Labor & Delivery Skills Checklist

Name*
First Last
Email*
Phone*
Proficiency:
1 = Minimal Experience
2 = Limited Experience
3 = Competent
4 = Highly Skilled
General Skills
Patient and Family Teaching*
- 1
- 2
- 3
- 4
Coaching Needs: Physical and Emotional*
- 1
- 2
- 3
- 4
Universal Precautions*
- 1
- 2
- 3
- 4
Care of the Patient in Isolation*
- 1
- 2
- 3
- 4
Care of the Patient in Restraints*
- 1
- 2
- 3
- 4
Cardiac Monitoring*
- 1
- 2
- 3
- 4
Pulse Oximetry*
- 1
- 2
- 3
- 4
Ventilator Management (Adult)*
- 1
- 2
- 3
- 4
Ventilator Management (Newborn)*
- 1
- 2
- 3
- 4
Prep and Administration of Emergency Meds*
- 1
- 2
- 3
- 4
Infant / Neonatal Cardiac / Respiratory Arrest*
- 1
- 2
- 3
- 4
Adult Cardiac / Respiratory Arrest*
- 1
- 2
- 3
- 4
End of Life Care*
- 1
- 2
- 3
- 4
Fetal Monitoring - Basic*
- 1
- 2
- 3
- 4
Fetal Monitoring - Advanced*
- 1
- 2
- 3
- 4
IV Therapy*
- 1
- 2
- 3
- 4
Administration of Blood / Blood Products*
- 1
- 2
- 3
- 4
Knowledge of Normal Lab Values*
- 1
- 2
- 3
- 4
Newborn*
- 1
- 2
- 3
- 4
Labor Patient*
- 1
- 2
- 3
- 4
Pain Management*
- 1
- 2
- 3
- 4
Automated Medication Dispensing System*
- 1
- 2
- 3
- 4
Care of the Patient with Pre-existing Conditions / High Risk OB
Cardiac Disease*
- 1
- 2
- 3
- 4
Neurological Disease*
- 1
- 2
- 3
- 4
Seizure Disorder*
- 1
- 2
- 3
- 4
Chronic Diabetes Mellitus*
- 1
- 2
- 3
- 4
Asthma*
- 1
- 2
- 3
- 4
Chronic Hypertension*
- 1
- 2
- 3
- 4
Pregnancy-Induced Hypertension*
- 1
- 2
- 3
- 4
Infectious Disease*
- 1
- 2
- 3
- 4
HBV*
- 1
- 2
- 3
- 4
HIV*
- 1
- 2
- 3
- 4
Sickle Cell Disease*
- 1
- 2
- 3
- 4
RH Incompatibilities*
- 1
- 2
- 3
- 4
Hemolytic Anemia*
- 1
- 2
- 3
- 4
Collagen Vascular Disease*
- 1
- 2
- 3
- 4
Hemorrhage*
- 1
- 2
- 3
- 4
Drug Addiction / Withdrawal*
- 1
- 2
- 3
- 4
Pyelonephritis*
- 1
- 2
- 3
- 4
Abruptio Placenta*
- 1
- 2
- 3
- 4
Placenta Previa*
- 1
- 2
- 3
- 4
Placenta Accreta*
- 1
- 2
- 3
- 4
Preeclampsia*
- 1
- 2
- 3
- 4
Premature Labor*
- 1
- 2
- 3
- 4
Malpresentations*
- 1
- 2
- 3
- 4
Breech*
- 1
- 2
- 3
- 4
Transverse Lie / Shoulder*
- 1
- 2
- 3
- 4
Face Presentation*
- 1
- 2
- 3
- 4
Brow Presentation*
- 1
- 2
- 3
- 4
Multiple Gestation*
- 1
- 2
- 3
- 4
PROM*
- 1
- 2
- 3
- 4
Chorioamnionitis*
- 1
- 2
- 3
- 4
Poly / Oligohydramnios*
- 1
- 2
- 3
- 4
Prior Tubal Ligation*
- 1
- 2
- 3
- 4
VBAC Management / Trial of Labor*
- 1
- 2
- 3
- 4
Uterine Rupture*
- 1
- 2
- 3
- 4
Incompetent Cervix (Shirodkar Suture / Cerclage)*
- 1
- 2
- 3
- 4
Spontaneous Abortions - Complete / Incomplete*
- 1
- 2
- 3
- 4
Intrauterine Growth Retardation (IUGR)*
- 1
- 2
- 3
- 4
Postdate Pregnancy*
- 1
- 2
- 3
- 4
HELLP Syndrome*
- 1
- 2
- 3
- 4
DIC*
- 1
- 2
- 3
- 4
Fetal Demise*
- 1
- 2
- 3
- 4
Antepartum
Triage of Obstetrical Patients*
- 1
- 2
- 3
- 4
Assessment of Birth Plan*
- 1
- 2
- 3
- 4
Perform Admission Risk Assessment*
- 1
- 2
- 3
- 4
Non-Stress Test (NST)*
- 1
- 2
- 3
- 4
Induction of Labor*
- 1
- 2
- 3
- 4
Oxytocin Challenge Test (OCT)*
- 1
- 2
- 3
- 4
Biophysical Profile*
- 1
- 2
- 3
- 4
Assist with Sonogram*
- 1
- 2
- 3
- 4
Perform Sonogram*
- 1
- 2
- 3
- 4
Assist with Amniocentesis*
- 1
- 2
- 3
- 4
Deep Tendon Reflex Check (DTR's)*
- 1
- 2
- 3
- 4
Edema Assessment*
- 1
- 2
- 3
- 4
Clonus*
- 1
- 2
- 3
- 4
Assess for Comfort*
- 1
- 2
- 3
- 4
Breathing / Relaxation Techniques*
- 1
- 2
- 3
- 4
Coaching*
- 1
- 2
- 3
- 4
Positioning*
- 1
- 2
- 3
- 4
Medications
Ritodrine*
- 1
- 2
- 3
- 4
Magnesium Sulfate*
- 1
- 2
- 3
- 4
Terbutaline*
- 1
- 2
- 3
- 4
Indomethacin*
- 1
- 2
- 3
- 4
Procardia*
- 1
- 2
- 3
- 4
Pitocin*
- 1
- 2
- 3
- 4
Oxytocin*
- 1
- 2
- 3
- 4
Cervidil*
- 1
- 2
- 3
- 4
Cytotec*
- 1
- 2
- 3
- 4
Prostin Suppositories*
- 1
- 2
- 3
- 4
Assist with Prostin Gel*
- 1
- 2
- 3
- 4
Antibiotics*
- 1
- 2
- 3
- 4
Antihypertensives*
- 1
- 2
- 3
- 4
Heparin*
- 1
- 2
- 3
- 4
Stadol*
- 1
- 2
- 3
- 4
Nubain*
- 1
- 2
- 3
- 4
Morphine*
- 1
- 2
- 3
- 4
Demerol*
- 1
- 2
- 3
- 4
Fentanyl*
- 1
- 2
- 3
- 4
Insulin Drips*
- 1
- 2
- 3
- 4
Insulin Dumps*
- 1
- 2
- 3
- 4
Insulin SC*
- 1
- 2
- 3
- 4
AZT / Other Antiviral Medications*
- 1
- 2
- 3
- 4
Rhogam*
- 1
- 2
- 3
- 4
IV Therapy / Procedures
Starting PIV's*
- 1
- 2
- 3
- 4
PICC Lines-Care and Maintenance*
- 1
- 2
- 3
- 4
Central Venous Lines-Care and Maintenance*
- 1
- 2
- 3
- 4
Invasive Hemodynamic Monitoring*
- 1
- 2
- 3
- 4
Blood Draw from PICC / CVL*
- 1
- 2
- 3
- 4
Administration of Blood / Blood Products*
- 1
- 2
- 3
- 4
Packed Red Blood Cells*
- 1
- 2
- 3
- 4
Platelets*
- 1
- 2
- 3
- 4
IV Infusion Pumps*
- 1
- 2
- 3
- 4
Blood / Fluid Warmers*
- 1
- 2
- 3
- 4
Pain Management / Anesthesia
Assess Pain Level*
- 1
- 2
- 3
- 4
Assess Acceptable Level of Pain*
- 1
- 2
- 3
- 4
Intranasal Pain Medications*
- 1
- 2
- 3
- 4
Oral Pain Medications*
- 1
- 2
- 3
- 4
IV Pain Medications*
- 1
- 2
- 3
- 4
PCA*
- 1
- 2
- 3
- 4
IV Conscious Sedation*
- 1
- 2
- 3
- 4
Epidural Pain Management*
- 1
- 2
- 3
- 4
Intervention for Anesthesia Toxicity*
- 1
- 2
- 3
- 4
Assist with Epidural Insertion*
- 1
- 2
- 3
- 4
Positioning of Patient*
- 1
- 2
- 3
- 4
Signs of a Dural Puncture*
- 1
- 2
- 3
- 4
Coaching Patient*
- 1
- 2
- 3
- 4
Fluid Challenge*
- 1
- 2
- 3
- 4
Hypotension*
- 1
- 2
- 3
- 4
Intrathecal Narcotics*
- 1
- 2
- 3
- 4
Labor Assessment / Procedures: Fetal
Fetal Heart Rate - Doppler*
- 1
- 2
- 3
- 4
Fetal Heart Rate - Auscultate*
- 1
- 2
- 3
- 4
Document Fetal Position*
- 1
- 2
- 3
- 4
Fetal Heart Rate Patterns: Identify Baseline*
- 1
- 2
- 3
- 4
Fetal Heart Rate Patterns: Identify & Treat*
- 1
- 2
- 3
- 4
Variability*
- 1
- 2
- 3
- 4
Variable Decelerations*
- 1
- 2
- 3
- 4
Early Decelerations*
- 1
- 2
- 3
- 4
Late Decelerations*
- 1
- 2
- 3
- 4
Prolonged Decelerations*
- 1
- 2
- 3
- 4
External Fetal Monitor Application*
- 1
- 2
- 3
- 4
Internal Fetal Monitor Application (Assist)*
- 1
- 2
- 3
- 4
Internal Fetal Monitor Application (Perform)*
- 1
- 2
- 3
- 4
Spiral Electrode*
- 1
- 2
- 3
- 4
Intrauterine Pressure Catheter (IUPC)*
- 1
- 2
- 3
- 4
Placement*
- 1
- 2
- 3
- 4
Calibration*
- 1
- 2
- 3
- 4
Fluid Filled*
- 1
- 2
- 3
- 4
Transducer Tipped*
- 1
- 2
- 3
- 4
Deliver / C-Section
Assist with Vaginal Delivery*
- 1
- 2
- 3
- 4
Forceps Extraction*
- 1
- 2
- 3
- 4
Vacuum Extraction*
- 1
- 2
- 3
- 4
Assist with High Risk Delivery*
- 1
- 2
- 3
- 4
Shoulder Dystocia*
- 1
- 2
- 3
- 4
Hemorrhage / Shock*
- 1
- 2
- 3
- 4
Emergency Delivery*
- 1
- 2
- 3
- 4
Abdominal Shave / Scrub Prep*
- 1
- 2
- 3
- 4
Perineal Prep*
- 1
- 2
- 3
- 4
Circulate for C-Section*
- 1
- 2
- 3
- 4
Scrub for C-Section*
- 1
- 2
- 3
- 4
Patient with General Anesthesia*
- 1
- 2
- 3
- 4
Patient with Epidural Anesthesia*
- 1
- 2
- 3
- 4
Circulate for Tubal Ligation*
- 1
- 2
- 3
- 4
Scrub for Tubal Ligation*
- 1
- 2
- 3
- 4
Assist with Placenta Delivery*
- 1
- 2
- 3
- 4
Fundus Massage*
- 1
- 2
- 3
- 4
Assist with Cervical Laceration Repair*
- 1
- 2
- 3
- 4
Assist with Uterine Laceration Repair*
- 1
- 2
- 3
- 4
Assist with Episiotomy Repair*
- 1
- 2
- 3
- 4
Immediate Care of Newborn in Delivery Room
Newborn Assessment*
- 1
- 2
- 3
- 4
Ballard*
- 1
- 2
- 3
- 4
Dubowitz*
- 1
- 2
- 3
- 4
Finnegan / Abstinence Scoring*
- 1
- 2
- 3
- 4
Apgar Scores*
- 1
- 2
- 3
- 4
Initial Vital Signs*
- 1
- 2
- 3
- 4
Suctioning*
- 1
- 2
- 3
- 4
Bulb*
- 1
- 2
- 3
- 4
Delee*
- 1
- 2
- 3
- 4
Wall*
- 1
- 2
- 3
- 4
Meconium Aspiration*
- 1
- 2
- 3
- 4
Collect Cord Samples*
- 1
- 2
- 3
- 4
Assist with UAC / UVC Insertion*
- 1
- 2
- 3
- 4
Insertion of IV, Including Scalp IV*
- 1
- 2
- 3
- 4
Radiant Warmer / Thermoregulation*
- 1
- 2
- 3
- 4
Interventions for LGA, SGA, IUGR*
- 1
- 2
- 3
- 4
Interventions for Infant of Diabetic Mother*
- 1
- 2
- 3
- 4
Oxygen Administration*
- 1
- 2
- 3
- 4
Bag / Mask Ventilation of the Newborn*
- 1
- 2
- 3
- 4
Assist with Intubation*
- 1
- 2
- 3
- 4
Transport Isolette*
- 1
- 2
- 3
- 4
Heel Stick Glucose*
- 1
- 2
- 3
- 4
Medications*
- 1
- 2
- 3
- 4
Eye Prophylaxis*
- 1
- 2
- 3
- 4
Vitamin K*
- 1
- 2
- 3
- 4
ID / Security Banding*
- 1
- 2
- 3
- 4
Promote Bonding Behaviors*
- 1
- 2
- 3
- 4
Lead Placement for Cardiac Monitor*
- 1
- 2
- 3
- 4
Apnea Monitoring*
- 1
- 2
- 3
- 4
Oxyhood*
- 1
- 2
- 3
- 4
Postpartum Care
Fundal Height*
- 1
- 2
- 3
- 4
Fundal Massage*
- 1
- 2
- 3
- 4
Lochia*
- 1
- 2
- 3
- 4
Episiotomy Care*
- 1
- 2
- 3
- 4
Perineum Care*
- 1
- 2
- 3
- 4
Maternal Vital Signs*
- 1
- 2
- 3
- 4
Recovering Post-Op C-Section Patient*
- 1
- 2
- 3
- 4
Recovering Post-Op Tubal Ligation Patient*
- 1
- 2
- 3
- 4
Fluid Balance*
- 1
- 2
- 3
- 4
Assessment for DVT*
- 1
- 2
- 3
- 4
Couplet Care*
- 1
- 2
- 3
- 4
Breast Care*
- 1
- 2
- 3
- 4
Breastfeeding*
- 1
- 2
- 3
- 4
Newborn Care
Cord Care*
- 1
- 2
- 3
- 4
Circumcision Care*
- 1
- 2
- 3
- 4
Bath Demonstration*
- 1
- 2
- 3
- 4
Assist with Breastfeeding*
- 1
- 2
- 3
- 4
Latch on*
- 1
- 2
- 3
- 4
Assist with Lumbar Puncture*
- 1
- 2
- 3
- 4
Administration of IV Antibiotics*
- 1
- 2
- 3
- 4
Newborn Vital Signs*
- 1
- 2
- 3
- 4
Care of Infant with
Drug Addiction / Withdrawl*
- 1
- 2
- 3
- 4
Cystic Fibrosis*
- 1
- 2
- 3
- 4
Meconium Aspiration*
- 1
- 2
- 3
- 4
Pneumonia*
- 1
- 2
- 3
- 4
Pulmonary Edema*
- 1
- 2
- 3
- 4
RDS*
- 1
- 2
- 3
- 4
NEC*
- 1
- 2
- 3
- 4
Cardiac Anomalies*
- 1
- 2
- 3
- 4
Neuromuscular Disease*
- 1
- 2
- 3
- 4
Spina Bifida*
- 1
- 2
- 3
- 4
Seizure Activity*
- 1
- 2
- 3
- 4
Tracheoesophageal Fistula*
- 1
- 2
- 3
- 4
Sepsis*
- 1
- 2
- 3
- 4
Sickle Cell Disease*
- 1
- 2
- 3
- 4
Low Birth Weight Infants*
- 1
- 2
- 3
- 4
Labor Assessment / Procedures: Maternal
Normal Vital Signs - Baseline*
- 1
- 2
- 3
- 4
Identify Common Cardiac Arrhythmias*
- 1
- 2
- 3
- 4
Assist with Sterile Speculum Exam*
- 1
- 2
- 3
- 4
Perform Sterile Speculum Exam*
- 1
- 2
- 3
- 4
Vaginal Exam - Manual*
- 1
- 2
- 3
- 4
Status of Membranes*
- 1
- 2
- 3
- 4
Assist with Rupture of Membranes*
- 1
- 2
- 3
- 4
Fern Test*
- 1
- 2
- 3
- 4
Nitrazine*
- 1
- 2
- 3
- 4
Presence of Clonus*
- 1
- 2
- 3
- 4
DTR's*
- 1
- 2
- 3
- 4
Edema*
- 1
- 2
- 3
- 4
Progression of Labor*
- 1
- 2
- 3
- 4
Dilation*
- 1
- 2
- 3
- 4
Effacement*
- 1
- 2
- 3
- 4
Fetal Position*
- 1
- 2
- 3
- 4
Fetal Presentation*
- 1
- 2
- 3
- 4
Station*
- 1
- 2
- 3
- 4
Contraction Characteristics*
- 1
- 2
- 3
- 4
Determination of Fetal Head Position*
- 1
- 2
- 3
- 4
Documentation of Labor Status and Interventions*
- 1
- 2
- 3
- 4
Labor Suppressants*
- 1
- 2
- 3
- 4
Collect Blood Specimens*
- 1
- 2
- 3
- 4
Collect Urine Specimens*
- 1
- 2
- 3
- 4
Toxicology Studies*
- 1
- 2
- 3
- 4
Collect Vaginal Cultures*
- 1
- 2
- 3
- 4
Fluid*
- 1
- 2
- 3
- 4
Herpes*
- 1
- 2
- 3
- 4
Chlamydia*
- 1
- 2
- 3
- 4
Group B Strep*
- 1
- 2
- 3
- 4
Perform Leopold's Maneuvers*
- 1
- 2
- 3
- 4
Amnioinfusion (assist or perform) for*
- 1
- 2
- 3
- 4
Variable Decelerations*
- 1
- 2
- 3
- 4
Meconium*
- 1
- 2
- 3
- 4
Prolapsed Cord*
- 1
- 2
- 3
- 4
Vasa Previa*
- 1
- 2
- 3
- 4
Catheter Insertion*
- 1
- 2
- 3
- 4
Straight Cath*
- 1
- 2
- 3
- 4
Foley*
- 1
- 2
- 3
- 4
Pregnancy Induced Diabetes Mellitus*
- 1
- 2
- 3
- 4
Eclampsia*
- 1
- 2
- 3
- 4
Normal Perinatal Vital Signs*
- 1
- 2
- 3
- 4
Age Specific Competency
Newborn / Neonate (Birth - 30 days)*
- 1
- 2
- 3
- 4
Infant (1 month - 1 year)*
- 1
- 2
- 3
- 4
Toddler (1 - 3 years)*
- 1
- 2
- 3
- 4
Preschooler (3 - 5 years)*
- 1
- 2
- 3
- 4
School Age Child (5 - 12 years)*
- 1
- 2
- 3
- 4
Adolescents (12 - 18 years)*
- 1
- 2
- 3
- 4
Young Adults (18 - 39 years)*
- 1
- 2
- 3
- 4
Middle Adults (39 - 64 years)*
- 1
- 2
- 3
- 4
Older Adults (64 - 79 years)*
- 1
- 2
- 3
- 4
Elderly Adults (Over 79+ years)*
- 1
- 2
- 3
- 4

Proficiency:

General Skills

Care of the Patient with Pre-existing Conditions / High Risk OB

Antepartum

Medications

IV Therapy / Procedures

Pain Management / Anesthesia

Labor Assessment / Procedures: Fetal

Deliver / C-Section

Immediate Care of Newborn in Delivery Room

Postpartum Care

Newborn Care

Care of Infant with

Labor Assessment / Procedures: Maternal

Age Specific Competency