OBSTETRICS / GYNAECOLOG One program to handle all talent management needs from acquisition to development Personal Information HiddenOverall ScoreName(Required) First Middle Last Last 4 Digits of Social Security Number Email(Required) HiddenDate MM slash DD slash YYYY Proficiency Scale1 – No Experience 2 – Need Training 3 – Able to perform with supervision 4 – Able to perform independentlyGYNAECOLOGYAbortion(Required) 1 2 3 4 Ectopic pregnancy(Required) 1 2 3 4 Genito-urinary Tract Infection(Required) 1 2 3 4 Infertility(Required) 1 2 3 4 Perineal Repairs(Required) 1 2 3 4 Uterine and ovarian tumors/fibroids(Required) 1 2 3 4 Utero-vaginal prolapse(Required) 1 2 3 4 OBSTETRICSAntepartum hemorrhage(Required) 1 2 3 4 Caesarian section - Elective(Required) 1 2 3 4 Caesarian section - Emergency(Required) 1 2 3 4 Cervical suture(Required) 1 2 3 4 High risk pregnancy: - Communicable diseases with pregnancy(Required) 1 2 3 4 High risk pregnancy: - Gestational diabetes(Required) 1 2 3 4 High risk pregnancy: - Grand multiparity(Required) 1 2 3 4 High risk pregnancy: - Pregnancy induced hypertension (Pre-eclampsia, eclampsia)(Required) 1 2 3 4 High risk pregnancy: - Polyhydramnios(Required) 1 2 3 4 NURSING SKILLS CHECKLISTIntrauterine death(Required) 1 2 3 4 Intrauterine growth retardation(Required) 1 2 3 4 Hyperemesis gravidarum(Required) 1 2 3 4 Normal pregnancy(Required) 1 2 3 4 Normal spontaneous delivery(Required) 1 2 3 4 Perineal block(Required) 1 2 3 4 Head to toe physical examination of pregnant woman(Required) 1 2 3 4 Post instrumental delivery(Required) 1 2 3 4 Post-partum hemorrhage(Required) 1 2 3 4 Premature rupture of membranes(Required) 1 2 3 4 Knowledge of drugs commonly used in obstetrics(Required) 1 2 3 4 Foetal monitoring techniques(Required) 1 2 3 4 Assess and manage newborn(Required) 1 2 3 4 Perform emergency resuscitation of newborn: Initiation and maintenance of CPR(Required) 1 2 3 4 Perform emergency resuscitation of newborn: Suctioning of airways(Required) 1 2 3 4 Perform emergency resuscitation of newborn: Mask and bagging technique(Required) 1 2 3 4 Perform emergency resuscitation of newborn: Dosage and administration of resuscitation drugs (bicarb, adrenaline, narcan, etc)(Required) 1 2 3 4 Perform initial critical newborn management : Maintenance of body temperature(Required) 1 2 3 4 Perform initial critical newborn management : Resuscitation(Required) 1 2 3 4 Perform complete examination of the newborn.(Required) 1 2 3 4 Collection of cord blood for TSH(Required) 1 2 3 4 Teach mother to breast feed(Required) 1 2 3 4 Assist with ante-natal classes and post natal exercises(Required) 1 2 3 4 Care of pre and post operative obstetrical and gynaecological patients(Required) 1 2 3 4 Manage nursing aspects of infertility patients(Required) 1 2 3 4 Working knowledge of specialized equipment common to obstetrical areas: Infusion control devices, IVAC, IMED, Abbott, syringe pump(Required) 1 2 3 4 Working knowledge of specialized equipment common to obstetrical areas: CTG(Required) 1 2 3 4 Working knowledge of specialized equipment common to obstetrical areas: Foetal monitor(Required) 1 2 3 4 Working knowledge of specialized equipment common to obstetrical areas: Doppler(Required) 1 2 3 4 Working knowledge of specialized equipment common to obstetrical areas: Ultrasound(Required) 1 2 3 4 Working knowledge of specialized equipment common to obstetrical areas: Isolette/incubator/resuscitaire(Required) 1 2 3 4 Working knowledge of specialized equipment common to obstetrical areas: Vacuum extractor, forceps(Required) 1 2 3 4 Working knowledge of specialized equipment common to obstetrical areas: Fetal scalp blood sampling machine(Required) 1 2 3 4 Insert /establish IV(Required) 1 2 3 4 Perform venepuncture for blood sampling(Required) 1 2 3 4 Assist doctors with performing fetal blood sampling(Required) 1 2 3 4 Assist with taking pap smear(Required) 1 2 3 4 Function as Charge Nurse(Required) 1 2 3 4 AuthorizationsLegal Consent(Required) I agree to the terms and conditions.Consumer Disclosure Regarding Conducting Business Electronically, Signing Documents Electronically, and Receiving Electronic Notices and Disclosures Please read the information below, carefully, as it concerns your rights. eSignatures are an efficient way to execute an agreement with the same legal force and effect of a handwritten or “wet ink” signature. 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