L&D RN

Labor and Delivery RN

Name*
Full Name
Date
MM slash DD slash YYYY
Self-Assessment Rating Scale:
No Experience
Theory or observation only during the past 12 months

Limited Experience
Performed less than 12 times within the past 12 months and may need a review

Experienced
Performed at least once per month within the past 12 months and may need minimal assistance

Highly Skilled
Performed on at least a weekly basis over the past 12 months; proficient

Ante Partum

	No Experience	Limited Expeirence	Experienced	Highly Skilled
Assessment - Assess for Comfort
Assessment - Breathing/Relaxing Techniques
Assessment - Coaching
Assessment - Positioning
Assist with Sonogram
Interpret - Amniotic Fluid Index
Interpret - Biophysical Profile
Perform - Delivery Table Setup
Perform - Foley and Straight Catheter Insertion
Perform - Sonogram

Labor Assessment

	No Experience	Limited Expeirence	Expeirenced	Highly Skilled
Assessment - Auscultate Fetal Heart Rate - Doppler
Assessment - Auscultate Fetal Heart Rate - Fetoscope
Assessment - Determine Fetal Position
Assessment - Document FHR Patterns
Assessment - FHR - Baseline
Assessment - FHR - Early Decelerations
Assessment - FHR - Late Decelerations
Assessment - FHR - Prolonged Decelerations
Assessment - FHR - Variable Decelerations
Assessment - Maternal - Deep Tendon Reflexes (DTR's)
Assessment - Maternal - Edema
Assessment - Maternal - Norms for Perinatal Vital Signs
Assessment - Maternal - Perform Admission Risk Assessment
Assessment - Maternal - Deep Tendon Reflexes (DTR's)
Assessment - Maternal - Edema
Assessment - Norms for Prenatal Vital Signs
Assessment - Maternal - Perform Admission Risk Assessment
Assessment - Maternal - Presence of Clonus
Assessment - Maternal - Progression of Labor - Contraction Characteristics
Assessment - Maternal - Progression of Labor - Dilation
Assessment - Maternal - Progression of Labor - Effacement
Assessment - Maternal - Progression of Labor - Fetal Presentation
Assessment - Maternal - Progression of Labor - Station
Assessment - Maternal - Progression of Labor - Status of Membranes
Assessment - Maternal - Progression of Labor - Sterile Speculum Exam
Assessment - Maternal - Progression of Labor - Vaginal Exam
Assessment - Rupture of Membranes - Fern Test
Assessment - Rupture of Membranes - Nitrazine
Medications - Assist with Prostin Gel
Medications - Administer/Monitor IV Drips - Antihypertensives
Medications - Administer/Monitor IV Drips - Heparin
Medications - Administer/Monitor IV Drips - Magnesium Sulfate
Medications - Administer/Monitor IV Drips - Narcotics
Medications - Administer/Monitor IV Drips - Oxytocin
Medications - Cervidil Insertion
Medications - Labor Suppressant
Medications - Use of Cytotec
Medications - Use of Prostin Suppositories
Perform - Amnioinfusion for Meconium
Perform - Amnioinfusion for Variable Decelerations
Perform - Assist with Artificial Rupture of Membranes - Prolapsed Cord
Perform - Assist with Artificial Rupture of Membranes - Recognize Potential Complications
Perform - Assist with Artificial Rupture of Membranes - Vesa Previa
Perform - Collect Blood/Urine Specimens
Perform - Collect Vaginal Cultures - Chlamydia
Perform - Collect Vaginal Cultures - Fluid
Perform - Collect Vaginal Cultures - Group B Strep
Perform - Collect Vaginal Cultures - Herpes
Document Labor Status
Perform - External Fetal Monitor - Doppler
Perform - External Fetal Monitor - Phono or Abdominal Transducer
Perform - External Fetal Monitor - Toctotransducer, Ultrasound
Perform - Internal Fetal Monitor - Intrauterine Pressure Catheter - Fluid Filled
Perform - Internal Fetal Monitor - Intrauterine Pressure Catheter - Spiral Electrode
Perform - Internal Fetal Monitor - Intrauterine Pressure Catheter - Transducer Tipped
Perform - Leopold's Maneuvers
Perform - Toxicology Studies

Complication of Pregnancy

	No Experience	Limited Experience	Expeirenced	Highly Skilled
Assessment - Identify Common Cardiac Arrythmias
Assessment - Identify Normal Cardiac Rhythms
Care of Patient - Abruptio Placenta
Care of Patient - Cardiac Disease
Care of Patient - Chorioamnioitis
Care of Patient - Diabetes
Care of Patient - Eclampsia
Care of Patient - HBV
Care of Patient - HELLP Syndrome
Care of Patient - Hemolytic Anemia
Care of Patient - Hemorrhage
Care of Patient - Hypertension
Care of Patient - Malpresentation
Care of Patient - Multiple Gestation
Care of Patient - Placenta Previa
Care of Patient - Preeclampsia
Care of Patient - Premature Labor
Care of Patient - RH Disease
Medications - Indomethacin
Medications - Insulin
Medications - Magnesium Sulfate
Medications - Procardia
Medications - Ritodrine
Medication - Terbutaline
Monitoring - Central Venous Lines
Monitoring - Invasive Hemodynamic Monitoring
Monitoring - Patients with General Anesthesia
Monitoring - Patients with Regional Anesthesia - Epidural
Monitoring - Patients with Regional Anesthesia - Local Infiltration
Monitoring - Patients with Regional Anesthesia - Spinal
Perform - Assist with External Version
Perform - Assist with Fetal Scalp Sampling
Perform - Assist with Forceps Vaginal Delivery
Perform - Assist with Percutaneous Umbilical Sampling
Perform - Assist with Spontaneous Vaginal Delivery
Perform - Assist with Umbilical Blood Sampling
Perform - Assist with Vacuum Extraction Delivery
Perform - Circulate for Cesarean Delivery
Perform - Circulate, Scrub for Bilateral Tubal Ligation
Perform - Conduct Contraction Stress Test - Breast Stimulation
Perform - Conduct Contraction Stress Test - Oxytocin Challenge
Perform - Conduct Non-Stress Test - Stimulate Fetus
Perform - Conduct Non-Stress Test - Vibroacoustic Samples
Perform - Glucose Reflectometer
Perform - Patient Education on Fetal Movement Counts
Perform - Scrub for Cesarean Section

Infant Post Delivery

	No Experience	Limited Experience	Experienced	Highly Skilled
Assessment - APGAR
Assessment - Ballard
Assessment - Dubowitz
Assessment - Finnegan Scoring
Assessment - Initial Vital Signs
Assessment - Risk Factors - IDM
Assessment - Risk Factors LGA, SGA. IUGR
Medications - Eye Propylaxis
Medications - Vitamin K
Perform - Assist with Initial Breast Feeding
Perform - Assist with Meconium Staining
Perform - Bath and Teach
Perform - Cardiac Respiratory Monitor Placement
Perform - Circumcision Care
Perform - Cord Care
Perform - Discharge Teaching
Perform - Heel Stick Glucose Determination
Perform - Infant Identification
Perform - Neonatal Resucitation
Perform - Obtain Hematocrit
Perform - Obtain Neonatal Toxicology Screen
Perform - Phototherapy
Perform - Promote Bonding Behaviors
Perform - Suctioning - Bulb
Perform - Suctioning- Wall

Post Partum

	No Experience	Limited Experience	Experienced	Highly Skilled
Assessment - Bladder Distention
Assessment - Breast Feeding - Latch On
Assessment - Breast Feeding - Positioning
Assessment - DVT
Assessment - Episiotomy
Assessment - Fluid Balance
Assessment - Fundal Height
Assessment - Locia Amount
Assessment - Maternal Vital Signs
Perform - Fundal Massage

Pain Management

	No Experience	Limited Experience	Experienced	Highly Skilled
Assessment - Pain Level/Tolerance
Assist with Delivery of Anesthesia - Anesthesia Toxicity
Assist with Delivery of Anesthesia - Coaching Patient
Assist with Delivery of Anesthesia - Documentation of Anesthesia
Assist with Delivery of Anesthesia - Epidural Block
Assist with Delivery of Anesthesia - Fluid Challenge
Assist with Delivery of Anesthesia - Hypotension
Assist with Delivery of Anesthesia - Intrathecal Narcotics
Assist with Delivery of Anesthesia - Hypotension
Assist with Delivery of Anesthesia - Intrathecal narcotics
Assist with Delivery of Anesthesia - Intravascular injection
Assist with Delivery of Anesthesia - S/S of dural puncture
Assist with Delivery of Anesthesia - Spinal anesthesia
Care of Patient - IV conscious sedation
Care of Patient - Patient controlled analgesia (PCA)

Phelbotomy/IV Therapy

	No Experience	Limited Experience	Experienced	Highly Skilled
Care of Patient - Central line/catheter/dressing
Perform - Administer packed RBC's
Perform - Draw blood from central line
Perform - Draw venous blood
Perform - Start IV (heparin lock)

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