OB/Labor and Delivery Checklist


Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Total Stars:

Obtained Stars:

Ranking: 0%

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

  PATIENT RIGHTS         Rating Stars (Click) 1 2 3 4
  Communicates and obtains information while respecting the rights and privacy and confidentiality of information  
  Involves the patient and family and respects their role in determining the nature of care to be provided  
  including Advanced Directives  
  Complies with nursing staff responsibility include in the hospital policy related to Organ Donation  
  Meets patient and families needs regarding communication  
  including interpreter services  
  Provides accurate information to patient and families in a timely manner  
  LABOR AND DELIVERY         Rating Stars (Click) 1 2 3 4
  Assess cervical dilation  
  Assess labor status  
  Speculum examination  
  Obtaining vaginal/cervical cultures  
  Application of external ECG/TOCO EFM  
  Application of internal ECG  
  Interpretation of external/internal ECG  
  Assisting with insertion of IUPC  
  Conducting NST/BSST  
  IV insertion  
  Pitocin Titration for induction/augmentation  
  Assist with epidural  
  Assist/monitor amnioinfusion  
  Assist with scalp pH test  
  Assist with vacuum delivery  
  Assist with forceps delivery  
  Assist with vaginal delivery  
  Circulate for cesarean section delivery  
  Emergency cesarean section set up  
  Assist with twin deliveries  
  Assist with breech  
  Management of D&C  
  Management of fetal demise/stillborn  
  Adoption procedures  
  Management of diabetic mother  
  Diabetic mother  
  PIH  
  Pre-eclamptic  
  Preterm labor  
  Prolapsed cord  
  Abruption  
  Placenta previa  
  Retained placenta  
  Herpes  
  Uterine prolapse  
  Hemorrhage  
  Shoulder dystocia  
  DIC  
  Accretia  
  Episiotomy  
  Delivery table set-up  
  MEDICATIONS         Rating Stars (Click) 1 2 3 4
  Magnesium  
  Pitocin  
  Terbutaline  
  Antibiotics  
  Narcotics  
  Hemabate  
  Methergine  
  Narcan  
  Insulin  
  Heparin  
  MATERNITY         Rating Stars (Click) 1 2 3 4
  Oobtain cord blood gas  
  Postpartum care  
  Nipple care  
  Episiotomy care  
  PIH  
  Pre-eclamptic  
  Postpartum hemorrhage  
  Care of newborn  
  Breastfeeding  
  Bottle feeding  
  Infant formulas  
  D10W  
  PKU Testing  
  Stabilize/admit to nursery  
  Care of newborn with anomaly  
  Heel sticks/dorsal sticks  
  Blood glucose monitoring  
  Phototherapy  
  Set up/care of newborn receiving phototherapy  
  Set up/assist with circumcision  
  Discharge of mother/baby  
  Age Specific Competencies         Rating Stars (Click) 1 2 3 4
  Infant (Birth - 1 year)  
  Preschooler (ages 2-5 years)  
  Childhood (ages 6-12 years)  
  Adolescents (ages 13-21 years)  
  Young Adults (ages 22-39 years)  
  Adults (ages 40-64 years)  
  Older Adults (ages 65-79 years)  
  Elderly (ages 80+ years)