UNIVERSITY OF ST.

LA SALLE
College of Nursing

NCM 101 – SKILLS LABORATORY

ESSENTIAL NEWBORN CARE CHECKLIST

Name: Date:
Year Level & Section: Group:

In advance, prepare decontamination solution by mixing 1 part 5% of chlorine bleach to 9 parts water to make 0.5%
chlorine solution at the beginning of each day or whenever solution is very contaminated or cloudy.
Desired Actual
Preparatory Phase: Comments
Score Score
1. Remove all jewelries 2
2. Put on mask and close cap. 2
3. Wash hands observing the WHO 1 to 11 steps procedure. 2
4. Prepare and arrange materials/ supplies in a linear sequence; gloves, dry linen,
bonnet. Syringe, plastic clamp, instrument clamp, scissors, 2 kidney basins. In 2
separate sequence, after breastfeeding; eye ointment, stethoscope, Vitamin. K,
Hepa-B and BCG vaccines, cotton balls.
5. Prepare a clean, newborn resuscitation area. 2
6. Check, if the equipment is clean, functional and within easy reach. 2
7. Don 2 pairs of sterile gloves. 2
8. Place a dry, sterile linen on the mother’s abdomen in preparation for drying the
2
baby.
9. Deliver the newborn applying aseptic technique. 2
10. Call all out time and sex of the baby. 2
Subtotal 20
Time Bounded: First 30 seconds
1. Immediate and thorough drying of the newborn.
a. Using dry & sterile gauze, wipe the mouth of the baby first & then the nose,
2
head, face and body gently taking care not to remove all the vernix caseosa.
b. Do tactile stimulation by gently rubbing the back or the soles of the feet to 2
stimulate the baby to cry, and quickly check for breathing
c. Assess the newborn using the APGAR Scoring tool within a minute after birth
2
1-3 minutes
1. Promote skin-to-skin contact between newborn and mother. 1
a. Remove the wet cloth
b. Place the newborn prone on the mother’s abdomen or chest.
c. Cover the newborn with dry blanket and bonnet. 4
d. Reevaluate the newborn using the APGAR Scoring tool five minutes after birth.
Assess the newborn in a cephalo-caudal manner.
2. Remove the soiled pair of gloves before handling the newborn’s cord.
2
3. Properly – time cord clamping and cutting.
a. Palpate and wait for the cord to stop pulsating. 2
b. Clamp the cord using the forceps with the latex band (or with an umbilical
clamp) 2cm. from the base of the cord. Do not milk the cord. 2
c. Apply the second forceps 5cm away from the base of the cord.
d. Cut the cord and place the latex band correctly on the cord. 2
e. Check for presence of the following:
e.1 (1) umbilical vein 2
e.2 (2) umbilical arteries
e.3 bleeding anywhere near the base of the cord
15-90 minutes
1. Promote early breastfeeding. Observe for feeding cues and nudge the newborn
2
to initiate feeding.
2. Support/advise mother for proper positioning and attachment. 2
Subtotal 25
Non – Time Bounded Procedures:
1. Administer Crede’s prophylaxis.
a. Open the newborn’s one eye by gently holding the upper lid upward with the
index finger and the lower lid downward with the thumb. 2
b. Squeeze eye ointment gently to deposit 1 cm of eye medication on the lower
lid. Apply the drug from the inner to the outer canthus.
c. Do the same thing to the other eye.
2. Place the ID band bearing the name of the baby & the mother on either the wrist
2
or ankle of the newborn.
3. Measure the newborn’s body length, head and chest circumference using the
2
tape measure.
4. Take the baseline core temperature of the newborn. 2
5. Check for anal patency by carefully inserting the tip of the NGT tube into the
2
anus while positioning the newborn appropriately.
6. Line the weighing scale with a diaper and take the newborn’s weight, being
2
careful in placing the newborn on the scale.
7. Do a thorough physical exam. 2
8. Prepare & inject Vitamin K intramuscular into the left vastus lateralis muscle.
4
(dose depends on the weight of the newborn) then the Hepa-B. on the right vastus
lateralis muscle.
9. Put on the baby’s clothing and wrap the baby. 2
Do after – care of materials and equipment.
Subtotal 20

TOTAL POINTS 65

Student’s Score:
Equivalent (70% transmutation):
CI’s Signature: