COLEGIO DE DAGUPAN

Arellano St., Dagupan City

COLLEGE OF NURSING

CLINICAL TEACHING PLAN

DELIVERY ROOM
SECOND SEMESTER, A.Y. 2019-2020

Pre-entry Competencies of Students

Knowledge in: Theories of Labor

Premonitory Signs of Labor
Stages of Labor
Therapeutic communication
Basic nursing skills
Principles of medication during labor and delivery
Care for New Born
Postpartum Care for Mother and Child
Family Planning
DR instrumentation

Skills in: Surgical/Medical hand washing, gloving and gowning

Labor and Delivery Assessment
Obtaining vital signs
Instrumentation

DR Orientation Activities for Nursing Instructors (coordinated with Training Officer/DR Supervising Nurse for 2 weeks with specific training program)

DR Orientation Activities for Students (scheduled by the Instructor on the first day of clinical rotation: 2-3 hours)

Orientation on the following:

1. Clinical set-up of the delivery room
2. DR personnel

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 3. DR protocol, policies and guidelines
4. DR documentation
5. Assessment and identification of patients
6. Purposes and indications of machines and equipment in the DR
7. Indications of emergency drugs and other drugs found in the DR
8. DR skills: surgical hand washing, gloving, maintenance of sterile field, serving DR instruments

General Objectives

This course syllabus aims to prepare and develop students in the application of theories in maternal and child nursing to the actual clinical set-up of the delivery room, to
train student nurses to assume the function of a basic clinical nurse in the delivery room department. The course enables students to gain knowledge of the specialist
nursing required within the delivery room so as to be able to identify patients’ needs, and plan and execute adequate nursing measures in a case-to-case basis.

Specific Objectives

After the students’ exposure in the Delivery Room Department of Pangasinan Provincial Hospital, they will be able to:

1. Apply the principal of infection control measures.

2. Use interpersonal communication skills and ethics specific to the care of the parturient woman.
3. Assess parturient woman during admission to the labor room through the following lines: o
a. Taking history: personal, family, medical and obstetrical history. Onset and character of true labor pain. Gush of fluid and its color
b. General examination: vital signs, heart, chest, edema of the lower limb, height and weight. o Abdominal examination: Fundal level, position and presentation of
the fetus and auscultation of fetal heart sound
c. Local P/V examination: Determine the condition of vulva and vagina. Dilatation and effacement of the cervix. Assess the condition of the membrane, the
presenting part and position of the fetus. Assess the pelvic capacity.
4. Monitor the progress of labor, during the first stage of labor through the assessment.
5. Provide care of woman during the first stage of labor: position and ambulation, rest and sleep, nutrition, bowel and bladder care. Supportive care of woman during labor
and observation woman, fetal condition and labor progress.
6. Observe signs and symptoms of the second stage of labor. Assist with the management of the second stage of labor.
7. Provide immediate care for the newborn
8. Observe signs of placental separation. Assist with the management of the third stage of labor
9. Examine the placenta for any abnormalities or missing lobes or membranes.
10. Record and report pertinent information.
11. The student should advise the mother for care of episiotomy, post natal, exercises, hygien, diet, care of the baby and benfites of breast feeding and family planning
methods.

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Activities in the Delivery Room:

Intermediate Objectives / Nursing Clinical Activities Method of Evaluation

Competencies to be Achieved Faculty Students

Discusses common labor/delivery cases and Assesses a client under labor Actual observation
I. Safe and Quality Nursing Care the corresponding nursing interventions Performance evaluation
checklist
Assesses client’s physical and psychological health Discusses and confers special consideration Demonstrate knowledge of labor problems Performance rating scale
needs and relate to information from chart and in performing nursing assessment to identified and its possible interventions and Audit of patient’s records
physician’s assessment patients with different labor/delivery treatment Case study
conditions Quizzes
Written evaluation exam
Gathers patient data for appropriate nursing
Supervises the students in the assessment Detects actual and potential variation in the
interventions
and identification of patients vital signs of patient and contributes
relevant information about patient’s
condition
Identify priority needs of the client in labor
Completes patient records
Participates in nursing audit according to basic
assessment
Identifies and reports variances in the condition of
patients under observation
Reviews principles and practice regarding Observes asepsis during and after delivery Actual observation
sterility in the delivery area of the mother Performance evaluation
Observes the principles of being sterile within the work checklist
area Gives feedback on student’s compliance / Observes universal precautions in handling Performance rating scale
non-compliance of asepsis inside the body fluids
delivery room
Performs the function of an DR nurse Explains the threats to injuries common in Assist in the proper positioning of patients Actual observation
the DR and their prevention in the DR bed Performance evaluation
checklist
Checks on safety or precautionary measures Protects client form further injuries like Performance rating scale
performed by students proper positioning

Provides and respect privacy of clients

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Provides appropriate nursing interventions to patients
under anesthesia and will be undergoing surgical
procedures
II. Management of Resources and Environment
Ensures availability, completeness and functionality,
and storage of OR instruments, equipment and other
resources
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Discusses the roles and functions of an OR
nurse
Reviews anatomy and physiology in
conjunction to treatment of patients
Guided supervision in performance of
various OR skills, like gloving, gowning,
handwashing and instrumentation
Reviews with the students and demonstrate
actual instruments for major and minor
operation, placement of ECG leads, pulse
oximeter, interpreting information in the
cardiac monitor and other related
procedures
Assists and supervises students in carrying
out physician’s orders
Reviews with student a brief drug study
before drug administration
Obtains regular feedback from the students
regarding relevant assessment, surgical
procedures and evaluation findings
Facilitates a mini-case study of selected
surgical case selected by the group
Performs various roles and functions as an
OR nurse
a. assess patients and gather of
necessary data
b. assist in the treatment of patients in
acute conditions while providing
basic interventions
c. assist the physician and staff nurses Actual observation
during major and minor operations Performance evaluation
and other diagnostic procedures checklist
performed in the operating room Performance rating scale
d. Promote therapeutic communication Written evaluation exam
with patients and relatives Graded mini-case analysis
e. Perform after-care of major and
minor OR instruments and other
equipment and machines used
Performs other appropriate nursing
interventions in a case-to-case basis
Presents a mini-case study of a selected
patient

Organizes work load and proper budgeting of time and
resources
Observes OR policies and procedures on infection
control and waste disposal while maintaining safe
environment
III. Health Education
Provides health education based on identified learning
needs of the patient
IV. Legal Responsibilities
Checks the completeness of chart and other relevant
data and forms of patients who will be undergoing
surgical procedures
Adheres to practices in accordance with the nursing law
and other relevant legislation including contracts and
informed consent
Adheres to organizational policies and procedures
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Reviews with students the concepts of
resource management and prioritization
Demonstrates the usage and discusses
functions of equipment and surgical
instruments
Confers procedures for disinfection,
sterilization, disposal of hazardous and non-
infectious wastes
Reviews with students steps to follow in
case of emergency situations and natural
catastrophes
Reviews with students the needed health
teaching and assessment of knowledge
deficit among patients
Supervises and assists students in actual
health teaching to family members
Discusses all legal considerations in patients
requiring surgical care and those admitted
in the hospital
Supervises students in accomplishing legal
forms
Identifies task to be done and planning the
performance of such based on priorities
Finishes work assignment on time
Determines the resources needed to deliver
patient care
Actual observation
Checks proper functioning of instruments Performance evaluation
and equipment and refers malfunctioning checklist
equipment to appropriate unit Performance rating scale
Observes proper disposal of wastes in their
proper containers and adhering to policies
and protocols on prevention and control of
infection
Destines steps to follow in case of fire,
earthquake and other emergency situations
Assesses patient’s knowledge regarding
their surgical case
Provides relevant health teachings to family
members
Confirms or validates information given
Obtains data accurately from patient or Actual observation
relatives Simulation
Checks the completeness of legal forms

Observes institutional policies regarding medico-legal
cases
Documents care rendered to patients
V. Ethico-Moral Responsibilities
Respect the rights of individual or groups
Accepts responsibility and accountability for own
decision and action
Adheres to the national and international code of ethics
for nurses
VI. Personal and Professional Development
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Elucidates the vision and mission of the
institution to the students
Act as a role model in accordance to the
institution’s rules and regulations
Reviews with the students the nature of
medico-legal cases and the implications on
proper documentation as a legal document
Supervises students in gathering patient’s
data, accomplishing forms
Act as a role model for students in
portraying professional attitudes and values
of a good OR nurse
Reviews with students the Patient’s Bill of
Rights and the Code of Ethics for Nurses
Articulates the vision and mission of the
institution
Actual observation
Performance evaluation
checklist
Identifies medico-legal cases and Performance rating scale
demonstrate appropriate actions as student Simulation
nurses for such
Utilizes appropriate patient care records and
report
Oral recitation
Accomplishes accurate documentation in all
matters concerning patient care in
accordance to the standards of nursing
practice
Actual observation
Renders nursing care in the operating room
department consistent with the Patient’s Bill
of Rights (i.e. confidentiality, privacy, etc.)
Audit of patient’s records
Justifies basis for nursing actions and
judgment
Projects a positive image of the profession
Adheres to the Code of Ethics for Nurses
and abides by its provision
Reports unethical and immoral incidents to Actual observation
clinical instructor and proper authorities Performance evaluation
checklist
Performance rating scale
Identifies own learning needs
Projects professional image of the nurse
Possesses positive attitude towards change and
criticism
Performs function according to professional standards
VII. Quality Improvement
Reports significant actual and potential observations
regarding surgical cases and in OR practices
VIII. Research
Gather data using different methodologies
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Assists students in identifying their
strengths and weaknesses; give positive
feedbacks on strengths and institute
measures to further improve them; provides
ancillary efforts to student’s weaknesses to
improve them
Act as a role model to students
Listens to students’ concerns and institute
strategies to enhance student learning
Assesses performance of practice of
students objectively
Explains to student current nursing practice
when situation calls for it
Regularly checks attendance and
promptness of students and impose
appropriate sanctions to students who
commit violations in conduct
Reviews with students the acceptable flow
of communication within the OR
Discusses the need for prompt and accurate
reporting of variances, facilitates discussion
during post-conferences
Coordinates with proper authority regarding
validated reports of variances
Verbalizes strengths, weaknesses and
limitations
Demonstrate willingness to learn and
change for the better as student nurses
Demonstrate good manners and right
conduct at all times
Behaves appropriately Actual observation
Performance evaluation
Listens to suggestions and checklist
recommendations from clinical instructors, Performance rating scale
physician and staff nurses
Assesses own performance of practice
Reports to clinical duty on time with
complete uniform and paraphernalia, and
abides to policies regarding breaks
Reports any variances in the operating
room
Reports significant observations about the
patient under observation to appropriate
authority and submits incident reports as
necessary
Discusses an audit of the operating room Actual observation

Applies research findings in nursing practice
IX. Records Management
Maintains legible, accurate and updated documentation
of patient care and data in the chart and/or other
forms
Submits timely, complete and accurate case slips on
major and minor operations handled
X. Communication
Communicates therapeutically with patient and their
significant others
Establishes professional relationship with members of
the operating room department
Utilizes proper channel of communication
XI. Collaboration and Teamwork
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Discusses and confers with student different
methodologies in gathering data and the
significance of such in analyzing surgical
problems
Combines qualitative and quantitative
nursing research design through simple
explanation on the phenomena observed
Facilitates journal sharing of relevant
research findings applicable in the operating
room department
Supervises students in applying evidenced-
based nursing care
Orients students on proper documentation
in the operating room and accomplishment
of charts and other forms
Checks accuracy of submitted case slips and
other OR records
Reviews with students the considerations in
effective communication with clients, his
significant others, and members of the
operating room department
Reviews and discusses with students the
forms of therapeutic communication
during post-conferences Performance evaluation
checklist
Performance rating scale
Participation in post-
conferences
Applies various methods in gathering data
while utilizing research in the explanation of
identified medical phenomena
Actual observation
Shares relevant research findings from Participation in small-group
journal readings discussion
Applies evidenced-based practice acceptable
in the OR
Documents actual observation or data in
appropriate records accurately, promptly
and completely
Displays good communication skills in Actual observation
interacting with clients and members of the Audit of patient’s records
operating room department
Interacts with patients and families as part
of crisis intervention
Maintains a collaborative relationship with colleagues Observes students during patient
and other members of the health team interaction

Actual observation
Promotes collaborative relationship with Serves as team members of the health Performance evaluation
members of the health team team checklist
Performance rating scale

Actual observation

OR Rotational Requirements
1. Paraphernalia
2. Case slip of cases, both scrub and circulating, handled
3. OR Write-Up
4. Mini-case study of a surgical problem encountered in the OR or an emergency situation where initial treatment was instituted in the OR
5. Quizzes and rotational exam

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PREPARED BY: NOTED BY: RECOMMENDING APPROVAL: APPROVED BY:

MA. MYLINE E. AQUINO, RN MAY JACKLYN ADC SAMSOM, RN, MAN MAY JACKLYN RADOC SAMSON, RN, MAN FELIZA ARZADON-SUA, EdD
Dean, College of Nursing Director for Academic Affairs Vice-President, Academics
Clinical Instructors, College of Nursing

10 November 2019 | Colegio de Dagupan