Labor and Delivery Skills Checklist

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Job Description:  Staff Nurse - RN – L&D   Evaluates, plans, implements, and documents nursing care for L&D  patient population. Assists physician during examinations and procedures. Provides comprehensive, family centered nursing care to mothers and babies during patient labor,  antepartum, intrapartum and postpartum periods. Requires an associate's degree and is certified as a registered nurse. Familiar with standard concepts, practices, and procedures within a particular field. Relies on experience and judgment to plan and accomplish goals. Performs a variety of tasks. A wide degree of creativity and latitude is expected. Typically reports to a manager or head of a unit/department.

KEY: For each criteria Score 1: Two plus years Expert Experience Score 2: One-Two Years Current Experience Score 3: Less than one year or Intermittent Experience Score 4: Theory, no experience

CRITERIA	SCORE
	1 2 3 4
ANTEPARTUM
Assessment
Assess for comfort
Breathing/relaxation techniques
Coaching
Positioning
Equipment & Procedures
Catheter insertion
Foley catheter
Straight catheter
Delivery table set-up
Amniotic fluid index
Assist with sonogram
Biophysical profile
Perform sonogram
LABOR ASSESSMENT
Fetal assessment
Auscultation of fetal heart rate
Doppler
Fetoscope
Determine fetal position
Document FHR patterns
Identify normal & treat abnormal FHR patterns
Baseline
Early decelerations
Late decelerations
Prolonged decelerations
Variability
Variable decelerations
Maternal Assessment
Deep tendon reflexes (DTR's)
Edema
Norms for prenatal vital signs
Perform admission risk assessment
Presence of clonus
Progression of Labor
Contraction characteristics
Dilation
Effacement
Fetal presentation/position
Station
Status of membranes
Sterile speculum exam
Vaginal exam
Rupture of membranes
Fern test
Nitrazine
Equipment & Procedures
Amnion fusion (assist or perform)
For meconium
For variable decelerations
Artificial rupture of membranes (assist)
Prolapsed cord
Recognize potential complications
Vasa Previa
Collect blood/urine specimens
Collect vaginal cultures
Chlamydia
Fluid
Group B Strep
Herpes
Document labor status/assessment & interventions
Anticonvulsants
Labor suppressants
External fetal monitor application
Doppler
Phono or abdominal, ECG transducer
Tocotransducer, ultrasound
Internal monitoring (assist or perform insertion)
Intrauterine pressure catheter
Fluid filled
Transducer tipped
Spiral electrode
Medications
Administer IM/SC
Administer IV meds/monitor IV drips
Antibiotics
Antihypertensive
Heparin
Magnesium sulfate
Narcotics
Oxytocin
Assist with prostin gel
Cervidil insertion
Use of Cytotec
Use of prostin suppositories
COMPLICATIONS OF PREGNANCY
Assessment
Identify common arrhythmias
Normal cardiac rhythms
Patient education - fetal movement counts
Equipment & Procedures
Assist with external version
Assist with fetal scalp sampling
Assist with percutaneous umbilical sampling
Circulate for Cesarean delivery
Circulate, scrub for bilateral tubal ligation
Conduct contraction stress test
Breast stimulation
Oxytocin challenge
Conduct non-stress test
Stimulate fetus
Vibroacoustic stimulation
Draw umbilical blood samples
Glucose reflectometer
Lines/monitoring
Central venous lines
Invasive hemodynamic monitoring
PICC lines
Pulmonary artery catheters
Scrub for Cesarean delivery
Set-up Cesarean deliver
Care of the patient with
Abruptio placenta
Asthma
Cardiac disease
Chorioamnionitis
Chronic hypertension
Collegen vascular disease
Diabetes
Eclampsia
HBV
HELLP syndrome
Hemolytic anemias
Hemmorrhage
HIV positive
Hypertension
Malpresentations
Multiple gestation
Other infections
Placenta previa
Preeclampsia
Premature labor
Pyelonephritis
RH disease
Sickle cell disease
Medcications
Indomethacin
Insulin
Magnesium sulfate
Procardia
Ritodrine
Terbutalint
IV
PO
Pump
SC
INTERVENTIONS DURING PREGNANCY
Cesarean Section
Forceps vaginal delivery
Monitor patients with anesthesia
General anesthesia
Regional anesthesia
Epidural
Local infiltration
Spinal
Spontaneous vaginal delivery
Vacuum extraction delivery
INFANT INTERVENTIONS POST DELIVERY
Assessment
Apgar scoring
Initial vital signs
Intervention/risk factors for
IDM
LGA, SGA, IUGR
Newborn physical assessment
Ballard
Dubowitz
Finnegan scoring
Equipment & Procedures
Assist with initial breast feeding
Assist with interventions for meconium staining
Bath-perform and teach
Cardiac-respiratory monitor placement
Circumcision care
Cord Care
Discharge teaching
Heelstick glucose determination
Infant identification
Neonatal resuscitation
Obtain hemotocrit
Obtain neonatal toxicology screen
Phototherapy
Promote bonding behaviors
Suctioning
Bulb
Delee
Wall
Medications
Eye prophylazis
Vitamin K
POST PARTUM INTERVENTIONS
Assessment
Bladder distention
Breast feeding
Latch-on
Positioning
DVT (Deep vein thrombosis)
Episiotomy
Fluid balance
Fundal height
Fundal massage
Lochia amount
Maternal vital signs
PHLEBOTOMY/IV THERAPY
Equipment & Procedures
Administration of blood/blood products
Cryoprecipitate
Packed red blood cells
Plasma/albumin
Whole blood
Drawing blood from central line
Drawing venous blood
Starting IV's
Angiocath
Butterfly
Heparin lock