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OB/Labor & Delivery Skills Checklist | ||||||
| NAME | |||||||
| LAST 4 OF SSN | |||||||
| DATE | |||||||
| I hereby certify that ALL information I have provided on this skills checklist and all other documentation, is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination. | |||||||
| Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below. | |||||||
| Proficiency Scale: |
1 = No Experience 2 = Need Training 3 = Able to perform with supervision 4 = Able to perform independently |
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| Rating Stars (Click) | PATIENT RIGHTS | 1 | 2 | 3 | 4 | ||
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Communicates
and obtains information while respecting the rights and privacy and
confidentiality of information |
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Involves
the patient and family and respects their role in determining the nature of
care to be provided, including Advanced Directives |
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Complies with nursing staff responsibility include in the hospital policy related to Organ Donation | ||||||
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Meets patient and families needs regarding communication, including interpreter services | ||||||
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Provides accurate information to patient and families in a timely manner | ||||||
| Rating Stars (Click) | LABOR AND DELIVERY | 1 | 2 | 3 | 4 | ||
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Assess cervical dilation | ||||||
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Assess labor status | ||||||
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Speculum examination | ||||||
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Obtaining vaginal/cervical cultures | ||||||
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Application of external ECG/TOCO EFM | ||||||
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Application of internal ECG | ||||||
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Interpretation of external/internal ECG | ||||||
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Assisting with insertion of IUPC | ||||||
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Conducting NST/BSST | ||||||
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IV insertion | ||||||
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Pitocin Titration for induction/augmentation | ||||||
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Assist with epidural | ||||||
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Assist/monitor amnioinfusion | ||||||
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Assist with scalp pH test | ||||||
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Assist with vacuum delivery | ||||||
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Assist with forceps delivery | ||||||
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Assist with vaginal delivery | ||||||
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Circulate for cesarean section delivery | ||||||
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Emergency cesarean section set up | ||||||
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Assist with twin deliveries | ||||||
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Assist with breech | ||||||
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Management of D&C | ||||||
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Management of fetal demise/stillborn | ||||||
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Adoption procedures | ||||||
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Management of diabetic mother | ||||||
| Procedures for the following: | |||||||
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Diabetic mother | ||||||
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PIH | ||||||
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Pre-eclamptic | ||||||
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Preterm labor | ||||||
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Prolapsed cord | ||||||
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Abruption | ||||||
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Placenta previa | ||||||
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Retained placenta | ||||||
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Herpes | ||||||
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Uterine prolapse | ||||||
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Hemorrhage | ||||||
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Shoulder dystocia | ||||||
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DIC | ||||||
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Accretia | ||||||
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Episiotomy | ||||||
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Delivery table set-up | ||||||
| Rating Stars (Click) | MEDICATIONS | 1 | 2 | 3 | 4 | ||
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Magnesium | ||||||
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Pitocin | ||||||
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Terbutaline | ||||||
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Antibiotics | ||||||
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Narcotics | ||||||
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Hemabate | ||||||
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Methergine | ||||||
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Narcan | ||||||
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Insulin | ||||||
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Heparin | ||||||
| Rating Stars (Click) | MATERNITY | 1 | 2 | 3 | 4 | ||
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Oobtain cord blood gas | ||||||
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Postpartum care | ||||||
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Nipple care | ||||||
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Episiotomy care | ||||||
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PIH | ||||||
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Pre-eclamptic | ||||||
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Postpartum hemorrhage | ||||||
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Care of newborn | ||||||
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Breastfeeding | ||||||
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Bottle feeding | ||||||
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Infant formulas | ||||||
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D10W | ||||||
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PKU Testing | ||||||
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Stabilize/admit to nursery | ||||||
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Care of newborn with anomaly | ||||||
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Heel sticks/dorsal sticks | ||||||
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Blood glucose monitoring | ||||||
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Phototherapy | ||||||
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Set up/care of newborn receiving phototherapy | ||||||
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Set up/assist with circumcision | ||||||
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Discharge of mother/baby | ||||||
| Rating Stars (Click) | Age Specific Competencies | 1 | 2 | 3 | 4 | ||
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Infant (Birth - 1 year) | ||||||
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Preschooler (ages 2-5 years) | ||||||
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Childhood (ages 6-12 years) | ||||||
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Adolescents (ages 13-21 years) | ||||||
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Young Adults (ages 22-39 years) | ||||||
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Adults (ages 40-64 years) | ||||||
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Older Adults (ages 65-79 years) | ||||||
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Elderly (ages 80+ years) | ||||||