MATI DOCTORS COLLEGE College of Nursing Mati City EVALUATION FOR DELIVERY ROOM EXPERIENCE Name: Class: I.

KNOWLEDGE / COGNITIVE 4 4 4 4 4 4 4 Date of Experience: Rating: RATING 3 3 3 3 3 3 3 2 2 2 2 2 2 2 1 1 1 1 1 1 1

1. Identifies stages of labor basing on presenting sign and symptoms. 2. Identifies signs and symptoms of any abnormalities or complications in actual delivery 3. Anticipate problems with any abnormal responses/ reactions. 4. Identifies appropriate action/approach and correlate them to what is being anticipated as needs 5. Identifies criteria in formulating objectives. 6. Discuses comprehensively what to expect during labor such as: signs and symptoms of different stages uterine contraction (duration, interval, intensity, and frequency.) Bearing down sensation Procedure to be performed and importance (internal examination, Cauterization, Episiotomy and Episiorrhapy) 7. Interpret doctors orders correctly and correlate significant laboratory result 8. Identifies and interprets legal implication of proper documentation of nursing action given to the patients. 9. Anticipate discharge planning. 10. Monitors / evaluate laboring clients response to therapy and nursing intervention. II. SKILLS / PSYCHOMOTOR (40%)

4 4 4 4 4

3 3 3 3 3

2 2 2 2 2

1 1 1 1 1

1. Assess the laboring clients status 2. Gather pertinent data through observations, interview or other non-verbal documentation. 3. Formulate define and prioritize nursing problems and identify appropriate nursing actions. - Utilize appropriate plans and implements based on identified physical and psychological needs. 4. Admission of mother to the labor room: - Gather data completely - Provision of psychological support/ building of rapport 5. Coaches mother to do specific breathing exercise during specific stages of labor. 6. Labor watching - Vital sign monitoring - Leopold maneuver - FHB monitoring and assessing of fetal condition - Encourage mother to empty bladder regularly. - Promotes rest by minimizing disturbance of mother in between period of contraction - Monitoring uterine contraction - Assist in doing vaginal examination 7. Performs the following with due application of the nursing principals involved. - IVF infusion (assist during insertion and proper regulation - Catheterization - Skin testing - Drug administration

4 4

3 3

2 2

1 1

4 4 4 4 4 4 4 4 4 4 4 4 4 4 4

3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

8. Circulates during the actual delivery

Anticipate the needs of delivery team Observe and assesses the reaction of patients Performs perineal care aseptically Prepares all the material needed for delivery, including Some equipment, (crib, blanket, diaper, etc.) Performs after care of equipments in DR Promoting mother and child bonding through latching On (Early breastfeeding) for 20-30 minutes

4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4 4

3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

Calling a ward man - Perform environmental sanitation 9. Scrub during delivery - Identifies function and responsibilities - Observe correct gowning and gloving - Proper preparation of DR table instrument Material and equipment needed - Proper positioning of patient - Drapes aseptically and systematically - Anticipate need of doctors whos responsible during Delivery process - Notes the time of delivery - Care of Post-Partum patient/ instrument used (Includes identification of the following: - Height of fundus Conditions of fundus - Assists during Episiotomy repair 10. Evaluate effectiveness of nursing action and identifies remaining problems which still needs total care III. ASSETS ( 20 % ) 1. Abides with all institutional policies 2. Participate attentively and actively in all ward teaching and learning activities 3. Accepts nursing responsibilities with interest eagerness to work initiative, resourcefulness and creativity 4. Accepts constructive criticism and profit from it 5. Establish professionalism with co- students, patient, significant others and other members of the health team.

4 4 4 4 4

3 3 3 3 3

2 2 2 2 2

1 1 1 1 1

Total: ________________

_____________________________ Students Signature

_____________________________ Clinical Instructor Signature

Issue: 05 April 2006

Revision Code: 003