HANDLING DELIVERY

Procedure Rationale

Procedure Rationale
sterile environment.

To prevent the spread

Do medical of infection to the To maintain a sterile
handwashing patient and maintain a Perform gowning and field and prevent
sterile environment. gloving technique contamination of the
sterile equipment.

To ensure that all

necessary equipment To maintain a sterile
and supplies are field and prevent
Prepare the OB pack Do draping
readily available for contamination of the
immediate use during sterile equipment.
the delivery.

Open the outer lining To maintain a sterile

4. Get ready with the delivery | To
ensure that the student nurse is
with your bare hands field and prevent
prepared to assist with the delivery
standing 1 ft away contamination of the
of the fetus and placenta.
from the sterile table sterile equipment.
4.1 Handle the delivery of the
fetus (student nurse to support
To maintain a sterile
the perineum) | To support the
mother and prevent injury to the
Open the inner lining field and prevent
perineum during the delivery of the
using a sterile forceps contamination of the
fetus.
sterile equipment.
Slide your hands to the neck and
the baby of the fetus as it delivered
Drop the surgical smoothly and easily. | To ensure
that the fetus is delivered safely
gloves in the sterile
To maintain a sterile and without injury.
field (prepare sterile
field and prevent 4.2 Place the baby to the
gloves for the
contamination of the mother's abdomen | To promote
surgeon, handle
sterile equipment. skin-to-skin contact between the
nurse and assisting
mother and baby, which is
nurse) beneficial for both.
4.3 Clamp the cord 8-10 inches
away from the umbilicus with
Action Rationale
Kelly forceps one-inch apart
clamp and cut with scissors in
--- --- between. (Kelly straight from
the base. (Kelly curves towards
the placenta) | To prevent
Do medical and To prevent the spread excessive bleeding from the
surgical handwashing of infection to the umbilical cord and to ensure that
patient and maintain a the cord is clamped properly.
4.4 Proceed with the delivery of
placenta | To ensure that the
 placenta is delivered safely and
completely. Procedure Rationale
Hold the forceps connecting
the placenta and wait 3-5 mins diaper to the mother.
for sign of placenta separation.
| To allow for the placenta to To ensure that
detach from the uterine wall. the mother is
Slowly pull cord while a slight 4.10 Do after
comfortable and
pressure exerts above the care:
recovering well
mons pubis. | To help deliver the after delivery.
placenta.
4.5 Once delivered, place
Position the To promote
placenta on its bowl and
mother comfort and
inspect the completeness of its
comfortably- reduce the risk
part. | To ensure that the entire
legs closed of bleeding.
placenta has been delivered and to
check for any abnormalities.
Take note of the methods of To maintain a
separation | To document the Remove clean and
method of placental separation for stained draper hygienic
future reference. environment.
Circulating nurse to get the
blood pressure of the mother | To assess the
To monitor the mother's vital signs Monitor the mother's overall
and ensure that she is stable. vital signs, health and well-
4.6 Assist in suturing the bleeding, and being and to
episiotomy | To repair any tears in consciousness identify any
the perineum that may have of the mother potential
occurred during delivery. complications.
Anticipate doctor's need during
suturing | To be prepared to assist To ensure that
the doctor with the suturing Check the all instruments
process. instruments if used during the
4.7 Flush site with normal complete delivery are
saline. | To clean the area and accounted for.
prevent infection.
To prevent the
spread of
Wash the
infection and to
instrument and
Procedure Rationale maintain a
let these dry
sterile
4.8 Apply To prevent environment.
betadine infection and
antiseptic on promote healing To ensure that
perineum of the perineum. all instruments
Pack clean
are properly
equipment and
4.9 Apply To absorb any cleaned and
autoclave
sanitary bleeding and sterilized for
pad/adult provide comfort future use.
 Procedure Rationale

instruments.

To access the
ASSISTING DELIVERY Open the inner
sterile
lining of the
instruments
pack
inside the pack.
Procedure Rationale

Use sterile
To ensure that
picking forceps To prevent
all necessary
facing down contamination
equipment and
when opening of the sterile
supplies are
Preparation of the inner lining instruments.
readily
equipment of the OB pack.
available for
immediate use
during the To ensure that
delivery. Check the all instruments
instrument pack are present and
accounted for.
To prevent the
spread of
infection to the To ensure that
Do medical Check if the all necessary
patient and
handwashing instruments are instruments are
maintain a
sterile complete available for
environment. the delivery.

To ensure that To ensure that

Get and prepare all necessary Prepare all necessary
the instrument instruments are additional equipment is
pack sterile and equipment available for
ready for use. the delivery.

To keep the To maintain a

Drop the
instrument sterile
Place it in the additional
pack organized environment
mayo table materials to the
and easily and prevent
open instrument
accessible. contamination
pack (sterile
of the
field)
instruments.
To access the
Open the outer
inner lining of
lining of the To administer
the instrument
instrument pack 10 cc disposable medications or
pack.
syringe fluids as
needed.
Use bare hands To prevent
in opening the contamination
outer lining of the sterile Sutures To close any
Procedure Rationale Procedure Rationale

wounds or during the

lacerations that delivery.
may occur
during the To ensure that
delivery. Strictly follow the gowning
the principles of and gloving
To clamp the gowning and technique is
umbilical cord gloving performed
10 pieces sterile
and prevent technique correctly and
OS
excessive effectively.
bleeding.
To keep the
2.4 Arrange the
To clamp the delivery area
materials
umbilical cord organized and
Umbilical cord according to
and prevent ensure that all
clamp use, from right
excessive necessary
to left (in
bleeding. materials are
laddered
easily
manner)
To suction accessible.
mucus from the
Bulb syringe
newborn's To clamp the
airway. 10 Sterile OS (in umbilical cord
laddered and prevent
To ensure that manner) excessive
the student bleeding.
nurse is
Actions:
prepared to 10 cc disposable
assist with the syringes (above
delivery. the umbilical To administer
cord clamp) - fill local anesthesia
To prevent the it up with to the mother
spread of lidocaine 2% during the
Do medical and infection to the with the help of delivery.
surgical patient and the circulating
handwashing maintain a nurse
sterile
environment. To clamp the
umbilical cord
Procedure Rationale Cord clamp and prevent
excessive
bleeding.
2.3 Do gowning To maintain a
and gloving sterile
technique environment Bandage To cut the
and prevent scissors umbilical cord
contamination and other
materials as
Procedure Rationale Procedure Rationale

needed. clamp with 1 umbilical cord

sterile OS and prevent
To clamp the (sponge tip) excessive
umbilical cord placental bowl bleeding.
Kelly curve and other
materials as To assist the
Assist the doctor
needed. doctor with the
during the
delivery of the
delivery of the
To clamp the baby and to
baby - serve the
umbilical cord ensure that all
instruments
Kelly straight and other necessary
(anticipate the
materials as instruments are
needs of the
needed. readily
doctor)
available.
Umbilical cord To cut the
cutter (optional) umbilical cord. Have the
To be prepared
sponges,
to assist the
sutures and
To cut the doctor with the
other
umbilical cord delivery of the
instruments
Surgical scissors and other baby.
ready for use
materials as
needed.
Handling each To ensure that
instrument in the doctor can
Needle holder such a way that easily access
with sutures the doctor can and use the
(matched the To hold the grasp it easily instruments.
suture on the suture needle
3rd teeth of the securely and to
needle holder, prevent Pass the
place it accidental instrument in
downward to needle sticks. the position that
avoid needle the doctor will
prick injury) use it, and To ensure that
placing the the doctor can
instrument's easily access
To grasp and ring handles and use the
Tissue forceps hold tissues firmly into the instruments.
without teeth during the surgeon's
delivery. palms. Pass it
with a snap
To grasp and sound.
Tissue forceps hold tissues
with teeth during the Procedure Rationale
delivery.

Do after care To ensure that

Ovum forceps To clamp the the delivery
Procedure Rationale

area is cleaned
and sanitized
and that all
instruments are
accounted for.

To ensure that
Counting of all instruments
instruments used during the
together with delivery are
the circulating accounted for
nurse and that none
are missing.

To prevent the
Clean the spread of
instruments and infection and to
make sure it is maintain a
complete (wash sterile
and dry) environment for
future use.