Microsoft word - l & d skills checklist.doc

Elite Medical Staffing, Inc.
LABOR & DELIVERY SKILLS CHECKLIST
Name:______________________________________________ Date:____________________
Directions: Place an X in the column which most accurately reflects your level of experience in each area.
A Very Experienced (Competent to supervise)
C Some Experience (Require assistance/supervision)
B Experienced (Competent to perform w/o supervision)
D No Experience/Knowledge
Skills Experience A B C D
Skills Experience A B C D
Antepartum
A. Assessment
B. Equipment and Procedures
5. Document labor status/assessment & intervention 7. Internal monitoring (assist or perform insertion) Labor Assessment
A. Fetal assessment
D. Medications
2. Administer IV meds/monitor IV drips : 4. Identify normal and treat abnormal FHR pattern B. Mental Assessment:
Complications of Pregnancy
A. Assessment
3. Patient education – fetal movement counts B. Equipment and Procedures
3. Assist with percutaneous umbilical sampling 4. Assist with umbilical blood sampling 6. Circulate, scrub for bilateral tubal ligation C. Equipment and Procedures
2. Artificial rupture of membranes (assist): Elite Medical Staffing, Inc.
LABOR & DELIVERY SKILLS CHECKLIST
Name:______________________________________________ Date:____________________
Directions: Place an X in the column which most accurately reflects your level of experience in each area.
A Very Experienced (Competent to supervise)
C Some Experience (Require assistance/supervision)
B Experienced (Competent to perform w/o supervision)
D No Experience/Knowledge
Skills Experience A B C D
Skills Experience A B C D
Infant Interventions – Post Delivery
A. Assessment
C. Care of patient with:
B. Equipment and Procedures
2. Assist with interventions for meconium staining C. Medications
D. Medications
Post Partum Interventions
A. Assessment
Interventions During Pregnancy
Phlebotomy/IV Therapy
A. Equipment and Procedures
1. Administration of blood/blood products: Elite Medical Staffing, Inc.
LABOR & DELIVERY SKILLS CHECKLIST
Name:______________________________________________ Date:____________________
Directions: Place an X in the column which most accurately reflects your level of experience in each area.
A Very Experienced (Competent to supervise)
C Some Experience (Require assistance/supervision)
B Experienced (Competent to perform w/o supervision)
D No Experience/Knowledge
Skills Experience A B C D
Age Specific Practice Criteria
Please check the letter below for each age group for which you have expertise in providing age-appropriate nursing care. A. Newborn/Neonate
B. School age children
C. Adolescents
D. Young adults
B. Care of Patient with:
E. Middle adults
F. Older adults
Pain Management & Anesthesia
A. Assessment of pain level/tolerance
B. Care of patient with:
Experience with age
A B C D E F G H I
3. Patient controlled analgesia (PCA pump) C. Assist with delivery of anesthesia
Documentation of anesthesia
Signature: _____________________________

Source: http://elitetravelnurse.com/pdfs/L&D_SKILLS_CHECKLIST.pdf