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    Western Mindanao State University College of Nursing Zamboanga City

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    Mae Avelina Jacoba
    This document contains forms from Western Mindanao State University College of Nursing in Zamboanga City for student nurses to document their clinical rotations in operating rooms, delivery rooms, and caring for newborns. The forms include spaces for the student name, hospital/area of assignment, date, patient initials, case number, procedure performed, and signatures of the supervising nurse and clinical instructor. Notes are provided by Sarah S. Taupan, the clinical coordinator.

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    Western Mindanao State University College of Nursing Zamboanga City

    Uploaded by

    Mae Avelina Jacoba
    102 views4 pages
    This document contains forms from Western Mindanao State University College of Nursing in Zamboanga City for student nurses to document their clinical rotations in operating rooms, delivery rooms, and caring for newborns. The forms include spaces for the student name, hospital/area of assignment, date, patient initials, case number, procedure performed, and signatures of the supervising nurse and clinical instructor. Notes are provided by Sarah S. Taupan, the clinical coordinator.

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    INDEX CARDS

    Original Title

    INDEX CARDS.doc

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    This document contains forms from Western Mindanao State University College of Nursing in Zamboanga City for student nurses to document their clinical rotations in operating rooms, delivery rooms, and caring for newborns. The forms include spaces for the student name, hospital/area of assignment, date, patient initials, case number, procedure performed, and signatures of the supervising nurse and clinical instructor. Notes are provided by Sarah S. Taupan, the clinical coordinator.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    102 views4 pages

    Western Mindanao State University College of Nursing Zamboanga City

    Uploaded by

    Mae Avelina Jacoba
    This document contains forms from Western Mindanao State University College of Nursing in Zamboanga City for student nurses to document their clinical rotations in operating rooms, delivery rooms, and caring for newborns. The forms include spaces for the student name, hospital/area of assignment, date, patient initials, case number, procedure performed, and signatures of the supervising nurse and clinical instructor. Notes are provided by Sarah S. Taupan, the clinical coordinator.

    Copyright:

    Attribution Non-Commercial (BY-NC)
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    WESTERN MINDANAO STATE UNIVERSITY COLLEGE OF NURSING Zamboanga City

    Name of St !ent" Y&# Le'e("%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% Rotation No# $ Date"%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% )o*+ita( $ A&ea of A**ignment"%%%%%%%%%%%%%%%%%%%%%

    O.R. SCRUB FORM MAJOR


    Date of Operation/ Time Started Patients INITIALS only Case Number SURGICAL PROCEDURE PERFORMED Name & Signature of OR Scrub Nurse Supervised by: Name and Signature of C.I.

    Note! by" SARAH S. TAUPAN, R.N., M.N. ,D.P.A C(ini,a( Coo&!inato&

    WESTERN MINDANAO STATE UNIVERSITY COLLEGE OF NURSING Zamboanga City


    Name of St !ent" Y&# Le'e("%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% Rotation No# $ Date"%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% )o*+ita( $ A&ea of A**ignment"%%%%%%%%%%%%%%%%%%%%%

    O.R. CIRCULATING FORM MAJOR


    Patients INITIALS only Date of Operation/ Time Started Case Number SURGICAL PROCEDURE PERFORMED Name & Signature of OR Scrub Nurse Supervised by: Name and Signature of C.I.

    Note! by" SARAH S. TAUPAN, R.N., M.N. ,D.P.A C(ini,a( Coo&!inato&

    WESTERN MINDANAO STATE UNIVERSITY COLLEGE OF NURSING Zamboanga City


    Name of St !ent" Y&# Le'e("%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% Rotation No# $ Date"%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% )o*+ita( $ A&ea of A**ignment"%%%%%%%%%%%%%%%%%%%%%

    ACTUAL DELIVERY FORM


    Pat ent!" INITIALS #on$%& Date Performed and T me Started Ca"e N'm.er (not applicable for Birthing /Lying In Clinics / Homes) PROCEDURE PERFORMED D.R. N'r"e On D't% #Name and S (nat're& #If M d) fe on D't%* S (nat're " not Re+' red& SUPERVISED BY, C$ n -a$ In"tr'-tor Name and S (nat're

    Note! by" SARAH S. TAUPAN, R.N., M.N. ,D.P.A C(ini,a( Coo&!inato&

    WESTERN MINDANAO STATE UNIVERSITY

    COLLEGE OF NURSING Zamboanga City


    Name of St !ent" Y&# Le'e("%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% Rotation No# $ Date"%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% )o*+ita( $ A&ea of A**ignment"%%%%%%%%%%%%%%%%%%%%%

    IMMEDIATE CARE OF T/E NE0BORN Date Performed and T me Started Pat ent!" INITIALS #on$%& Ca"e N'm.er
    (not applicable for Birthing /Lying In Clinics / Homes)

    Immed ate Ne).orn Cord Care PERFORMED


    Ind -ate )1ere 2erformed e.(. D.R.* N'r"er%* NICU* or /ome

    D.R. N'r"e On D't% #Name and S (nat're&


    #If M d) fe on D't%* S (nat're " not Re+' red&

    SUPERVISED BY, C$ n -a$ In"tr'-tor Name and S (nat're

    Note! by" SARAH S. TAUPAN, R.N., M.N. ,D.P.A C(ini,a( Coo&!inato&

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