PERFORMANCE EVALUATION CHECKLIST NEWBORN COMPETENCY

Name of Student:____________________ Year/Clinical Group: _____________________School Year: ______________________ Semester/Term: ____First Semester ________Second Semester:________ Summer Inclusive Dates of Clinical Rotation:__________________________________________
NEWBORN COMPETENCIES SAFE AND QUALITY NURSING CARE Establishes and maintains patent airway Puts the newborn in Trendelenburgs Position Suctions mouth and nose of the newborn gently Dries newborn and wraps warmly. Places under droplight as needed Performs and interprets APGAR scoring correctly Immediately after delivery After 5 minutes Ensures proper identification of newborn (name tag: name of mother, date and time of delivery, gender and name of attending physician Performs physical assessment Takes anthropometric measurements including weight, height, head, chest, abdominal circumference Takes vital signs (temperature per rectum to check patency) Give oil/ water and soap bath according to institutional policy Latches newborn to the mothers breast immediately after birth Applies CREDES prophylaxis on the eyes Performs cord dressing aseptically Disinfects area properly according to hospital policy Clamps and cuts cord 1 inch from the abdomen Check for the presence of 2 arteries and 1 vein Dresses cord aseptically according to hospital policy Administers Vit. K (1mg/M) into the lateral anterior thigh or vastus lateralis Keeps baby wrapped warmly under floor lamp or beside mother according to institutional WEIGHT 3 1 2 1 2 SCORE REMARKS

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policy until discharge Records pertinent observations and nursing care done Reports any signs of deviation/ abnormality to the pediatrician MANAGEMENT OF RESOURCES, ENVIRONMENT, AND EQUIPMENT Prepares instrument, and equipment needed Suction bulb, cord clamp, gauze, cotton balls, disinfectant, blanket, droplight, Vit. K, antimicrobial ophthalmic ointment Ensures use of sterile equipment during immediate care of the newborn NEWBORN COMPETENCIES Maintain adequacy of supplies as newborn care is rendered Maintains orderliness of working area Observes precautionary measures related to use of electrical equipment Ensures a warm and quiet environment Uses supplies diligently Ensures proper disposal of hospital wastes HEALTH EDUCATION Provides instructions to the mother on daily cord care and prevention of cord infection Provides discharge instructions to the mother on when to expect cord to fall off or to report signs of cord infection Provides information regarding newborn screening, immunization, feeding, etc. Responds to questions of mother and relatives regarding expectations LEGAL RESPONSIBILITY Identifies newborn by comparing ID band with data in the chart Documents all pertinent data correctly and completely Reports accurately any deviations/ abnormal findings and nursing interventions Ensures that birth certificate and other civil registration forms are accomplished/ filled out according to institutional policy Performs foot printing according to hospital policy ETHICO-MORAL RESPONSIBILITY Respects the religious, cultural, and ethnic practices of the family of the newborn Maintains privacy and confidentiality of findings of assessments PERSONAL AND PROFESSIONAL DEVELOPMENT

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Updates oneself with the latest trends and developments in newborn care Projects a professional image of pediatric nurse Accepts criticisms and recommendations Performs functions according to standards QUALITY IMPROVEMENT Identifies deviation of practice from the standards Participates in audit practices in the nursery Recommends corrective and preventive measures for the identified deviations RESEARCH Identifies researchable problems related to immediate care of newborn Initiates a research study on an identified researchable problem Participates as a member of a research team in the conduction of a research study Utilizes findings of research studies in the immediate care of the newborn NEWBORN COMPETENCIES RECORDS MANAGEMENT Documents accurately relevant data about the newborn Maintains an organized system of filing and record keeping COMMUNICATION Utilizes appropriately all forms of communication: verbal, non-verbal, electronic Maintains an open line of communication with the mother and other family members Informs mother of relevant information about the newborn Listens attentively to queries and requests of mothers and family members COLLABORATION AND TEAMWORK Function effectively as a team player in the nursery Communicates findings of assessment to all concerned Establishes a collaborative relationship with members of the health team and family of the newborn TOTAL SCORE

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SCORE

REMARKS

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EVALUATED BY:

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Signature over Printed Name Clinical Instructor

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Signature over Printed Name Student