LABOR AND DELIVERY KNOWLEDGE & SKILLS CHECKLIST

DIRECTIONS: Please indicate your level of experience by

NAME:       placing a check (√) in the box. Experience level:
ID #:       1 NO EXPERIENCE
DATE:       2 MINIMAL EXPERIENCE-requires supervision/assistance
3 MODERATELY EXPERIENCED-requires initial review,
This Skills Checklist is for use by nurses with more than then performs independently
one year experience in their discipline and specialty. 4 VERY EXPERIENCED- proficient
Please be accurate with your assessment.

DESCRIPTION 1 2 3 4
DESCRIPTION 1 2 3 4 PROVIDE INTRAPARTUM CARE TO PATIENT WITH
MEDICATION ADMINISTRATION 1. Pregnancy – induced hypertension
1. Interactions, incompatibilities, and side effects 2. Preeclampsia
2. Administer IM, SC medications 3. Eclampsia (seizures)
3. Monitor IV Drips 4. Placenta previa
a. Oxytocin induction, augmentation 5. Abruptio placenta
b. Magnesium sulfate therapy (& other 6. Multiple gestation
anti-convulsants for pre-eclampsia) 7. Malpresentations
c. Labor suppressants (e.g. Ritrodrine) 8. Premature labor
d. Antibiotics 9. Diabetes mellitus
e. Heparin 10. Cardiac disease
IV THERAPY 11. Asthma
1. Start IV lines 12. Infectious diseases
2. Regulate IVs 13. Hemorrhage
3. Mix IV infusion using additives 14. Pyelonephritis
4. Discontinue peripheral IVs 15. Cystitis
5. Use IV infusion pumps 16. Sickle Cell Disease
6. Use heparin locks 17. Rh incompatibilities
7. Institute and monitor blood/blood products OBSTETRIC TECHNIQUES AND PROCEDURES
8. Draw blood for lab studies 1. Stress test (oxytocin challenge test)
ASEPTIC TECHNIQUE RELATIVE TO L & D 2. Conduct Fetal Activity Determinants
1. Set up a delivery table 3. Perform cardiopulmonary resuscitation
2. Set up a cesarean section table a. Infant (assist intubation)
3. Circulate for cesarean section b. Infant (umbilical artery catheter)
4. Scrub for a cesarean section c. Infant (mix resuscitation drugs)
5. Circulate, scrub for a post partum tubal ligation d. Infant (administer IM narcan)
6. Assist with an Artificial Rupture of 4. Assess & document progression of labor
Membranes a. Contraction characteristics
7. Assist with placement of fetal scalp b. Changes in behavior, appearance
electrodes for monitoring c. Status of membranes
8. Assist w/ fetal scalp blood sampling d. Assess and document fetal status
9. Insert a straight or Foley catheter e. Determine fetal position
10. Perform a vaginal exam & assess effacement,
dilatation, station, presentation

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 LABOR AND DELIVERY KNOWLEDGE & SKILLS CHECKLIST

ID #:      
Name:      
DESCRIPTION 1 2 3 4
OBSTETRIC TECHNIQUES AND PROCEDURES (CONT)
f. Auscultate FHR (fetal heart rate) using:
(1) Fetoscope
(2) Doptone (Doppler Ultrasound)
5. Monitor uterine activity & FHR patterns using fetal monitors:
a. External monitor (tocotransducer,
ultrasound, phono or abdominal ECG
transducer)
b. Internal monitor (including connecting
the leads and calibrating machine)
c. Identify FHR patterns
(1) Variability reactivity
(2) Decelerations- early, late, variable
(3) Tachycardia – Brachycardia
6. Assess & document maternal status:
a. Vital signs (BP, P) according to stage
of labor and patient stability
b. Deviations from the norm (edema,
deep reflexes, clonus)
7. Assess and document maternal status:
a. Intake and output including testing
urine for glucose, protein, specific
gravity, ketones
8. Escort patient to assist with:
a. Pelvimetry
b. Ultrasound scan
INTERVENTIONS DURING LABOR
1. Provide physical comfort measures
2. Provide emotional support
3. Support, guide labor coach
4. Change woman’s position
5. Do a perineal prep
6. Coach in psychoprophylactic breathing and
relaxation technique
INTERVENTIONS DURING DELIVERY
1. Spontaneous vaginal delivery
2. Provide care and monitor after rupture of
membranes (spontaneous or artificial)
3. Cesarean section
4. Labor room delivery

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 LABOR AND DELIVERY KNOWLEDGE & SKILLS CHECKLIST
DESCRIPTION 1 2 3 4
5. Obstetric anesthesia – monitor those requiring: Name:      
a. Special surveillance
b. General anesthesia Please check the boxes below for each age group for
c. Regional anesthesia which you have expertise in providing age-appropriate
d. Epidural nursing care.
e. Spinal
f. Local infiltration A. Newborn/Neonatal (birth – 30 days)
IMMEDIATE CARE OF INFANT POST-BIRTH B. Infant (30 days – 1 year)
1. Assign Apgar scores C. Toddler (1 – 3 years)
2. Physically examine newborn (anomalies, D. Preschool (3 – 5 years)
respiratory status) E. School Age Children (5 – 12 years)
3. Suction infant F. Adolescent (12 – 18 years)
4. Weigh infant G. Young Adults (18 – 39 years)
5. Identify infant using bracelet, footprints, H. Middle Adults (40 – 64 years)
and mother’s bands I. Older Adults (64 + years)
6. Eye prophylaxis
7. Collect cord blood samples EXPERIENCE WITH AGE GROUPS:
8. Transfer to newborn nursery 1. Able to assess age appropriate behavior, motor skills
POSTPARTUM ASSESSMENT and physiological norms.
1. Fundus consistency
2. Lochia A B C D E F G H I
3. Bladder distension
4. Episiotomy
5. Incision (for Cesarean delivery) 2. Able to adapt care according to normal growth and
6. Vital signs development.
POSTPARTUM INTERVENTION
1. Initiate fundal massage A B C D E F G H I
2. Provide perineal care
3. Apply ice to perineum
4. Foster parent-infant bonding 3. Able to communicate and instruct patient according to
5. Initiate post-anesthesia recovery precautions their age, maturity and comprehension ability.
a. Epidural
b. General A B C D E F G H I
c. Spinal
COMPUTERIZED CHARTING
1. Cerner 4. Able to provide a safe environment according to the
2. Eclipsys specific needs of various age groups.
3. Epic
A B C D E F G H I
4. McKesson
5. Meditech
6. Other:

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 LABOR AND DELIVERY KNOWLEDGE & SKILLS CHECKLIST

ID #:      

I HAVE CURRENT CERTIFICATIONS FOR:

TYPE EXPIRATION DATE (MM/DD/YY)

ARRHYTHMIA      
CRITICAL CARE      
ACLS      
BLS      
TNCC      
NRP      
PALS      
NALS      
CCRN      
Other            
Other            

The information I have provided in this knowledge and

skills checklist it true and accurate to the best of my
knowledge.

           
Signature (Written/Electronic) Date
ID #:      

This skills checklist has been reviewed and approved by

Nicole Bloxham, RN.

           
Signature (Written/Electronic) Date
ID #:      

Please return to: Northwest Nurse Staffing Company, PA

ATTN: Records Dept.
Fax: (866) 352-4338

Email: records@nns-ic.com

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