Assisting Delivery Name: Mary Grace G. Rivera Grade: - Year and Section:BSN-2D Date

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ASSISTING DELIVERY

Name: Mary Grace G. Rivera Grade:__________________________

Year and Section:BSN-2D Date:___________________________


Legend:
1- Excellent
2- Very Satisfactory
3- Satisfactory
4- Needs Improvement
5- Poor
PROCEDURE RATIONALE 1 2 3 4 5
STEPS
Preparation and Action of a student nurse Assisting the Saves time and energy
Delivery:
Assisting Nurse:
Preparation of equipment For convenience and
easy access of the
Get OB pack materials during the
o Place it in the mayo table procedure.
Check the OB pack Allows smooth
o Check if the instruments are complete procedure without
interruption
Open the outer lining of the OB pack Outer lining is
o Use bare hands in opening the outer lining unsterile; there
is no need to
waste by
sterile gloves
in opening
outer lining.

Open the outer lining of the pack To maintain the


o Use sterile picking forceps facing down sterility of the inner
when opening the inner lining of the OB lining of the OB pack
pack.
Prepare additional equipment Easy access of the
o Put the additional instruments to the open materials during the
OB pack procedure.
Actions: Maintains
2.2 Do surgical hand washing sterility and
avoids risk for
spreading
contamination
in the work
place.
2.3 Do gowning and gloving Avoid
contamination
o Strictly follow the principles of gowning and and protect
gloving. the care
provider and
the patient
from risk of
infection

2.4 Arrange the equipment acceding to use In order to


attain and
uninterrupted
procedure.

ATTITUDE
Accept constructive criticism and suggestion Provides room
for
improvements.
Accept responsibility of his/her action A good nurse
must me
responsible or
her actions

Scoring:

1x ____________ = __________

2x ____________ = __________

3x ____________ = __________

4x ____________ = __________

5x ____________ = __________

Total divided by no. of items = __________

Comments:

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_______________________________________

_______________________________________

Student’s Signature over Printed Name

Clinical Instructor’s Signature and Date over Printed Name

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