Professional Documents
Culture Documents
Faculty of Nursing
Department of Midwifery
Spring 2007
Course Information
Course Title Midwifery 2 (Clinical)
Course Number MW 338
Prerequisites MW 336 or concurrent with
Course Website Not applicable
Instructors Ms. Shurouq Hawamdeh, RM, Msc
Office Location N2-L4
Office Phone 23740
Office Hours 11-12 Thursday
1-2 Thursday
2-3 Thursday
E-mail shurouq@just.edu.jo
Teaching Assistant Dr. Reem Hatamleh, RN, RM, PGD, PhD.
Ms. Shurouq Hawamdeh, RM, MSc.
Mrs. Taroob Al-Lataifeh, RN, Msc.
Mrs.Haia Ajloni, RN, RM.
Course Description
The course provides practice essential to the midwifery care of normal and high – risk childbearing
women. Emphasis is on the application of intra-partum skills based on the concept of "normality"
in child birth, the appliance of the "midwifery Model of care", evidence based practice, risk
assessment and management.
The student midwife will demonstrate the midwifery approach of care, attend physiological
childbirth and assist in high risk deliveries. Also, the student will display proper techniques to
solve problems rise in the area of reproductive health.
Text Book
Title Skills for Midwifery Practice
Author(s) Johnson, R. & Taylor, W.
Publisher Churchill living stone
Year 2002
Edition 14th Edition
Book Website -
Enkin, M., Keirse, M. J. N. C., Renfrew, M. & Neilson, J. (Editors)
References (2000) A Guide to Effective Care in Pregnancy and Childbirth (3rd
Edition). Oxford: Oxford University Press.
Assessment Policy
Assessment Type Expected Due Date: Weight
lab exam (written) Feb, 25. 2007
15%
Intrapartum skills. April, 17.2007 30%
a) Abdominal
examination
during labour
(7-10 times)
5%.
b) Examination
pervaginam
(7-10
times)7.5%.
c) Management
of the
Second stage
of labour (7-
10
times)7.5%.
d) Third stage
issues and
examination
of the
placenta (7-
10 times)
5%.
e) Immediate
newborn
assessment
(10 times)
5%.
Evidence and Debate April, 17.2007 10%
Midwifery class (one).
a- written part 5%.
b- Presentation part 5%.
Final clinical exam April. 22, 2007- May. 22, 2007 20%
Clinical evaluation
May, 20. 2007 20%
criteria
1. Audio-visual materials.
2. Group presentation.
3. Case presentation (hospital).
Useful Resources
Fraser (D) and cooper (M) (2003): Myles text book for midwives 14th ed
Edinburgh Churchill living stone.
Johnson (R) Taylor (W) (2002): Skills for Midwifery Practice 3th ed Churchil living stone.
Ann (L) and Perecival (P) (2000): The new midwifery: science and sensitivity in practice 2th ed
Churchill living stone.
Additional Notes
Assignments
One daily documentation, one evidence class per semester
Cheating According to university regulation
Attendance
According to university regulation
Laboratory exam One written exam
Appendixes
4
Final clinical exam
- The clinical exam aimed at evaluating the students' ability to manage childbearing women,
mainly, in second and third stages of labour.
- Each student will be examined while conducting a normal delivery in the assigned clinical area,
starting from (April. 22, 2007- May. 22, 2007).
- Any student who does not attend the exam in the hospital will immediately receive a grade of
Zero! No make up and no excuses are accepted.
Appendix. A
Scale :
1. Poor
2. Satisfactory
3. Good
4. Very good
5. Excellent
Items score
1. Explain the procedure to the women
2. Gather the equipment:
a. Measurement meter.
b. Sonicad.
c. Watch/ clock with second hand.
d. Lubricantgel.
e. Patient file.
3. Instruct the woman to empty her bladder
4. provide privacy and prepare the
environment.
5. wash hands using warm water.
6. Position the women supine with knees
slightly flexed. place a small pillow or towel
under one side.
7. Inspect the abdomen for :
a. Size.
b. Shape.
c. Skin changes.
d. Umbilical hernia.
e. Fetal movement.
8. Palpate the funds for :
a. Fundal height.
b. Presence of fetal pole (head or buttocks).
c. Contractions, if felt, for :
a. Intersity.
b. Duration.
c. Frequency.
9. Palpate the main body of the uterus using
the later at palpation for :
a. Fetal position identification.
b. Lie confirmation.
10. Pelvic palpation using 'two hands'
technique or 'pawliks' maneuver, for:
a. Presenting part.
b. Engagement.
c. Attitude confirmation.
11. Auscultate the fetal heart, for:
a. Rate.
b. Rhythm.
12. Assist the woman in to a comfortable
position and discuss the findings.
13. Document the findings and acts
accordingly.
a. Fundal height.
b. Lie.
c. Presenting part and Degree of engagement.
d. Position.
e. Fetal heart rate , Equipment used.
f. Fetal movement felt.
j. Uterine contractions felt.
h. Any additional in formation, such as:
inspection of small size abdomen, vertical
scars and asymmetry of the abdomen.
Total
Total × 5 Grade =
13 /5%
Appendix. A
Scale :
1= Poor
2= Satisfactory
3= Good
4= Very good
5= Excellent
Items score
1. Explain the procedure to the woman.
2. Provide privacy and Prepare the environment.
3. Collect equipment required:
a. Sterile gloves.
b. Sterile lubricant.
c. Antiseptic solution.
d. Disposable sheet.
e. Pinard or sonicaid stethoscope.
f. Galipot.
J. Gauze or Cotton.
4. Encourage the woman to empty her bladder.
5. Auscultate the fetal heart.
Note: Abdominal exam should be undertaken
prior to perform PV exam.
6. Ask the women to turn on to back with knees
flexed (dorsal recumbent position), placing the
disposable sheet beneath her buttocks.
7. Wash hands while the assistant opens the
gloves sliding the gloves on to the sterile field.
8. Dry hands and put on gloves.
9. Ask the assistant to pour antiseptic solution
into the galipot and remove the covers from the
women.
10. Swab the perineum from front to back using
cotton or gauze soaked with savlon or warm
water, passing the swabs from examining (clean)
hand to the non- examining (dirty) hand.
-Use each swab once and dispose it.
11. Discard drops of clean lubricating gel on tips
of gloved fingers.
12. place non dominant hand on the outer edges
of the woman's vulva and spread the labia while
inspecting the external genitalia for:
a. Lesions.
b. Clustered pinpoint vesicles.
c. Open ulcerated sores.
e. Varicosities.
13. Look for escaping amniotic fluid or the
presence of umbilical cord or bleeding.
14. If there is no bleeding or cord visible,
Introduce the index and middle fingers of
dominant hand gently in to the vagina, directed
them into the posterior vaginal wall. Asses the
vagina for warmness and moisture.
15. Locate and Palpate the cervix for :
a. Position.
b. Consistency, firm or soft.
c. Extent of dilatation (palpate the anterior rim or
lip of cervix).
d. Application to the presenting part.
16. Estimate the degree of effacement.
17. Estimate whether membranes are intact.
18. Locate the Ischial spine, to:
a. Rate the station of the presenting part.
b. Identify the presentation.
19. Establish the fetal position, for example,
Right Occiputo Anterior (ROA).
20. Withdraw the fingers gently.
21. Wipe the perineum front to back to remove
secretions or examining solution.
22. Leave client comfortable and turned to side.
23. Dispose equipment appropriately and wash
hands.
24. Document findings and acts accordingly.
a. External genitalia.
b. Vagina.
c. Cervix.
d. The membranes.
e. Presentation
f. Position
g. Pelvic outlet for prominent Ischial spines.
Total
Total X 7.5 Grade=
24 /7.5%
Appendix. A
Scale :
1= Poor
2= Satisfactory
3= Good
4= Very good
5= Excellent
Items Score
1. Prepare the environment and gather the equipment.
2. Give reassurance and explanations to the woman.
3. Place the disposable sheets in the area of perineum.
4. The second midwife maintains fetal and mother
observation.
5. Wash hands whilst the assistant opens the outer
covering of the delivery pack.
6. Open the pack and dry hands while the assistant
slides the sterile gloves onto the sterile field.
7. Apply gloves and gown.
8. Check the swabs and instruments in the delivery
pack while the assistant adds aseptic solution to the
galipot on sterile field.
9. Arrange the trolley in a way that suits , having cord
clamps and the receiver for the placenta accessible.
10. Continue to observe the advancing fetus.
11. Swab the perineum using gauze and aseptic
solution front to back, using each swap once using a
'clean and dirty' hand technique.
12. Place sterile drapes appropriately to provide a
sterile field.
13. Position the anal pad.
14. As the head crowns, consider applying gentle
pressure to it with one hand to slow the birth; guard
the perineum with the other hand.
15. As the head restitutes, feel below the occiput for
the presence of the cord around the neck – if felt, it
may be pulled gently to loop over the head.
16. As the next contraction occurs and the woman has
urges to push again, apply traction to the anterior
shoulder (in direction away from the symphysis pubis)
to deliver it, followed by traction in the opposite
direction to deliver the posterior one.
17. Administration of intramuscular syntocinon or
syntometrine following the birth of the anterior
shoulder.
18. Deliver the body and limbs of the baby by lateral
flexion, following the curve of the birth canal, in an
upward direction towards the woman's abdomen.
19. Note the time of delivery.
20. The baby is placed ideally skin to skin with his
mother and dried completely.
21. Complete Apgar score.
22. Clamping and cutting of the cord, ensuring both
ends are secured.
23. Breast feeding may be facilitated.
24. Provide perineal care after birth.
25. Document labour events and acts accordingly.
Total
Total X 7.5 Grade=
25 /7.5%
Appendix. A
Jordan University of Science and Technology
Faculty of Nursing/ Department of Midwifery
Midwifery 2 (MW. 338)
Evaluation of Intrapartum skills (30%)
Appendix. B
Jordan University of Science and Technology
Faculty of Nursing/ Department of Midwifery
Midwifery 2 (MW. 338)
Evidence and Debate Midwifery class (10%)
3. Content 10%
- Clear and accurate.
- Comprehensible.
- Relevant and applicable to midwifery.
- Appropriate to the level of audiences.
4. Organisation 10%
- Starts and finishes on time.
- Well prepared for the presentation.
- Conduct presentation in an organized manner.
- Appropriate preparation to physical environment.
- Able to control audiences.
5. Process 7.5 %
- Allows time for questions and gives appropriate answers.
- summarises the main points and terminates Session properly.
Date:--------------------------------------.
Name of client:-----------------------------------------.
Date of admission:--------------------------------------.
Age: ------------.
L.M.P:-----------------------. E.D.D:------------------------.
G T P A L: --------------------------------------.
Reason for
admission:-------------------------------------------------------------------------------------------------------
--------------------------------------------
Vital signs:------------------------------------------------------------------------.
Fetal condition:--------------------------------------------------------------------
P.V exam
findings:---------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
----------------
Abdominal exam
findings:---------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------.
Uterine activity:
--------------------------------------------------------------------------------------------------------------.
Lab
tests:--------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
----------
Medications:-----------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------
--------------------------------------------
Coping with
contractions:-----------------------------------------------------------------------------------------------------
-------------------------------------------------
Time of complete cervical dilatation and effacement:-------------------------
Type of delivery: a. fetus:---------------------.
b. placenta and membranes:-------------------.
Type of episiotomy:------------------------------.
Degree of laceration:------------------------------.
Labour complications:----------------------------------------------.
Newborn's data:
Gender:--------------------------.
Weight:---------------------------.
Length:----------------------------.
Head circumference:-------------.
Chest circumference:-------------.
Apgar score:
1 minute:---------------.
5 minutes:---------------.
Resuscitation:…………
Newborn immediate care:-----------------------------------------------------
----------------------------------------------------------------------------------------------------------------
----------------------------------------------------------
Assessment:
a. Subjective data:
b. Objective data:
Nursing DX (actual):
Objectives:
Interventions (implemented):
Teaching:
Appendix. D
Jordan University of Science and Technology
Faculty of Nursing/ Department of Midwifery
Midwifery 2 (MW. 338)
Final clinical exam (20%)
Scale :
1= Poor
2= Satisfactory
3= Good
4= Very good
5= Excellent
Items Score
1. Prepare the environment and gather the equipment.
2. Give reassurance and explanations to the woman.
3. Place the disposable sheets in the area of perineum.
4. The second midwife maintains fetal and mother
observation.
5. Wash hands whilst the assistant opens the outer
covering of the delivery pack.
6. Open the pack and dry hands while the assistant
slides the sterile gloves onto the sterile field.
7. Apply gloves and gown.
8. Check the swabs and instruments in the delivery
pack while the assistant adds aseptic solution to the
galipot on sterile field.
9. Arrange the trolley in a way that suits , having cord
clamps and the receiver for the placenta accessible.
10. Continue to observe the advancing fetus.
11. Swab the perineum using gauze and aseptic
solution front to back, using each swap once using a
'clean and dirty' hand technique.
12. Place sterile drapes appropriately to provide a
sterile field.
13. Position the anal pad.
14. As the head crowns, consider applying gentle
pressure to it with one hand to slow the birth; guard
the perineum with the other hand.
15. As the head restitutes, feel below the occiput for
the presence of the cord around the neck – if felt, it
may be pulled gently to loop over the head.
16. As the next contraction occurs and the woman has
urges to push again, apply traction to the anterior
shoulder (in direction away from the symphysis pubis)
to deliver it, followed by traction in the opposite
direction to deliver the posterior one.
17. Administration of intramuscular syntocinon or
syntometrine following the birth of the anterior
shoulder.
18. Deliver the body and limbs of the baby by lateral
flexion, following the curve of the birth canal, in an
upward direction towards the woman's abdomen.
19. Note the time of delivery.
20. The baby is placed ideally skin to skin with his
mother and dried completely.
21. Complete Apgar score.
22. Clamping and cutting of the cord, ensuring both
ends are secured.
23. Breast feeding may be facilitated.
24. Ensure empty bladder.
25. Place a sterile towel over the woman's abdomen.
26. Place the non dominant hand over the fundus, wait
a contraction and observe for signs of placental
separation.
27. Apply the controlled cord traction to deliver the
placenta.
28. If resistance is felt, stop and wait for 2 minutes
before attempting again, ensuring the uterus is
contracted.
29. When the placenta appears at the vulva, traction
should be applied in an upward direction.
30. The non dominant hand is moved down to help
ease the placenta into the receiver, allowing
membranes to be expelled slowly.
31. Observe the condition of the woman throughout,
particularly, any blood loss per vaginam.
32. Note the time of placental and membranes
delivery.
33. Assess the condition of the uterus.
34. Assess the amount of blood loss.
35. Asses the woman's vital signs.
36. Assess the condition of the genital tract and need
for suturing.
37. Assist woman into comfortable position.
38. Provide perineal care.
39. Examine the placenta.
40. Dispose of the placenta and equipment correctly.
41. Document findings and acts accordingly.
Total
Total × 20 Grade =
41
Appendix. E
Jordan University of Science and Technology
Faculty of Nursing/ Department of Midwifery
Midwifery 2 (MW. 338)
Clinical evaluation criteria (20%)
Scale :
1= Poor
2= Satisfactory
3= Good
4= Very good
5= Excellent