L&D Nursing Checklist

Labor & Delivery Workflow Reference

L&D Checklist ✿
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Room

Triage workflow

Patient registration, first orders, ongoing charting & discharge

🌸Registration & Setup

First steps when patient arrives

🩺Hands On Care

Initial patient assessment

πŸ“‹Orders & Documentation

Cerner orders and adhocs

⏱Ongoing Charting

While patient is in triage

πŸ‘‹Discharge

Wrap up & cleanup

Non-Stress Test

Outpatient antenatal NST workflow

πŸ“Setup & Orders

Get the patient registered

πŸ’—Patient Care

Monitor and document

βœ…Wrap Up

Discharge from NST

Induction & Labor Admit

Room prep, first hour care & initial documentation

🌷Room Prep β€” Before

Set up the room

⏰First Hour

Hands-on patient care

πŸ“„Paper Forms

Get these signed early

πŸ’»Orders & Charting

Initial Cerner work

πŸ—‚Behind-the-Scenes

Misc setup tasks

Ongoing Labor Patient

Continuing care throughout labor β€” checks, charting & timing

Frequencies: FHR q30min (q15m pushing) Β· Pitocin: FHT q15min & Oxy checklist q30min Β· VS per protocol

πŸ›Room Check

Confirm setup is complete

πŸ“Charting

Stay current in Cerner

🩺Hands On Care

Patient assessments

⏱VS Timing Reference

By patient type

πŸ•Check Times

Mark off the times you completed checks

Interval
Start time

Epidural placement

Before, during & after epidural β€” hands-on care plus charting

πŸ“žPre-Procedure Setup

Call & prep

πŸͺ·During Procedure

Patient positioning & monitoring

🌸After Procedure

Post-epidural care

πŸ’»Orders & Charting

Cerner documentation

⏱VS Frequency Post-Epidural

Strict protocol

Vaginal Delivery

Prep, delivery & first 2 hours postpartum

🌷Prior to Delivery

Last-minute setup

πŸ’»Orders & Charting

Transition labor β†’ PP

πŸ“¦Omnicell

Medications

⏱Fundal Check & VS β€” q15min x 2hrs

Then q1h once Β· q4h to 24hr Β· q shift to d/c

πŸ“Documentation

Maternal delivery items

🌟Provider-Specific Prep

Delivery prep notes

Newborn β€” Birth to 2hrs

First two hours of life β€” assessment, meds & documentation

πŸ‘ΆAt Delivery

Birth time & immediate care

🌸Hour 1 & 2

Continued newborn care

πŸ’»Orders & Adhocs

Newborn Cerner setup

πŸ“‹Verification

Double-check these

πŸ“žCall Pediatrician If

Conditions requiring notification

πŸ“Charting Recap

Don't forget

Scheduled Cesarean

Morning prep for scheduled cesarean delivery

πŸ›Room Prep

Get everything ready

🌸Hands On Care

Patient prep

πŸ’»Orders & Consents

Cerner & paperwork

πŸ’‰Anesthesia

Coordinate with anesthesia

Emergency Cesarean

For patient already admitted β€” also reference C/S checklist

⚑ Time-critical: Move efficiently. Decision for C/S documented, calls made, prep done in parallel.

⚑Decision & Calls

First steps

πŸ“‹Documentation

Adhocs & consents

🩺Pre-Surgery Prep

Patient ready for OR

πŸ₯In OR β€” Setup

Once in operating room

⏱Timing & Charting

OR documentation

πŸ“ŒReference

Quick facts

PACU Recovery

Minimum 1hr stay Β· Post-anesthesia care

Discharge criteria: VS stable x15 Β· O2 sat >92% RA Β· Patent airway x30min Β· Alderete score >8 Β· Two assessments completed

🌿Initial Care

PACU arrival

⏱Continued Care Frequencies

Strict timing protocols

πŸ•Assessment Times

Mark off as completed

πŸ“Assessment Categories

Chart these in PACU

πŸ’»Orders & POCs

Cerner management

βœ“Discharge from PACU

Final tasks

Postpartum care

Mom & baby ongoing care

πŸ’—Mom

Maternal care assumption

πŸ’ŠMom β€” Meds

MAR responses

πŸ“ŠMom β€” VS & Fundals Q4H

Check orders for after 24hrs

πŸ“Mom β€” Misc

Ongoing tasks

πŸ‘ΆBaby

Newborn care assumption

🌟Baby β€” VS

At 4hrs, then Q4H x24hrs, then q shift

🍼Baby β€” Feeds & Output

Track all feeds

πŸ“‹24-36hr Care

Brain sheet + check orders

Discharge workflow

Mom & baby discharge, documentation & post-d/c tasks

πŸ’—Maternal β€” Documentation

Cerner items to complete

🩺Maternal β€” Patient Care

Before they leave

βœ“Maternal β€” After Discharge

Wrap-up tasks

πŸ‘ΆNewborn β€” Documentation

Verify completion

🌼Newborn β€” Patient Care

Final hands-on items

πŸ““Every Shift Charting

Ongoing while admitted

Quick Reference

Cerner shortcuts, order sets, and how-tos

πŸ–¨ MSI Printer Shortcuts

  • Print armband: 1 "%"
  • Print facesheet: 11 "$"
  • Print patient stickers: pre-reg tab "enter"

πŸ§ͺ Specimen Labs Process

  • Handheld printer at the nurse station
  • Click "Specimen collection" in Cerner toolbar
  • Checkmark the lab you are drawing
  • Scan patient wristband
  • Print
  • Place label on drawn specimen and write initials, date, time

πŸ”— Connecting FetaLink to Patient Bed

  • Click the box to the left of room number to open up that strip
  • Click "associate"
  • Scan patient wristband
  • Backtime the start time to when the patient came into the room

🧬 Placenta to Pathology

  • Label on the side and top of the white container
  • Order: placenta tissue
  • Print order: right click β†’ select print
  • Facesheet and order inside biohazard bag (clear bag w/ red rim) with placenta inside
  • Walk placenta to pathology

πŸ“‚ Placing Orders β€” Path

  • MCHS β†’ Inpatient summary β†’ order entry / new order β†’ shared β†’ Langlais, Beth β†’ green button

🌸 Order Sets β€” Triage

  • Triage: Langlais, Beth β†’ Favorites β†’ FHMC Triage / Outpatient orders

🀰 Order Sets β€” Maternal Admit

  • Labor admit: search for provider favorites
  • C/S admit: search for provider favorites
  • Admit to Obs: n/a β†’ keep as triage for up to 24hrs
  • Antepartum admission: search for provider favorites

🩸 Order Sets β€” Diabetes / Hypoglycemia

  • Maternal hypoglycemia: Langlais, Beth β†’ Favorites β†’ FHMC Diabetes: OB hypoglycemia treatment
  • Antepartum / Postpartum SQ insulin: Langlais, Beth β†’ Favorites β†’ FHMC Diabetes: antepartum/postpartum SQ insulin
  • Labor SQ insulin: Langlais, Beth β†’ Favorites β†’ FHMC diabetes: Labor SQ insulin
  • Labor IV insulin: Langlais, Beth β†’ Favorites β†’ FHMC diabetes: OB IV insulin

⚠️ Order Sets β€” Preeclampsia

  • Preeclampsia / GHTN: add order β†’ OB preeclampsia and other hypertensive disorders of pregnancy
  • Additional preeclampsia BP meds: suborder β†’ OB preeclampsia anti-hypertensive acute control
  • Eclampsia: add order β†’ OB eclamptic seizure orders

πŸ†˜ Order Sets β€” Maternal Hemorrhage

  • MOH: add order β†’ OB hemorrhage multiphase powerplan
  • MOH PP recovery: Langlais, Beth β†’ Favorites β†’ FHMC OB modified postpartum care: stage 2 (3)

🦠 Order Sets β€” Maternal Infection

  • Chorio antibiotics / labs: add order β†’ OB chorioamnionitis / endometritis
  • Maternal sepsis: Langlais, Beth β†’ Favorites β†’ Sepsis maternal orderset
  • Severe maternal sepsis: Langlais, Beth β†’ Favorites β†’ Severe Sepsis maternal orderset

πŸ’‰ Order Sets β€” Maternal Misc

  • Amnioinfusion: add order β†’ OB amnioinfusion
  • Increase Pit to 30: Langlais, Beth β†’ Favorites β†’ FHMC OB increased upper limit oxytocin orders
  • Delivery medication, delivered PTA: Langlais, Beth β†’ Favorites β†’ FHMC post delivery medications
  • Epidural: Tsau, Kang β†’ 1 cama OB epidural (level) most recent

πŸ‘Ά Order Sets β€” Newborn

  • Newborn admit: Langlais, Beth β†’ Favorites β†’ FHMC newborn: routine care
  • Late preterm newborn (35.1-36.6w): Langlais, Beth β†’ Favorites β†’ FHMC newborn: late preterm pathway
  • Newborn Hypoglycemia: Langlais, Beth β†’ Favorites β†’ FHMC newborn hypoglycemia glucose gel treatment