PPR Healthcare Staffing, Inc.
333 1st. St. North -- Suite 200
Jacksonville Beach, FL 32250
Fax:(888) 794-5038

  

LABOR/DELIVERY/RECOVERY/POST-PARTUM SKILLS CHECKLIST
First Name:
Last Name:
Phone:
Email:
SSN (last 4 only):
Date:
 
Key - for each box mark:   1 - Limited or no experience 2 - Somewhat experienced but may need review
    3 - Can function independently 4 - Competent to supervise
  1     2     3     4     1     2     3     4
STAGES OF PREGNANCY   |   Care of Patient with continued  
Pregnancy/Antepartum   |     Cardiac Disease
  Assessment   |     Chorioamnionitis
    Comfort of Normal Changes   |     Collagen Vascular Disease
    of Pregnancy |     Diabetes
    Breathing/Relaxation Techniques |     Eclampsia
    Vital Signs   |     Hepatitis B
      BP |     HELLP Syndrome
      Heart Rhythms |     Hemolytic anemias
    Fetal Heart Tones |     Hemorrhage
    Fetal Development Measures |     HIV Positive
    General Systems Assessment |     Hypertension
    Knowledge Deficits re:   |     Malpresentations
    Pregnancy Issues |     Multiple gestation
    Lab Values   |     Infections
      Blood Glucose |     Placenta Previa
      Ketones |     Preeclampsia
  Procedures   |     Premature Labor
    Sonogram   |     Pyelonephritis
      Amniotic Fluid Index |     Rh Disease
      Assist with Sonogram |     Sickle Cell Disease
      Biophysical Profile |   Medications  
    Stress Testing |     Indomethacin (Indocin)
    Non-stress Testing |     Insulin
    Vaginal Examination |     Magnesium Sulfate
    Pelvimetry |     Nifedipine (Procardia)
  Equipment   |     Ritodrine (Yutopar)
    Sonogram Machine |     Terbutaline (Brethine)
    Glucose Reflectometer |     Betamethasone
  Care of Patient with   |     Dexamethasone (Decadron)
    Abruptio Placenta |
    Asthma |  
|  

 
 
  1     2     3     4     1     2     3     4
Labor   | Procedures Continued  
  Fetal Assessment   |       Local Infiltration
    Auscultate Fetal Heart Rate   |     Leopold’s Maneuver
      Doppler |     Toxicology Studies
      Fetoscope |   Equipment  
    Fetal Position |     Fetal Monitors  
    Fetal Heart Patterns   |       Internal
      Baseline |       External
      Early Decelerations |   Care of Patient with  
      Late Decelerations |     Prolapsed Cord
      Prolonged Decelerations |     Vasa Previa
      Variability |     Multiple gestation
      Variable Decelerations |     Induced Labor
  Maternal Assessment   |     Normal Progression of Labor
    Vital Signs |   Medications  
    Edema |     Antihypertensives
    Deep Tendon Reflexes |     Heparin
    Neuro Hyperactivity (Clonus) |     Magnesium Sulfate
    Progression of Labor |     Narcotics
    Contraction Characteristics |     Oxytocin
    Dilation |     Cervidil
    Effacement |     Prostin Suppositories
    Fetal Presentation | Delivery  
    Station |   Assessment  
    Status of Membranes |     Cervical Dilation
  Procedures   |     Stage of Labor
    Status/Rupture of Membranes   |     Crowning
      Fern Test |   Equipment  
      Nitrazine |     Delivery Table Set-up
    Vaginal Exam |     Cesarean Delivery Set-up
    Amnioinfusion |     Infant Warmer
    Collection of Blood/Urine Specimens |     Vacuum Extractor
    Collect Vaginal Cultures |   Care of Patient with  
    External Fetal Monitor Application   |     Spontaneous Vaginal Delivery
      Doppler |     Vacuum Extraction Delivery
      Phono or abdominal, ECG Transducer |     Forceps Vaginal Delivery
      Tocotransducer, ultrasound |     Cesarean Delivery
    Internal Monitoring   |     Anesthesia  
      Intrauterine Pressure Catheter |       General
      Fluid Filed Monitor |       Epidural
      Transducer Tipped |       Spinal
      Spiral Electrode |
|
 
 
  1     2     3     4     1     2     3     4
Infant Care Post-Delivery   | Assessment continued  
  Assessment   |     Fundal Height
    Apgar Scoring |     Lochia
    Initial Vital Signs |     Vital Signs
    Newborn Physical Assessment |   Procedures  
      Dubowitz/Ballard Exam |     Fundal Massage
      Finnegan Scoring |     Baby Care Teaching
  Procedures   |     Breast Feeding Instruction
    Cardiac-Respiratory Monitor Placement |     Catheterization
    Cord Care |   Equipment  
    Heelstick Glucose Determination |     Breast Pump
    Infant Identification |     Catheter Tray and Bag
    Neonatal Resuscitation |   Care of Mother with  
    Blood Specimen Collection |     Vaginal Delivery  
    Phototherapy |       with Epidural Anesthesia
    Suctioning   |       with Spinal Anesthesia
      Bulb |     Cesarean Delivery  
      Delee |       with General Anesthesia
      Wall |       with Spinal Anesthesia
  Equipment   |     Precipitous Delivery
    Infant Warmer |     Perineal Lacerations
    Isolette |   Medications  
  Care of Infant with   |     Antibiotics
    Circumcision |     RhoGAM
    Phototherapy |     Oxytocin
    Diabetic Mother (IDM) |     Analgesics
    Large for Gestational Age (LGA) | Go to End
    Small for Gestational Age (SGA) |
    Intrauterine Growth Restriction (IUGR) |
  Medications   |
    Eye Prophylaxis |
    Vitamin K |
Mother Care Post-Delivery   |
  Assessment   |
    Bladder Distention |
    Breast Feeding   |
      Knowledge Level |
      Positioning |
      Latch-on |
    Deep Vein Thrombosis (DVT) |
    Episiotomy |
    Fluid Balance |
The information I have provided in this skills checklist is true and accurate to the best of my knowledge. I hereby authorize PPR to release this information to client facilities of PPR in relation to consideration of my employment to those facilities.
 



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