Labor and Delivery Skills Checklist Date:* Name: (First, MI, Last)* Email ANTEPARTUM CAREAssessment* N/A Inexperienced Limited Experience Experienced Highly Experienced Fetal Heart Rate Patterns:* N/A Inexperienced Limited Experience Experienced Highly Experienced Fetal Monitoring:* N/A Inexperienced Limited Experience Experienced Highly Experienced Fetal Status:* N/A Inexperienced Limited Experience Experienced Highly Experienced Progression of Labor:* N/A Inexperienced Limited Experience Experienced Highly Experienced Reflexes/Clonus :* N/A Inexperienced Limited Experience Experienced Highly Experienced Equipment & Procedures* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with Ultrasound :* N/A Inexperienced Limited Experience Experienced Highly Experienced Non-Stress Test :* N/A Inexperienced Limited Experience Experienced Highly Experienced Oxytocin Challenge Test :* N/A Inexperienced Limited Experience Experienced Highly Experienced Use of PICC/Other Long Term Lines :* N/A Inexperienced Limited Experience Experienced Highly Experienced Care of the Antepartum Patient with* N/A Inexperienced Limited Experience Experienced Highly Experienced Diabetes :* N/A Inexperienced Limited Experience Experienced Highly Experienced Fetal Demise :* N/A Inexperienced Limited Experience Experienced Highly Experienced HELLP Syndrome :* N/A Inexperienced Limited Experience Experienced Highly Experienced Hyperemesis :* N/A Inexperienced Limited Experience Experienced Highly Experienced Immunologic Disorder :* N/A Inexperienced Limited Experience Experienced Highly Experienced Infectious Disease :* N/A Inexperienced Limited Experience Experienced Highly Experienced Multiple Gestation :* N/A Inexperienced Limited Experience Experienced Highly Experienced Placenta Previa/Abruptio :* N/A Inexperienced Limited Experience Experienced Highly Experienced Post Trauma :* N/A Inexperienced Limited Experience Experienced Highly Experienced Pre-Term Labor :* N/A Inexperienced Limited Experience Experienced Highly Experienced Pregnancy Induced Hypertension (PIH) :* N/A Inexperienced Limited Experience Experienced Highly Experienced Premature Rupture of Membranes (PROM) :* N/A Inexperienced Limited Experience Experienced Highly Experienced Substance Abuse :* N/A Inexperienced Limited Experience Experienced Highly Experienced Underlying Cardiac Disorder :* N/A Inexperienced Limited Experience Experienced Highly Experienced Underlying Neurologic Disorder :* N/A Inexperienced Limited Experience Experienced Highly Experienced Underlying Pulmonary Disorder :* N/A Inexperienced Limited Experience Experienced Highly Experienced Underlying Renal Disorder:* N/A Inexperienced Limited Experience Experienced Highly Experienced LABOR MANAGEMENTAdmission Assessment:* N/A Inexperienced Limited Experience Experienced Highly Experienced Identify Normal/Abnormal Maternal/Fetal VS :* N/A Inexperienced Limited Experience Experienced Highly Experienced Auscultate Fetal Heart Tones (Doppler/Fetoscope) :* N/A Inexperienced Limited Experience Experienced Highly Experienced Determine Fetal Position :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assess Contraction Characteristics :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assess Status of Membranes :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assess Station :* N/a Inexperienced Limited Experience Experienced Highly Experienced Assess Dilation & Effacement :* N/A Inexperienced Limited Experience Experienced Highly Experienced Breathing/Relaxation Techniques :* N/A Inexperienced Limited Experience Experienced Highly Experienced Coaching :* N/A Inexperienced Limited Experience Experienced Highly Experienced Positioning :* N/A Inexperienced Limited Experience Experienced Highly Experienced Leopold's Maneuvers :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assess for Clonus :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assessment of Response to Pain Management Interventions :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assess for Edema :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assessment of Pain Level :* N/A Inexperienced Limited Experience Experienced Highly Experienced Identify, Document & Treat Abnormal FHR Patterns* N/A Inexperienced Limited Experience Experienced Highly Experienced Baseline :* N/A Inexperienced Limited Experience Experienced Highly Experienced Early Decelerations :* N/A Inexperienced Limited Experience Experienced Highly Experienced Late Decelerations :* N/A Inexperienced Limited Experience Experienced Highly Experienced Prolonged Decelerations :* N/A Inexperienced Limited Experience Experienced Highly Experienced Variable Decelerations :* N/A Inexperienced Limited Experience Experienced Highly Experienced Sinusoidal Pattern :* N/A Inexperienced Limited Experience Experienced Highly Experienced Variability :* N/A Inexperienced Limited Experience Experienced Highly Experienced Equipment and Procedures During Labor* N/A Inexperienced Limited Experience Experienced Highly Experienced Start and Maintain IV :* N/A Inexperienced Limited Experience Experienced Highly Experienced Administer Blood/Blood Products :* N/A Inexperienced Limited Experience Experienced Highly Experienced Amnioinfusion (Assist or Perform) :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist Artificial Rupture of Membranes (AROM) :* N/A Inexperienced Limited Experience Experienced Highly Experienced Bladder Catheterization :* N/A Inexperienced Limited Experience Experienced Highly Experienced Collect Blood/Urine Specimens :* N/A Inexperienced Limited Experience Experienced Highly Experienced Collect Vaginal Cultures :* N/A Inexperienced Limited Experience Experienced Highly Experienced Recognize Complications of AROM :* N/A Inexperienced Limited Experience Experienced Highly Experienced Fetal Monitoring* N/A Inexperienced Limited Experience Experienced Highly Experienced External :* N/A Inexperienced Limited Experience Experienced Highly Experienced Internal (Intrauterine Pressure Catheter - IUPC)-Placement :* N/A Inexperienced Limited Experience Experienced Highly Experienced Internal (Intrauterine Pressure Catheter - IUPC)-Monitoring :* N/A Inexperienced Limited Experience Experienced Highly Experienced Spiral Electrode Placement :* N/A Inexperienced Limited Experience Experienced Highly Experienced Spiral Electrode Monitoring:* N/A Inexperienced Limited Experience Experienced Highly Experienced DELIVERY MANAGEMENTDelivery Table Set Up :* N/A Inexperienced Limited Experience Experienced Highly Experienced Circulate Vaginal Delivery :* N/A Inexperienced Limited Experience Experienced Highly Experienced Circulate C-Section :* N/A Inexperienced Limited Experience Experienced Highly Experienced Scrub C-Section :* N/A Inexperienced Limited Experience Experienced Highly Experienced Circulate Tubal Ligation :* N/A Inexperienced Limited Experience Experienced Highly Experienced Scrub Tubal Ligation :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with Infant Delivery :* N/A Inexperienced Limited Experience Experienced Highly Experienced Radiant Warmer :* N/A Inexperienced Limited Experience Experienced Highly Experienced Neonatal Management* N/A Inexperienced Limited Experience Experienced Highly Experienced APGAR Scores :* N/A Inexperienced Limited Experience Experienced Highly Experienced Neonatal Vital Signs :* N/A Inexperienced Limited Experience Experienced Highly Experienced Neonatal Resuscitation :* N/a Inexperienced Limited Experience Experienced Highly Experienced Nasopharyngeal Suctioning :* N/A Inexperienced Limited Experience Experienced Highly Experienced Oropharyngeal Suctioning :* N/A Inexperienced Limited Experience Experienced Highly Experienced Bulb Syringe Suction:* N/A Inexperienced Limited Experience Experienced Highly Experienced COMPLICATIONSCare of the Patient with* N/A Inexperienced Limited Experience Experienced Highly Experienced Abruptio Placenta :* N/A Inexperienced Limited Experience Experienced Highly Experienced Asthma :* N/A Inexperienced Limited Experience Experienced Highly Experienced Cardiac disease :* N/A Inexperienced Limited Experience Experienced Highly Experienced Chorioamnionitis :* N/A Inexperienced Limited Experience Experienced Highly Experienced Chronic Hypertension :* N/A Inexperienced Limited Experience Experienced Highly Experienced Diabetes :* N/A Inexperienced Limited Experience Experienced Highly Experienced Pregnancy Induced Hypertension :* N/A Inexperienced Limited Experience Experienced Highly Experienced HELLP :* N/A Inexperienced Limited Experience Experienced Highly Experienced Hemolytic Anemia :* N/A Inexperienced Limited Experience Experienced Highly Experienced Hemorrhage :* N/A Inexperienced Limited Experience Experienced Highly Experienced HIV Positive :* N/A Inexperienced Limited Experience Experienced Highly Experienced HBV Disease :* N/A Inexperienced Limited Experience Experienced Highly Experienced Malpresentations :* N/A Inexperienced Limited Experience Experienced Highly Experienced Multiple Gestation :* N/A Inexperienced Limited Experience Experienced Highly Experienced Placenta Previa :* N/A Inexperienced Limited Experience Experienced Highly Experienced Pre-Term Labor :* N/A Inexperienced Limited Experience Experienced Highly Experienced Pyelonephritis :* N/A Inexperienced Limited Experience Experienced Highly Experienced Fetal Demise :* N/A Inexperienced Limited Experience Experienced Highly Experienced RH Disease :* N/A Inexperienced Limited Experience Experienced Highly Experienced Sickle Cell Disease:* N/A Inexperienced Limited Experience Experienced Highly Experienced MEDICATIONSCervical Ripening Agents :* N/A Inexperienced Limited Experience Experienced Highly Experienced Magnesium Sulfate :* N/A Inexperienced Limited Experience Experienced Highly Experienced Oxytocin :* N/A Inexperienced Limited Experience Experienced Highly Experienced Narcotics :* N/A Inexperienced Limited Experience Experienced Highly Experienced Antibiotics :* N/A Inexperienced Limited Experience Experienced Highly Experienced Antihypertensives :* N/A Inexperienced Limited Experience Experienced Highly Experienced Heparin :* N/A Inexperienced Limited Experience Experienced Highly Experienced Terbutaline :* N/A Inexperienced Limited Experience Experienced Highly Experienced Terbutaline :* N/A Inexperienced Limited Experience Experienced Highly Experienced Insulin :* N/A Inexperienced Limited Experience Experienced Highly Experienced Ritodrine:* N/A Inexperienced Limited Experience Experienced Highly Experienced SPECIAL PROCEDURESConduct Stress Test :* N/A Inexperienced Limited Experience Experienced Highly Experienced Conduct Non-Stress Test :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with External Version :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with Percutaneous Umbilical Sampling :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with Sonogram :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assist with Umbilical Blood Sampling :* N/A Inexperienced Limited Experience Experienced Highly Experienced Use of Nitrazine/Fern Test:* N/A Inexperienced Limited Experience Experienced Highly Experienced PAIN MANAGEMENTMonitor and Assist with* N/A Inexperienced Limited Experience Experienced Highly Experienced Epidural Anesthesia :* N/A Inexperienced Limited Experience Experienced Highly Experienced General Anesthesia :* N/A Inexperienced Limited Experience Experienced Highly Experienced Local Anesthesia :* N/A Inexperienced Limited Experience Experienced Highly Experienced Spinal Anesthesia:* N/A Inexperienced Limited Experience Experienced Highly Experienced POST PARTUM CARECare of the Post Partum Patient with HIV :* N/A Inexperienced Limited Experience Experienced Highly Experienced Infectious disease :* N/A Inexperienced Limited Experience Experienced Highly Experienced Multiple Births :* N/A Inexperienced Limited Experience Experienced Highly Experienced Pregnancy Induced Hypertension (PIH) :* N/A Inexperienced Limited Experience Experienced Highly Experienced Seizures :* N/A Inexperienced Limited Experience Experienced Highly Experienced Substance Abuse :* N/A Inexperienced Limited Experience Experienced Highly Experienced Post Anesthesia Care* N/A Inexperienced Limited Experience Experienced Highly Experienced Epidural/Epidural Morphine :* N/A Inexperienced Limited Experience Experienced Highly Experienced General :* N/A Inexperienced Limited Experience Experienced Highly Experienced Local :* N/A Inexperienced Limited Experience Experienced Highly Experienced Spinal :* N/A Inexperienced Limited Experience Experienced Highly Experienced Breastfeeding* N/A Inexperienced Limited Experience Experienced Highly Experienced Breast Care :* N/A Inexperienced Limited Experience Experienced Highly Experienced Breast Milk Collection and Storage :* N/A Inexperienced Limited Experience Experienced Highly Experienced Breast Pump :* N/A Inexperienced Limited Experience Experienced Highly Experienced Latch Score :* N/A Inexperienced Limited Experience Experienced Highly Experienced Tube at Breast :* N/A Inexperienced Limited Experience Experienced Highly Experienced Finger Feeding :* N/A Inexperienced Limited Experience Experienced Highly Experienced Teach & Assist with* N/A Inexperienced Limited Experience Experienced Highly Experienced Contraceptive Counseling :* N/A Inexperienced Limited Experience Experienced Highly Experienced Infant Care Restraint Systems :* N/A Inexperienced Limited Experience Experienced Highly Experienced Infant Caretaking Skills :* N/A Inexperienced Limited Experience Experienced Highly Experienced Perineal Care :* N/A Inexperienced Limited Experience Experienced Highly Experienced Discharge Planning:* N/A Inexperienced Limited Experience Experienced Highly Experienced NORMAL NEONATAL CAREAssessment* N/A Inexperienced Limited Experience Experienced Highly Experienced Ballard Scale/Dubowitz :* N/A Inexperienced Limited Experience Experienced Highly Experienced Infant Measurement :* N/A Inexperienced Limited Experience Experienced Highly Experienced Reflexes :* N/A Inexperienced Limited Experience Experienced Highly Experienced Jaundice :* N/A Inexperienced Limited Experience Experienced Highly Experienced Respiratory Distress :* N/A Inexperienced Limited Experience Experienced Highly Experienced Infant Vital Signs :* N/A Inexperienced Limited Experience Experienced Highly Experienced Bowel and Bladder Patterns :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assessment of Pain in Neonate :* N/A Inexperienced Limited Experience Experienced Highly Experienced Assessment of Response to Pain Management Interventions :* N/A Inexperienced Limited Experience Experienced Highly Experienced Interpretation of Lab Results* N/A Inexperienced Limited Experience Experienced Highly Experienced Bilirubin :* N/A Inexperienced Limited Experience Experienced Highly Experienced Blood Cultures :* N/A Inexperienced Limited Experience Experienced Highly Experienced Blood Glucose :* N/A Inexperienced Limited Experience Experienced Highly Experienced Neonatal CBC/Interpretation for Sepsis :* N/A Inexperienced Limited Experience Experienced Highly Experienced Transcutaneous Bilirubin :* N/A Inexperienced Limited Experience Experienced Highly Experienced Equipment & Procedures* N/A Inexperienced Limited Experience Experienced Highly Experienced Bulb Syringe :* N/A Inexperienced Limited Experience Experienced Highly Experienced Circumcision Care/Teach to Parents :* N/a Inexperienced Limited Experience Experienced Highly Experienced Cord Care/Teach to Parents :* N/A Inexperienced Limited Experience Experienced Highly Experienced Heelstick :* N/A Inexperienced Limited Experience Experienced Highly Experienced IM/Subcutaneous Injections :* N/A Inexperienced Limited Experience Experienced Highly Experienced Immunizations :* N/A Inexperienced Limited Experience Experienced Highly Experienced Infant Identification/Security :* N/A Inexperienced Limited Experience Experienced Highly Experienced Neonatal CPR :* N/A Inexperienced Limited Experience Experienced Highly Experienced Obtain Cultures :* N/A Inexperienced Limited Experience Experienced Highly Experienced Obtain Specimens for Drug Screen :* N/A Inexperienced Limited Experience Experienced Highly Experienced Obtain Urine/Stool Specimens :* N/A Inexperienced Limited Experience Experienced Highly Experienced Phototherapy :* N/A Inexperienced Limited Experience Experienced Highly Experienced Thermoregulation:* N/A Inexperienced Limited Experience Experienced Highly Experienced MISCELLANEOUSNational Patient Safety Goals :* N/A Inexperienced Limited Experience Experienced Highly Experienced Restraint Use and Documentation :* N/A Inexperienced Limited Experience Experienced Highly Experienced Preceptor Experience :* N/A Inexperienced Limited Experience Experienced Highly Experienced Charge Experience :* N/A Inexperienced Limited Experience Experienced Highly Experienced Pyxis Medication Admin. System :* N/a Inexperienced Limited Experience Experienced Highly Experienced Other Medication Admin. System :* N/A Inexperienced Limited Experience Experienced Highly Experienced Computerized Charting* N/A Inexperienced Limited Experience Experienced Highly Experienced Cerner :* N/A Inexperienced Limited Experience Experienced Highly Experienced Eclipsys :* N/A Inexperienced Limited Experience Experienced Highly Experienced Epic :* N/A Inexperienced Limited Experience Experienced Highly Experienced GE :* N/A Inexperienced Limited Experience Experienced Highly Experienced McKesson :* N/A Inexperienced Limited Experience Experienced Highly Experienced Other:* N/A Inexperienced Limited Experience Experienced Highly Experienced My experience is primarily in the following settingsLabor & Delivery: Deliveries Labor & Delivery: Month LDRP: Deliveries LDRP: Month Antepartum: Deliveries Antepartum: Month Mother/Baby: Deliveries Mother/Baby: Month LD-OR: Deliveries LD-OR: Month Other: Deliveries Other: Month Certifications/Licensures/Registrations:ACLS: MM slash DD slash YYYY BLS: MM slash DD slash YYYY AWHONN Fetal Monitoring - Intermediate: MM slash DD slash YYYY AWHONN Fetal Monitoring - Advanced: MM slash DD slash YYYY Other MM slash DD slash YYYY NRP: MM slash DD slash YYYY S.T.A.B.L.E.: MM slash DD slash YYYY Areas of Expertise:Consent* By submitting this form, I agree to all terms and conditions and agree to authorize consent PhoneThis field is for validation purposes and should be left unchanged.