Name: _________________________________ Year & Section: ____________ Score: _________

Subject: _______________________________ Date: __________________

IMMEDIATE NEWBORN CARE RUBRICS

PROCEDURE CRITERIA
PROFICIENT APPROACHING DEVELOPING BEGINNING
PROFICIENCY
Independently Performs skills Performs skills with
performs all Performs skills with assistance assistance of
skills fluently with assistance of of faculty 3 - 4 faculty greater
and without faculty 1 - 2 times during than 4 times
difficulty. times during simulation. during simulation.
simulation.

3
4 2 1

ATTITUDE

1. Displays readiness in
performing the procedure

2. Accepts criticism by showing

effort to correct mistakes

3. Shows enthusiasm and interest

in performing the procedure.

4. Employs professionalism,
reliability, and confidence in
performing the procedure.

5. Answer rationale questions

correctly.

KNOWLEDGE & SKILLS

1. Perform hand washing and don

open gloving.

2. Dress the umbilical cord:

a. Fold one (1) OS into lengthwise,

soak it with sterile water for
injection, and wrap it around the
base of the umbilical cord.

b. Wipe the cord with the soaked

OS upward. Discard the used OS.

3. Clamp the umbilical cord 1 inch

(2.54 cm) from the base of the
cord. Ensure that the clamp is
locked.
Note: Position the umbilical cord at
the center of the umbilical clamp.

4. Wrap the base of the umbilical

cord with OS (below the
umbilical clamp).

5. Cut the umbilical cord

immediately right on top of the
umbilical clamp. Use the

surgical scissors provided.

6. Wipe the umbilical cord and

clamp using the OS/gauze
wrapped at the base of the cord
to remove blood.

7. Check for the umbilical blood

vessels.

8. Remove gloves.

9. Take note of the

anthropometric measurements
like vital signs, weight, length,
head, chest, abdominal and
arm circumference, Apgar and
Ballard score.

10. Attach identification band.

11. Administer vitamin K at right

thigh and hepatitis B vaccine at
left thigh and eye prophylaxis.

12. Wrap the baby snuggly.

13. Initiate early breastfeeding.

14. Monitor newborn’s vital signs

every 15 minutes.
 15. Report for any
abnormalities/unusual ties.

TOTAL POINTS: 80

____________________________________________
Signature over Printed name of the Student

____________________________________________
Signature over Printed name of the Clinical Instructor

Prepared:
Marie Christine N. Mercado, RN, MAN, Ed.D
Level II – RLE Coordinator

Noted:
Jill Marie C. Hermogenes, RN, MAN, Ed.D
Assistant Dean

Approved:
Michelle B. Yu, RN, MAN, DM
Dean