ROSE and the Four Ds: Implementing Goldilocks Principles in Fluid Resuscitation and Therapy

Author(s): Jan M Headley

Contact Hours 1.25

CERP A 1.25

Expires Oct 17, 2026

Topics: Hemodynamics

Population: Adult

Role: Staff

Added to Collection

Activity Summary

Required reading for all learners: Implicit Bias impacts patient outcomes

Too much or too little fluid in resuscitation efforts can lead to a plethora of adverse events. Asking a series of four questions concerning drug, dose, duration, and de-escalation (the four Ds) facilitates optimal fluid therapy. The four phases in fluid resuscitation are resuscitation, optimization, stabilization and de-resuscitation (ROSE). Each phase has evidence-based rationale for specific hemodynamic targets and interventions. This intermediate-level session presents a Goldilocks strategy using dynamic parameters to achieve a patient’s optimal Starling curve.

Objectives

  • Apply current research addressing outcomes related to optimizing fluids and fluid balance.
  • Describe the four conceptual phases in the process of fluid resuscitation (ROSE).
  • Develop a strategy in using SV and SVV to determine the patient’s individual optimal Starling curve location.

Continuing Education Disclosure Statement

Successful Completion

Learners must complete the entire activity and the associated evaluation to be awarded contact hours AND read Implicit Bias impacts patient outcomes. No partial credit will be awarded.

Accreditation

The American Association of Critical-Care Nurses is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
Provider approved by the California Board of Registered Nursing, Provider number CEP 1036, for {contactHours} contact hours.

Disclosures

Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content will be identified by the Nurse Planner within the activity. Any relevant relationship between an ineligible company and an individual with the ability to influence clinical content has been mitigated.

Accreditation refers to recognition of continuing education only and does not imply AACN, ANCC, or CBRN approval or endorsement of any commercial products discussed or displayed in conjunction with this educational activity. Activities with pharmacology hours are to assist the APRN in fulfilling the pharmacotherapeutic education requirements for licensure and certification renewals.

Activities meet the standards for most states that require mandatory continuing education for license and/or certification renewal. AACN recommends consulting with your own state board of nursing or credentialing organization before submitting your certificate of completion.

Refund Policy

Continuing Education Activities are nonrefundable.