Assesses maternal behaviour during labour CD Signature CI Signature Date Date Monitors maternal wellbeing using vital observations in labour (in addition, please refer to general health assessment skills) CD Signature CI Signature Date Date Monitors fetal wellbeing in labour (in addition, please refer to fetal wellbeing assessment skills) CD Signature CI Signature Date Date Assesses, monitors and evaluates maternal pain in labour CD Signature CI Signature Date Date Assess maternal bowel and bladder function in labour Signature CI Signature Date Date Monitoring Maternal Wellbeing in the Postnatal Period monitoring well-being in the postnatal period Assesses maternal wellbeing immediately following birth CD Signature CI Signature Date Date Assesses the perineum following birth: classifying perineal trauma CD Signature CI Signature Date Date Examines the placenta and membranes CD Signature CI Signature CD/
Early Obstetric Warning System’ Date Date Monitoring Fetal Wellbeing Assesses vaginal amniotic liquor volume and colour Signature CI Signature Date Date Monitors, records and interprets fetal heart rate using a Pinard stepthoscope and sonicad CD Signature CI Signature Date Date Assesses fetal growth through abdominal palpation and height measurement CD Signature CI Signature Date Date Justifies the use of and applies electronic fetal monitoring CD Signature CI Signature Date Date Justifies the use of and applies a fetal scalp electrode E/CD Signature CD Signature Date Date Interprets accurately fetal cardiotocograph patterns CD Signature CI Signature Date Date Prepares equipment for fetal blood sampling Signature CI Signature Date Date
position, mobilisation, birthing aids Date Date Adapts the labour room environment to meet the woman’s needs CD Signature CI Signature Date Date Provides emotional support during labour for the woman and her family/partner CD Signature CI Signature Date Date Ensures nutrition and hydration needs are met during labour CD Signature CI Signature Date Date Ensures hygiene needs are met during labour CI Signature CI Signature Date Date Uses appropriate measures to prevent infection during labour CD Signature CI Signature Date Date Cares for the woman’s bladder during labour CD Signature CI Signature Date Date In partnership with the woman, plan coping and pain management strategies CD Signature CI Signature Date Date CD Signature CI Signature
Appropriately uses non pharmacological methods of pain relief during labour Date Date Cares for women using transcutaneous electrical nerve stimulation Signature CI/ CS Signature Date Date In accordance with NMC regulations administers pharmacological methods of pain relief pain in labour CD Signature CD Signature Date Date Cares for a woman using epidural anaesthesia CD Signature CD Signature Date Date Justifies the use of and performs amniotomy in labour Signature CD Signature Date Date Facilitates management of the second stage of labour; actively preparing the environment for the birth CD Signature CI Signature Date Date Infiltrates the perineum with local anaesthetic and performs an episiotomy Signature Signature Date Date Actively manages and monitors maternal condition in the third stage of labour, facilitating safe delivery of the placenta and membranes CD Signature CI Signature Date Date CS
Postnatal Care Demonstrates appropriate perineal suturing technique Signature Signature Date Date Safely transfers women and their newborn to the postnatal ward or home CD Signature CD Signature Date Date Provides emotional support to the mother and family during the postnatal period Signature CD Signature Date Date Provides advice on pelvic floor exercises Signature CI Signature Date Date Provide information to women and their partners regarding sexual health and contraception CD Signature CI Signature Date Date Cares for women with restricted mobility Signature CI Signature Date Date Educate women with regard to perineal hygiene CI Signature CI Signature Date Date Bed-making – occupied and unoccupied CI Signature Signature
Date Date MATERNAL Preparation for Parenthood and Health Education Encourages women to consider their health and lifestyle choices Signature CD CI Date Provides individualised health information for the woman and her family which is easily understood Signature CD/CI CI Date Assesses and responds to parenthood and educational needs Signature CD CI Date Plans and delivers a parent education session Signature E CD Date In partnership with the woman facilitates birth planning, including place of birth Signature CD CI Date Explores opportunities for care Signature CD CI Date
MATERNAL Screening/Diagnostic Investigations Performs venepuncture including appropriate and safe procedure for specimen collection and transport Signature CD CD Date Provides information to facilitate informed choices and antenatal screening tests, respecting the subsequent maternal decision Signature CD/CI CI Date Interprets data accurately from screening results and sensitively shares this information with women Signature CD CI Date Justifies the use of and performs a wound swab Signature CI CI Date Justifies the use of and performs high, low and vaginal swab Signature CI CI Date Justifies the use of and performs MRSA swabs for screening Signature CI CI Date Justifies the use of and performs a speculum examination Signature CD CI Date Signature CD/CI CI
Justifies the use of and obtains a midstream urine sample Date MATERNAL Complex Maternal Care Identifies and acts on deviations from the normal in the antenatal period, referring to the appropriate health professional Signature CD CI Date Identifies and acts on deviations from the normal in labour, referring to the appropriate health professional Signature CD CI Date Identifies and acts on deviations from the normal in the postnatal period, reporting to the appropriate health professional Signature CD CI Date Recognise women who require specialised services, and refer appropriately Signature Date CD CI Communicates sensitive information: (breaking bad news) Signature CD CI Date Cares for women and families suffering pregnancy loss Signature E/CD CD Date Contributes to the support of women experiencing a complex pregnancy Signature CD/CI CI Date
MATERNAL Explore Sensitive Issues and Responding Appropriately in the Following Areas: Sexual health Signature E CI Date Safeguarding children and adults Signature E CI Date Vulnerable women Signature E CI Date MATERNAL Emergency Procedures Demonstrates the care and management of antepartum haemorrhage Signature CS/CD CD/CS Date Demonstrates the care and management of postpartum haemorrhage Signature CS/CD CD/CS Date Demonstrates the care and management of shoulder dystocia Signature CS/CD CD/CS Date Demonstrates the care and management of the unconscious woman Signature CS/CD CD/CS Date
Demonstrates the care and management of undiagnosed breech delivery Signature CD/CS Date Demonstrates the care and management of cord prolapse Signature CD/CS Date Is able to initiate the basic emergency call and demonstrates maternal resuscitation Signature CD/CS CD/CS Date Health and Safety Risk Assessment Is able to apply knowledge of risk assessment in practice Signature CD CI Date Appropriately assesses risk and promotes skin integrity Signature CI CI Date Uses appropriate risk assessment tool and promotes practises that reduces the risk of conditions Signature CI CI Date Safety Works within the ‘Lone Worker policy’ Signature CD CD/CI Date
Adheres to fire and security policies Signature CI CI Date Safely applies the principles of load management in practice Signature CI CI Date Correct and safe disposal of clinical and household waste Signature CI CI Date Correct and safe disposal of blood and body fluids Signature CI CI Date Correct and safe use and disposal of sharps Signature CI CI Date Prevent and Control Infection Adheres to standard principles of infection control Signature CI CI Date Adheres to the local trust hand hygiene policy Signature CI CI Date
Adheres to the local trust asepsis policy Signature CI CI Date Medical Technology Safely uses medical devices/ equipment Signature CD CI Date Medicine Management Applies knowledge of NMC standards and legal and ethical frameworks to the documentation and administration of medicinal products Signature CD CD Date Understand the roles and responsibilities of the multidisciplinary team in the administration of medicinal products Signature CD CD Date Is able to read, and interpret, prescriptions for accuracy in terms of the correct dosage, route and treatment plan Signature CD CD Date Clearly identifies the woman/ baby for whom the medication is intended Signature CD CD Date Obtains an accurate medicine history Signature CD CD Date
Safely administers medicinal products by the following routes: Oral Signature CD CD Date Topical treatments Signature CD CD Date Inhalational Signature CD CD Date Intramuscular injection Signature CD CD Date Sub-cutaneous injection Signature CD CD Date Per vaginum Signature CD CD Date Per rectum Signature CD CD Date
Intravenous administration of routine medicines (following university simulation) Signature Date Via cannulation CD/CS Via direct vein access CD/CS In accordance with NMC regulations is able to participate in controlled drug administration Signature CD CD Date Demonstrates the ability to safely involve women in the self-administration of medicinal products Signature CD CD Date Demonstrates accurate calculation of medicinal products in midwifery practice Signature CD CD Date Demonstrates the ability to order, receive and store medicines safely, applying knowledge of local Trust policies Signature CD CD Date Correctly dispenses medicines Signature CD CD Date Safely administers medicine to the neonate Signature CD CD Date Demonstrates the administration of an Signature CD/CS CD/CS
injection to the neonate Date Demonstrates oral administration of medicine to the neonate Signature CD CD Date Accurately documents medicine administration Signature CD CD Date Responds to, and reports, adverse drug reactions and near miss incidents Signature CD/CS CI Date Demonstrates an awareness of complementary therapies and refers appropriately to a registered complementary therapist Signature CD CI Date
Interpersonal Skills Communication Skills Demonstrates effective communication that is clear, unambiguous and appropriate for the care setting Signature CD/CI CI Date Initiates conversation and uses strategies to enhance communication such as removing communication barriers Signature CD/CI CI Date Answers the telephone professionally and deals appropriately with enquiries Signature CD CD Date Uses verbal skills of questioning, paraphrasing and reflection to enhance communication Signature CD/CI CI Date Actively listens and responds to verbal and non-verbal cues, respecting silences Signature CD/CI CI Date Uses touch appropriately Signature CD/CI CI Date Communicates effectively and sensitively with women who have physical, cognitive or sensory disability Signature CD/CI CI Date Ensures effective communication with women/ Signature CD CI
families who do not speak English Date Is able to explain findings from observations in a sensitive and clear manner, encouraging women to ask questions Signature CD CD Date Communicates and works with multi-professional agencies, valuing other roles and responsibilities Signature CD CI Date Communicate and works effectively with the multidisciplinary team, valuing other roles and responsibilities Signature CD CI Date Works effectively, providing support to others, as a midwifery team member Signature CD CI Date Collaborative Working Confidently refers to an appropriate professional when the expertise required for care is outside the midwife’s scope of practice Signature CD CI Date Date
Personal Attributes Practises in a way which treats the woman and her family with respect Signature CI CI Date Demonstrates empathy, kindness and compassion Signature CI CI Date Respects women’s rights and autonomy in decision-making and acts as their advocate Signature CI CI Date Demonstrate assertiveness in practice Signature CD CI Date Is proactive in maintaining privacy and dignity Signature CI CI Date
Is able to record and retrieve information using information technology Signature CD CI Date Informed Consent Uses appropriate strategies to enable women to make informed choices Signature CD CI Date Obtains maternal informed consent prior to undertaking any procedure Signature CI CI Date Anti – discriminatory Practice Uses a non-discriminatory and diversity sensitive approach to practice Signature CI CI Date
Neonatal Care Assessment Assess and monitor neonatal wellbeing Signature CD CI Date Accurately assesses neonatal vital signs: colour; tone; respiratory rate and pattern, and heart rate, stools, temperature, blood glucose, oxygen saturation Signature CD CI Date Performs an initial examination of the neonate Signature CD CI Date Accurately records neonatal birth weight Signature CI CI Date Performs a new born blood spot Signature CD CI Date Care Management Promotes an environment that minimises separation of mother and baby Signature CI CI Date Promotes an environment that facilitates skin-to-skin contact Signature CD CI Date Signature CD CI
Provides advice and support on hygiene needs of the baby Date Provides advice and support on umbilical cord care Signature CI CI Date Refers to additional specialist services when appropriate e.g. BCG, renal scan Signature CD CI Date Ensuring Safety and Security of the Baby Ensures safety and protection of the baby Signature CI CI Date Safely discharges the baby to the postnatal ward or home Signature Date CD CD Complex Neonatal Care Examine and cares for babies with complex needs Signature CD CI Date Provides support for families with an ill/preterm baby Signature CD CI Date
Justifies and obtains swabs from the neonate Signature CD/CI CI Date Recognise signs of infection in baby and report appropriately Signature CD CI Date Performs a neonatal capillary blood sample Signature CD CI Date Support and assist the mother with nasogastric feeding of her baby Signature CD CD Date Emergency Procedures Initiates the emergency call and demonstrates resuscitation of the newborn baby Signature CD/CS CD/CS Date
INFANT FEEDING Initiation and Continuation of Breastfeeding Communicates sensitively the benefits of exclusive breastfeeding for mother and baby Signature CD/CI CI Date Communicates sensitively the benefits and risks associated with formula feeding Signature CD/CI CI Date Considers cultural traditions and beliefs relating to breastfeeding Signature CD/CI CI Date Facilitates forums where information is shared relating to the advantages and disadvantages of different infant feeding methods Signature E CD Date Explains the principles of Baby Friendly Initiative (skin-to-skin, baby-led feeding, rooming in) Signature CD CI Date Recognises effective positioning, attachment, suckling and milk transfer Signature CD CI Date Empowers women to recognise effective positioning, attachment, suckling and milk transfer Signature CD CI Date of Signature CD CI
Recognises common complications of breastfeeding and responds appropriately Date Teaches principles of hand expression of breast milk to the mother Signature CD CI Date Provides accurate information on the safe storage, freezing and warming of breast milk Signature CD CI Date Directs women to breastfeeding support Signature CD CI Date Advises women via telephone when contacted for advice on breastfeeding issues Signature CD CI Date Advises women how to optimise lactation when separated from baby Signature CD CI Date Appropriate use of breast pump Signature CD CI Date Identifies babies that require managed approach to feeding Signature CD CI Date