Newborn Care Performance Checklist

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SAN PEDRO COLLEGE

Davao City

PERFORMANCE CHECKLIST
NEWBORN CARE

Name: ______________________________________________________ Grade: ___________________


Year & Section: _______________________________________________ Date: ____________________

LEGEND: 5- EXCELLENT 4- VERY GOOD 3-GOOD 2-FAIR 1-POOR

Introuction: Inside the delivery room you should wear mask and close cap.
What is immediate newborn care? IMMEDIATE NERBORN CARE ARE ACTIVITIES THAT WILL PREVENT THE
OCCURANCE OF UNTOWARD EFFECT IN THE NEWBORN INCLUDING HYPUTHERMIA, INFECTION, AND BLEEDING.
Purposes: to prevent bleeding from the cord, to prevent infection of the cord and eyes, to oprevent hypothermia.

In preparation for the delivery of the babyy...

I. PROCEDURE 5 4 3 2 1
1. Disinfects and prepares the crib before the delivery of the newborn. Including the
frame and you have to clean the rest of the crib and you have to apply also new linen.
2. Prepares the two (2) droplights.
3. Assemble all equipment.
4. Performs medical handwashing then, disinfects hand using sanitizer. Prepare a
working area in preparation for the coming of the baby.
Lay down the baby’s layette on the table over the infants warmer.
 Babys dress
 Diaper
 Bonet
 Booties
 mittens
 Babys layette
 Binder- to restrain the newborns knee when we are going to apply medication

5. Prepares the hypotray:


a. 4 Cotton Balls ( 2 dry; 2 soaked with alcohol) 2 dry- disinfect the ampule and
after injection. 2 soaked – disinfect ampule and disinfect thigh
b. Tape measure- for the anthropometric mmeasurement
c. Eye Ointment- credes prophylactic
d. Vitamin K Ampule-
e. Tuberculin Syringe – for injection
f. Thermometer
g. Comb- to clean the babys head.
h.Kidney basin as waste receptacle. – for waste receptacle
I. Stetoscope

6. Prepare medications. (Terramycin ointment; Vitamin K)


9. Washes hands and don a pair of working gloves.
10. Upon receiving the newborn , checks the ID band; weighs the baby, provides warmth,
checks for bruises and deformities.
11. Takes Vital Signs for 1 full minute( RR, CR, rectal Temp)
12. Takes the Anthropometric Measurements accurately and record it.
13. Restrain the upper and lower extremities.
14. Applies Crede’s Prophylaxis properly from inner to outer canthus
15. Gets 1 sterile cotton ball with alcohol and disinfects the site for intramuscular
injection.
16. Injects the vitamin K correctly into the vastus lateralis, and applies light pressure using
dry CB.
17. Releases the restraints from the upper and lower extremities.
18. Takes the vital signs (RR,CR,Temp:axillary).
19. Cleanses the newborn using a towel and comb.
20. Dress the Newborn:
a. Provide a clean bonnet
b. Change the newborn’s layette
c. Put on the newborn’s sterile gown
c. Put on the diaper, mittens and booties
21. Swaddle the baby.
22. Does the after care. Soaks instruments for 30 minutes in a disinfectant solution then
rinses and dries the instruments.
23. Document accurately.
23. Monitors the vital signs every 15 minutes until stable. If stabalize na sya Then, every
30 minutes X 4 takes. (EQUIVALENT TO 2 HRS)
II. PERSONAL ATTRIBUTES
1. Performed procedure with ease and confidence.
2. Showed interest in his/her work.
3. Attentive while doing the procedure.
4. Analyzed the importance of personal hygiene and good grooming.
5. Accepted constructive criticism and suggestions with a positive attitude.
6. Performed procedure with honesty.
7. Handled the newborn with tender loving care.
--------------------------------------------------------------------------------------------SUB-TOTAL:
COMMENTS:

___________________________________ _________
CLINICAL INSTRUCTOR’S SIGNATURE DATE

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