Newborn Bath

JOSE RIZAL UNIVERSITY
College of Nursing and Health Sciences
Performance Checklist
Immediate Newborn Bath
Name of Student: Enriquez, Charlotte D. Date: Nov 09 2022

Year/Section/Group No.: 2ndyr/201N/Group 1 Grade: __________
Rate the student’s performance by checking the appropriate box using the following criteria:
5- Excellent Carries out procedure efficiently, systematically and independently

4- Very Satisfactory Carries out procedure efficiently and systematically but requires minimal guidance and
supervision
3- Satisfactory Carries out procedure efficiently and systematically but requires moderate guidance and
supervision
2- Fair Carries out procedure with close guidance and supervision

1- Poor Carries out procedure inefficiently and unsystematic
CRITERIA RATIONALE 5 4 3 2 1
A. KNOWLEDGE
1 Assess the infant is condition and Assessing the infant will help the health
. wash hands. care
I provider to know if the state of the
infant for newborn bath is ready.
Washing hands is also essential to
ensure that we will not contaminate and
spread
microorganisms to the baby.
2 Gather the equipment: To easily access the equipment that we
. Bath towel need for the procedure
Complete set of baby dress and diaper
Dry cotton balls
Wash cloth
Soap and soap dish
2 big basin / baby bath tub
Warm water
Kidney basin
B. SKILLS
3 Place towel, laid out in diamond It is shaped in diamond for bigger
. fashion on top of the table next to coverage of
basin/bath tub. undercover and corners are accessible
when pat
drying body parts
4 Remove all clothing except shirt and To keep the baby warm and make them
. diaper. ready for a bath.
5 Wipe the eyes using a cotton ball To prevent the lacrimal gland from
1
. moistened with water starting from coming into contact with dirt and
the inner to outer canthus. Use new bacteria.
cotton ball for each eye.
6 Dip wash cloth. Make a mitt and wash To clean the face of the baby
. the face, ears and neck. Dry all areas
thoroughly.
7 Hold infant on one arm (Football To clean the infants head and scalp
. Hold) over the basin/bath tub and wet
hair. Soap own hands and lather to
hair and scalp using gentle, circular
motion. Splash water against head to
rinse off.
8 Place infant on towel and dry the head To dry immediately and prevent
. using the corners of the towel. hypothermia.
9 Undress the infant. Wet upper To clean the extremities of the baby
. extremities, front, back, buttocks and
legs using wash cloth. Apply soap and
lather.
1 Pick up infant and slowly lower him Remember that the skin of a infant is
0 into the basin/ bath tub to rinse of sensitive.Ensure that there are no soap
. left that can lead to skin rashes
1 Support the infant while lifting him To hold the infant carefully to prevent
1 from the tub/basin by placing your them from slipping because they are
. hand and arm around the infant. wet from bathing.
Cradling his head and neck in your
elbow.
1 Grasp his thigh with other hand. Dry To make sure you are properly holding
2 infant’s body gently but thoroughly. the baby because some of them may be
. kicking and moving their arms. To keep
the baby warm and guard against
catching a cold, dry their body.
1 A. For Female: Cleaning the genitals of infants can help

3 Separate labia, and with cotton ball prevent
. moistened with soap and water infections and can keep the baby
cleansed downward one of each side. healthy.
Use new piece of cotton ball on each
2
side.
B. For Male:
Retract foreskin and gently cleanse
glans penis with a cotton ball
moistened with soap and water.
Use a new cotton ball on each side.
1 Check cord and dress infant. To identify if there’s any problem with
4 the chord after bathing, dress the infant
. to provide warm to the baby.
1 Document the procedure don To have a record of the procedure and

5 e. action done by the nurse.
.
C. ATTITUDE
1 Shows responsibility by having a
6 complete set of equipment needed in
. the activity and shows interest in
doing the procedure.
1 Displays courtesy and consideration
7 in acknowledging criticisms and
. suggestions by the Clinical Instructor.
1 Demonstrates integrity by doing the
8 skill honestly, competently and
. completely.
Knowledge - Total score / Total no of items x 60 + 40 = _____x .3= ______________
Skills - Total score / Total no of items x 60 + 40 = _____x .6= ______________
Attitude - Total score / Total no of items x 60 + 40 = _____x .1= ______________
TOTAL = ___________________
Clinical Instructor’s Comments / Suggestions:
_____________________________________________________________________________________________.
Students’ Comments / Suggestions:
_____________________________________________________________________________________________.
_______________________________ _________________________
Student’s name & signature C.I.’s name & signature
3
4

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JOSE RIZAL UNIVERSITY

College of Nursing and Health Sciences

Name of Student: Enriquez, Charlotte D. Date: Nov 09 2022

5- Excellent Carries out procedure efficiently, systematically and independently

2- Fair Carries out procedure with close guidance and supervision

1 A. For Female: Cleaning the genitals of infants can help

1 Document the procedure don To have a record of the procedure and

Knowledge - Total score / Total no of items x 60 + 40 = _x .3= __________

Skills - Total score / Total no of items x 60 + 40 = _x .6= __________

Attitude - Total score / Total no of items x 60 + 40 = _x .1= __________

Clinical Instructor’s Comments / Suggestions:

Students’ Comments / Suggestions:

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