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Proficiency Scale
1 =
No Experience
2 =
Need Training
3 =
Able to perform with supervision
4 =
Able to perform independently
Assessment Section
Work Settings
✔ Couplet Care
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✔ Antepartum
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✔ Postpartum
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✔ Newborn Nursery
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✔ LDRP
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Postpartum
✔ Vaginal Delivery
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✔ Cesarean Section
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✔ Anesthesia - General
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✔ Anesthesia - Local
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✔ Anesthesia - Spinal
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✔ Bladder Distention
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✔ Breast Milk Collection and Storage
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✔ Breast Pump
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✔ Breastfeeding - Latch Score
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✔ Breastfeeding - Supplemental Feeding
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✔ Breastfeeding Support
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✔ Contraceptive Education
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✔ Epidural/PCA
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✔ Homan's Sign
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✔ Multiple Births
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✔ Parent/Infant Interaction/Attachment
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✔ Post Partum Hemorrhage
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✔ Pregnancy Induced Hypertension
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✔ Tubal Ligation
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Antepartum
✔ Amniocentesis
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✔ Cardiac Disorders
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✔ Diabetes
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✔ Hyperemesis
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✔ Multiple Gestation
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✔ Non-Stress Test
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✔ PIH/HELLP
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✔ Placenta Previa/Abruptio
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✔ Post-Trauma
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✔ Pre-Term Labor/Premature Rupture of Membranes
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✔ Substance Abuse
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✔ FHM Interpretation and Management
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✔ Fetal Assessment
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✔ Labor Assessment
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✔ Assist with Ultrasound
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Medications
✔ Antibiotics/Antivirals
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✔ Antihypertensives
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✔ Antiseizure
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✔ Cervical Ripening Agents
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✔ Immunizations - Mother
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✔ Insulin
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✔ Magnesium Sulfate
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✔ Methergine
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✔ Opioids and Reversal Agents
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✔ Pitocin
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✔ Terbutaline
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IV Therapy
✔ Starting IVs
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✔ IV Management
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✔ Blood Product Administration
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Newborn Care
✔ Newborn Assessment
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✔ Ballard Scale/Dubowitz
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✔ Car Seat Education
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✔ Circumcision Care/Teach to Parents
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✔ Cord Care/Teach to Parents
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✔ Immunizations - Infant
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✔ Infant Caretaking Skills
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✔ Infant Identification and Security
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✔ Metabolic Screen
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✔ Phototherapy
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✔ Thermoregulation
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Professional Knowledge and Skills
✔ National Patient Safety Goals/Core Measures
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✔ Experience in a Baby Friendly Facility
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✔ Fall Risk Assessment/Prevention
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✔ Pressure Ulcer Risk Assessment/Prevention
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✔ Restraints/Use of Least Restrictive Device
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✔ Parent/Family Teaching
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✔ Age Specific/Population-Based Care
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✔ Isolation Precautions
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✔ Infection Prevention
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✔ Pain Assessment & Management - Adult
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✔ Pain Assessment & Management - Neonate
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✔ Charge Experience
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✔ Interpretation and Communication of Lab Values
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Age Specific Competencies
✔ Infant (Birth - 1 year)
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✔ Preschooler (ages 2-5 years)
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✔ Childhood (ages 6-12 years)
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✔ Adolescents (ages 13-21 years)
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✔ Young Adults (ages 22-39 years)
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✔ Adults (ages 40-64 years)
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✔ Older Adults (ages 65-79 years)
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✔ Elderly (ages 80+ years)
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EMR
✔ Epic
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✔ Cerner
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✔ Eclipsys
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✔ McKesson
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✔ Meditech
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✔ Other Computerized System
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✔ Computerized Physician Order Entry
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✔ Bar Coding for Medication Administration
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✔ EMR Conversion
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✔ Other: Specify
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✔ FHM - Other Specify
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