case ni chorvah
Post on 04-Jun-2018
217 Views
Preview:
TRANSCRIPT
8/13/2019 Case Ni Chorvah
http://slidepdf.com/reader/full/case-ni-chorvah 1/5
St. Joseph College of Cavite Inc.Cavite City
INSTITUTE OF HEALTH SCIENCES
Tel no. : 431 -1937/7778/7779/ fax No. : 431-6037
Email Add: stjosephcollegecavite@yahoo.com
SURGICAL SCRUB in ___Bautista Hospital/ Cavite City/ Cavite__________
Hospital, Municipality/City/Province
Prepared by:
Printed Name and Signature of Student____Jerome V. Villaverde_____
Date Performed
and
Time Started
Patient’s INITIALS Only
SURGICAL PROCEDURE
PERFORMED
O.R. Nurse On Duty
(Name only)
SUPERVISED BY
Clinical Instructor
Name and Signature
Case Number
July 27, 2013
1:33 pm
CPW
#27646Cholecystectomy Carla S. Tan R.N.
Nancy S. Moreno R.N,
MAN
July 27, 2013
6:30 pm
JMS
#27668 Exploratory Laparotomy Spleenectomy Carla S. Tan R.N.
Nancy S. Moreno R.N,
MAN
Prepared by:
Printed Name and Signature of Student____Jerome V. Villaverde_____
Date Performed
andTime Started
Patient’s INITIALS Only
SURGICAL PROCEDUREPERFORMED
O.R. Nurse On Duty(Name only)
SUPERVISED BY
Clinical InstructorName and SignatureCase Number
January 4, 2013
3:00 PM
CPP
#25643 ParotidectomyCarla S. Tan R.N.
Nancy S. Moreno R.N,
MAN
January 4, 2013
10:00 am
KMR
#27674 Mesh HerniorraphyCarla S. Tan R.N.
Nancy S. Moreno R.N,
MAN
(STRICTLY NO DESIGNATES)[These Forms must be printed at the back of the 1 st page of the Competency-Based Performance Evaluation Checklist by the BoN]
ODC Form 1A
O.R. SCRUB FORM
Major
ODC Form 1B
O.R. CIRCULATING
FORM
8/13/2019 Case Ni Chorvah
http://slidepdf.com/reader/full/case-ni-chorvah 2/5
St. Joseph College of Cavite Inc.Cavite City
INSTITUTE OF HEALTH SCIENCES
Tel no. : 431 -1937/7778/7779/ fax No. : 431-6037
Email Add: stjosephcollegecavite@yahoo.com
SURGICAL SCRUB in ___Cavite Medical Center/ Cavite City/ Cavite__________
Hospital, Municipality/City/Province
Prepared by:
Printed Name and Signature of Student____Jerome V. Villaverde_____
Date Performed
and
Time Started
Patient’s INITIALS Only
SURGICAL PROCEDURE
PERFORMED
O.R. Nurse On Duty
(Name only)
SUPERVISED BY
Clinical Instructor
Name and Signature
Case Number
October 19, 20137:00 am
AAB#63226
Partial Hip Arthroplasty Karen Denise R.Crisostomo R.M, R.N.
Patrick Joseph Elopre R.M,R.N.
(STRICTLY NO DESIGNATES)
[These Forms must be printed at the back of the 1 st page of the Competency-Based Performance Evaluation Checklist by the BoN]
ODC Form 1B
O.R. CIRCULATING
FORM
8/13/2019 Case Ni Chorvah
http://slidepdf.com/reader/full/case-ni-chorvah 3/5
St. Joseph College of Cavite Inc.Cavite City
INSTITUTE OF HEALTH SCIENCES
Tel no. : 431 -1937/7778/7779/ fax No. : 431-6037
Email Add: stjosephcollegecavite@yahoo.com
SURGICAL SCRUB in ___Dra.Olivia Salamanca Memorial District Hospital/ Cavite City/ Cavite___
Hospital, Municipality/City/Province
Prepared by:
Printed Name and Signature of Student____Jerome V. Villaverde_____
Date Performed
and
Time Started
Patient’s INITIALS Only
SURGICAL PROCEDURE
PERFORMED
O.R. Nurse On Duty
(Name only)
SUPERVISED BY
Clinical Instructor
Name and Signature
Case Number
October 12, 2012
3:00 pm
SAM
#226968Low Transverse Caesarian Section Aiza Day Viado R.N.
Maribeth A. Asenjo R.N.
M.A.N
(STRICTLY NO DESIGNATES)
[These Forms must be printed at the back of the 1st page of the Competency-Based Performance Evaluation Checklist by the BoN]
ODC Form 1A
O.R. SCRUB FORM
Major
8/13/2019 Case Ni Chorvah
http://slidepdf.com/reader/full/case-ni-chorvah 4/5
St. Joseph College of Cavite Inc.Cavite City
INSTITUTE OF HEALTH SCIENCES
Tel no. : 431 -1937/7778/7779/ fax No. : 431-6037
Email Add: stjosephcollegecavite@yahoo.com
ACTUAL DELIVERY in Dr. Jose Fabella Memorial Hospital/ Lope de Vega St./Sta. Cruz Manila/ Metro Manila
Hospital, Municipality/City/Province
Prepared by:
Printed Name and Signature of Student____Jerome V. Villaverde_____
Date Performed
and
Time Started
Patient’s INITIALS Only
PROCEDURE PERFORMED D.R. Nurse/Midwife On Duty
(Name only)
SUPERVISED BY
Clinical Instructor
Name and Signature
Case Number
December 16, 2013
2:12PM
AB
#528696 Normal Spontaneous DeliveryMaribelle Marcelino R.M.
Linda M. Villanueva R.M.
December 16, 2013
3:22PM
JB
#538555 Normal Spontaneous Delivery Maribelle Marcelino R.M. Linda M. Villanueva R.M.
Prepared by:
Printed Name and Signature of Student____Jerome V. Villaverde_____
Date Performed
and
Time Started
Patient’s INITIALS Only
Immediate Newborn
Cord Care PERFORMEDIndicate where performed e.g. D.R.,
Nursery, NICU, or Home
Nurse/Midwife On Duty
(Name only)
SUPERVISED BY
Clinical InstructorName and Signature
Case Number
December 9, 2013
2:00PM
BBV
#135376017 Essential Intrapartum Newborn Care Nilda M. Gadiano R.N Maribelle Marcelino R.M. December 9,2013
3:36PM
BBT
#13536800 Essential Intrapartum Newborn Care Nilda M. Gadiano R.N Maribelle Marcelino R.M. December 9, 2013
6:35PM
BBL
#13537647 Essential Intrapartum Newborn Care Nilda M. Gadiano R.N Maribelle Marcelino R.M.
(STRICTLY NO DESIGNATES)
[These Forms must be printed at the back of the 1st
page of the Competency-Based Performance Evaluation Checklist by the BoN]
D.R. Form
ACTUAL DELIVERY
FORM
ICNB Form
IMMEDIATE CARE OF THE
NEWBORN FORM
8/13/2019 Case Ni Chorvah
http://slidepdf.com/reader/full/case-ni-chorvah 5/5
St. Joseph College of Cavite Inc.
Cavite City
INSTITUTE OF HEALTH SCIENCES
Tel no. : 431 -1937/7778/7779/ fax No. : 431-6037
Email Add: stjosephcollegecavite@yahoo.com
ACTUAL DELIVERY in ___Dra.Olivia Salamanca Memorial District Hospital/ Cavite City/ Cavite___
Hospital, Municipality/City/Province
Prepared by:
Printed Name and Signature of Student____Jerome V. Villaverde_____
Date Performed
and
Time Started
Patient’s INITIALS Only
PROCEDURE PERFORMED D.R. Nurse/Midwife On Duty
(Name only)
SUPERVISED BY
Clinical Instructor
Name and Signature
Case Number
January 18, 20122:30 AM
ODS#216668 Normal Spontaneous Delivery Mercy Casino R.M Karen J. Bartolome R.N, R.M.
(STRICTLY NO DESIGNATES)
[These Forms must be printed at the back of the 1st page of the Competency-Based Performance Evaluation Checklist by the BoN]
D.R. Form
ACTUAL DELIVERY
FORM
top related