JAMIATU MARAWI AL-ISLAMIA FOUNDATION

College of Health and Science

Performance Evaluation Checklist

ESSENTIAL INTRAPARTUM AND NEWBORN CARE (EINC)

Name of Student: __________________________________ Date Performed: _________________

Level & Section: ___________________________________

Legend (Rating Criteria)

1 – Expert (student performs all task proficiently and independently)
2 – Competent (student performs efficiently in an effective and efficient manner).
3 – Progress Acceptable (performance is always effective and but not always).
4 – Needs improvement (progress in performance is too low to judge satisfactorily).
5 – Progress Unacceptable (no progress in performance has been demonstrated).

Materials:  Plastic Cellophane  Tape measure

 2 pairs of Sterile Gloves  Kelly Straight/Curve  Thermometer
 Dry linen  Kidney Basin  Vitamin K
 Oxytocin Injection (2 iu)  Erythromycin  Hepa B
 Cord clamp  Stethoscope  Cotton balls

Procedure
Prior to Woman’s Transfer to the Delivery Room 1 2 3 4 5
1. Ensure that mother is in her position of choice while in labor.
2. Asked the mother if she wishes to eat/drink or void.
3. Labor monitoring patient every 1hour or 30 minutes:
 Monitor Uterine Contractions
 Assess progress of labor (Rupture of BOW, Cervical dilatation,
effacement & degree of descent of the fetal head)
4. Obtaining patient’s data.
 Patient Identity
 OB score (GTPAL, LMP, AOG)
 Vital signs
 Obtain FHT
 Perform Leopold’s Manuever
5. Secure articles needed: Patient and baby.
 Adult diaper
 Hospital Gown
 Wet wipes
 Big Plastic Cellophane (2)
 Baby cloth (“Lampin with Hood”)
 Baby’s bonnet
 Cord clamp
6. Assist in internal examination (IE) as necessary.
 Perform catheterization as needed.
 Change patient as necessary.
 Secure patient’s comfort
 Study patient’s case (complications, special procedures, medication
given)
7. Communicate with the mother – Inform her progress of labor, give
reassurance and encouragement.
Preparing for Delivery 1 2 3 4 5
1. Check the temperature in DR area to be 25-28 degrees Celsius.
2. Ask the patient if she is comfortable in the semi – upright position.
(Lithotomy position)
3. Prepare a clear, clean newborn resuscitation area. Check the equipment if
clean, functional and within easy reach.
4. Ensure the patient’s privacy.
5. Remove all pieces of jewelry, bra and wash hands thoroughly.
6. Arrange materials needed in linear sequence according to use:
 Sterile linen (2) for mayo table and patient abdomen
 Kelly curve/straight
 Bandage Scissor
 Needle Holder
 OS
 V/S
 Cord clamp
 Vicryl Needle (as needed)
 10cc syringe
 Sterile Gloves
7. Do the Perineal Care with 7.5% and 10% Betadine Solution.
8. Wash hands and put on 2 pairs of sterile gloves aseptically.
At the Time of Delivery 1 2 3 4 5
1. Encourage the woman to push /bear down as desired.
2. Drape the sterile and dry towel linen over mother’s abdomen in preparation
for drying the baby.
3. Apple pressure to the perineal and do controlled delivery of the head.
4. Call out time of birth and sex of the baby.
5. Inform mother of the outcome.
First 30 seconds 1 2 3 4 5
1. Thoroughly dry the baby for at least 30 seconds, starting from the face and
head, going down to the trunk and extremities while performing quick check
for breathing.
At 1 to 3 minutes 1 2 3 4 5
1. Remove the wet cloth.
2. Place the baby in skin – to – skin contact on the mother’s abdomen or
chest.
3. Use wet cloth to wipe the soiled gloves. Give IM oxytocin to the mother
within 1 minute after the delivery of the baby. Drop the soiled wet cloth on
the floor.
4. Palpate umbilical cord for pulsations.
5. After the pulsation have stop, clamp the cord using the cord clamp. Tie 2
centimeter from the base.
6. Place the Kelly straight/curve instrument clamped 5 centimeters away from
the base.
7. Cut near the cord clamped (not midway).
8. Perform the remaining steps of AMSTL.
 Wait for strong contractions then apply controlled cord traction and
counter traction on the uterus, continuing until placenta is delivered.
 Massage gently the uterus until it is firm.
9. Inspect the lower vagina and perineum for lacerations/tears and repair
lacerations /tears as necessary.
10. Examine the placenta for completeness and abnormalities.
11. Clean the mother, flush the perineum and apply pad/napkin/cloth.
12. Check the baby’s color and breathing; check that the mother is
comfortable, uterus contracted.
13. Dispose placenta in the leak-proof container or plastic bag.
14. Wear gloves. Decontaminate (Soaked in 0.5% chlorine solution)
instruments for at least 10 minutes before cleaning.
15. Advise the mother to maintain skin – to skin contact. Baby should be in
prone position on mother’s chest/ or in between breast with head turned to
one side.
16. Get the data needed for the baby: Height, Birth weight, HC, CC and AC.
17. Perform thorough physical assessment. Check the baby’s vital signs: Heart
Rate, Respiratory Rate and Temperature.
At 15 – 90 Minutes 1 2 3 4 5
1. Advise the mother to observe for feeding cues and cite example of feeding
cues.
2. Support mother, instruct her on proper positioning attachment.
3. Wait for full breastfeed to be completed.
4. After complete breastfeed; administer eye ointment, administer vitamin K,
Hepatitis B and BCG injections. (Simultaneously explain the purpose of each
intervention).
5. Advise OPTIONAL/DELAYED bathing of the baby (Explain the rationale).
6. Advise the breastfeeding per demand and about danger signs for early
referral.
7. In the first hour: check the baby’s breathing and color; and check mother’s
vital signs and massage the uterus every minute.
8. In the second hour: check mother – baby dyad every 30 minutes to 1 hour.
9. Complete all records.
TOTAL

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Clinical Instructor
(Sign over printed name)