Standards Care Staffing

LDRP Skills Checklist

Please indicate your overall practical experience level with each skill using the key below. All fields are required.

Key
0	No experience
1	Requires additional training
2	Have performed and able to do without supervision
3	Very experienced and able to perform independently
4	Able to teach and supervise

Labor and Delivery	0	1	2	3	4
Abdominal Shave/Scrub Prep
Assist with Fetal Scalp Blood Sampling
Assist with High Risk Delivery
Assist with Placement of Intrauterine Pressure Catheter
Assist with Vaginal Delivery
Circulate for C-Section
Emergency Delivery
Forceps Vaginal Delivery
Fundal Assessment/Height
Identify FHR Patterns
Internal Monitor/Lead Connection and Calibration
Interpretation of Fetal Monitoring
Perineal Prep
Scrub for C-Section
Sterile Vaginal Exams
Use of Fetoscope/Doppler
Care of Patient With:	0	1	2	3	4
Abruptio Placenta
Diabetes Mellitus
Drug Addiction/Withdrawal
HIV
Infectious Diseases
Malpresentation
Multiple Gestation
Placenta Previa
Preeclampsia
Pregnancy Induced Hypertension
Premature Labor
RH Incompatibilities
Sickle Cell Disease
Use and Administration of the Following:	0	1	2	3	4
Insulin Drips
Magnesium Sulfate Therapy
Pitocin
Ritodrine
Immediate Care of Baby in the Delivery Room:	0	1	2	3	4
APGAR Scores
Collect Cord Samples
Eye Prophylaxis
Suctioning
Newborn/Pediatric Care	0	1	2	3	4
Apnea Monitoring
Cord and Circumcision Care
Newborn Nursery
Obtain Specimens from UAC and UVC
Phototherapy
Radiant Warmers
Postpartum Care	0	1	2	3	4
Bladder Distention
Episiotomy
Fundus Consistency
Lochia
Post-Op C-Section
Care of Patient With:	0	1	2	3	4
Diabetes Mellitus
Sickle Cell Disease
Infectious Disease
Cardiac Disease
Neurological Disease
Tubal Ligation

How many years have you worked in LDRP:


	The information I have provideded is true and accurate to the best of my knowledge. I hereby authorize my prospective employer to release this Checklist to Client in relation to consideration of my employment with them.