Evaluation, and Follow-Up
Show details- Link to Written Test
Upon completion of this program, the learner will be able to:
- Follow OSHA protocol for suturing
- Assess post-childbirth genital injuries, including OASIS (third and fourth degree)
- Plan the repair
- Determine the appropriate local anesthetic, and administer local anesthetic
- Perform instrument ties
- Perform the following stitches: interrupted, basting stitch, locked blanket stitch, and locked mattress stitch
- Proper charting for suturing
- Provide clients with aftercare options
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Instructor Bio:
Terms and Conditions
Due to the small cohort format of this course, there are different terms and conditions than our purely on-demand online courses. These Terms and Conditions are needed in order for the course delivery process to be smooth for you, the fellow members of your cohort, and the next cohort (that will be using your supply kits once returned).
By enrolling in this course, you are agreeing to these Terms and Conditions, so please read them carefully:
1. Upon enrollment, you will have instant access to the on-demand portion. The on-demand portion (with the exception of portions marked as "bonus" content) must be completed by one half hour prior to your small group session.
2. You also must pass the written test with an 80% or greater by one half hour prior to your small group session.
3. Attendance and participation in the small group session is required. The small group session for this cohort is:
Tuesday, February 25th, 2025
Pacific: 9:15am to 12:30pm
If you cannot attend the small group session for any reason, including not completing 1 and 2 above, you may attend the make-up session listed below, for an additional $100. You may also choose to take this session in addition to the standard session, if you would like additional practice, and feedback from the instructor (same fee). The make-up session for this cohort is:
Tuesday, March 4th, 2025
Pacific: 9:15am to 12:30pm
(additional $100 fee applies)
4. After you attend a small group practice session, you must also attend a 1 hour private session with Holly Scholles, which will include a skills test. Sessions are available the same day as the small group session, and the same day as the make-up session. Upon enrollment, you will be able to sign up for a testing session using an online scheduler.
Private skills test sessions are available for this cohort (each private session is 1 hour - for example, 1pm to 2pm):
Tuesday, February 25th, 2025
and
Tuesday, March 4th, 2025
Pacific: 1pm to 4pm
We provide six test slots for the six students per cohort. If you cannot make any of the available times, you may request an alternate test time outside of those appointment slots, which may be arranged for an additional $100 fee.
If you are unable to pass your skills test, there will be a $100 fee for a second (or third) private skills test session.
Your skills test must be completed within 2 weeks of your original small group session date.
5. Certain supplies are required to participate in the live portions of this course. Supplies for participants outside the United States are handled on a case-by-case basis, please email [email protected] to discuss.
Participants in the United States have two options for supply kits:
1. A Keeper Kit, for an additional fee
2. A Loaner Kit, at no additional fee
If you purchase a Keeper Kit, nothing needs returned, and section 5 does not apply to you.
If you do not purchase a Keeper Kit, you will be sent a loaner kit at no additional cost. This Kit is due back by two weeks after the small group session, and you will be sent a prepaid USPS return label along with return instructions.
If the Loaner Kit is not in transit by two weeks after the small group session, you will accrue late fees at the rate of $5 per day, which will be billed to your debit or credit card on file. If the Loaner Kit is not received by three weeks after the small group session, you will be billed the full amount of a Keeper Kit. Late fees for supply kits will be billed to your debit or credit card on file.
Any missing items, or items damaged beyond normal wear-and-tear, will be charged the following replacement costs:
- needle holder, unmarked Russian forceps, hemostat, or scissors - $20 per item
- marked Russian forceps - $30
- clamp stand - $20
Fees for missing items will be billed to your debit or credit card on file.
6. The CE certifications require you to complete a course evaluation. We'll send you a direct link after your skills test.
7. Your CE Certificate for 10 hours of continuing education will be sent via email once Steps 1-6 are complete, and any fees incurred during those steps have been paid in full. The date on the certificate, once sent, will be the date your passed your skills test.
(For example, if your small group cohort is on Thursday, September 17th, you sign-up for your skills test to be the same day, send your supply kit back the next day, the earliest you would receive your certificate would be Monday, September 21st. But your certificate would be dated for the 17th, as that was the day you passed your skills test.)
Refunds and Cohort Exchanges
A full refund is available if ALL the following conditions are met:
1. Less than 10% of the on-demand portion has been accessed.
2. It has been less than 30 days since enrollment.
3. It is more than 30 days until the small group cohort.
If it has been more than 30 days since enrollment, and/or more than 10% of the on-demand portion has been accessed, but still more that 30 days until the small group cohort, then you may switch to a different small group cohort, if available, at no additional fee.
This course was designed to meet the requirements of the hands-on Category 1 course for the NARM Midwifery Bridge Certificate, and for the new "LD&D Renewal" for Oregon LDMs.
If you are a midwife in Colorado, please email jesica@HiveCE. We have a low-cost supplemental course you will need to take along with Hands-On Suturing in order to meet the requirements for your state.
This course is appropriate for APRNs, CNMs, RNFAs, and other nurses who perform post-childbirth perineal repairs. It is not appropriate for all nurses. Course completion does not authorize the learner to use skills outside their scope. Please refer to your state guidelines for determining scope of care.
HiveCE is an approved provider of continuing education by the California Board of Nursing, and this course meets the California Board of Nursing criteria for 10 hours of continuing education. Provider approved by the California Board of Registered Nursing, Provider Number 17686, for 10 contact hours.
Approved by MEAC for 10 hours of CE, approval number M2324-75-0701.
Midwives of Color/Student Midwives of Color may receive a partial scholarship for this course. Please email [email protected] to request this scholarship.