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Board of Nursing
Republic of the Philippines
Professional Regulation Commission
BOARD OF NURSING
www.bonphilippines.org
Telephone No. (+632) 735 1534 Fax No. (+632) 735 4476
ANNEX TO PRC-BON MEMORANDUM CIRCULAR NO. 01 Series 2009Subject ``` : New Intra-Partal, Immediate Care of the Newborn, andIntra-operative FormsApplicability : BSN Students and Graduates covered by CHED Memorandum OrderNo. 14, s. 2009
DESCRIPTION OF FORMSIn accordance with PRC-BoN Memorandum No. 01, series 2009 thefollowing forms shall be submitted to the Commission on Higher Education(CHED) by Nursing Colleges as evidence of obtaining Intra-Partal,Immediate Care of the Newborn, and Intra-Operative Care Competenciesby nursing students and graduates covered by CMO No. 14, s. 2009 for
purposes of securing “special orders” for graduation together with other
CHED requirements:
1.
Summary Performance Evaluation for Intra-Partal Care Competency2.
Summary Performance Evaluation for Immediate Care of the NewbornCompetency3.
Summary Performance Evaluation for Intra-Operative Care CompetencyKindly follow the new BoN Prescribed Performance Evaluation Forms as well asthe Student Summary CASE FORMs.The Case Forms may be printed back-to-back with the appropriate CompetencyPerformance Evaluation Forms or the school may choose to adopt separateprinting modes according to the discretion of the Nursing CollegeAdministration.For Intra-Operative Competencies there must be 3 scrub cases and 3circulating cases as per BoN Memorandum No. 1 series 2009.
Forms are to be accomplished in TRIPLICATE copies (1 for the CollegeRegistrar, 1 for CHED, 1 for the Student)
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Board of Nursing
BOARDOF NURSING
Hon. Carmencita M. AbaquinChairpersonHon. Leonila A. Faire Hon. Perla G. PoMember MemberHon. Betty F. Merritt Hon. Marco Antonio C. Sto TomasMember MemberHon. Yolanda C. Arugay Hon. Amelia B. RosalesMember Member
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Board of Nursing
_____________________________________________ UniversityCollege of Nursing(Exact Business Address, Tele-Fax No. and E-Mail Address)SUMMARY PERFORMANCE EVALUATION ACHIEVINGINTRA-PARTAL CARE COMPETENCY
In Accordance with PRC Board of Nursing Memorandum No. 01
Series 2009
Signature over Printed Name of Student: ___________________________________________
INTRAPARTAL COMPETENCIES
DESIREDRATINGACTUALRATING
I. SAFE AND QUALITY NURSING CARE (SQC)
1. Obtains obstetrical history including parity, gravida score,LMP, EDC, AOG, BOW onset of true labor.
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2. Checks vital signs.
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3. Conducts physical examination.
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4.
Performs Leopold’s maneuver.
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5. Checks Fetal Heart Rate and Fundic height.
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6. Monitor progress of labor/ uterine contractions as to:
Frequency
Duration
Intensity
Interval
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7. Observes for the timely rupture of membrane.
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8. Coaches mother on process of labor.
2PERFORMS FUNCTIONS DURING ACTUAL LABOR
1. Transports clients safely while providing privacy.
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2. Places mother in lithotomy position.
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3. Performs perineal care using sterile technique correctly.
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4. Performs proper hand scrub.
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5. Wears gown and gloves according to hospital policy.
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6.
Performs Ritgen’s maneuver safely.
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7. Coaches mother on breathing and pushing techniques.
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8. Delivers baby and placenta carefully.
Checks and manages cord recoil correctly
Clamps and cuts the cord correctly
Identify signs of placental separation
Checks the characteristic/ completeness of the placenta
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9. Assesses amount of blood loss (Normal: <500 cc)
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10. Employs interventions to achieve and maintain a wellcontracted uterus to prevent/control hemorrhage.
Uterine massage
Correct administration of oxytocin
Cold compress
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11. Assesses presence and degree of laceration.
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12. Assists in episiorrhaphy.
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13. Checks size, consistency and location of uterus.
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