self-assessment form

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Use these questions to assess your performance, reflect on what you did well and what you can improve in the future

Guidelines to help you assess your performance

  • Facilitates Relationship
    • takes responsibility for negotiating an effective partnership
    • maintains comfortable rapport with the woman
    • establishes trust
    • is responsive to the needs expressed by the woman
    • maintains professional manner and presentation
  • Assesses
    • assesses woman’s own knowledge and experience
    • identifies woman’s needs and responds
    • recognises woman’s social, cultural and health context
  • Shares Information
    • displays an accurate knowledge base
    • provides quality evidence based information
    • appropriate options offered
    • communicates clearly and effectively
    • establishes woman’s understanding
  • Conclusion
    • brief summary of information provided
    • establishes availability for ongoing discussion/advice
    • documents discussions, assessments and actions

Specific guidelines to help you assess your actions

  • Assesses woman and baby's condition
    • mother's general condition
    • physical assessment including blood pressure, respiration, temperature, pulse
    • assess blood loss, uterine contraction/s, bladder
    • checks placenta and membranes for health and completeness,
    • assess perineum to see if it requires repair
    • appropriate equipment ready, including emergency resuscitation equipment and medication
    • support of mother during third stage of labour including keeping bladder empty, encouraging baby to breastfeed, comfort measures, ongoing monitoring of mother's health, when and how to cut the cord, when and how to push placenta
    • monitoring of progress
    • assessment of baby's condition
    • what support and comfort measures does the woman need need?
    • reviews history and background from woman’s notes, exclude risk factors
    • reviews careplan
  • Sharing information
    • findings of all assessments
    • what to expect in the third stage of labour including how to birth the placenta and membranes - position, how to push, comfort measures,progress
    • cutting the cord and care of the placenta
    • things that will necessitate further assessment and treatment eg delayed progress, excessive blood loss
    • possible need for perineal repair and after care
    • ongoing monitoring of health of mother and baby
    • first breastfeed
    • initial care of newborn baby including administration of vitamin K
  • Plan for ongoing care
    • support mother to birth placenta, including control of excessive blood loss

repair perineum if required

    • ensure skin-to-skin contact between mother and baby, including first breastfeed
    • provide ongoing support, comfort measures and reassurance as required
  • Concludes discussion appropriately
    • briefly summarize advice and plan of action
    • ensure woman’s understanding
    • emphasize her choice about plan of action
    • make sure she knows you will be providing ongoing support
  • Documents discussion including advice and plan for ongoing care
    • date, time, signature
    • information woman shared with you
    • advice you gave woman
    • plan of action