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Labor and Delivery/Obstetrics-Gynecology

(OB-GYN) Unit Manual

The Unit Practice Manual policies can be viewed or printed using Adobe Acrobat.

Please Note: These policies, procedures and protocols are provided for informational purposes only for the staff of John Dempsey Hospital. The owner and authors assume no liability whatsoever in connection with the use of the information contained within.

The Lippincott Manual of Nursing Practice should be used for nursing procedures not found in the Nursing Practice or Unit Practice Manual’s. Procedures in the Nursing Practice Manual or Unit Practice Manuals supersede the Lippincott reference.


Scope of Services

Structure Standards

Protocol: Admission to the Labor & Delivery Unit (L&D)
Protocol: Admission to the OB-GYN Unit
Procedure: Amniocentesis
Procedure: Amnioinfusion
Procedure: Amnioreduction: Assistance with
Procedure: Amniotomy (Artificial Rupture of Membranes): Assistance with
Procedure: Assessment: Scope of Nursing Physical Assessment in L&D / OB-GYN
Procedure: Attire, Surgical
Protocol: AZT (Zidovudine) Intravenous Administration
  AZT Bolus Infusion Rates
  AZT Maintenance Infusion Rates

Procedure: Baptism
Guidelines: Birth Certificate Worksheet: Completion of
Procedure/ Protocol: Breast Pumping, Breast Milk Use and Storage
Protocol: Breastfeeding Full-term and Late Pre-term Infants

Protocol: Cell Phones, Camera Phones and Video Equipment
Procedure: Cerclage Placement/Removal: Assistance with
Protocol: Cervidil for Preinduction Cervical Ripening and Introduction of Labor
Protocol: Cesarean Delivery: Care of the Patient Following
Protocol: Cesarean Section: Immediate Preoperative and Intraoperative Care of the Patient
Procedure: Cesarean Section - JDH OR Scrub Person Coverage of L&D/OB-GYN
Procedure: Cesarean Section: Scrub Assistant Responsibilities
Procedure: Cord Blood Samples
Clinical Protocol/ Procedure: Counts:  Prevention of Retained Surgical Items
Procedure: Cup Feeding

Procedure: Death (Stillborn and Neonatal): Process for Completion of Documentation
Teaching Plan: Diabetic: Pregnant Patient
Standard Care Plan: Diabetes: Antepartum Patient
Protocol: Diabetes: Care of the Antepartum Patient
Protocol: Diabetes: Care of the Post Partum Patient Requiring Insulin

Protocol: Electrocautery: Use of during Cesarean Section
Procedure/ Protocol: Electrosurgical Unit (ESU) Safety
Protocol: Emergency Cesarean Delivery
Protocol: Epidural Anesthesia: Care of the Obstetric Patient
Procedure: Eye Prophylaxis: Administration of

Protocol: Falls: Risk Identification, Prevention and Management in Labor & Delivery and OB-GYN
Procedure: Four-Hour Obstetrical Hold

Procedure: Glucose Screening in Newborns at Risk for Hypoglycemia
Protocol: Grieving: Care of the Patient who has Suffered an Infant Loss
Protocol: Group B Streptococcal (GBS) Disease: Prevention and Management
Protocol: GBS Algorithm

Protocol: Hemodynamic Monitoring
Protocol: Hospitalized Infant: Care of the Family
Protocol: Hydralazine: Care of the Patient Receiving a Hydralazine, IV Push for Hypertension Management
Protocol: Hyperemesis Gravidarum
Standard Care Plan: Hypertensive Disorders: Antepartum Patient
Protocol: Hypertensive Disorders of Pregnancy: Care of the Patient
Teaching Plan: Hypertensive Disorders of Pregnancy
Protocol: Hysterectomy: Care of the Patient
Standard Care Plan: Hysterectomy: Care of the Patient Admitted to OB-GYN
Teaching Plan: Hysterectomy (Post): Self-Care Educational Needs

Procedure: Identification and Security of Newborns
Teaching Plan: Infant Care Educational Needs
Protocol: Infant Fall, Risk Identification, Prevention and Management in Labor and Delivery, OB and Newborn Nursery
Procedure: Insulin: Continuous Intravenous Administration

Protocol: Labetalol: Care of the Obstetrical Patient Receiving IV Labetalol for Hypertensive Disorders of Pregnancy
  Labetalol Continuous Infusion Rates
Protocol: Labor and Delivery: Care of the Laboring Patient in Labor and Delivery
Standard Care Plan: Laparotomy: Care of the Patient Admitted to OB-GYN
Protocol: Lithotomy Position - Delivery Room

Protocol: Magnesium Sulfate: Use in Hypertensive Disorders of Pregnancy and Preterm Labor (PSOL): Care of the Patient
Teaching Plan: Maternal Post-Partum Self Care Education Needs
Protocol: Misoprostol for Preinduction Cervical Ripening and Induction of Labor
Protocol: Monitoring: External Fetal Heart Rate/Uterine Activity: Care of the Patient on
Procedure: Monitoring: Fetal Heart Rate: Internal
Procedure: Monitoring: Internal Uterine Activity

Protocol: Newborn (Term): Care of the Newborn in the Birthing Room/Delivery Room
Protocol: Nifedipine Administration for Tocolytic Purposes
Protocol: Non-Stress Test (NST)

Administrative Protocol: Obstetrical Patient - Triage of
Standard Care Plan: Ovarian Hyperstimulation Syndrome
Protocol: Ovarian Hyperstimulation (OHSS): Care of the Patient with
Teaching Plan: Ovarian Hyperstimulation  Syndrome (OHSS): Care of the Patient
Procedure: Oxytocin Administration via the Infusion Pump

Procedure: Percutaneous Umbilical Blood Sampling (PUBS) and Intrauterine Fetal Blood Transfusion: Assistance with
Procedure: Perineal Scrub for Vaginal Delivery
Procedure: Placenta: Collection and Care of
Protocol: Precipitous Delivery: Care of the Patient During
Procedure: Precipitous High Risk Delivery: Transfer of Infant to Resuscitation Room
Standard Care Plan: Premature Rupture of Membranes (PROM): Antepartum Patient
Standard Care Plan: Premature Spontaneous Onset of Labor: Antepartum Patient
Teaching Plan: Preterm Labor (PTL): Care of the Patient
Protocol: Preterm Labor (PTL): Care of the Patient in L&D and OB-GYN Unit
Protocol: Preterm, Premature Rupture of Membranes (PROM): Care of the Patient in the L&D and on OB-GYN


Preterm, Prolonged, Premature Ruptured Membranes Pregnant Patient (PROM)
Teaching Plan: Prostaglandin Induction/Termination of Pregnancy
Standard Care Plan: Prostaglandin Termination of Pregnancy
Procedure: Rapid HIV Testing in Labor & Delivery
Protocol: Resuscitation of Infants Outside the Nurseries


Protocol: Safe Haven
Protocol: Safety and Security of Newborns
Protocol: Sickle Cell Disease: Acute Pain Management of the Patient with Sickle Cell Disease in L&D/GYN - Initiation of the Sickle Cell Acute Pain Management Clinical Pathway - DRAFT
Protocol: Sterile Field, Maintenance of
Protocol: Subgaleal Hemorrhage: Care of the Infant at Risk for

Procedure: Terbutaline (Brethine): Administration of Terbutaline for Tocolytic Purposes
Protocol: Terbutaline (Brethine): Care of the Patient Receiving Terbutaline for Tocolytic Purposes
Procedure: Terbutaline Infusion Therapy: Use of the Home Care Agency and Pump
Protocol: Termination of Pregnancy, Second Trimester - Care of the Patient Undergoing
Procedure: Termination of Pregnancy, Second Trimester: Scheduling and Admission of Patient
Standard Care Plan: Third Trimester Bleeding: Antepartum Patient
Procedure: Transfer Process between L&D and OB-GYN Units: Completion of Documentation

Protocol: Vaginal Bleeding in Pregnancy
Teaching Care Plan: Vaginal Bleeding in Pregnancy
Protocol: Vaginal Delivery: Care of the Delivered Patient
Procedure: Version, External: Assistance with
Protocol: Visitation: in the Nurseries
Protocol: Visitation in the Nurseries: Maternal Fever and

Association of Perioperative Registered Nurses (AORN) Recommended Practices

In addition to the above standards, staff in this area are directed to the following AORN Recommended Practices:

  • Environmental Cleaning in the Surgical Practice Setting
  • Hand Antisepsis, Surgical
  • Skin Antisepsis, Preoperative Patient


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