Checklist Delivery
Checklist Delivery
Checklist Delivery
I. LABOR ROOM 5 4 3 2 1
A. Establish rapport with the client and family
B. Able to evaluate the mother's status based on:
1. Accurate history taking (LMP, EDC, AOG
2. Assess the physical and psychological condition of the mother (including FH, FHT)
3. Identifies possible risk factors
C. Able to monitor the client's condition and progress of labor:
1. Accurate taking and recording of vital signs
2. Monitoring progress of labor through uterine contraction (Duration, interval, frequency,
Intensity)
3. Monitoring FHT & records accurately
D. Shows patience and understanding of the mother's condition
E. Able to answer specific questions by the mother regarding labor and delivery
F. Provides comfort and safety measures like positioning, non-pharmacologic control of
pain, regular voiding, physical care, etc.
G. Maintaining hydration/nutritional needs
II. PREPARATION/SET-UP OF STERILE TABLE
A. Applies the principles and techniques of skin preparation sharing, perineal flushing, etc.)
B. Selects pertinent supplies/equipment/instruments pertinent to the care
C. Does skin preparation with minimum supervision ( ) Applicable ( ) N/A ( )
III. SKIN PREPARATION ( ) applicable ( ) N/A
A. Applies the principles of asepsis when opening items
B. Does skin preparation with minimum supervision
C. Maintains patient's comfort and privacy during the procedure
IV. DELIVERY ROOM
A. Applies the principles of asepsis throughout the delivery
B. Maintains a supportive and patient attitude towards mother
C. Attends to the normal delivery of the baby
1. Assists mother in proper position at the DR table
2.
3. Cleanse vulva and perineum
4. Actual handling of delivery of the baby:
4.1 Knowledge of the mechanism of labor
4.2 Proper handling of the baby after the delivery
4.3 Proper cord cutting
5. Actual placental delivery
5.1 Knowledge of the signs of placental separation
5.2 Actual delivery of the placenta
6. Vital signs monitoring
7. Proper technique in newborn care
7.1 Keeping airway clear
7.2 Keeping baby warm
7.3 Able to cord care aseptically
7.4 APGAR scoring vital signs
7.5 Taking anthropometric measurement
8. Initiation of latching-on
8.1 Knowledge of the reason for latching-on and able to explain it to mother
8.2 Proper teaching in latching-on
9. After care in the delivery room
V. WARD CARE
A. Rooming-in done properly
B. Health teaching done properly
C. Monitoring vital sign
D. Providing comfort to both mother and baby
(HIGHEST POSSIBLE SCORE) Total
(CATEGORY WITH N/A CHECKED) Total
Name of Student:
Year & Section:
Evaluated By: