PostPartum/AntePartum/Nursery RN

Postpartum RN

Name
First Last
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

Normal Neonatal Care

	No Experience	Limited Experience	Experienced	Highly Skilled
Assessment - Ballard scale
Assessment - Bladder distention
Assessment - Breast engorgement
Assessment - Breast feeding - Latch on
Assessment - Breast feeding - Positioning
Assessment - Circumference
Assessment - Dubowitz scale
Assessment - Length
Assessment - Neonatal Jaundice
Assessment - Reflexes
Assessment - Vital Signs
Assessment - Weight
Assist with circumcision - Assess site post op
Assist with circumcision - Teach circumcision care to patients
Perform - Administer injections
Perform - Bathe Infant
Perform - Culture suspect infectious neonate
Perform - Discharge procedure
Perform - Incubator/Isolettes
Perform - Phototherapy
Perform - Infant Identification
Perform - Monitor bladder and bowel patterns
Perform - Neonate CPR
Perform - Obtain urine specimen
Perform - Test stool for blood
Perform - Test stool for reducing substances
Perform - Thermo-neutral environment

Post Partum

	No Experience	Limited Experience	Experienced	Highly Skilled
Assessment - DVT
Assessment - Episiotomy
Assessment - Fluid Balance
Assessment - Fundal Height
Assessment - GI Function Post Anesthesia
Assessment - Locia Amount
Assessment - Maternal Vital Signs
Assessment - Locia amount
Assessment - Maternal Vital Signs
Assessment - Parental/Infant Interaction
Assessment - Perineum for Hematoma
Care of Patient - Cesarean section
Care of Patient - Diabetes mellitus
Care of Patient - Infectious disease
Care of Patient - Known substance abuse
Care of Patient - Multiple births
Care of Patient - Post tubal litigation
Care of Patient - Pregnancy induced hypertension
Care of Patient - Spontaneous vaginal delivery
Interpret - Check Urine for Glucose
Interpret - Check Urine for Ketones
Interpret - Check Urine for Protein
Interpret - Check Urine for Specific Gravity
Medications - Antibiotics
Medications - Diluted oxytocin infusion
Medications - IM Administration
Medications - Rhogam Administration/Teaching
Perform - Adult CPR
Perform - Contraceptive Counseling
Perform - Infant care restraint systems
Perform - Infant caretaking skills
Perform - Perineal care
Perform - Discharge Teaching
Perform - Foley and Straight catheter insertion
Perform - Formula preparation and feeding
Perform - Foster parental-infant attachment
Perform - Fundal Massage
Perform - Post Anesthesia Care - Epidural
Perform - Post Anesthesia Care - General
Perform - Post Anesthesia Care - Local
Perform - Post Anesthesia Care - Spinal
Perform - Post cesarean care
Perform - Sitz Bath
Perform - Teaching and Assist with breastfeeding - Latch-on Procedure
Perform - Teaching and Assist with breastfeeding - Positioning
Perform - Teaching and Assist with breastfeeding - Use of electric breast pump
Perform - Teaching and Assist with breastfeeding - Use of manual
Breast Pump

Pain Management

	No Experience	Limited Experience	Experienced	Highly Skilled
Assessment - Pain level/tolerance
Care of Patient - Epidural anesthesia/analgesia
Care of Patient - IV Conscious Sedation
Care of Patient - Patient Controlled Analgesia (PCA)

Phlebotomy/IV Therapy

	No Experience	Limited Experience	Experienced	Highly Skilled
Assessment - Site and patency
Care of Patient - Central line/catheter/dressing
Care of Patient - Peripheral line/dressing
Perform - Administer Packed RBC's
Perform - Administer Plasma/Albumin
Perform - Draw blood from central line
Perform - Draw venous blood
Perform - Start IV (heparin lock)
Perform -

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