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COLLEGE OF NURSING
ROXAS CITY, PHILIPPINES
Tele- Fax No. 6213- 075/ Email: fcc_registrar@yahoo.com
____________________________________________ ____________________________________________
Clinical Instructor Clinical Coordinator
License Number: ____________________________ License Number: ____________________________
PRC Card - Validity Date: ______________________ PRC Card - Validity Date: ______________________
____________________________________________
DEAN ____________________________________________
License Number: ____________________________ Academic Year Graduated
PRC Card - Validity Date: ______________________
FILAMER CHRISTIAN UNIVERSITY
COLLEGE OF NURSING
ROXAS CITY, PHILIPPINES
Tele- Fax No. 6213- 075/ Email: fcc_registrar@yahoo.com
____________________________________________ ____________________________________________
Clinical Instructor Clinical Coordinator
License Number: ____________________________ License Number: ____________________________
PRC Card - Validity Date: ______________________ PRC Card - Validity Date: ______________________
____________________________________________
DEAN ____________________________________________
License Number: ____________________________ Academic Year Graduated
PRC Card - Validity Date: ______________________
FILAMER CHRISTIAN UNIVERSITY
COLLEGE OF NURSING
ROXAS CITY, PHILIPPINES
Tele- Fax No. 6213- 075/ Email: fcc_registrar@yahoo.com
DESIRED ACTUAL
INTRAPARTAL COMPETENCIES AVERAGE
RATING RATING
I. SAFE AND QUALITY NURSING CARE (SQC)
1.Obtains obstetrical history including parity, gravida score, 4
LMP, EDC, AOG, BOW onset of true labor
2. Checks vital signs. 1
3. Conducts physical examination 2
4. Performs Leopold's maneuver. 2
5. Checks Fetal Heart Rate and Fundic Height 2
6. Monitor progress of labor/ uterine contractions as to:
• Frequency 1
• Duration 1
• Intensity 1
• Interval 1
7. Observes for the timely rupture of membrane. 1
8. Coaches mother on process of labor. 2
PERFORMS FUNCTIONS DURING ACTUAL LABOR
1. Transports clients safety while providing privacy. 1
2. Places mother in lithotomy position. 1
3. Performs perineal care using sterile technique correctly. 1
4. Performs proper hand scrub. 1
5. Wears gown and gloves accoring to hospital policy. 1
6. Performs Ritgen's maneuver safely. 2
7. Coaches mother on breathing and pushing techniques. 1
8. Delivers baby and placenta carefully.
• Checks and manages cord recoil correctly 1
• Clamps and cuts the cord correctly 1
• Identify signs of placental separation 1
• Checks the characteristics/ completeness of the placenta 1
9. Assesses amount of blood loss (Normal: <500 cc) 2
10. Employs interventions to achieve and maintain a well
contracted uterus to prevent/ control hemorrhage.
• Uterine massage 1
• Correct administration of oxytocin 1
• Cold compress 1
11. Assesses presence and degree of laceration. 1
12. Assists in episiorrhaphy. 1
13. Checks size, consistency and location of uterus. 1
INTRAPARTAL COMPETENCIES
14. Performs perineal care and applies pad correctly 1
15. Provides emotional support to the mother throughout labor 1
and delivery.
16. Evaluates patient's condition and records pertinent data 2
accordingly
17. Prepares patient for transfer to recovey room/ ward. 1
II. MANAGEMENT OF RESOURCES, ENVIRONMENT AND EQUIPMENT (MRE)
1. Prepares room, instruments and equipment needed.
• Sterile drape 1
• Sterile instruments and equipment (Forceps, scissors, bulb 1
syringe, gauze, suture, needle holder, catheter (optional)
• Kelly pad 1
• Disinfectant 1
2. Performs sterilization procedure 1
3. Maintains adequacy of supplies as the delivery progresses. 1
4. Maintains orderliness of the sterile table. 1
5. Observes precautionary measures related to use of electrical 1
equipment.
6. Ensures a quiet environment 1
7. Uses supplies diligently 1
8. Performs after care of the materials and equipments used. 1
9. Ensures proper disposal of hispital waste including blood 1
and other fluids.
III. HEALTH EDUCATION (HE)
1. Teachers client on basic preparation during labor and 1
deliver can be done in the labor room)
2. Coaches' client on breathing/ bearing down feeding technique 2
3. Demonstrates proper "latch-on" breast feeding technique 1
(done post- partum period.)
4. Gives instructions to parents regarding infant care before 1
discharge (done post- partum period.)
5. Provides discharge instructions as to feeding, bathing, 1
administration of ordered medications, appointment dates
for post natal and well baby check up (done post- partum
period)
6. Responds to questions of clients and relatives regarding 1
expectations.
IV. LEGAL RESPONSIBILITIES (LR)
1. Secures informed consent in all procedures related to labor 1
and delivery
2. Reports accurately and honestly the gender, time of 2
delivery of the baby and placenta.
3. Ensures proper identification of the mother and newborn 2
4. Documents all pertinent data correctly and completely. 1
V. ETHICO- MORAL RESPONSIBILITIES (EMR)
1. Respects the religious, cultural and ethnic practices of the 1
family iof the woman in labor and delivery.
2. Promotes emotional security by supporting needs. 1
3. Ensures privacy and confidentiality 1
VI. PERSONAL AND PROFESSIONAL DEVELOPMENT (PPD)
1. Updates oneself with the latest trends and development in 1
labor and delivery.
2. Projects a professional image of a delivery room nurse. 1
3. Accepts critisms and recommendations. 1
4. Performs functions according to standards. 1
VII. QUALITY IMPROVEMENT (QI) (PREFERABLY DONE DURING POST CONFERENCES)
1. Identifies deviation of practice from the standards. 1
2. Participates in audit practices in the delivery room/ lying in. 1
3. Recommends corrective and preventive measures for the 1
identified deviations
VIII. RESEARCH (R ) (PREFERABLY DONE DURING POST CONFERENCES)
1. Identifies researchable problems related to labor and 2
deliverably
2. Utilize findings of research studies in intra- partal care. 2
IX. RECORDS MANAGEMENT N(RM)
1. Documents accurately relevant data about client. 1
2. Maintains an organized system of filing and keeping 1
records of the client.
X. COMMUNICATION (Comm)
1. Utilizes appropriately all forms of communication, verbal, 1
non- verbal, electronic
2. Inform client's significant others of the progress of labor and 1
delivery.
3. Listens attentively to clients and families queries and 1
requests.
XI. COLLABORATION AND TEAMWORK (CTW)
1. Functions effectively as a team player in the delivery 1
room/ lying in.
2. Communicates the progress of labor/ delivery to significant 1
others
3. Establishes collaborative relationship with members of the 1
health team and family members.
TOTAL SCORES: 90
EQUIVALENT GRADE: 100
____________________________________________ ____________________________________________
Clinical Instructor Clinical Coordinator
License Number: ____________________________ License Number: ____________________________
PRC Card - Validity Date: ______________________ PRC Card - Validity Date: ______________________
____________________________________________
DEAN ____________________________________________
License Number: ____________________________ Academic Year Graduated
PRC Card - Validity Date: ______________________
__________
__________
FILAMER CHRISTIAN UNIVERSITY
COLLEGE OF NURSING
ROXAS CITY, PHILIPPINES
Tele- Fax No. 6213- 075/ Email: fcc_registrar@yahoo.com
DESIRED ACTUAL
INTRAPARTAL COMPETENCIES AVERAGE
RATING RATING
I. SAFE AND QUALITY NURSING CARE (SQC)
1.Obtains obstetrical history including parity, gravida score, 4
LMP, EDC, AOG, BOW onset of true labor
2. Checks vital signs. 1
3. Conducts physical examination 2
4. Performs Leopold's maneuver. 2
5. Checks Fetal Heart Rate and Fundic Height 2
6. Monitor progress of labor/ uterine contractions as to:
• Frequency 1
• Duration 1
• Intensity 1
• Interval 1
7. Observes for the timely rupture of membrane. 1
8. Coaches mother on process of labor. 2
PERFORMS FUNCTIONS DURING ACTUAL LABOR
1. Transports clients safety while providing privacy. 1
2. Places mother in lithotomy position. 1
3. Performs perineal care using sterile technique correctly. 1
4. Performs proper hand scrub. 1
5. Wears gown and gloves accoring to hospital policy. 1
6. Performs Ritgen's maneuver safely. 2
7. Coaches mother on breathing and pushing techniques. 1
8. Delivers baby and placenta carefully.
• Checks and manages cord recoil correctly 1
• Clamps and cuts the cord correctly 1
• Identify signs of placental separation 1
• Checks the characteristics/ completeness of the placenta 1
9. Assesses amount of blood loss (Normal: <500 cc) 2
10. Employs interventions to achieve and maintain a well
contracted uterus to prevent/ control hemorrhage.
• Uterine massage 1
• Correct administration of oxytocin 1
• Cold compress 1
11. Assesses presence and degree of laceration. 1
12. Assists in episiorrhaphy. 1
13. Checks size, consistency and location of uterus. 1
INTRAPARTAL COMPETENCIES
14. Performs perineal care and applies pad correctly 1
15. Provides emotional support to the mother throughout labor 1
and delivery.
16. Evaluates patient's condition and records pertinent data 2
accordingly
17. Prepares patient for transfer to recovey room/ ward. 1
II. MANAGEMENT OF RESOURCES, ENVIRONMENT AND EQUIPMENT (MRE)
1. Prepares room, instruments and equipment needed.
• Sterile drape 1
• Sterile instruments and equipment (Forceps, scissors, bulb 1
syringe, gauze, suture, needle holder, catheter (optional)
• Kelly pad 1
• Disinfectant 1
2. Performs sterilization procedure 1
3. Maintains adequacy of supplies as the delivery progresses. 1
4. Maintains orderliness of the sterile table. 1
5. Observes precautionary measures related to use of electrical 1
equipment.
6. Ensures a quiet environment 1
7. Uses supplies diligently 1
8. Performs after care of the materials and equipments used. 1
9. Ensures proper disposal of hispital waste including blood 1
and other fluids.
III. HEALTH EDUCATION (HE)
1. Teachers client on basic preparation during labor and 1
deliver can be done in the labor room)
2. Coaches' client on breathing/ bearing down feeding technique 2
3. Demonstrates proper "latch-on" breast feeding technique 1
(done post- partum period.)
4. Gives instructions to parents regarding infant care before 1
discharge (done post- partum period.)
5. Provides discharge instructions as to feeding, bathing, 1
administration of ordered medications, appointment dates
for post natal and well baby check up (done post- partum
period)
6. Responds to questions of clients and relatives regarding 1
expectations.
IV. LEGAL RESPONSIBILITIES (LR)
1. Secures informed consent in all procedures related to labor 1
and delivery
2. Reports accurately and honestly the gender, time of 2
delivery of the baby and placenta.
3. Ensures proper identification of the mother and newborn 2
4. Documents all pertinent data correctly and completely. 1
V. ETHICO- MORAL RESPONSIBILITIES (EMR)
1. Respects the religious, cultural and ethnic practices of the 1
family iof the woman in labor and delivery.
2. Promotes emotional security by supporting needs. 1
3. Ensures privacy and confidentiality 1
VI. PERSONAL AND PROFESSIONAL DEVELOPMENT (PPD)
1. Updates oneself with the latest trends and development in 1
labor and delivery.
2. Projects a professional image of a delivery room nurse. 1
3. Accepts critisms and recommendations. 1
4. Performs functions according to standards. 1
VII. QUALITY IMPROVEMENT (QI) (PREFERABLY DONE DURING POST CONFEREN
1. Identifies deviation of practice from the standards. 1
2. Participates in audit practices in the delivery room/ lying in. 1
3. Recommends corrective and preventive measures for the 1
identified deviations
VIII. RESEARCH (R ) (PREFERABLY DONE DURING POST CONFERENCES)
1. Identifies researchable problems related to labor and 2
deliverably
2. Utilize findings of research studies in intra- partal care. 2
IX. RECORDS MANAGEMENT N(RM)
1. Documents accurately relevant data about client. 1
2. Maintains an organized system of filing and keeping 1
records of the client.
X. COMMUNICATION (Comm)
1. Utilizes appropriately all forms of communication, verbal, 1
non- verbal, electronic
2. Inform client's significant others of the progress of labor and 1
delivery.
3. Listens attentively to clients and families queries and 1
requests.
XI. COLLABORATION AND TEAMWORK (CTW)
1. Functions effectively as a team player in the delivery 1
room/ lying in.
2. Communicates the progress of labor/ delivery to significant 1
others
3. Establishes collaborative relationship with members of the 1
health team and family members.
TOTAL SCORES: 90
EQUIVALENT GRADE: 100
____________________________________________ ____________________________________________
Clinical Instructor Clinical Coordinator
License Number: ____________________________ License Number: ____________________________
PRC Card - Validity Date: ______________________ PRC Card - Validity Date: ______________________
____________________________________________
DEAN ____________________________________________
License Number: ____________________________ Academic Year Graduated
PRC Card - Validity Date: ______________________
_______________
_____________
_____________
_______________
FILAMER CHRISTIAN UNIVERSITY
COLLEGE OF NURSING
ROXAS CITY, PHILIPPINES
Tele- Fax No. 6213- 075/ Email: fcc_registrar@yahoo.com
DESIRED ACTUAL
NEWBORN COMPETENCIES AVERAGE
RATING RATING
I. SAFE AND QUALITY NURSING CARE (SQC)
1. Establishes and maintains patent airway 3
2. Puts the newborn in Trendelenburg position. 1
3. Suctions mouth and nose of the newborn gently. 2
4. Dries newborn and wraps warmly. 1
• Places under droplight as needed.
5. Performs and interprets APGAR scoring correctly
• Immediately after delivery 2
• After 5 minutes 2
6. Ensures proper identification of newboen (name tag: name of mother, daate and time 2
of delivery, gender and name of attending physician).
7. Performs physical assessment including anthropometric measurements including 4
weight, height, head, chest, abdominal circumference.
8. Takes vital signs (temperature per rectum to check patency) 1
9. Gives oil/ water and soap bath according to institutional policy. 1
10. Latches newborn to the mother's breast immediately after birth 1
11. Applies CREDE's prophylaxis on the eyes. 1
12 Performs cord dressing aseptically.
• Disinfects area properly according to hospital policy 1
• Clamps and cuts cord 1 inch from the abdomen 1
• Checks for the presence of 2 arteries and 1 vein 1
• Dresses cord aseptically according hospital policy 1
13. Administers Vitamin K (1 mg/M) into the lateral anterior thigh or vastus lateralis. 1
14. Keeps baby wrapped warmly under floor lamp or beside mother according to 1
institutional policy until discharge.
15. Records pertinent observations and nursing care done. 1
16. Reports any signs of deviation/ abnormality to the pediatrician. 1
II. MANAGEMENT OF RESOURCES, ENVIRONMENT AND EQUIPMENT (MRE)
1. Prepares instrument and equipment needed
• Suction bulb, cord clamp, gauze, cotton balls, disinfectant, blanket, drop light, 4
Vitamin K, antimicrobial opthalmic ointment.
2. Ensures use of sterile equipment during immediate care of the newborn. 1
3. Maintain adequacy of supplies as newborn care is rendered 1
4. Maintains orderliness of the working area. 1
5. Observes precautionary measures related to use of electrical equipment. 1
6. Ensures a warm and quiet environment. 1
7. Uses supplies diligently 1
8. Ensures proper disposal of hospital waste. 1
III. HEALTH EDUCATION (HE)
1. Provides instructions to the mother on daily cord care and prevention of cord infection. 2
2. Provides discharge instructions to the mother on when to expect cord to fall off or to 1
report signs of cord infection.
3. Provides information regarding newborn screening, immunization, feeding, etc. 2
4. Responds to questions of mother and relatives regarding expectations 1
IV. LEGAL RESPONSIBILITIES (LR)
1. Identifies newborn by comparing ID band with data in the chart. 2
2. Documents all pertinent data correctly and completely. 1
3. Reports accurately any deviations/ abnormal findings and nursing interventions 1
rendered.
4. Ensures that birth certificate and other civil registration forms are accomplished/ filled 2
out according to institutional policy.
5. Performs foot printing according to hospital policy. 1
V. ETHICO- MORAL RESPONSIBILITIES (EMR)
1. Respects the religious, cultural and ethnic practices of the family of the newborn. 1
2. Maintains privacy and confidentiality of findings of assessments. 1
VI. PERSONAL AND PROFFESIONAL DEVELOPMENT (PPD)
1. Updates oneself with the latest trends and developments in newborn care. 1
2. Projects a professional image of the pediatric nurse. 1
3. Accepts criticisms and recommendations 1
4. Performs functions according to standards. 1
VII. QUALITY IMPROVEMENT (QI)
1. Identifies deviation of practice from the standards. 1
2. Participates (whenever possible) in audit practices in the nursery. 1
3. Recommends corrective and preventive measures for the identified deviations. 1
VIII. RESEARCH (R )
1. Identifies researchable problems related to immediate care of newborn. 2
2. Utilizes findings of research studies in the immediate care of the newborn 2
IX. RECORDS MANAGEMENT (RM)
1. Documents accurately relevant data about the newborn 1
2. Maintains an organized system of filing and record keeping. 1
X. COMMUNICATION (Comm)
1. Utilizes approriately all forms of communication; verbal, non-verbal, electronic. 1
2. Maintains an open line of communication with the mother and other family members. 1
3. Informs mother of relevant information about the newborn. 1
4. Listens attentively to queries and request of mothers and family members. 1
XI. COLLABORATION AND TEAMWORK (CTM)
1. Functions affectively as a team player in thr nursery. 1
2. Communications findings of assessment to all concerned. 1
3. Establishes a collaborative relationship with members of the health team and family of 1
the newborn.
TOTAL SCORE: 75
EQUIVALENT GRADE: 100
____________________________________________ ___________________________________
Clinical Instructor Clinical Coordinator
License Number: ____________________________ License Number: ______________________
PRC Card - Validity Date: ______________________ PRC Card - Validity Date:________________
____________________________________________
DEAN ____________________________________
License Number: ____________________________ Academic Year Graduated
PRC Card - Validity Date: ______________________