STABLE - Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional support

S.T.A.B.L.E. neonatal education focuses on post-resuscitation or pre-transport stabilization with a concentration on Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional support. S.T.A.B.L.E. certification provides additional training to physicians, nurse midwives, registered nurses (L&D, postpartum, nursery, emergency department, etc.), LPNs, nursing assistants, respiratory therapists, and emergency responders, such as EMTs and paramedics.

S.T.A.B.L.E Learner Course Format

Neonatal nursing, medical, and respiratory experts administer the S.T.A.B.L.E Learner course in a didactic-interactive format over one to two days, typically within 8 to 9 hours. S.T.A.B.L.E instructors or administrators develop the structure of their Learner courses, potentially using skills stations and simulations, and taught in-person or by teleconferences, such as through Zoom or Teams. However, instructors must follow the S.T.A.B.L.E. guidelines.

HealthStream provides an online S.T.A.B.L.E. course with quizzes and a final post-course test suitable for new Learners and those wanting to renew their S.T.A.B.L.E. Learner course. 

• Completion Time: About 5.5 to 6 hours

• Cost: $165

Course Outline

The S.T.A.B.L.E. neonatal education learner course includes a pre-test, six care modules, and assessments, with a seventh module on quality improvement now included. Participants engage in an 8-hour interactive-didactic course, skills station, and simulated environment with quizzes. A final post-test evaluates comprehension by testing a mixture of the modules. Learning objectives include:

Sugar and Safe Care

• Neonatal patient safety and methods of error reduction

• Conditions that predispose infants to develop hypoglycemia

• The morbidity and mortality impact on late-preterm neonates

• Gestational diabetes screening recommendations

• The physiology of aerobic and anaerobic metabolism

• Providing initial IV fluids

• Blood glucose monitoring guidelines

• Signs of infant hypoglycemia, intravenous treatment, and post-treatment assessment

• Umbilical catheter placement and safety

• Abdominal conditions that present as bowel obstructions

Temperature

• Factors increasing infant hypothermia risk

• Physiologic response to cold stress on term infants

• Heat gain and loss mechanisms

• Hypothermia response in term and preterm infants

• Therapeutic neuroprotective hypothermia candidates

• Rewarming techniques and monitoring for hypothermic infants

Airway

• Necessary labs and tests during neonatal post-resuscitation or pre-transport

• Recognize neonatal respiratory distress and determine whether mild, moderate, or severe

• Interpreting blood gas tests and treating respiratory and metabolic acidosis

• Identify signs of respiratory failure

• Recognize respiratory illnesses and airway challenges during neonatal period

• Assisted ventilation principles, including continuous positive airway pressure (CPAP) candidates, bag and or T-piece resuscitator positive pressure ventilation (PPV), and assisting with endotracheal (ET) intubation, including chest x-ray evaluation for ET tube position, securing the tube, and initial ventilatory support

• Identification and treatment of pneumothorax

• Safe administration of analgesics

Blood Pressure

• Differentiation of compensated and uncompensated shock

• Identify factors that affect cardiac output and heart rate during shock

• Conducting physical exam to evaluate shock

• Recognize the causes and initial treatment of hypovolemic, cardiogenic, and septic shock in infants

Lab Work

• Risk factors that predispose infants to infection during perinatal and postnatal care

• Recognize neonatal sepsis and initial antibiotic treatments

• Identify the organisms that cause bacterial and viral infections

• Calculate and interpret the absolute neutrophil count and immature to total ratio of white blood cell (WBC) development

Emotional Support

• Understanding the crisis families experience during infant admission and treatment in a neonatal intensive care unit (NICU)

• Methods to support families of NICU patients

• Facilitating parenting skills in the NICU

An additional seventh module emphasizes quality improvement, communication, and teamwork. Its learning objectives include:

Quality Improvement

• Promote patient safety and methods to reduce or eliminate medical errors and prevention of adverse events

• Harm prevention and promotion of patient safety through communication and teamwork

• Improving patient safety using simulation-based techniques

• Evaluation of post-resuscitation or pre-transport care using self-assessment and debriefing

S.T.A.B.L.E. Instructor Course Format

S.T.A.B.L.E. administrators created a Teleconference National Instructor course for online video instruction. Instructor candidates include experts in neonatal intensive care. Intructor course providers limit teleconference sessions to 12 attendees per course.

All instructor candidates must pass a 40-question pretest with a minimum passing score of 70%, complete the S.T.A.B.L.E. Online Learner course, and attend a one-day teleconference instructor course with a National Faculty instructor who formally trains instructors. Qualified instructors receive training by completing a S.T.A.B.L.E. instructor course in Lead and Support roles.

• Cost: $450 includes the S.T.A.B.L.E Program Online Learner course, the one-day teleconference instructor course, a completion card, education credits, instructor manual, and course paperwork

Any healthcare provider with neonatal post-resuscitation or pre-transportation responsibilities may take the S.T.A.B.L.E. Program Learner or Provider course. Eligible healthcare professionals include:

• Physicians: Pediatric, emergency departments, family practice, and obstetric physicians or residents

• Nurses: RNs working in L&D, postpartum, nursery, emergency departments, nurse midwives, LPN, and nursing assistants.

• Other healthcare providers: Respiratory therapists, pre-hospital providers, such as EMTs and paramedics.

Candidates register for a S.T.A.B.L.E. course by locating a learner or provider course. They may also contact a lead instructor directly to determine their course schedule, associated fees, and availability.

S.T.A.B.L.E. completion cards are valid for two years. Candidates must renew their certification by completing a full-length course if their completion card expired or the S.T.A.B.L.E. Program updated the course with a new edition.

Candidates can renew their learner course certification using three options:

• Full-length renewal course

• Short-length renewal course

• Online learner course offered through partnership with HealthStream

The instructor determines whether the renewal candidate should take a full-length or short-length renewal course based on the candidate’s neonatal experience and knowledge and the level of care and where the newborn receives care, such as Level 1 (basic), Level 2 (intermediate), or Level 3-4 (NICU).

Full-Length Learner Course Renewal

Candidates who participate in a full-length learner course renewal in the classroom must have access to the most current edition of program materials. They must complete all module quizzes and achieve a final passing score by getting no more than two answers wrong. The instructor indicates they’re a renewal candidate on the roster.

Recommended for:

• Level 1 facilities or those without obstetric services

• Healthcare providers primarily caring for well to mildly ill newborns in Level 2 and 3 facilities

• Facilities with low transport/transfer volumes due to having few infants born ill and/or premature

• Students with expired course completion cards

• Students with unexpired course completion cards but lack the expertise level to attend a short-length renewal course

• All students regardless of course completion card status if the S.T.A.B.L.E. course has been updated to a new edition

• Participants who didn’t earn a course completion card due to previously answering 5 or more questions wrong during the mixed module test

Short-Length Learner Course Renewal

The short-length learner course takes approximately 5 hours to complete. Candidates must have access to the most current edition of program materials. They must complete all module quizzes and achieve a final passing score by getting no more than two answers wrong. The instructor indicates they’re a renewal candidate on the roster.

Recommended for:

• Students who previously completed a full-length learner course

• Students with an unexpired learner course completion card (if the S.T.A.B.L.E. course hasn’t been updated with a new edition)

• Nurses, physicians, and respiratory therapists who work with NICU patients

It’s the lead instructor's responsibility to verify whether students previously completed a full-length learner course, students have an unexpired course completion card, and healthcare professionals have the appropriate knowledge level and work area to renew through a short-length course versus a full-length course.

HealthStream awards up to 5.5 contact hours of Continuing Education (CE), Continuing Nursing Education (CNE), Continuing Medical Education (CMEs), and Continuing Respiratory Care Education (CRCE) credit to physicians, nurses, and respiratory care professional for completing the Learner course. Other healthcare professionals earn verifying certificates for AMA-PRA credit and receive ANCC contact hours. The S.T.A.B.L.E. Program isn’t responsible for continuing education credit applications. The instructor must complete this step.

The following accrediting bodies approve the S.T.A.B.L.E. Learning course:

• American Association for Respiratory Care (AARC)

• Accreditation Council for Continuing Medical Education (ACCME)

• American Nurses Credentialing Center (ANCC)

Student learners must have the 6th edition Learner Manual during the course. They can receive the manual up to one month before beginning the course to study the material.

• 7th Ed. S.T.A.B.L.E. Program Learner Manual: $64.95

• 2nd Ed. S.T.A.B.L.E. Cardiac Module Book: $64.95 (not required)

• 2nd Ed. S.T.A.B.L.E. Cardiac Module Online Slides: $159.00

• 3rd Ed. S.T.A.B.L.E. Physical and Gestational Age Assessment Slides: $129.00

• 3rd Ed. S.T.A.B.L.E. Physical and Gestational Age Assessment of the Newborn Slides: $129.00

Instructors utilize course slides in addition to the learning manual. Relevant costs include:

• 6th Ed. S.T.A.B.L.E. Program Instructor Course includes slides, quizzes and other resources. Cost: $450

S.T.A.B.L.E. candidates may want to consider other certifications that focus on neonatal resuscitation, such as:

• The Neonatal Resuscitation Program (NRP) introduces the basic skills required for neonatal resuscitation.

• Pediatric Advanced Life Support (PALS) providers recognize and intervene when pediatric patients experience a respiratory emergency, shock, or cardiopulmonary arrest.

• The Pediatric Emergency Assessment, Recognition and Stabilization (PEARS) course teaches a systematic approach to assessing, recognizing causes, and stabilizing a pediatric patient during respiratory, cardiopulmonary arrest, or shock emergencies before transferring the patient to an advanced provider.