Skill Checklists
OB/OBGYN RN
Name
Email
LAST 4 OF SSN
This checklist was electronically signed on (Today’s date)
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.
Proficiency Scale:
1 = No Experience
2 = Need Training
3 = Able to perform with supervision
4 = Able to perform independently
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
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
Magnesium
Pitocin
Terbutaline
Antibiotics
Narcotics
Hemabate
Methergine
Narcan
Insulin
Heparin
Oobtain cord blood gas
Postpartum care
Nipple care
Episiotomy care
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
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)
I hereby certify that ALL information I have provided on this skills checklist and all other documentation is true and accurate. I understand and acknowledge that any misrepresentation or omission may result in disqualification from employment and/or immediate termination.
