| Work Settings | Rating Stars (Click) | 1 | 2 | 3 | 4 | 
|---|---|---|---|---|---|
| Couplet Care | |||||
| Antepartum | |||||
| Postpartum | |||||
| Newborn Nursery | |||||
| LDRP | 
| Postpartum | Rating Stars (Click) | 1 | 2 | 3 | 4 | 
|---|---|---|---|---|---|
| Vaginal Delivery | |||||
| Cesarean Section | |||||
| Anesthesia - General | |||||
| Anesthesia - Local | |||||
| Anesthesia - Spinal | |||||
| Bladder Distention | |||||
| Breast Milk Collection and Storage | |||||
| Breast Pump | |||||
| Breastfeeding - Latch Score | |||||
| Breastfeeding - Supplemental Feeding | |||||
| Breastfeeding Support | |||||
| Contraceptive Education | |||||
| Epidural/PCA | |||||
| Homan's Sign | |||||
| Multiple Births | |||||
| Parent/Infant Interaction/Attachment | |||||
| Post Partum Hemorrhage | |||||
| Pregnancy Induced Hypertension | |||||
| Tubal Ligation | 
| Antepartum | Rating Stars (Click) | 1 | 2 | 3 | 4 | 
|---|---|---|---|---|---|
| Amniocentesis | |||||
| Cardiac Disorders | |||||
| Diabetes | |||||
| Hyperemesis | |||||
| Multiple Gestation | |||||
| Non-Stress Test | |||||
| PIH/HELLP | |||||
| Placenta Previa/Abruptio | |||||
| Post-Trauma | |||||
| Pre-Term Labor/Premature Rupture of Membranes | |||||
| Substance Abuse | |||||
| FHM Interpretation and Management | |||||
| Fetal Assessment | |||||
| Labor Assessment | |||||
| Assist with Ultrasound | 
| Medications | Rating Stars (Click) | 1 | 2 | 3 | 4 | 
|---|---|---|---|---|---|
| Antibiotics/Antivirals | |||||
| Antihypertensives | |||||
| Antiseizure | |||||
| Cervical Ripening Agents | |||||
| Immunizations - Mother | |||||
| Insulin | |||||
| Magnesium Sulfate | |||||
| Methergine | |||||
| Opioids and Reversal Agents | |||||
| Pitocin | |||||
| Terbutaline | 
| IV Therapy | Rating Stars (Click) | 1 | 2 | 3 | 4 | 
|---|---|---|---|---|---|
| Starting IVs | |||||
| IV Management | |||||
| Blood Product Administration | 
| Newborn Care | Rating Stars (Click) | 1 | 2 | 3 | 4 | 
|---|---|---|---|---|---|
| Newborn Assessment | |||||
| Ballard Scale/Dubowitz | |||||
| Car Seat Education | |||||
| Circumcision Care/Teach to Parents | |||||
| Cord Care/Teach to Parents | |||||
| Immunizations - Infant | |||||
| Infant Caretaking Skills | |||||
| Infant Identification and Security | |||||
| Metabolic Screen | |||||
| Phototherapy | |||||
| Thermoregulation | 
| Professional Knowledge and Skills | Rating Stars (Click) | 1 | 2 | 3 | 4 | 
|---|---|---|---|---|---|
| National Patient Safety Goals/Core Measures | |||||
| Experience in a Baby Friendly Facility | |||||
| Fall Risk Assessment/Prevention | |||||
| Pressure Ulcer Risk Assessment/Prevention | |||||
| Restraints/Use of Least Restrictive Device | |||||
| Parent/Family Teaching | |||||
| Age Specific/Population-Based Care | |||||
| Isolation Precautions | |||||
| Infection Prevention | |||||
| Pain Assessment & Management - Adult | |||||
| Pain Assessment & Management - Neonate | |||||
| Charge Experience | |||||
| Interpretation and Communication of Lab Values | 
| Age Specific Competencies | Rating Stars (Click) | 1 | 2 | 3 | 4 | 
|---|---|---|---|---|---|
| Infant (Birth - 1 year) | |||||
| Preschooler (ages 2-5 years) | |||||
| Childhood (ages 6-12 years) | |||||
| Adolescents (ages 13-21 years) | |||||
| Young Adults (ages 22-39 years) | |||||
| Adults (ages 40-64 years) | |||||
| Older Adults (ages 65-79 years) | |||||
| Elderly (ages 80+ years) | 
| EMR | Rating Stars (Click) | 1 | 2 | 3 | 4 | 
|---|---|---|---|---|---|
| Epic | |||||
| Cerner | |||||
| Eclipsys | |||||
| McKesson | |||||
| Meditech | |||||
| Other Computerized System | |||||
| Computerized Physician Order Entry | |||||
| Bar Coding for Medication Administration | |||||
| EMR Conversion | |||||
| Other: Specify | |||||
| FHM - Other Specify |