LABOR & DELIVERY SKILLS EVALUATION - Page 3
LABOR & DELIVERY SKILLS EVALUATION - Page 3
Personal Information
Name
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First
Last
Title / Specialty
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Email
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Phone
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Pregnancy - Care of Patient
Indomethacin
Experienced
Limited Experience
No Experience
Insulin
Experienced
Limited Experience
No Experience
Magnesium sulfate
Experienced
Limited Experience
No Experience
Procardia
Experienced
Limited Experience
No Experience
Ritodrine
Experienced
Limited Experience
No Experience
Terbutaline - IV
Experienced
Limited Experience
No Experience
Terbutaline - PO
Experienced
Limited Experience
No Experience
Terbutaline - Pump
Experienced
Limited Experience
No Experience
Terbutaline - SC
Experienced
Limited Experience
No Experience
Cesarean section
Experienced
Limited Experience
No Experience
Forceps vaginal delivery
Experienced
Limited Experience
No Experience
Pregnancy - Interventions / Monitor Patients with Anesthesia
General
Experienced
Limited Experience
No Experience
Epidural
Experienced
Limited Experience
No Experience
Local
Experienced
Limited Experience
No Experience
Spinal
Experienced
Limited Experience
No Experience
Spontaneous vaginal delivery
Experienced
Limited Experience
No Experience
Vaccuum extraction delivery
Experienced
Limited Experience
No Experience
Pregnancy - Interventions / Pain Management
Assessment of pain level / tolerance
Experienced
Limited Experience
No Experience
Epidural analgesia
Experienced
Limited Experience
No Experience
IV conscious sedation
Experienced
Limited Experience
No Experience
Infant Interventions Post Delivery - Assessment
Apgar scoring
Experienced
Limited Experience
No Experience
Initial vital signs
Experienced
Limited Experience
No Experience
Intervention / risk factors for IDM
Experienced
Limited Experience
No Experience
Intervention / risk factors for LGA, SGA IUGR
Experienced
Limited Experience
No Experience
Infant Interventions Post Delivery - Newborn Physical Assessment
Ballard
Experienced
Limited Experience
No Experience
Dubowitz
Experienced
Limited Experience
No Experience
Finnegan scoring
Experienced
Limited Experience
No Experience
Suctioning
Bulb
Experienced
Limited Experience
No Experience
Delee
Experienced
Limited Experience
No Experience
Wall
Experienced
Limited Experience
No Experience
Identification
Bands
Experienced
Limited Experience
No Experience
Footprints
Experienced
Limited Experience
No Experience
Radiant warmer
Experienced
Limited Experience
No Experience
Age Specific Practice Criteria
Able to adapt care to incorporate normal growth and development
Newborn / Infant (0 - 30 Days)
School Age (6 - 12 Years)
Adolescent (13 - 18 Years)
Young Adult (19 - 40 Years)
Middle Adult (40 -64 Years)
Able to adapt method and terminology of patient instructions to age, comprehension and maturity level
Newborn / Infant (0 - 30 Days)
School Age (6 - 12 Years)
Adolescent (13 - 18 Years)
Young Adult (19 - 40 Years)
Middle Adult (40 -64 Years)
Able to ensure a safe environment to reflect needs and alter environment accordingly
Newborn / Infant (0 - 30 Days)
School Age (6 - 12 Years)
Adolescent (13 - 18 Years)
Young Adult (19 - 40 Years)
Middle Adult (40 -64 Years)
Able to administer medications appropriately and understand different meds, dosages and possible side effects
Newborn / Infant (0 - 30 Days)
School Age (6 - 12 Years)
Adolescent (13 - 18 Years)
Young Adult (19 - 40 Years)
Middle Adult (40 -64 Years)
