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Date
* Applicant's Name: Last
Middle Initial
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To ArdorHealthSolutions Healthcare Professionals:
The following checklist is a profile used to assess your clinical proficiency and assist in matching your skills with available assignments. Your employment is not dependent upon responses given in this checklist. Please rate your ability as accurately as possible by checking the appropriate box.
The information I have given here is true and accurate to the best of my knowledge. In addition, I also authorize ArdorHealthSolutions to release this skills checklist to client institutions of ArdorHealthSolutions in relation to my employment with that institution.
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Please Mark Your Level of Experience 1 - No Experience: Theory / Observed Only 2 - Intermittent Experience: < 5 Times Per Year; Needs Review 3 - Moderate Experience: > 5 Times Per Year; May Need Minimal Resource 4 - Competent: Performs on Daily or Weekly Basis; Proficient
General Obstetrical Management
1
2
3
4
Assessment of Labor:
Assess for Risk Factors
Cervical Dilation and Changes
Cervical Effacement and Changes
Duration of Contractions
Identity of Fetal Part
Obtain OB History
Psychological/Behavioral Status of Patient
Quality of Contractions
Station of Presenting Part
Amnioinfusion
Collection of Cultures
Epidural Catheter Placement
Antepartum Care
Preterm Labor
Premature Rupture of Membranes
Pylonephritis
Hyperemesis Gravidarum
Assist with Interventions During Labor
Assist/Monitor those Requiring Special Surveillance:
General Anesthesia
Regional Anesthesia:
Epidural
Local Infiltration
Spinal
Cesarean Section
Delivering a Birthing Room Setting
Forceps Vaginal Delivery/Vacuum Extraction Delivery
Initiate Emergency Measures
Knowledgeable of S/S of Infant Distress
Labor Room Delivery
Spontaneous Vaginal Delivery
Interventions During Labor
Administer Analgesics
Change Woman's Position, PRN
Coach in Relaxation Techniques and Psychoprophylactic Breathing
Do a Perineal Prep
Guide and Support Labor Coach
Initiate Emergency Protocols
Monitor Fluid Status
Provide Care and Monitor After Rupture of Membranes (Spontaneous or Artificial)
Provide Emotional Support
Provide Physical Comfort Measures
Intrapartum Care of Women With
Asthma
Cardiac Disease
Cystitis
Diabetes Mellitus
Drug Abuse
Eclampsia (seizures)
Hemorrhage
Hypotension from Regional Anesthesia
Infectious Disease:
Group Beta Strep
Hepatitis B
Hepatitis C
Herpes
HIV
Malpresentations
Multiple Gestation
Patient with History of Substance Abuse
Pregnancy-Induced Hypertension
Preeclampsia
Placenta Previ
Premature Labor
Prolapsed Cord
Rh Incompatibilities
Sickle Cell Crisis
Trauma (MVA)
Medication Administration
Administer from a Stock Medication System
Administer IM, SC Medications (i.e., Narcotics)
Monitor IV Drips:
Cervical Ripening Agents:
Cervidil
Cytotec
Prostaglandin
Insulin
Labor Suppressants:
MgSo4
Ritodrine
Terbutalene
MgSo4 for Pre-eclampsia
Oxytocin Induction/Augmentation/Prostaglandin
Induction
Use a Unit Dose System
Use of Patient Controlled Analgesia Pump
Phlebotomy/IV Therapy
Draw Blood:
Aterial Stick
Central Line
Venous Stick
Discontinue Peripheral IVs
Initiate and Monitor Blood / Blood Products
Measure CVP Readings
Mix IV Infusion Using Additives
Use IV Infusion Pumps
Use Heparin Locks
Patient Controlled Analgesia
Regulate IV's
Start IV Lines
Postpartum Assessment
Accurate Assessment and Documentation of:
Amount & Character of Loch
Bladder Status
Cesarean
Episiotomy
Fundal Consistency & Height
Incision
Post Anesthesia Assessment Score
Postpartum Intervention
Assess/Foster Parent-Infant Bonding
Assist with Initial Attempts with Breast Feeding at/after Delivery
Bladder Care
Bowel Care
Breast Care
