Checklist Development For Nurses To Assist In Normal Vaginal Delivery

https://doi.org/10.33698/NRF0313-Jyoti, Sunita Sharma, Avinash Rana, Vanita Suri

Abstract: The normal vaginal delivery is a fundamental skill in the intra partum care of women and new born baby for nurses. Managing the major task of comprising of many small tasks is always difficult at a given point of time by the nurses. So it is vital to provide the nurses with checklist of articles required before conduction of deliveries to prevent complications and wastage of time. The current study was undertaken with the objective to develop a nursing checklist for the nurses for assisting in normal vaginal delivery in clean labour room, Nehru Hospital, PGIMER, Chandigarh. The methodological design adopted for the study. The first step was development of preliminary draft byreview of literature. In second step, a penal of experts was formed to validate the content by Delphi technique. The Pilot study was conducted to assess its feasibility. Research setting was clean labor room at Nehru Hospital, PGIMER, Chandigarh. In try out, total 60 delivery events were selected by using total enumerative sampling technique. The Cronbach’s alpha method was used to test the reliability. The study reveals that total 217 items (includes activities and articles) were required for delivery room, nursery room and scrub room. Out of 217 items, total 116 items contributed to delivery room, 101 items to nursery room and 4 items to scrub room. In final designing of checklist, common domains related to activities were clubbed and improved to make it easier to fill.

Keywords:Normal vaginal delivery, checklist

Introduction:A childbirth journey is a unique experience for each individual woman. It is found that eighty-five percent of women can give birth to their babies without

Correspondence at:Dr Sunita Sharma Lecturer National Institute of Nursing Education PGIMER, Chandigarh

interventions or problems.1,2 normal vaginal deliveries (NVD) is a term for a vaginal delivery, it may be assisted or not assisted. In normal term, labor is the culmination of a sequence of interrelated hormonal shifts. Assisting in normal vaginal delivery is a fundamental skill in the intrapartum care of women for nurses.3 Essential services by nurses in delivery room are assisting normal delivery, identifying and m a n a g i n g c o m p l i c a t i o n s , a c t i v e management of third stage of labour and immediate new born care including new born resuscitation.The highest risk period for maternal death is from the onset of labor to the immediate postpartum period. The maternal mortality rate is high at the time of delivery. The main causes are hemorrhage, hypertensive disorders, sepsis, obstructed labor, and unsafe abortion. In neonates, nearly half of newborn deaths (many of which involve extremely premature infants) occur during the first 24 hours after birth, The neonatal mortality rate in India was Many studies recommendations related to temperature for delivery room and nursery room are nonspecific, stating only “the neonate should be put in a warm place” immediately after delivery. American Academy of Pediatrics attempted to maintain delivery room temperature at approximately 26°C for all preterm deliveries.7 Susan A and Furdon recommends that in all nurseries, the environmental temperature should be maintained at more than 70°F (>21°C).8 Evidence-based practices reduce the complications to much extent. The essential practices if missed result in enhancement of the risk that may be avoidable during providing care to the mother.9 The checklist use for improving the health has a large evidence base and checklist-based solutions have been shown to reduce complications that help to save lives.10,11 A checklist is a type32.30 in 2011.4 India accounts for nearly of informational job aid used to reduce failure 28% of the global deaths among newborn children, approximately 80% of low-birth- weight infants require resuscitation and stabilization at delivery. Many of these early deaths also have a component of asphyxia or respiratory depression as an aetiology. For the surviving infants, effective management of asphyxia in the first few minutes of life may influence long-term outcome.5 For this reason, all personnel involved in delivery room care of the mother should be trained adequately in all aspects of maternal resuscitation and neonatal resuscitation. Additionally, equipment that is appropriately sized to resuscitate infants of all gestational ages should be available in delivering institution. Darmstadtetal. emphasizes essential newborn care including hygienic cord care, maintenance of warmth, and immediate and exclusive breast feeding as a means to reducing newborn deaths.6 by compensating the limits of human memory and attention. It helps to ensure consistency and completeness in carrying out a task. A basic example is the “to do list”. The checklist-based interventions help management of complex or neglected tasks and have been shown to reduce harm in healthcare. There are some common problems during the resuscitation of the new born babies like equipment preparation, availability of the articles and drugs availability. Finer et al (2012) describes the experience of using checklists as an essential component of the actual resuscitation of potentially high-risk infants. The use of checklists during neonatal resuscitation was helpful in improving overall communication which help in rapid identification of obstacles.12

T h e W H O a n d o t h e r h e a l t h organizations have provided the checklist in many health departments which have declared it as a important tool to deliver health care.13-16 Introduction of the WHO Safe Childbirth Checklist program markedly improved delivery of essential safety practices by health workers.17 In 2013, The NRHM provided the Maternal and Newborn health toolkit for assisting in the delivery in different setting. Delivery unit which includes the receiving area, examination room, pre- delivery room (1st stage area), delivery (Labour) room (2nd–3rd stage), post- delivery observation room (4th stage area) should be prepared to assist a delivery. Their toolkit consists of essential equipment and accessories for maternity rooms and newborn care corners.18 During the clinical posting of the researcher, in spite of the fact that the second stage is such an important stage to be managed, many gaps were observed such as no carbolisation of delivery table after every delivery, unavailability of drugs during needy conditions, unsterile techniques like improper gowning, hand washing, gloving, improper toileting, lack of equipments and confusion among the staff members. One of the causative major factors was poor arrangement of articles before delivery that arise to all these gaps which could lead to complications to the mother as well as to baby also. So need was felt to develop a checklist to assist a normal delivery .

Objective:To develop achecklist for nurses for assisting in normal vaginal delivery.

Materials and Methods:The study was conducted in labor room, Nehru Hospital, PGIMER, Chandigarh. It is a major referral hospital in north India.The specialized quality of services of the Institute is renowned not only at national Level, but also internationally. It has a capacity of 1600 beds. Obstetrics and Gynaecology department provides diagnostic, therapeutic and curative services. Clean labour room is situated on the 3rd floor of Nehru Hospital. It is 16 bedded. Labor room consists of various units and the bed capacity of units are; Observation room (7beds), Eclampsia room (2 beds), Post natal room (6 beds), Delivery room( 2 delivery tables beds), Nursery with capacity of five cradles, one resuscitaire and one transport incubator. Target population of study was all assisted normal delivery procedure. The pre-labour ,laboring mothers and high risk pregnancy cases are admitted in clean labour room. The high risk cases involves hypertensive disorder, diabetes mellitus, cardiac disease, hepatic disorders and renal disorders etc. in the mothers. All assisted normal delivery procedure in the clean labour, PGIMER, Chandigarh in the month of October – November, 2013 were involved.The checklist was developed under five phases and under each phase some steps had been taken. In phase-I preliminary draft of the checklist was prepared after review of literature to collect recent evidences related to the use of checklist in nursing, gynae and obstetric and other health departments. Different checklists, protocols and guidelines tools were analyzed and items related to normal delivery and newborn care got selected. In this items were categorized under 10 headings :- Basic equipment,delivery pack, perineal /vaginal/cervical repair pack, equipment for vacuum extraction or forceps delivery, neonatal resuscitation pack , essential drugs , antiseptic solutions, intravenous solutions, information from previous staff/antenatal room, scrub room, sources for transfer of mother from delivery room.In phase –II For the validation of the tool, total number of 12 penalist were selected from different departments(6 Gynae&Obs experts,2 pediatricians, 1 anesthetic expert & 3 Nursing experts) .The first draft was circulated among 12 experts from the above stated fields.The modified Delphi technique was used to validate the draft by choosing experts from the concerned fields. All the panelists were requested to give their valuable suggestions pertaining to item list relevant to the content, tool accuracy for information and the items order i.e. organization and sequences of the items .The suggestions given by the panelists were incorporated to generate the second draft of the tool.In first Delphi round, the preliminary draft content divided into 4 headings: Delivery room, Nursery room, scrub room and transfer of mother with equipments and Manpower. These heading had further subheadings. The column for quantity of items was deleted from the preliminary draft. In second Delphi round, Complete nursing checklist – divided into three main headings : Delivery room, Nursery room and scrub room .Deletion of heading having the transfer of mother from delivery room was deleted. In Delivery room checklist- Addition of Emergency resuscitation cart and other essential drugs eg. drotaverine, fortwin, phenergen etc was done. Record books was excluded. In Nursery room checklist- addition of articles in resuscitation cart suction catheter no-(10F,12F 14FG), endotracheal tube, essential drugs like –dopamine, dobutamine and biomedical waste buckets was done. Basic information from previous staff was excluded .In Scrub room checklist sterillium was added. In third Delphi round the checklist was again distributed among panelists. All Expertise suggested that all articles should be checked accordingly for their presence, accuracy, working condition, sterilization, carbolization and different sizes(if applicable). So the checklist was framed up in a new format in this round. In forth Delphi round all panelists returned the nursing checklist draft –III after making final suggestions. In Delivery Room addition of Inj. Carboprost and deletion of dextrose 25% was done. In Nursery room deletion of E.T-4mm and intravenous solution N/2. There was no change done in scrub room. Nursing Checklist draft-IV was made after final Delphi round. In phase –III after fourth Delphi Rounds, Nursing Checklist draft-IV was used for Pilot study on 6 assisted normal deliveries to assess the feasibility of study. Ethical permission was taken. No modification was done in the draft after pilot study.In phase –IV final try out of the draft was done to assess the reliability of the tool, The nurses in the delivery room and nursery room were trained in groups of 5-6 nurses about using checklist while assisting normal vaginal delivery.Group discussion was done related to the checklist items, new added items and how to use this checklist to prepare the items for delivery and immediate care of the new born in the nursery room. Observational method was used by the researcher to collect the data.The items were ticked in the yes/no columns before a delivery, during the delivery, postnatal period and immediate care of the new born in the checklist. Consent was taken from nurses for the data collected in month of October–November 2013 from 8am to 2 pm for observation and they were made clear that study is not an evaluation of individual performance. Total 60 delivery events were observed by the same method.

Results:The data was analyzed by SPSS (Version 20). Cronbach’s Alpha was used to find out the internal consistency reliability of the developed protocol.There were total 217 items in the tool and the overall Cronbach ‘s alpha coefficient of newly developed tool was 0.76 which indicated the reliability and internal consistency of the tool. (Table-1)

Number of Items	217
Sample size	60
Cronbach’s Alpha coefficient	0.76

Table-1 Result of Cronbach’s alpha application

Item analysis shows us how each item score is related to total scale score of the group of items. Corrected item-total correlation is the correlation between one item scores and total scores excluding the item score from total score. High corrected item-total correlation tells us the item scores and all the other item scores are “conformable.”(Table-2)

Table -2 Result of application of Corrected Item-Total Correlation

Total Items	217
Items with Corrected Item-Total Correlation between 0.2- 0.8	43
Items with Corrected Item-Total Correlation less than 0.2	174

To check the individual contribution of items in the delivery room , each item was deleted one by one to see the changes in the value of Cronbach’s alpha coefficient. But none of the items showed any increase in the value of Cronbach’s alpha coefficient. Rather, the value of Cronbach’s alpha coefficient remained same or it decreased. Even on deleting certain items, having item to total correlation less than 0.2, the value of Cronbach’s alpha coefficient did not increase. Hence these remaining items were also contributing to the reliability of the tool.Moreover as per experts these items are very important. (Table-3—Table-6 )

Table – 3 Reliability analysis of delivery room accessories

Sr.

No.

Articles

Corrected Item-Total Correlation

Cronbach’s Alpha if Item Deleted

Delivery table-

Carbolized

Prepared with Mattress

Prepared With protective Sheet and Kelly pad Prepared with Draw Sheet

Remote in working order

Straps on both side of table present Foot block

<0.01*

-0.01*

-0.01* 0.22

-0.02* 0.02*

0.21

0.76

Room temperature maintained at 25°C – 28°C Availability of heater/warmer

<0.01*

0.76

Availability of –

Movable spotlight

Spotlight in working condition Biomedical waste buckets with lids Disinfectant solutions

Weighing machine

Wall clock providing accurate time Screen

Stethoscope BP instrument

Doppler foetoscope Refrigerator for drugs storage Refrigerator in working order Sterile drum with lids

Hub cutter

0.16*

0.10*

0.84

<0.01*

-0.01* 0.01*

0.34

0.44

0.29

0.04*

-0.01*

<0.01* 0.22

0.20

0.76

0.75

0.76

0.75

0.76

0.75

0.76

Forceps and Ventouse articles

Autoclaved Forceps (outlet forceps, LMCF) Autoclaved Ventouse

Availability of Suction with Ventouse Availability of Vacuum Pressure Meter

-0.01* 0.01*

0.08*

0.15*

0.76

Table-4 Checklist items for delivery tray preparation, intravenous solutions and drugs.

Sr.

No.

Articles

Corrected Item-Total Correlation

Cronbach’s Alpha if Item Deleted

Delivery Tray Preparation – Bowl with sterile swabs Sponge holder

Urinary catheters

Arteries forceps(Curved, Straight) Kocher Forceps ( Curved, Straight) Episiotomy Scissors

Dissecting Forceps(Tooth , Plain) Needle Holder

Cord cutting Kidney Tray Surgical suture Strile draping sheet Sterile gloves Swabs/gauze Gynae pads Syringe(10cc) Needles(22G,24G)

<0.01*

-0.05*

<0.01* 0.84

<0.01* 0.10*

0.29

-0.09*

<0.01*

<0.01* 0.05*

0.16*

0.76

0.75

0.76

0.75

0.76

Additional items

Lubricating jelly

Antiseptic solution(betadine) Syringe with size(5cc) Syringe with size(10cc) Intravenous cannula(18g) Gown

Caps Mask

Plastic apron

0.01*

<0.01*

-0.04* 0.02*

0.03*

-0.01*

-0.06*

0.75

0.76

0.75

0.76

Intravenous solutions

Normal saline Ringer lactate Dextrose(5%) Dextrose(10%)

-0.04* 0.84

0.84

0.76

0.75

Essential obstetric drugs

Inj. Oxytocin Tab. Misoprostol InjCarboprost Inj Lignocaine

Inj Methyl Ergometrine Inj Magnesium Sulphate

-0.1*

-0.03*

-0.08*

<0.01*

<0.01* 0.19*

0.76

0.75

Table-5 Resuscitation trolley articles and drugs in the delivery room

Sr.

No.

Articles

Corrected Item-Total Correlation

Cronbach’s Alpha if Item Deleted

Resuscitation trolley articles

AMBU bag is disinfected

AMBU bag working with pressure valve Reservoir attached

AMBU bag of adult size(1.6) Ventury face mask 2/3 Laryngoscope disinfected

Laryngoscope working with bulb and battery Laryngoscope blades sizes(3/4) Endotrachial tube with cuff with size -6mm Endotrachial tube with cuff with size -6.5mm Endotrachial tube with cuff with size -7mm

Endo treachial tube with cuff with size -7.5mm Vein flown (IV Cannula) – Size (18G)

Vein flow (IV cannula)(16G) Gloves with size 6.5

Glove with size -7 Gloves with size7.5 Gloves with size 8

Suction catheter with size-14FG Suction catheter size(16FG) Urinary catheter with size-14FG Urinary catheter with size-16FG

<0.01*

<0.01* 0.13*

<0.01*

<0.01* 0.38

<0.01*

-0.02*

<0.01* 0.47

0.12*

0.25

0.11*

0.38

0.09*

0.23

0.07*

0.20

0.75

0.76

0.75

0.7

0.76

0.75

Emergency resuscitation drug tray

Inj. Adrenaline Tartrate (1 Mg/Ml) Inj. Atropine Sulphate (0.6mg/Ml) Inj. Dopamine (40mg/Ml) Inj. Dobutamine (50 Mg/Ml) Inj. Diazepam (5 Mg/Ml) Inj. Dexamethasone (4mg/Ml) Inj. Midazolam (1mg/Ml) Inj. Nitroglycerine (5mg/Ml)

Inj. Pheniramine (22.75mg/Ml) Inj. Phenytoin (50mg/Ml)

Inj. Sodium Bicarbonate(.178mm/Ml) Inj .Sodium Valproate (100mg/Ml) Inj. Lasix (10mg/Ml)

Inj. Etophyllin (169.4mg?Ml) Inj. Theophyllin (50.6mg/Ml) Inj. Hydrocortisone (100mg/Ml)

<0.01* 0<.01*

0.01*

<0.01* 0.12*

0.06*

0.04*

0.84

-0.01*

<0.01*

-0.06* 0.046*

<0.01*

0.75

0.76

0.75

0.76

0.75

Table-6 Other miscellaneous drugs in the delivery room checklist.

Sr.

No.

Articles

Corrected Item-Total Correlation

Cronbach’s Alpha if Item Deleted

Other drugs

InjEpidosin InjDrotin InjBuscopan InjMetoclopromide InjFrusemide InjFortwin InjPhenergen

Inj Labetalol Inj Phenytoin Inj Diazepam Inj Diclofenac Inj Ranitidine Inj morphine Inj pethidine Inj perinorm Inj heparin

-0.05*

-0.05* 0.02*

0.11*

-0.01* 0.01*

0.07*

-0.01* 0.14*

-0.01* 0.03*

0.12*

0.28

-0.02*

-0.03*

0.76

0.75

0.76

0.75

0.76

0.75

0.76

0.75

0.76

Reliability analysis of Nursery room:To check the individual contribution of items in the nursery room, each item was deleted one by one to see the changes in the value of Cronbach’s alpha coefficient. But none of the items showed any increase in the value of Cronbach’s alpha coefficient. Rather, the value of Cronbach’s alpha coefficient remained same or it decreased. Even on deleting certain items, having item to total correlation less than 0.2, the value of Cronbach’s alpha coefficient did not increase. Hence these remaining items were also contributing to the reliability of the tool. Moreover as per experts these items are very important.(Table 7-Table 9)

Table-7 Checklist equipments and essentials that should be checked before delivery to provide immediate care of newborn in the Nursery Room

Sr.

No.

Articles

Corrected Item-Total Correlation

Cronbach’s Alpha if Item Deleted

Immediate care of newborn equipments Nursery room temp maintained at 27° -30°C Warmer/heater working or not?

Central Oxygen supply working with O2 (connecting tube) Central Oxygen supply working with O2 pressure monitor Central Oxygen supply working with humidifier

Central Oxygen supply working with O2 box Suction apparatus is working with electric plug Suction apparatus is working with pressure meter Suction apparatus is working with connecting tubes Suction apparatus is working with suction bottle

<0.01*

-0.02* 0.27

0.16*

<0.01*

<0.01* 0.31

0.27

0.01*

0.75

0.76

0.75

Neonatal Resuscitation tray

AMBU bag is disinfected

AMBU bag is patent with pressure valve Reservoir Attach to AMBU bag

AMBU bag available in size – a. (250ml) b. -(500ml)

Face mask is disinfected

Face mask available in size- a. 00,

b. 0

c. 1 Suction catheter for ELBW baby with size a. 5/6 FG Suction catheter for non muconium stained b. (8/10FG) Suction catheter for non muconiumstained c. (10 FG) Suction catheter for non muconium stained d. (12FG) Laryngoscope is disinfected

Laryngoscope is working with bulb and battery Laryngoscope have blades size a. (0)

b. (1)

End tracheal tube without cuffs with size- a. 2mm

b. 2.5mm

c. 3.0mm

d. 3.5mm

e. 4.0mm

<0.01*

<0.01* 0.84

<0.01*

<0.01* 0.02*

0.13*

-0.03* 0.48

<0.01*

<0.01* 0.84

0.09*

-0.02*

<0.01* 0.04*

0.19*

0.75

0.76

0.75

0.76

0.75

0.76

0.75

0.76

0.75

Intravenous solution Normal saline Dextrose -5%

-10%

-25%

Isolyte-P N/4(0.225w/v)

<0.01*

-0.07* 0.21

<0.01* 0.84

0.75

0.76

0.75

Table- 8. Nursery room accessories and resuscitation drugs in the nursery room.

Sr.

No.

Articles

Corrected Item-Total Correlation

Cronbach’s Alpha if Item Deleted

Accessories

Baby cot is disinfected

Baby cot prepared with –a. Matress

-b. Cotten sheet Baby cot have railing

Electric plug of the baby cot is working Radiant warmer is disinfected

It have100 cm distance from cot surface It have minimum no.of sheet-3 for

It have connection to electric plug

It have essential probes or not a. -temp-probe

B.-O2 probe

Incubator is disinfected

It have o2 cylinder for O2 supply. It is portable with wheels

It have connected to electric plug

It is able to maintain temperature(36.5-37.5) Phototherapy is disinfected

It have florescent tubes

It have electric plug connection Boiler is clean

It have lid

It have electric plug connection Baby wt. Machine is disinfected It have protective sheet

It is set at zero

It have connected to electric plug Pulse oxy meter have probe

0.29

<0.01*

<0.01* 0.09*

<0.01* 0.21

<0.01* 0.29

<0.01

-0.02*

<0.01*

<0.01* 0.22

<0.01*

<0.01* 0.22

<0.01*

<0.01* 0.22

0.18*

0.000*

0.01*

0.75

0.76

0.75

Neonatal Resuscitation drugs tray

Inj Adrenaline

Inj Calcium Gluconate InjVit-K

Inj Naloxone Inj Dopamine InjDobutamine

Inj Sodium Bicarbonate Inj Hydrocortisone

Inj Non-Adrenaline InjKcl

< 0.01* 0.18*

<0.01* 0.48

<0.01*

<0.04*

<0.01* 0.25

<0.01* 0.84

0.75

Table-9 Checklist essentials for newborn care, hand washing and Biomedical waste buckets maintenance

Sr.

No.

Articles

Corrected Item-Total Correlation

Cronbach’s Alpha if Item Deleted

Additional Items

Sterile Surgical blades No -23 Sterile Surgical blade no- 24 Disposable Syringes syringe- 2cc Disposable Syringes syringe- 5cc Disposable Syringes syringe-10cc Disposable needle- 23G Disposable needle – 26G Disposable Umbilical Cord clamp Pediatric infusion set (120 ml) Intra venous cannula size- 24G Intra venous cannula size -26G Cotton swabs

Gauze pieces Absorbent sheet Antiseptic solution Caps

Masks

<0.01* 0.06*

<0.01*

<0.01* 0.06*

<0.01*

<0.01* 0.25

<0.01*

<0.01* 0.21

<0.01*

<0.01* 0.31

0.33

0.75

Hand washing

Water taps providing clean water Soap/disinfectant solution Sterilium

Povidine iodine

<0.01*

<0.01* 0.84

<0.01*

0.75

0.76

Bio medical waste bucket

Colour coding(black, red blue yellow) Lids

Disinfection solution

<0.01* 0.84

-0.021*

0.75

.075

0.75

-*Items in the tool which shows item to total correlation <0.2

-Overall reliability is 0.76.

Discussion:Nurses play a important role in conducting delivery in a hospital. Essential services by nurses in Labour room are: assisting normal delivery, identifying and m a n a g i n g c o m p l i c a t i o n s , a c t i v e management of third stage of labour and immediate newborn care including newborn resuscitation. Many evidence-based interventions were felt to be important in achieving better outcome in the delivery room. Use of a checklist to prepare for all high-risk neonatal resuscitations is one of t h e e v i d e n c e b a s e d p r a c t i c e . A methodological study design was adopted to prepare checklist for delivery room In a study F S Roger and H P Robert found that use of checklist to prepare for all high-risk neonatal resuscitations should be included in a evident based intervention.19 In the present study the preliminary tool was refined as per suggestions by panelists during the Delphi rounds. Total of four rounds were conducted by which common consensus was obtained. The Delphi technique was first developed by Dalkey and Halmer at the Rand Corporation in 1953.20 The Delphi technique has been described as a structured communication technique, originally developed as a systematic, interactive forecasting method which relies on a panel of expertsTaylor-Powell (2002) stated that the number of participants in a Delphi study depends on the purpose of the study , Ten to 15 participants may be an adequate number for a Delphi study.21 In the present study twelve participants were involved.The NRHM provided the Maternal and Newborn health toolkit to assist the delivery in different settings. The toolkit consists of essential equipment and accessories for maternity rooms ,newborn care corners and nursing interventions in different settings.18 The WHO safe childbirth checklist was designed that targets the major causes of maternal and newborn mortality globally(namely, hemorrhage, infection, obstructed labour and hypertensive disorders), intrapartum-related stillbirths (namely, inadequate intrapartum care), and neonatal deaths (namely birth asphyxia, infection and complications related to prematurity) in low-income countries.17 The present study contains very specific 217 items for delivery room including hand washing items in nursery room. Present study includes the domains such as equipments check, the multiple resources needed for resuscitation of mother and baby. Some of the study were reviewed for reliability of the tool .In one of the study done by CorwinE J. et al “The Impact of Fatigue on the Development of Postpartum Depression” cronbach’s alpha reliability during the postpartum ranged from .70 to .84,which shows the significant range22. In present study, the internal consistency was observed by the Cronbach’s alpha that was 0.76 showing the reliability of the tool.We conclude that a nursing checklist for delivery room nurses was developed. The checklist was subdivided into –Delivery room and Nursery room which contains total of 217 items. The list was validated and reliable. This checklist can be used for assisting in vaginal delivery by the nurses who are working in the Labour Room. It can be used to improve Safe Motherhood and childbirth.

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Checklist Development For Nurses To Assist In Normal Vaginal Delivery

Table-1 Result of Cronbach’s alpha application

Table -2 Result of application of Corrected Item-Total Correlation

Table – 3 Reliability analysis of delivery room accessories

Table-7 Checklist equipments and essentials that should be checked before delivery to provide immediate care of newborn in the Nursery Room

Recent Index Articles

Index Articles