CLINICAL OBJECTIVES AND
COMPETENCY/SKILLS CHECKLIST
Clinical Objective (see
details below in objective
list)
PCO 1: History Taking:
Identify pertinent Hx (current
pregnancy prenatal care, OB,
GYN,Med/Surg, Allergies,
Psych, Social (habits) Family,
abuse screen )
PCO 2: Labs Identify
significance for care and
management in lab values,
screening findings, and Dx.
PCO 2: Medications Identify
routine OB patient
medications; pain
management; complications
medications; chronic disease
management
Postpartum Assessment
(Head-to-toe); maternal
adaptation; discharge
planning; family support
Labor and Delivery
Assessment (Maternal
assessment and support; EFM
and perinatal assessment;
Coping and Pain management)
Newborn Assessment
(Head to toe; Ballard
gestational age; Breastfeeding
basics)
Observation and
Demonstration
Novice Competency
INTRAPARTUM LEARNING OBJECTIVES
At the completion of the intrapartal clinical experience, the student will be able to:
1.
Obtain your PCO data base for the laboring woman on admission to the labor and
delivery unit. Include a full history, noting important variations.
2.
Assess the woman's behavior in each stage of labor; identify influencing stimuli; identify
and critique management of discomfort.
3.
Provide support for the laboring woman and her family in an environment conducive to
effective communication and trust.
4.
Use verbal and non-verbal communication to assist the woman in labor to focus, relax
and maximize comfort.
5.
Demonstrate awareness of one’s own cultural biases and feelings pertinent to the
childbirth process and discuss how these feelings may affect nursing care provided.
6.
Discuss current monitoring methods and how they are used to support the well-being of
mother and fetus.
7.
Discuss nursing responsibility during any interventions (for example, amniotomy
oxytocin augmentation,and magnesium sulfate infusion)
8.
List types of analgesia and anesthesia used in intrapartal period, state appropriate use,
maternal-fetal-neonatal effects and discuss nurse's responsibility.
9.
Perform initial maternal and newborn assessment; immediate care of the newborn and
Apgar assessment of the neonate.
CHECKLIST for Labor and Delivery
CHECKLIST EXPERIENCE/SKILLS
Assist with admission of patient including an admission history.
Assess maternal Vital signs; Pain Assessment and Support
Collect blood samples for lab and place IV. Collect and test urine noting results
and significance; and send urine sample to lab as necessary.
Orient patient to room, and explain routines of the unit.
Listen to fetal heart; Assess EFM variability, accelerations, decelerations and
patterns.
Assess contractions: frequency, strength (palpate and know values).
Assess patient's level of preparation for labor and delivery, and provide
DATE
information as necessary. Utilize therapeutic communication.
Support patient, significant other, and family throughout labor and delivery.
Prep patient for vaginal delivery including breaking the bed; preparation of birth
table; newborn care in warmer and resuscitation equipment;
Prep patient for Surgical delivery including, foley catheter insertion, maintaining
sterile fields, standardized procedures, and transferring patient to delivery room.
Practice Charting assessments, observations and procedures.
Administer oral and intramuscular medications.
Monitor intravenous fluids and intravenous medication administration.
Take advantage of opportunity to perform skills such as urethral catheterization
and starting intravenous fluid administration with supervision of the
nursing staff or instructor.
Observe, document, and list procedures performed by M.D. or midwife,
(including delivery, delivery of placenta and fundal massage; inspection of
perineum and any repair)
Observe immediate care of newborn; how is the newborn temperature
maintained? Do Apgar rating on newborn at 1 and 5 minutes after birth.
Observe and facilitate SOFT; self-latch of infant for nursing mother; bonding
and contact in first hour after delivery.
Help with transfer of mother and infant to recovery room and follow-through
recovery process.
OBJECTIVES FOR POSTPARTUM CARE
At the completion of postpartum clinical experience the student will be able to:
1.
Perform complete head-to-toe assessment and care of the postpartum woman/family.
2.
Apply the steps of the nursing process to develop a plan of care for the postpartum
woman/family which illustrates research findings in perinatal nursing.
3.
Identify stimuli that may interfere with parental role-taking and perform interventions to
promote bonding/ attachment.
4.
Identify major learning needs of the postpartum family and apply principles of effective
communication and teaching/learning to instruct the family.
5.
Develop a discharge plan and teach new mothers to promote effective maternal self-care
and infant care.
6.
Perform newborn physical and gestational age (Ballard) assessment and identify findings
as within normal range or variations.
7.
Plan and implement nursing care for health maintenance of the normal neonate.
8.
Describe newborn screening tests (including hearing) and explain their significance to the
mother.
9.
Identify common problems experienced by the postpartum woman, influencing factors
and discuss medical and nursing management with nursing instructor, nursing staff and
medical staff.
10.
Identify actual or potential moral, ethical and legal problems in the clinical setting.
11.
Demonstrate accountability for own learning needs and nursing actions.
12.
Accurately document all nursing care given, including teaching, to the postpartum family.
Checklist for Activities/Skills in Postpartum
CHECKLIST EXPERIENCE/SKILLS
DATE
Take vital signs T.P.R. B/P after morning report and repeat vital signs at required
intervals.
Assess patient’s pain and create a plan for pain management. Report any
deviation from normal to staff member immediately.
Do physical assessment head-to-toe, with emphasis on breasts, fundus, bladder,
lochia, perineum and lower extremities, pain, bonding with infant.
Assess psychosocial behavior including mother's interaction with infant.
Give a.m. care and assist patient with breakfast.
Give standard postpartum medications at appropriate times according to hospital
protocol; Student should have a licensed staff member or instructor
remove medications from the medication cart and supervise
administration of medications.
Identify the learning needs of your assigned patient and develop an appropriate
teaching plan.
Provide assistance to the mother as necessary in performing infant and self-care,
including breastfeeding.
Do discharge instructions for self-care and infant care:
Self-Care Instruction
- Breast Care
- Peri-Care
- Nutrition for physical recovery
and lactation
- Comfort measures
- Signs of illness
- Contraception
-Wound care (c-section)
-Pain management
-Postpartum exercise
- Postpartum check-up
Infant Care
- Feeding
- Elimination
- Behavior cues
- Signs of illness
- Circumcision care
- Bathing and cord care
-Newborn screening tests
-Immunization and injections
-Signs of newborn jaundice
OBJECTIVES FOR CARE OF NEWBORN
CHECKLIST EXPERIENCE/SKILLS
Take vital signs. Know normal ranges.
Do physical assessment on each baby assigned, document on appropriate form
and report any deviations to the staff nurse.
Do gestational age assessment (Ballard) on at least one baby and identify if
small, appropriate, or large for weeks of gestation.
Observe newborn bath and give bath with supervision.
Help with admission of new babies including Vit K injection, Hep B, and
application of erythromicin ointment.
Record amount of food taken, each urine, and stool.
Safety factors to be observed:
a.
b.
c.
d.
e.
ASEPSIS (newborn immunity).
Prevent heat loss (major problem).
Avoid injury - proper hold, support head, etc.
Observe for aspiration, using bulb syringe PRN.
Proper identification of infant before giving any care. If the
infant is taken from the mother’s room for any reason, he/she
must be identified on return by checking arm bands of both
mother and infant. Document identification.
DATE
Infant nutrition; Breastfeeding support; Shadow Lactation consultant
Observe circumcision, including pain management and post-procedure care