Standards › Standard 12 › Forms
Form · OBS-FRM-004 · Version 1.0 · Approved by the ASF Expert Committee
Purpose
Records the newborn’s assessment at birth, care given, identifiers and any transfer.
How to complete
- Record the assessment at birth.
- Record the care and any resuscitation.
- Record the identifier matched to the mother.
Checks
| Check | Entry |
|---|---|
| Time of birth and Apgar or equivalent assessment | Yes |
| Warmth, airway and drying given | Yes |
| Resuscitation given (yes or no) and time | Yes or N/A |
| Newborn identifier matched to mother | Yes |
| Transferred (yes or no) and receiving unit | Yes or N/A |
| Recorded by and time | Yes |
Evidence
| Reference | Note |
|---|---|
| E-009 | Based on the WHO recommendations on newborn health (2017). |
| E-006 | ASF Policy Framework v1.2. Adapted. |
| E-009 | ASF Expert Committee consensus. |
Change history
| Version | Date | What changed | Approval |
|---|---|---|---|
| 1.0 | the date of approval | First version | set Expert Committee approval |
E-learning for this document
- Emergency Medical Equipment & AED Readiness (MED-02)
- Safety & Emergency Preparedness (H-05)
- Patient Identification, Informed Consent and Patient Rights (T-07)
- Records, Confidentiality and Data Protection (T-11)
References
- Accréditation Sans Frontières (2026). ASF Policy Framework v1.2. (E-006)
- Accréditation Sans Frontières (2026). ASF Expert Committee consensus on Standard 1. (E-009)