Johns Hopkins Hospital
Gynecology and Obstetrics

To support our continued effort to provide optimal patient care and maximize team communication, all obstetrical nursing staff and medical providers will obtain a Certificate of Added Qualification in Electronic Fetal Monitoring (EFM). The National Certification Corporation  for Obstetric, Gynecologic and Neonatal Nursing Specialties (NCC) test will be used. EFM re-certification is required every three years.

• Online Course
  • Fetal Heart Monitoring by MCIC Vermont - RELIAS Learning Portal
    
    

• Textbooks/Study Guide:
  • Mosby's Pocket Guide to Fetal Monitoring: A Multidisciplinary Approach by Lisa A. Miller CNM JD, David Miller and Susan Martin Tucker MSN RN PHN.
  • Electronic Fetal Monitoring (EFM) Certification Review Book, by Cydney Afriat Menihan, CNM, MSN, RDMS, C-EFM; available via Amazon.com. This book has practice questions.
    
  • Essentials of Fetal Monitoring by Michelle Murray PhD RNC, Gayle Huelsmann BSN RNC and Nanci Koperski RNC MBA MHSA LNCC.
    
    
• Fetal Heart Patter Recognition and Intervention
  • Physiology of Fetal Heart Rate Monitoring
    
  • Interpretation of Fetal Heart Rate Monitoring
    
  • Interventions for Intrapartum Fetal Heart Rate Abnormalities
    
  • Management of Category II Fetal Heart Rate Tracing
    
  • Study Guide - Self-assessment guide to be used with the textbook
    
    

• NCC Resources - (NEW)
  • NCC EFM Tracing Game –- this web game uses NICHD terminology to identify strip elements and categorize the EFM strips. Both free and paid collections are available to play.
  • Download this FREE PDF - NCC monograph “Fetal Assessment and Safe Labor Management (2021) by Kathleen Rice Simpson, PhD, RNC-OB, CNS-BC, FAAN.
  • Download the FREE Quick Reference PDF - NICHD 2008 Terminology, Tiers and Management (reaffirmed 2015)
  • NCC EFM Toolkit - Electronic Fetal Monitoring Tools
    
    
• Practice Bulletins:
  • ACOG Management of intrapartum fetal heart rate tracings. Practice Bulletin, No. 116. American Congress of Obstetricians and Gynecologists. Obstetrics & Gynecology 2010;116:1232–40.
  • ACOG Antepartum fetal surveillance: Practice Bulletin, No. 146. American Congress of Obstetricians and Gynecologists. Obstetrics & Gynecology 2021.
  • ACNM Clinical Bulletin (2015) - Intermittent Auscultation for Intrapartum Fetal Heart Rate Surveillance.
  • AWHONN Position Statement (2018) - Fetal Heart Rate Monitoring
    
    
• Case Studies/Review Questions
  • CCPR Electronic Fetal Monitoring Case Book - Please do not print out the entire case book from the intranet. To complete the case studies, select the desired worksheet and select “Print this page” option on the print selection screen.
  • Monitoring the Preterm Fetus during Labor (2004) by Kathleen Rice Simpson, PhD, RNC, FAAN, MCN November-December, pg. 381 - 388.
  • Review Questions: (NEW)
    • EFM Review Questions #1 - 35 practice questions
    • EFM Review Questions #2 - 55 practice questions
    • EFM Review Questions #3 - 100 practice questions
    • EFM Review Questions #4 - 110 practice questions
    • EFM Review Questions #5 - 50 practice questions
    • EFM Review Questions #6 - 50 practice questions
    • EFM Review Questions #7 - 100 practice questions
      

• Online Exams ($$)
  • CCPR Electronic Fetal Monitoring Online Practice Subspecialty Exam -This test has 125 questions. The practice test uses the same format as a certification exam.
  • NCC Preview Test - Offered by NCC. Test questions provide applicant with types of questions and content areas on the NCC test outline. Preview test contains 30 questions. Cost is $35.
  • Perinatal Quality Foundation Fetal Monitoring Credentialing program - The test consists of 70-80 questions. Cost is $150.00 per individual.
    
    
• Review Courses/Conference/Seminars ($$$)
  • AWHONN Advanced Fetal Monitoring Course - This course uses a case study approach to focus on the analysis of complicated FHM patterns.
  • Advanced Fetal Monitoring Course - This is a 2-Day Seminar that offers a study session with expert Lisa A. Miller, CNM, JD. Sponsored by Professional Education Center.
    
    
• Other Resources
  • Ethics in Healthcare: Improving Patient Outcomes
  • American Nurses Association Ethical Principles and Theories
  • Kim Armour, CNP, APN, RDMS, MSN,Antepartum Maternal-Fetal Assessment,   AWHONN Lifelines, Volume 8 (3), June - July 2004 pg. 232-240.
  • Intrapartum Fetal Evaluation, Chapter 16 in Gabbe et al, 2012. Obstetrics: Normal and Problem Pregnancies, 6th ed.
  • Intrapartum Fetal Surveillance, Chapter 33 in Creasy and Resnik et al., 2014. Maternal Fetal Medicine Principles and Practice Elsevier, 2014, pp 488-496.
  • Multidisciplinary Teamwork Approach in Labor and Delivery and Electronic Fetal Monitoring Education:  A Medical-Legal Perspective.  Dawn E. Collins, RNC, JD, J Perinat Neonat Nurs, Vol. 22, No. 2, pp. 125–132.
    
  • March of Dimes Presentation on Management of Fetal Arrhythmias by Anjan Batra, MD, Pediatric Cardiology Director, Children’s Hospital of Orange County University of California-Irvine.

The NCC EFM exam is a national exam and staff will be allowed to take the EFM exam only twice in one year, which begins from the date of the first exam.

Computer testing is available all year around.   Testing occurs in 90 day cycles starting on the 5th and 20th of each month. Visit the NCC website for details.