ST.

THERESE - MTC COLLEGES

College of Nursing
La Fiesta Site, M.H. delPilar St., Molo, Iloilo City

SUMMARY PERFORMANCE EVALUATION ACHIEVING CARE OF THE NEWBORN COMPETENCY In Accordance with PRC Board of Nursing Memorandum No. 1 Series of 2009

Signature over Printed Name of Student: ___________________________________________________

NEWBORN COMPETENCIES RLE Exposure No. 1 2 3 DESIRED RATING ACTUAL RATING

I. SAFE AND QUALITY NURSING CARE (SQC) 1. Establish and maintain patent airway. 2. Puts the newborn in Trendelenburg position. 3. Suction mouth and nose of the newborn gently. 4. Dries newborn and wraps warmly. Place under droplight as needed 5. Performs and interprets APGAR Scoring correctly. Immediately after delivery After 5 minutes 6. Ensures proper identification of newborn (name tag: name of mother, date and time of delivery, gender, and name of Attending Physician) 7. Perform physical assessment. 8. Take anthropometric measurements including weight, height head, chest, abdominal circumference. 9. Take Vital signs (temperature per rectum to check patency) 10. Gives oil/water & soap bath according to institutional policy. 11. Latches newborn to the mother's breast immediately after birth. 12. Applies CREDE'S prophylaxis on the eyes. 13. Performs cord dressing aseptically. disinfects area according to hospital policy Clamps and cuts the cord 1 inch from the abdomen Checks for the presence of 2 arteries and 1 vein Dress cord aseptically according to hospital policy 14. Administer Vitamin K (1mg/IM) into the lateral anterior thigh or vastuslateralis 15. Keeps baby wrapped warmly under floor lamp or beside mother according to institutional policy until discharge 16. Records pertinent observation and nursing care done. 17. Reports any signs of deviation/abnormality to the pediatrician II. MANAGEMENT OF RESOURCES, ENVIRONMENT, AND EQUIPMENT (MRE) 1. Prepares instruments and equipment needed Suction bulb, cord clamp, gauze, cotton balls, disinfectant, blanket, droplight, vitamin K, antimicrobial ophthalmic ointment

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2. Ensures use of sterile equipment during immediate care of the newborn 3. Maintain adequacy of supplies as newborn care is rendered 4. Maintains orderliness of the working area 5. Observes precautionary measures related to use of electrical equipment 6. Ensures a warm and quit environment 7. Uses supplies diligently 8. Ensures proper disposal of hospital waste III. HEALTH EDUCATION (HE) 1. Provides instruction to the mother on daily cord care and prevention of cord infection 2. Provides discharge instruction to the mother on when to expect cord to fall off or to report signs of infection 3. Provides information regarding newborn screening, immunization, feeding, etc. 4. Responds to question of mother and relatives regarding expectations IV. LEGAL RESPONSIBILITIES (LR) 1. Identifies newborn by comparing ID band with data in the chart 2. Documents all data correctly and completely 3. Reports accurately any deviations/subnormal findings and nursing interventions rendered 4. Ensures the birth certificate and other civil registration forms are accomplished/filed out according to institutional policy 5. Performs foot printing according to policy V. ETHICO-MORAL RESPONSIBILITIES (EMR) 1. Respects the religious, cultural, and ethnic practices of the family of the newborn 2. Maintains privacy and confidentiality of findings of assessment VI. PERSONAL AND PROFESSIONAL DEVELOPMENT (PPD) 1. Updates one's self with the latest trends and developments in newborn care 2. Projects a professional image of a pediatric nurse 3. Accepts criticisms and recommendation 4. Performs function according to standard VII. QUALITY IMPROVEMENT (QI) 1. Identifies deviations of the practices from the standard 2. Participates of audit practices in nursery 3. Recommends corrective and preventive measures for the identified deviations VIII. RESEARCH ( R ) 1. Identify researchable problems related to immediate care of newborn 2. Initiates a research study on an identified researchable problems 3. Participates as a member of the research team in the conduction of the research study 4. Utilizes findings of the research studies in the immediate care of the newborn IX. RECORDS MANAGEMENT (RM) 1. Documents accurately relevant data about the newborn 2. Maintains an organized system of filing and record keeping X. COMMUNICATIONS (COM) 1. Utilizes appropriately all forms of communication, verbal, non-verbal, electronic 2. Maintains an open line of communication with the mother and other family members 3. Informs mother of relevant information about the newborn 4. Listens attentively to queries and requests of mother and family member XI. COLLABORATION AND TEAM WORK (CTW) 1. Functions effectively as a team member in the nursery

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2. Communicate findings of assessment to all concerned 3. Establishes a collaborative relationship with members of the health team TOTAL SCORE

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PERCENTAGE: __________ Graded RLE: Academic Year __________________ 1stSem_____ 2ndSem_____ Summer_____

Certified True and Correct:

(Printed Name and Signature)

Name: PRC No.: Valid Until:

_________________________________ Clinical Instructor _________________________________ _________________________________

Name: PRC No.: Valid Until:

_________________________________ Clinical Coordinator _________________________________ _________________________________

Name: PRC No.: Valid Until:

_________________________________ Dean _________________________________ _________________________________