Labor & Delivery Skills Checklist Name* First Last Email* Phone*Proficiency: 1 = Minimal Experience 2 = Limited Experience 3 = Competent 4 = Highly SkilledGeneral SkillsPatient and Family Teaching*1234Coaching Needs: Physical and Emotional*1234Universal Precautions*1234Care of the Patient in Isolation*1234Care of the Patient in Restraints*1234Cardiac Monitoring*1234Pulse Oximetry*1234Ventilator Management (Adult)*1234Ventilator Management (Newborn)*1234Prep and Administration of Emergency Meds*1234Infant / Neonatal Cardiac / Respiratory Arrest*1234Adult Cardiac / Respiratory Arrest*1234End of Life Care*1234Fetal Monitoring - Basic*1234Fetal Monitoring - Advanced*1234IV Therapy*1234Administration of Blood / Blood Products*1234Knowledge of Normal Lab Values*1234Newborn*1234Labor Patient*1234Pain Management*1234Automated Medication Dispensing System*1234Care of the Patient with Pre-existing Conditions / High Risk OBCardiac Disease*1234Neurological Disease*1234Seizure Disorder*1234Chronic Diabetes Mellitus*1234Asthma*1234Chronic Hypertension*1234Pregnancy-Induced Hypertension*1234Infectious Disease*1234HBV*1234HIV*1234Sickle Cell Disease*1234RH Incompatibilities*1234Hemolytic Anemia*1234Collagen Vascular Disease*1234Hemorrhage*1234Drug Addiction / Withdrawal*1234Pyelonephritis*1234Abruptio Placenta*1234Placenta Previa*1234Placenta Accreta*1234Preeclampsia*1234Premature Labor*1234Malpresentations*1234Breech*1234Transverse Lie / Shoulder*1234Face Presentation*1234Brow Presentation*1234Multiple Gestation*1234PROM*1234Chorioamnionitis*1234Poly / Oligohydramnios*1234Prior Tubal Ligation*1234VBAC Management / Trial of Labor*1234Uterine Rupture*1234Incompetent Cervix (Shirodkar Suture / Cerclage)*1234Spontaneous Abortions - Complete / Incomplete*1234Intrauterine Growth Retardation (IUGR)*1234Postdate Pregnancy*1234HELLP Syndrome*1234DIC*1234Fetal Demise*1234AntepartumTriage of Obstetrical Patients*1234Assessment of Birth Plan*1234Perform Admission Risk Assessment*1234Non-Stress Test (NST)*1234Induction of Labor*1234Oxytocin Challenge Test (OCT)*1234Biophysical Profile*1234Assist with Sonogram*1234Perform Sonogram*1234Assist with Amniocentesis*1234Deep Tendon Reflex Check (DTR's)*1234Edema Assessment*1234Clonus*1234Assess for Comfort*1234Breathing / Relaxation Techniques*1234Coaching*1234Positioning*1234MedicationsRitodrine*1234Magnesium Sulfate*1234Terbutaline*1234Indomethacin*1234Procardia*1234Pitocin*1234Oxytocin*1234Cervidil*1234Cytotec*1234Prostin Suppositories*1234Assist with Prostin Gel*1234Antibiotics*1234Antihypertensives*1234Heparin*1234Stadol*1234Nubain*1234Morphine*1234Demerol*1234Fentanyl*1234Insulin Drips*1234Insulin Dumps*1234Insulin SC*1234AZT / Other Antiviral Medications*1234Rhogam*1234IV Therapy / ProceduresStarting PIV's*1234PICC Lines-Care and Maintenance*1234Central Venous Lines-Care and Maintenance*1234Invasive Hemodynamic Monitoring*1234Blood Draw from PICC / CVL*1234Administration of Blood / Blood Products*1234Packed Red Blood Cells*1234Platelets*1234IV Infusion Pumps*1234Blood / Fluid Warmers*1234Pain Management / AnesthesiaAssess Pain Level*1234Assess Acceptable Level of Pain*1234Intranasal Pain Medications*1234Oral Pain Medications*1234IV Pain Medications*1234PCA*1234IV Conscious Sedation*1234Epidural Pain Management*1234Intervention for Anesthesia Toxicity*1234Assist with Epidural Insertion*1234Positioning of Patient*1234Signs of a Dural Puncture*1234Coaching Patient*1234Fluid Challenge*1234Hypotension*1234Intrathecal Narcotics*1234Labor Assessment / Procedures: FetalFetal Heart Rate - Doppler*1234Fetal Heart Rate - Auscultate*1234Document Fetal Position*1234Fetal Heart Rate Patterns: Identify Baseline*1234Fetal Heart Rate Patterns: Identify & Treat*1234Variability*1234Variable Decelerations*1234Early Decelerations*1234Late Decelerations*1234Prolonged Decelerations*1234External Fetal Monitor Application*1234Internal Fetal Monitor Application (Assist)*1234Internal Fetal Monitor Application (Perform)*1234Spiral Electrode*1234Intrauterine Pressure Catheter (IUPC)*1234Placement*1234Calibration*1234Fluid Filled*1234Transducer Tipped*1234Deliver / C-SectionAssist with Vaginal Delivery*1234Forceps Extraction*1234Vacuum Extraction*1234Assist with High Risk Delivery*1234Shoulder Dystocia*1234Hemorrhage / Shock*1234Emergency Delivery*1234Abdominal Shave / Scrub Prep*1234Perineal Prep*1234Circulate for C-Section*1234Scrub for C-Section*1234Patient with General Anesthesia*1234Patient with Epidural Anesthesia*1234Circulate for Tubal Ligation*1234Scrub for Tubal Ligation*1234Assist with Placenta Delivery*1234Fundus Massage*1234Assist with Cervical Laceration Repair*1234Assist with Uterine Laceration Repair*1234Assist with Episiotomy Repair*1234Immediate Care of Newborn in Delivery RoomNewborn Assessment*1234Ballard*1234Dubowitz*1234Finnegan / Abstinence Scoring*1234Apgar Scores*1234Initial Vital Signs*1234Suctioning*1234Bulb*1234Delee*1234Wall*1234Meconium Aspiration*1234Collect Cord Samples*1234Assist with UAC / UVC Insertion*1234Insertion of IV, Including Scalp IV*1234Radiant Warmer / Thermoregulation*1234Interventions for LGA, SGA, IUGR*1234Interventions for Infant of Diabetic Mother*1234Oxygen Administration*1234Bag / Mask Ventilation of the Newborn*1234Assist with Intubation*1234Transport Isolette*1234Heel Stick Glucose*1234Medications*1234Eye Prophylaxis*1234Vitamin K*1234ID / Security Banding*1234Promote Bonding Behaviors*1234Lead Placement for Cardiac Monitor*1234Apnea Monitoring*1234Oxyhood*1234Postpartum CareFundal Height*1234Fundal Massage*1234Lochia*1234Episiotomy Care*1234Perineum Care*1234Maternal Vital Signs*1234Recovering Post-Op C-Section Patient*1234Recovering Post-Op Tubal Ligation Patient*1234Fluid Balance*1234Assessment for DVT*1234Couplet Care*1234Breast Care*1234Breastfeeding*1234Newborn CareCord Care*1234Circumcision Care*1234Bath Demonstration*1234Assist with Breastfeeding*1234Latch on*1234Assist with Lumbar Puncture*1234Administration of IV Antibiotics*1234Newborn Vital Signs*1234Care of Infant withDrug Addiction / Withdrawl*1234Cystic Fibrosis*1234Meconium Aspiration*1234Pneumonia*1234Pulmonary Edema*1234RDS*1234NEC*1234Cardiac Anomalies*1234Neuromuscular Disease*1234Spina Bifida*1234Seizure Activity*1234Tracheoesophageal Fistula*1234Sepsis*1234Sickle Cell Disease*1234Low Birth Weight Infants*1234Labor Assessment / Procedures: MaternalNormal Vital Signs - Baseline*1234Identify Common Cardiac Arrhythmias*1234Assist with Sterile Speculum Exam*1234Perform Sterile Speculum Exam*1234Vaginal Exam - Manual*1234Status of Membranes*1234Assist with Rupture of Membranes*1234Fern Test*1234Nitrazine*1234Presence of Clonus*1234DTR's*1234Edema*1234Progression of Labor*1234Dilation*1234Effacement*1234Fetal Position*1234Fetal Presentation*1234Station*1234Contraction Characteristics*1234Determination of Fetal Head Position*1234Documentation of Labor Status and Interventions*1234Labor Suppressants*1234Collect Blood Specimens*1234Collect Urine Specimens*1234Toxicology Studies*1234Collect Vaginal Cultures*1234Fluid*1234Herpes*1234Chlamydia*1234Group B Strep*1234Perform Leopold's Maneuvers*1234Amnioinfusion (assist or perform) for*1234Variable Decelerations*1234Meconium*1234Prolapsed Cord*1234Vasa Previa*1234Catheter Insertion*1234Straight Cath*1234Foley*1234Pregnancy Induced Diabetes Mellitus*1234Eclampsia*1234Normal Perinatal Vital Signs*1234Age Specific CompetencyNewborn / Neonate (Birth - 30 days)*1234Infant (1 month - 1 year)*1234Toddler (1 - 3 years)*1234Preschooler (3 - 5 years)*1234School Age Child (5 - 12 years)*1234Adolescents (12 - 18 years)*1234Young Adults (18 - 39 years)*1234Middle Adults (39 - 64 years)*1234Older Adults (64 - 79 years)*1234Elderly Adults (Over 79+ years)*1234