Nurse Diagnosis Mentor Diagnosis Nurse Treatment Mentor (Ideal) Treatment No complications No complications Routine PP Care Routine PP Care Uterine Atony Uterine Atony IV Fluids initiated IV Fluids initiated Post-Partum Hemorrhage Post-Partum Hemorrhage IV Antibiotics IV Antibiotics given Vaginal Laceration Vaginal Laceration IV Uterotonic (i.e. IV Uterotonic (i.e. Oxytocin) Oxytocin) Cervical Laceration Cervical Laceration IM Uterotonic (Oxytocin) IM Uterotonic (Oxytocin) Retained Placenta Retained Placenta Uterine Massage Uterine Massage Retained Placental Retained Placental Fragments Fragments Bladder Catheterization Bladder Catheterization Uterine Inversion Uterine Inversion Attempt at repair of Attempt at repair of laceration laceration Uterine Rupture Uterine Rupture Attempt manual removal Attempt manual removal Puerperal Sepsis Puerperal Sepsis of placenta or placental of placenta or placental Other: ___________ Other: ___________ fragments fragments Other: ___________ Other: ___________ Bimanual compression of Bimanual compression of uterus uterus Transfer to District Transfer to District Hospital Hospital Other: ______________ Other: ______________ Other: ______________ Other: ______________ Postnatal Care How many hours after delivery was the baby discharged hours _______ from the hospital? Were the following tasks completed within one Yes No Comments hour before discharge: Check the umbilical cord? Take the baby’s temperature? Weigh the baby? Observe and counsel on breastfeeding? Counsel on newborn danger signs? (poor breastfeeding, yellow skin, breathing fast, feeling hot or cold to the touch)
Nurse Diagnosis Mentor Diagnosis Nurse Treatment Mentor (Ideal) Treatment No complications Uterine Atony Post-Partum Hemorrhage Vaginal Laceration Cervical Laceration Retained Placenta Retained Placental Fragments Uterine Inversion Uterine Rupture Puerperal Sepsis Other: ___________ Other: ___________ No complications Uterine Atony Post-Partum Hemorrhage Vaginal Laceration Cervical Laceration Retained Placenta Retained Placental Fragments Uterine Inversion Uterine Rupture Puerperal Sepsis Other: ___________ Other: ___________ Routine PP Care IV Fluids initiated IV Antibiotics IV Uterotonic (i.e. Oxytocin) IM Uterotonic (Oxytocin) Uterine Massage Bladder Catheterization Attempt at repair of laceration Attempt manual removal of placenta or placental fragments Bimanual compression of uterus Transfer to District Hospital Other: ______________ Other: ______________ Routine PP Care IV Fluids initiated IV Antibiotics given IV Uterotonic (i.e. Oxytocin) IM Uterotonic (Oxytocin) Uterine Massage Bladder Catheterization Attempt at repair of laceration Attempt manual removal of placenta or placental fragments Bimanual compression of uterus Transfer to District Hospital Other: ______________ Other: ______________ Postnatal Care How many hours after delivery was the baby discharged from the hospital? _______ hours Were the following tasks completed within one hour before discharge: Yes No Comments Check the umbilical cord? Take the baby’s temperature? Weigh the baby? Observe and counsel on breastfeeding? Counsel on newborn danger signs? (poor breastfeeding, yellow skin, breathing fast, feeling hot or cold to the touch)
Mentor_and_PP_Checklist.docx