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/depts/uwhealth/ambulatory-education/ambulatory-orientation/checklists/resources/Obstetrics-Gynecology-Checklist-12122017.pdf

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UWHC,UWMF,

Learning and Development,

Departments & Programs,UW Health,Ambulatory Education,Ambulatory Orientation,Checklists - Core and Department Specific,Resources

Obstetrics/Gynecology

Obstetrics/Gynecology - Departments & Programs, UW Health, Ambulatory Education, Ambulatory Orientation, Checklists - Core and Department Specific, Resources



Obstetrics/Gynecology Clinical Training Checklist

Name: ___________________________ ID: _________ Clinic: ______________ Start Date: ________ Due Date: ________
Area of Orientation

Discussed/
Observed
(D/O)
Preceptor’s
Initials
Date
Completed
Online Training: Utilize the Learning and Development System (LDS)
ξ Review and Complete CBT List found in your yellow folder
ξ In LDS complete the CBT titled "TB Skin Test Administration and
Reading"

ξ Perform TB skin test and reading twice for review
1.________ 2._________

Basic Office Visit: Data collection will include the following
ξ Collect reason for visit and short summary of chief complaint (use of .nn
smart phrases)

ξ Review smoking history
GYN information
ξ Menstrual history
ξ Family planning issues
ξ Sexual concerns
ξ Expedited partner therapy
ξ History – health management, social and family
ξ Physical signs/symptoms of domestic abuse
ξ Psychosocial health status when indicated
ξ Information regarding relationships with significant others
ξ Appropriate resources for gaps in family support structure
OB information
ξ Normal physiological changes of pregnancy
ξ Signs/symptoms of hypertension, preterm labor, abruptio placenta,
miscarriage

ξ Growth and development of fetus
ξ Fetal well-being and fetal heart rate

V 12/13/2017 Draft Ambulatory RN Orientation Review
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Area of Orientation

Discussed/
Observed
(D/O)
Preceptor’s
Initials
Date
Completed
ξ Appropriate action for fetal distress; notify provider, turn on left side,
begin O2, start IV, call 911/transport if needed

ξ Postpartum assessment: signs of bleeding, infection, mastitis
ξ Signs of depression and able to administer and tally the CES-Depression
Scale

GYN Health Education
ξ Demonstrate breast self-exam
ξ Contraceptive options, effectiveness, risks and benefits of each method
ξ Exercise and nutrition programs and information
ξ Infertility programs
ξ Pre-conceptual counseling program
ξ Prevention and treatment of sexually transmitted diseases
ξ PAP tests; both normal and abnormal
ξ Abnormal vaginal bleeding
ξ Special needs of adolescent/pediatric GYN patient
ξ Special needs of perimenopausal and postmenopausal patient
ξ Hormone replacement therapy
ξ Stress incontinence and uro-gynecological issues
OB Health Education
ξ Pre-pregnancy medical conditions and previous pregnancy complications
ξ Normal growth and development of the fetus
ξ Adverse effects of illicit drugs, alcohol, caffeine, nicotine
ξ Maternal and fetal nutrition
ξ Antepartum bleeding
ξ Preterm labor
ξ Preeclampsia and pregnancy induced hypertension
ξ Abruptio placenta
ξ Multiple gestation
ξ Intrauterine growth retardation
ξ Gestational diabetes

V 12/13/2017 Draft Ambulatory RN Orientation Review
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Area of Orientation

Discussed/
Observed
(D/O)
Preceptor’s
Initials
Date
Completed
ξ Insulin dependent diabetes in pregnancy
ξ Blood glucose monitoring
ξ HELLP syndrome
ξ Patient with cardiac or pulmonary problems in pregnancy
ξ Genetic/prenatal testing
ξ 1st trimester screen/Quad screen/Triple screen
ξ High risk pregnancy self-care practices
ξ Fetal movement monitoring
ξ Bed rest in lateral position
Demonstrate ability to counsel and provide appropriate resources for:
ξ Pregnancy loss/termination
ξ Anomalous fetus
ξ Malignant tumors of breast or reproductive tract
ξ Tubal pregnancy loss
ξ Teen pregnancy
Telephone Calls and Triage
ξ Demonstrates knowledge of telephone call documentation requirements;
use of smart phrases

ξ Demonstrates knowledge and use of MyChart messages
ξ Review HIPPA and telephone calls; leaving a voice message
ξ Able to complete consults/referrals to other departments as needed and
provide patient with appropriate resources

ξ Triage resources: Has knowledge of resources appropriate for the age
population

ξ Barton Schmitt Pediatric triage book
ξ Telephone Triage Protocols for Nurses by Julie Briggs
ξ Telephone Triage for Obstetrics and Gynecology by Vicki E. Lond
ξ External Resources available on HealthLink and Health Facts for You
documents on UConnect


V 12/13/2017 Draft Ambulatory RN Orientation Review
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Area of Orientation

Discussed/
Observed
(D/O)
Preceptor’s
Initials
Date
Completed
ξ Conduct telephone triage; assessing patient’s/parent’s concerns and
provide the best disposition for the situation

ξ Preceptor to review a minimum of 10 triage calls within first month for
completeness, disposition, and documentation

Policies/Protocols specific to OB/GYN
ξ UTI protocol
Procedures - Demonstrate set-up/assist/patient care/follow-up with
ξ Endometrial biopsy
ξ Labial, vulvar and cervical biopsies
ξ Lesion removal
ξ Hysteroscopy
ξ Colposcopy and Cryosurgery
ξ LEEP
ξ Staple removal
ξ Abnormal bleeding or shock during a procedure
ξ Emergency delivery in the office
ξ IV hydration for hyper-emesis, ketones etc.
ξ IUD insertion
ξ Implantation insertion/removal
ξ Correct labeling of specimens and paperwork
ξ Non stress test (NST)
Surgery
ξ Schedule surgery of patient appropriately
ξ Obtain pre-authorization of surgery
ξ OB/GYN Surgical Checklist

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Area of Orientation

Discussed/
Observed
(D/O)
Preceptor’s
Initials
Date
Completed
Sterilization of instruments/autoclaving
ξ Instrument cleaning and autoclaving completed properly
ξ Proper wrapping and marking of packs
ξ Proper cleaning of autoclave