Labor and Delivery Skills Checklist

LABOR AND DELIVERY SKILLS CHECKLIST

Nurse: ______CHECK PROFICIENCY 1 2 3 4 Date: ______Deep tendon reflexes (DTRs) Edema Key: 1 = No Experience 2 = Little Experience Norms for perinatal vital signs 3 = Moderate Experience Perform admission risk assessment 4 = Extensive Experienced Presence of clonus Progression of Labor: CHECK PROFICIENCY 1 2 3 4 Contraction characteristics ANTEPARTUM Dilation 1. Assessment Effacement Assess for comfort Breathing/relaxation techniques Fetal presentation/position Coaching Station Positioning Status of membranes 2. Equipment & procedures Sterile speculum exam Foley catheter insertion Vaginal exam Straight catheter insertion Delivery table set up Rupture of membrane: Fern test Sonogram: Rupture of membrane: Nitrazine Amniotic fluid index 2. Equipment and Procedures Assist with sonogram Amnioinfusion (assist or perform): Biophysical profile For meconium Perform sonogram For variable decelerations LABOR ASSESSMENT Artificial rupture of membranes (assist): 1. Fetal Assessment Prolapsed cord Auscultate fetal heart rate: Recognize potential complications Doppler Vasa previa Fetoscope Collect blood/urine specimens Determine fetal position Collect vaginal cultures: Document FHR patterns Chlamydia Identify normal & tread abnormal FHR patterns: Fluid Baseline Group B strep Early decelerations Herpes Late decelerations Document labor states/assessment & interventions: Prolonged deceleration Anticonvulsants Variability Labor suppressants Variable decelerations External fetal monitor application: 2. Mental Assessment Doppler LABOR AND DELIVERY SKILLS CHECKLIST

CHECK PROFICIENCY 1 2 3 4 CHECK PROFICIENCY 1 2 3 4 Phono or abdominal, ECG transducer Conduct non-stress test: Tocotransducer, ultrasound Stimulate fetus Internal Monitor – Assist/perform insertion: Vibroacoustic stimulation Intrauterine pressure catheter: Draw umbilical blood samples Fluid filled Glucose reflectometer Transducer tipped Lines/monitoring: Spinal electrode Central venous lines Perform Leopold’s maneuvers Invasive hemodynamic monitoring Toxicology studies PICC lines LABOR ASSESSMENT (continued) Pulmonary artery catheters 4. Medications Scrub for Cesarean delivery Administer IM/SC Set up for Cesarean delivery Administer IV meds/monitor IV Drips: 3. Care of patient with: Antibiotics Abruptio placenta Antihypertensives Asthma Heparin Cardiac disease Magnesium sulfate Chorioanmionitis Narcotics Chronic hypertension Oxytocin Collagen vascular disease Assist with prostin gel Diabetes Cervidil insertion Eclampsia Use of Cytotec HBV Use of prostin suppositories HELLP syndrome COMPLICATIONS OF PREGNANCY Hemolytic anemias 1. Assessment Hemorrhage Identify common arrhythmias HIV positive Normal cardiac rhythms Hypertension Patient education – fetal movement counts Malpresentations 2. Education & procedures Multiple gestation Assist with external version Other infections Assist with percutaneous umbilical sampling Placenta previa Assist with umbilical blood sampling Preeclampsia Circulate for Cesarean delivery Premature labor Circulate, scrub for bilateral tubal ligation Pyelonephritis Conduct contraction stress test: RH disease Brest stimulation Sickle cell disease Oxytocin challenge LABOR AND DELIVERY SKILLS CHECKLIST

CHECK PROFICIENCY 1 2 3 4 CHECK PROFICIENCY 1 2 3 4 5. Medications Heelstick glucose determination Indomethacin Infant identification Insulin Neonatal resuscitation Magnesium sulfate Obtain hemotocrit Procardia Obtain neonatal toxicology screen Ritodrine Phototherapy Terbutaline: Promote bonding behaviors IV Suctioning: PO Bulb Pump Delee SC Wall INTERVENTIONS DURING PREGNACY 3. Medications Cesarean section Eye prophylaxis Forceps vaginal delivery Vitamin K Vacuum extraction delivery POST PARTUM INETERVENTIONS Spontaneous vaginal delivery 1. Assessment Monitor patients anesthesia: Bladder distention General Breast feeding: Epidural Latch-on Spinal Positioning INFANT INTERVENTIONS POST DELIVERY DVT (Deep vein thrombosis) 1. Assessment Episiotomy Apgar scoring Fluid Balance Initial vital signs Fundal height Intervention/risk factors for IDM Intervention/risk factors for LGA, SGA, IUGR Fundal massage Newborn physical assessment: Lochia amount Ballard Maternal vital signs Dubowitz PHLEBOTOMY/IV THERAPY Finnegan scoring 1. Equipment & procedures 2. Equipment & Procedures Administration of blood/blood products: Assist with initial breast feeding Cryoprecipitate Assist w/interventions for meconium staining Packed red blood cells Bath – perform and teach Plasma/albumin Cardiac-respiratory monitor placement Whole blood Circumcision care Drawing blood from central line Cord care Starting IV’s: Discharge teaching Angiocath LABOR AND DELIVERY SKILLS CHECKLIST

CHECK PROFICIENCY 1 2 3 4 CHECK PROFICIENCY 1 2 3 4 Butterfly Heparin lock LABOR AND DELIVERY SKILLS CHECKLIST

CHECK PROFICIENCY 1 2 3 4 CHECK PROFICIENCY 1 2 3 4 2. Care of patient with: Epidural block Central line/catheter/dressing Fluid challenge Peripheral line/dressing Hypotension PAIN MANAGEMENT Intrathecal narcotics 1. Assessment Intravascular injection Pain level/tolerance Positioning patient 2. Care of the patient with: Signs/symptoms of dural puncture Epidural anesthesia/analgesia Spinal anesthesia IV conscious sedation 4. Documentation of anesthesia: Patient controlled analgesia (PA Pump) Computer 3. Assist with delivery of anesthesia: Flowchart Anethesia toxicity Coaching patient

Total Number of Years in Labor and Delivery: ______

YEARS OF EXPERIENCE BY FIELD IN LABOR AND DELIVERY SPECIALTIES Field Years Labor & delivery LDR LDRP Community hospital Rural hospital Teaching Hospital

YEARS OF EXPERIENCE BY AGE GROUP Age Group Years Newborns (birth – 30 days) Infants (30 days – 1 year) Toddler (1-3 years) Preschooler (3-5 years) School Children (5-12 years) Adolescents (12-18 years) Young Adults (18-39 years) Middle aged adults (39-64 years) Senior Adults (64+ years)

The information I have provided is true and accurate to the best of my knowledge. I authorize Northwest Nurse Staffing to release this Skills Checklist to client hospitals as needed in relation to my employment. LABOR AND DELIVERY SKILLS CHECKLIST

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Signature: ______

Date: ______