COMPETENCY ITEMS AND VALIDATION TECHNIQUES
COMPETENCY: POSTPARTUM MATERNAL AND NEWBORN NURSING CARE
Standard: Postpartum maternal and newborn nursing care promotes postpartum adjustment, health maintenance of the newborn and family adaptation and is an integral component of maternal and child health home visiting care.
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I. The nurse demonstrates knowledge of and ability to conduct a postpartum maternal assessment & develop a plan of care. |
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Technical Skills |
Interpersonal Skills |
Critical Thinking Skills |
Validation |
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1. Demonstrates postpartum maternal physical assessment, compares data with norms and reports abnormal findings to physician or certified nurse midwife for the following areas (refer to the Guide for Maternal Postpartum Assessment, Anticipatory Guidance & Health Teaching - under development): · general health (vital signs, nutrition, weight, sleep/activity level, & resources)· breasts/nipples· uterus· lochia· perineum· cesarean birth· elimination· circulatory (extremities)· discomforts· affect
2. Lists signs and symptoms as well as client education for each of the following: · uterine infection· deep vein thrombosis· hemorrhage
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3. Demonstrates ability to create an environment of privacy for communication and/or physical assessment 4. Clarifies information, definitions, medical jargon, and medical practice routines
5. Demonstrates the ability to engage the client in sensitive topics such as sexual activity, birth control & nutrition 6. Reviews with client the signs and symptoms for which the physician or certified nurse midwife should be called
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7. Develops and modifies the plan of care based on maternal: · risk factors- health history - psychosocial - environmental - lifestyle · physical findings· cultural and ethnic traditions
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Observation of home visit Technical skill item #1 Physical assessment includes the following areas and evaluation of nurse’s ability to compare data with norms and report abnormal findings to physician or certified nurse midwife:
Written or verbal test Technical skill item #2 List 3 signs & symptoms as well client education for the following:
Observation of home visit Interpersonal skill item #3 Privacy and respect is observed when the nurse suggests to client that exam be performed in private space; exam is performed with a sensitivity to client exposure/vulnerability; and the nurse asks permission of client before any part of the examination is performed. Interpersonal skill item #4 Language is clear and understandable if: the client demonstrates understanding of the material by asking questions that elaborate the material being presented; client demonstrates follow through; and the client is responsive in the interactions.
In follow-up discussion Interpersonal skill item #5 The nurse is able to engage the client in sensitive topics such as sexual activity, birth control and nutrition. Interpersonal skill item #6 Did the nurse review with the client the signs and symptoms for which the physician or nurse midwife should be called? In follow-up discussion Critical thinking skill #7 Describe the risk factors, physical findings and culture/ethnic traditions which influenced the client's plan of care?
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II. The nurse demonstrates the ability to assess psychosocial adjustment of the family unit. |
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Technical Skills |
Interpersonal Skills |
Critical Thinking Skills |
Validation |
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1. Lists predisposing factors of postpartum depression 2. Describes normal maternal/infant attachment 3. Defines reportable abuse & neglect according to state law 4. Lists community resources for: · parent education· treatment of substance abuse· mental health· domestic violence |
5. Assists the client or family in identifying available support systems 6. Involves caregivers in problem solving and planning to meet the needs of self, baby, and family 7. Reviews with client the signs and symptoms of postpartum depression for which her physician or certified nurse midwife should be called
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8. Builds a realistic plan of care considering the following: · parent/infant interaction· family dynamics· family support systems (availability & quality)· community resources |
Written Test Technical skill item #1 List 3 predisposing factors of postpartum depression. Technical skill item #2 List 5 descriptors of normal maternal/infant attachment. Technical skill item #3 Define reportable abuse and neglect according to state law. Technical skill item #4 List one community resource for each of the following:
Observation of a home visit Interpersonal skill item #5 Was the nurse able to assist the family in identifying 1 or more available support systems? Interpersonal skill item #6 Were the caregivers involved in developing the plan of care? Interpersonal skill item #7 Did the nurse review with the client 3 signs and symptoms of postpartum depression for which she should call her physician or certified nurse midwife? In follow-up discussion Critical skill item #8 Describe a factor related to parent/infant interaction, family dynamics, family support systems and community resources that influenced the plan of care?
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III. The nurse demonstrates the application of current information relating to the continuum of postpartum health maintenance. |
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Technical Skills |
Interpersonal Skills |
Critical Thinking Skills |
Validation |
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Section A 1. Describes postpartum nutrition requirements 2. Describes adjustments in diet in the presence of:
3. Identifies the following community nutrition support systems:
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4. Adjusts teaching based on such factors as: · breastfeeding· family resources (e.g. kitchen facilities, finances)· food preferences· eating habits· eating disorders· weight gain/loss· client goals |
Written test Technical skill item #1 Describe current recommendations for postpartum client using the food groups/food pyramid. Technical skill item #2 List at least 2 adaptations of the diet for each of the following:
Technical skill item #3 Identify at least 1 community resource for each of the following:
In follow-up discussion Critical skill item #4 How did you adjust your teaching based upon such factors as breastfeeding, resources, food preferences, eating habits, eating disorders, weight gain/loss, and client goals |
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III. The nurse demonstrates the application of current information relating to the continuum of postpartum health maintenance. |
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Technical Skills |
Interpersonal Skills |
Critical Thinking Skills |
Validation |
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Section B 1. For the following discomforts associated with postpartum, identifies prevention or self-care measures:
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Written test Technical skill item #1 List 2 prevention or self-care measures for each of the following discomforts associated with postpartum:
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Section C 1. Describes exercises that safely restore abdominal and pelvic tone during postpartum |
Written test Technical skill #1 Describe 2 exercises that safely restore abdominal and pelvic floor tone during postpartum. |
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Section D 1. Describe the advantages, disadvantages and contraindications of common birth control methods:
2. Lists the factors that influence resumption of sexual relations 3. Describes the prevention of sexually transmitted diseases |
Observation of home visit or role play Technical skill item #1 Name the advantages, disadvantages and contraindications of at least one birth control method discussed with client.
Written test Technical skill item #2 List 3 factors that influence resumption of sexual relations (other than having no partner.) Technical skill item #3 List 3 sexually transmitted diseases and 2 methods of preventing them. |
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IV. The nurse demonstrates knowledge of and ability to conduct a newborn physical assessment and develop a plan of care. |
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Technical Skills |
Interpersonal Skills |
Critical Thinking Skills |
Validation |
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Section A 1. Demonstrates newborn physical assessment, compares data with norms, and reports abnormal findings to physician or certified nurse midwife for the following areas (refer to Guide for Newborn Physical Assessment, Anticipatory Guidance and Health Teaching):
2. Lists acceptable low/high for normal newborn temperature 3. Identifies the maximum expected weight loss for normal newborns in the first week of life |
4. Demonstrates respect for parents' role as primary care giver/first teacher of the infant by: · requesting permission of parent before beginning examination· explaining to the parent the process of the examination, and the findings of the assessment· clarifying information, definitions, medical jargon, and medical practice routines· engaging the parent’s curiosity and empathy |
5. Develops and modifies the plan of care based on: · Risk factors- psychosocial - environmental - lifestyle · Physical findings
· cultural and ethnic traditions |
Observation of home visit Technical skill item #1 Physical assessment includes the following areas and the ability to compare data with norms and report abnormal findings to physician or certified nurse midwife:
Written test Technical skill item #2 List acceptable low/high for newborn temperature. Technical skill item #3 Identify the maximum expected weight loss for normal newborns in the first week of life. Observation of home visit Interpersonal skills item #4 Did the nurse request permission before beginning examination? Did the nurse explain the examination process and the findings? Was the language used with the client clear and understandable for the client? Did the nurse engage the parent’s curiosity and empathy? Follow-up discussion Critical thinking skill item #5 How did a risk factor, physical finding and culture/ethnic tradition influence the plan of care? |
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Section B 1. Lists signs and symptoms of neonatal:
2. Lists physical findings of neonatal jaundice that would indicate the need for a pediatric care provider referral as it relates to:
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3. Reviews with parent(s) signs and symptoms for which their pediatric health care provider should be called. |
Written test Technical skills item #1 List 3 signs and symptoms for each of the following newborn problems:
Technical skills item #2 Describe physical findings of neonatal jaundice that would indicate a pediatric health care provider referral as it relates to:
Interpersonal skill item #3 Did the nurse review signs and symptoms with parent(s) for which the pediatric health care provider should be called? |
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V. The nurse demonstrates the ability to support parents' understanding and response to the newborn's adaptation and health needs. |
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Technical Skills |
Interpersonal Skills |
Critical Thinking Skills |
Validation |
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Section A 1. Describes adequate nutritional intake for a newborn in cc or ounces of formula and/or in number of breastfeedings in 24 hours. |
Written or verbal test Technical skill item #1 Describe adequate nutritional intake of both a formula fed and breastfed newborn. |
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Section B 1. Identifies cues of infant response/tolerance to stimulation (touch, sound, and visual) 2. Identifies techniques that support the newborn's ability to come into a quiet or alert state 3. Describes the importance of stimulation and interaction on the development of the brain |
Written test Technical skill item #1 List 3 cues of overstimulation of the newborn. Technical skill item #2 List 3 techniques of supporting an infant in quieting and coming into an alert state. Technical skill item #3 Identify factors that promote healthy brain development in the first 3 years of life |
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V. The nurse demonstrates the ability to support parents' understanding and response to the newborn's adaptation and health needs. |
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Technical Skills |
Interpersonal Skills |
Critical Thinking Skills |
Validation |
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Section C 1. Lists preventive measures related to
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2. Engages parent(s) in a discussion of car safety, environmental smoke, shaking or other inappropriate handling and sleep safety |
Written or verbal test Technical skill item #1 List at least 1 preventive measure related for each of the following:
Observation of a home visit Interpersonal skill item #2 Was the nurse able to engage the parent(s) in a discussion of one of the following topics: car safety, environmental smoke, shaking or other inappropriate handling and sleep safety. |
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Section D 1. Describes recommended well child health care:
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Written or verbal test Technical skill item #1 List recommended immunizations for a 2 month old using the Vermont Department of Health Immunization Schedule. List recommended well child care for a 6 week old using the Vermont Department of Health Health Screening Recommendations for Children and Adolescents. |
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