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1.877.891.4286
Home
About
Professional Licensure
Payroll & Documents
Apply Now
Open Jobs
Contact
Home
About
Professional Licensure
Payroll & Documents
Apply Now
Open Jobs
Contact
Antepartum/Postpartum Nursery – Skills Checklist
This self evaluation is for assessing your experience in specific clinical areas. This self evaluation will not be a determining factor in accepting your application to become an employee of Precision Nationwide Staffing.
0 = Not Applicable
1 = No Experience
2 = Some Experience
3 = Intermittent Experience
4 = Experienced
5 = Very Experienced
Age of Patients Cared For
Newborn/Neonate (birth - 30 days)
*
0
1
2
3
4
5
Infant (30 days - 1 year)
*
0
1
2
3
4
5
Toddler (1 - 3 years)
*
0
1
2
3
4
5
Preschooler (3 - 5 years)
*
0
1
2
3
4
5
School Age Child (5 - 12 years)
*
0
1
2
3
4
5
Adolescents (12 - 18 years)
*
0
1
2
3
4
5
Young Adults (18 - 39 years)
*
0
1
2
3
4
5
Middle Adults (39 - 64 years)
*
0
1
2
3
4
5
Older Adults (64 - 79 years)
*
0
1
2
3
4
5
Elderly Adults (79+ years)
*
0
1
2
3
4
5
General Skills
Standard Precautions
*
0
1
2
3
4
5
Isolation Precautions
*
0
1
2
3
4
5
Patient Head to Toe Assessment
*
0
1
2
3
4
5
Infant/Neonatal Cardiac/Respiratory Arrest
*
0
1
2
3
4
5
Adult Respiratory/Cardiac Arrest
*
0
1
2
3
4
5
Prep and Administration of Emergency Meds
*
0
1
2
3
4
5
Crash Carts
*
0
1
2
3
4
5
Defibrillators
*
0
1
2
3
4
5
Care of Patient in Restraints
*
0
1
2
3
4
5
Automated Med Dispensing Systems
*
0
1
2
3
4
5
Automated Med Dispensing Systems - List Types
*
Electronic Documentation
*
0
1
2
3
4
5
Electronic Documentation - List Types
*
Care Planning & Discharge Planning
*
0
1
2
3
4
5
Antepartum Assessments/Care
Non-Stress Test
*
0
1
2
3
4
5
Fetal Heart Rate Patterns
*
0
1
2
3
4
5
Contraction Patterns
*
0
1
2
3
4
5
Care of Antepartum Patient With
Preterm Labor
*
0
1
2
3
4
5
Premature Rupture of Membranes
*
0
1
2
3
4
5
Infectious Disease
*
0
1
2
3
4
5
Asthma
*
0
1
2
3
4
5
Cardiac Diseases
*
0
1
2
3
4
5
Diabetes
*
0
1
2
3
4
5
Eclampsia
*
0
1
2
3
4
5
HELLP Syndrome
*
0
1
2
3
4
5
PIH
*
0
1
2
3
4
5
Pre-eclampsia
*
0
1
2
3
4
5
Placenta Abruptio
*
0
1
2
3
4
5
Placenta Previa
*
0
1
2
3
4
5
Substance Abuse
*
0
1
2
3
4
5
Multiple Births
*
0
1
2
3
4
5
Medications Knowledge and Use Of
Oxytocin/Pitocin
*
0
1
2
3
4
5
Terbutaline
*
0
1
2
3
4
5
Magnesium Sulfate
*
0
1
2
3
4
5
Insulin (IV and SQ)
*
0
1
2
3
4
5
Cervical Ripening Agents
*
0
1
2
3
4
5
Post Partum Maternal Assessment/Care
Care of Patient with an Epidural
*
0
1
2
3
4
5
Vital Signs/Pulse Oximetry
*
0
1
2
3
4
5
Care of Post-Op Tubal Ligation Patient
*
0
1
2
3
4
5
Care of Post C-section Patient
*
0
1
2
3
4
5
Care of Post Vaginal Delivery Patient
*
0
1
2
3
4
5
Care of Patient with Postpartum Hemorrhage
*
0
1
2
3
4
5
Care of Patient with Fetal Demise
*
0
1
2
3
4
5
Post Anesthesia Care (Epidural, General, Local, Spinal)
*
0
1
2
3
4
5
Breast Care
*
0
1
2
3
4
5
Fundal Assessment
*
0
1
2
3
4
5
Lochia Assessment
*
0
1
2
3
4
5
Episiotomy Assessment/Care
*
0
1
2
3
4
5
Perineum Assessment/Care
*
0
1
2
3
4
5
Bowel Function Assessment
*
0
1
2
3
4
5
Insertion of Catheter (foley or straight)
*
0
1
2
3
4
5
Assessment for DVT
*
0
1
2
3
4
5
Postpartum Care of the Mother With
Asthma
*
0
1
2
3
4
5
Cardiac disease
*
0
1
2
3
4
5
Diabetes
*
0
1
2
3
4
5
PIH
*
0
1
2
3
4
5
Substance Abuse
*
0
1
2
3
4
5
Infectious Disease
*
0
1
2
3
4
5
Multiple Births
*
0
1
2
3
4
5
Newborn Assessment/Care
Apgar Score
*
0
1
2
3
4
5
Length/Weight/Chest/Head Measurements
*
0
1
2
3
4
5
Infant Identification
*
0
1
2
3
4
5
Vital Signs
*
0
1
2
3
4
5
Ballard Scale Score
*
0
1
2
3
4
5
Dubowitz Scale Score
*
0
1
2
3
4
5
Administer Injections to Neonate
*
0
1
2
3
4
5
Bathe Infant
*
0
1
2
3
4
5
Reflexes
*
0
1
2
3
4
5
Thermal-Neutral Environment to Prevent Stress
*
0
1
2
3
4
5
Incubator/Isolettes
*
0
1
2
3
4
5
Respiratory Distress
*
0
1
2
3
4
5
Bulb Suction
*
0
1
2
3
4
5
Monitor Bladder and Bowel Patterns
*
0
1
2
3
4
5
Bonding Behaviors (Mother/Infant)
*
0
1
2
3
4
5
Assist with Circumcision
*
0
1
2
3
4
5
Assess Post-Op Circumcision
*
0
1
2
3
4
5
Possible Infectious Process
*
0
1
2
3
4
5
Neonatal Jaundice/Phototherapy
*
0
1
2
3
4
5
Drug Addiction/Withdrawal
*
0
1
2
3
4
5
Temperature Regulation Problems
*
0
1
2
3
4
5
Phlebotomy and IV Therapy
Insertion, Care and Maintenance of Peripheral IV
*
0
1
2
3
4
5
Care of the Patient with Central Line
*
0
1
2
3
4
5
Drawing Venous Blood
*
0
1
2
3
4
5
Heelstick
*
0
1
2
3
4
5
Drawing Blood from Central Line
*
0
1
2
3
4
5
Administration of Blood/Blood Products
*
0
1
2
3
4
5
Medications
Antibiotics
*
0
1
2
3
4
5
Insulin (IV and SQ)
*
0
1
2
3
4
5
Oxytocin
*
0
1
2
3
4
5
Rhogam
*
0
1
2
3
4
5
Analgesics
*
0
1
2
3
4
5
Reversal Agents
*
0
1
2
3
4
5
PCA for Analgesia
*
0
1
2
3
4
5
Patient Education
Breastfeeding
*
0
1
2
3
4
5
Car Seat Safety
*
0
1
2
3
4
5
Latch-on Procedures
*
0
1
2
3
4
5
Positioning
*
0
1
2
3
4
5
Use of Electric Breast Pump
*
0
1
2
3
4
5
Use of Manual Breast Pump
*
0
1
2
3
4
5
Formula Preparation and Feeding
*
0
1
2
3
4
5
Infant Caretaking Skills
*
0
1
2
3
4
5
Teach Circumcision Care to Parents
*
0
1
2
3
4
5
Contraceptives
*
0
1
2
3
4
5
Discharge Planning and Infant Requirements
*
0
1
2
3
4
5
Electronic Documentation
*
0
1
2
3
4
5
Electronic Documentation - List Types
*
Information & Agreement
Application ID
*
Please enter your application ID. This ID should be 15 characters long and have the format of PHNMS##########. You should have received an email containing your application ID when you submitted your initial application. If not, please contact our staff.
Applicant Name
*
First
Last
Applicant Email
*
Applicant Phone
*
I certify that the information provided above accurately reflects education received and my experience in each of the clinical areas identified within the last 2 years.
*
I agree to the terms below.
The information I have given is true and accurate to the best of my knowledge, and I hereby authorize Fusion Medical Staffing to release this Skills Checklist to staffing clients of Precision Nationwide Staffing. Submit this skills evaluation with your initial application. To be updated annually.
Signature
*