my prc final exhibit form

Name of Student: ELDEN JOY TAYABAS CUBERO____________________________________________________Name & Address of School: DMMA College of Southern Philippines Tigatto Road, Buhangin, Davao City, Philippines Accredited Level: Not applicable Year Granted: Not applicable____________________________________________ Date School/Program was Recognized: July 23, 2007 Number: 019 Year: 2007______________________________First Course: Not applicable School Graduated: Not applicable Year: Not applicable__________________________ Year of Admission in the Bachelor of Science in Nursing Program: 2006___________________________________Year Graduated (BSN Program): 2010_______________________________________________________________

MINOR SCRUBS

No. Date of Operation

Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital Name of OR Scrub Nurse

Name and Signature of Qualified Clinical Instructor

01 January 27, 2009

110093 Jeff Cosmeño Lacerated wound right

eyebrow

Suturing Local Anesthesia Dr. Cuñado Medical Mission Group Hospital & Health

Services Cooperative of Tagum

Darwin Cariño, R.N. Vanessa April T. Prantilla RN, MN

Prepared by:

ELDEN JOY TAYABAS CUBERO Signature over printed name of applicant

A C

O

SOU

ILIPP

1 9 9 3

DMMA COLLEGE OF SOUTHERN PHILIPPINES Tigatto Road, Buhangin, Davao City, Philippines

Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Noted by:

HILLARI BIANCA L. EUSEBIO, RN, MN___

Signature over printed name of Clinical CoordinatorDate Signed:_____________________________ Degree: Master in Nursing_________________ a). PRC No.: 0368845______________________Valid Until: January 28, 2011____________ b). PNA No. : 055100______________________ Valid Until: October 31, 2010_______________

Approved by:

LUDIVINA S. ALEJANDRE, RN, MaED, MAN

Signature over printed name of Dean of NursingDate Signed: _____________________________Degree: Master of Arts in Nursing_________ a). PRC No.: 0079838_____________________ Valid Until: June 2, 2012__________________ b). PNA No.: 055099_____________________ Valid Until: October 31, 2010______________ ADPCN No.: 0827_______________________ Valid Until: December, 2010_______________

P


Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Concurred by:

JUAN G. PANUNCIO, BSN, RN____________

Signature over printed name of Chief NurseDate Signed: _____________________________Degree: Bachelor of Science in Nursing__ __ a). PRC No.: 0155974______________________ Valid Until: April 3, 2011 __________________b). PNA No.:18893________________________Valid Until: Lifetime Member_______________c.) ANSAP No.: 01609____________________Valid Until: December 31, 2010_____________

Name of Student: ELDEN JOY TAYABAS CUBERO ___________________________________________________Name & Address of School: DMMA College of Southern Philippines Tigatto Road, Buhangin, Davao City, Philippines Accredited Level: Not applicable Year Granted: Not applicable____________________________________________ Date School/Program was Recognized: July 23, 2007 Number: 019 Year: 2007______________________________First Course: Not applicable School Graduated: Not applicable Year: Not applicable__________________________ Year of Admission in the Bachelor of Science in Nursing Program: 2006___________________________________Year Graduated (BSN Program): 2010_______________________________________________________________

MINOR SCRUBS


Case No. Name of Patient Diagnosis Operation Performed

Type of Anesthesia Name of Surgeon Name of Hospital Name of OR Scrub Nurse

Name and Signature of Qualified Clinical

Instructor

02 February 28, 2009

2072 Leonardo Siasy Suturing Laceration at scalp area

Local Anesthesia Dr. Perfecto Llaguno, MD

Davao Adventist Hospital Garth Plandes, R.N. Alberto S. Alejandre, II, R.N.

03 April 12, 2009

0003 Alexis Cuajao Phimosis Circumcision Local Anesthesia Dr. Perfecto Llaguno, MD

Davao Adventist Hospital Sheikh Clarence Ortuoste, R.N.

Alberto S. Alejandre, II, R.N.

04 April 12, 2009

0004 Jake Pepito Non-Phimosis Circumcision Local Anesthesia Dr. Perfecto Llaguno, MD



05 April 12, 2009

0052 Juvy Cabrera Sebaceous Cyst Exision of Cyst Local Anesthesia Dr. Perfecto Llaguno, MD



Prepared by:


Noted by:

HILLARI BIANCA L. EUSEBIO, RN, MN_____

Signature over printed name of Clinical CoordinatorDate Signed:_______________________________ Degree: Master in Nursing___________________ a). PRC No.: 0368845_______________________Valid Until: January 28, 2011_________________b). PNA No. : 055100_______________________Valid Until: October 31, 2010________________

Approved by:


Signature over printed name of Dean of NursingDate Signed: _____________________________Degree: Master of Arts in Nursing__________ a). PRC No.: 0079838_____________________ Valid Until: June 2, 2012__________________ b). PNA No.: 055099_____________________ Valid Until: October 31, 2010______________ ADPCN No.: 0827_______________________ Valid Until: December, 2010_______________

Concurred by:

MERLYN L. GERSAVA RN, MAN_____

Signature over printed name of Chief NurseDate Signed: ________________________ Degree: Masters of Arts in Nursing_____ a). PRC No.: 0123405________________ Valid Until: July 7, 2011______________ b). PNA No.: 019488_________________ Valid Until: October 31, 2010__________ c.) ANSAP No.: 0354________________ Valid Until: Lifetime member__________


MAJOR SCRUBS


Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesia

Name of Surgeon Name of Hospital Name of OR Scrub Nurse


Instructor

01 February 2, 2009

110219 Estelita Lagumbay Repeat Caesarian Delivery to an Alive Baby Boy Cephalic Gravida 2 Para 2

(2002) Apgar Score 8-10-10 Body

Weight 3.2 Kilograms

Low Transverse Cesarean Section2

Sub Arachnoid Block

Dr. Sigrid Balingit, M.D.

Medical Mission Group Hospital & Health Services

Cooperative of Tagum

Ariel Bunquin, RN Vanessa April T. Prantilla RN, MN


110424 Joel Durban Encarcerated wound ankle; right median aspect; Transected

posterior tibial nerve artery and vein

Debridement; Wound exploration of Post Tibial

Artery and Vein neurorraphy

Sub Arachnoid Block

Dr. Miller Alaba, M.D. Medical Mission Group Hospital & Health Services


Darwin Cariño, RN Vanessa April T. Prantilla RN, MN

Prepared by:


Noted by:



Concurred by:

JUAN G. PANUNCIO, BSN, RN________

Signature over printed name of Chief NurseDate Signed: _________________________Degree: Bachelor of Science in Nursing__ a). PRC No.: 0155974__________________ Valid Until: April 3, 2011 ______________b). PNA No.:18893____________________Valid Until: Lifetime Member____________c.) ANSAP No.: 01609__________________Valid Until: December 31, 2010___________

Approved by:


Signature over printed name of Dean of NursingDate Signed: _____________________________Degree: Master of Arts in Nursing__________ a). PRC No.: 0079838_____________________ Valid Until: June 2, 2012__________________b). PNA No.: 055099_____________________Valid Until: October 31, 2010______________ADPCN No.: 0827_______________________Valid Until: December, 2010_______________

P


Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

P


Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Name of Student: ELDEN JOY TAYABAS CUBERO _______________________________________________________Name & Address of School: DMMA College of Southern Philippines Tigatto Road, Buhangin, Davao City, Philippines Accredited Level: Not applicable Year Granted: Not applicable____________________________________________ Date School/Program was Recognized: July 23, 2007 Number: 019 Year: 2007______________________________First Course: Not applicable School Graduated: Not applicable Year: Not applicable__________________________ Year of Admission in the Bachelor of Science in Nursing Program: 2006___________________________________Year Graduated (BSN Program): 2010_______________________________________________________________

MAJOR SCRUBS


Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesia

Name of Surgeon Name of Hospital Name of OR Scrub Nurse


Instructor

03 April 21, 2009

112038 Arlene Diaz Ovarian Cyst right twist; pregnancy uterine 6-9 weeks Graviada 1 Para 0

Exploratory Laparotomy Oophorectomy

Sub Arachnoid Block




Jazel Armilla, RN Vanessa April T. Prantilla RN, MN

05 February 7, 2010

Elanzano Low Transverse Cesarean Section2

Sub Arachnoid Block




Joecel Bonane, RN Vanessa April T. Prantilla RN, MN

Prepared by:


SO

P9 9


Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Noted by:



Concurred by:



Approved by:


Signature over printed name of Dean of NursingDate Signed: ___________________________ __ Degree: Master of Arts in Nursing a). PRC No.: 0079838 Valid Until: June 2, 2012b). PNA No.: 055099_____________________Valid Until: October 31, 2010______________ADPCN No.: 0827_______________________Valid Until: December, 2010_______________


MAJOR SCRUBS


Case No. Name of Patient Diagnosis Operation Performed Type of Anesthesia Name of Surgeon Name of Hospital Name of OR Scrub Nurse Name and Signature of Qualified Clinical

Instructor


04-32-18 Ernesta Felicida Mature Cataract Left eye Cataract Surgery Local Anesthesia Dr. Myra Grace Villanueva, M.D.

Davao Adventist Hospital

Aida M. Lamera RN Alberto S. Alejandre II, R.N.

Prepared by:


Noted by:



Concurred by:

MERLYN L. GERSAVA RN, MAN_____Signature over printed name of Chief NurseDate Signed: ________________________Degree: Masters of Arts in Nursing_____ a). PRC No.: 0123405________________ Valid Until: July 7, 2011______________b). PNA No.: 019488_________________Valid Until: October 31, 2010__________c.) ANSAP No.: 0354________________Valid Until: Lifetime member__________

Approved by:


Signature over printed name of Dean of NursingDate Signed: ______________________________Degree: Master of Arts in Nursing ___________a). PRC No.: 0079838______________________ Valid Until: June 2, 2012____________________b). PNA No.: 055099_______________________Valid Until: October 31, 2010________________ADPCN No.: 0827_________________________Valid Until: December, 2010_________________


CORD DRESSING

No. Case No. Date Performed Name of Baby Gender of Baby

Name of Mother Age Name of Hospital Name and Signature of Qualified Clinical Instructor

04 01919 December 27, 2009 Sobrino Baby Boy Male Girlie Sobrino 18 Guisok Lying -In Pamela M. Veroy RN, MAN

Prepared by:


SO

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Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Noted by:



Concurred by:

MARCELA P. GUISOK RM__________

Signature over printed name of Chief NurseDate Signed: ________________________Degree: Registered Midwife ____________ a). PRC No:0039514__________________ Valid Until: June 29, 2013______________

Approved by:




CORD DRESSING



01 112204 April 27, 2009 Chan Baby Girl Female Chona Chan 24 Medical Mission Group Hospital & Health Services Cooperative

of Tagum

Pamela M. Veroy RN, MAN

Prepared by:


DMM

A C

OLL

EGE OF SOUTHERN PHILIPPINES

1 9 9 3


Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Noted by:



Approved by:



Concurred by:




CORD DRESSING



02 09-211 May 18,2009 Hangad Baby Girl Female Marilyn Hangad 21 La Suerte Lying -In Pamela M. Veroy RN, MAN

Prepared by:


DMM

A C

OLL


1 9 9 3


Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Noted by:



Concurred by:

NORMA L. ALIMPOLO , RM________

Signature over printed name of Chief NurseDate Signed: _______________________Degree: Registered Midwife_ _________ a). PRC No: 0042935_________________ Valid Until: February 22, 2011__________

Approved by:




CORD DRESSING



03 00-00-67 July 7, 2009 Ginson Baby Boy Male Mary Ann Ginson 34 Mother’s Knows Best Alberto S. Alejandre II, R.N.

0500-00-88 December 24, 2009 Baring Baby Girl Female Erling Mae Baring 20 Mother’s Knows Best Alberto S. Alejandre II, R.N.

Prepared by:


DMM

A C

OLL


1 9 9 3


Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Noted by:



Concurred by:

SYLVIA P. CASTILLO, RM________


Approved by:




DELIVERED HANDLED

No. Case No. Diagnosis Name of Mother Age Date of Delivery Time of Delivery

Gender of Baby

Name of Hospital Type of Delivery Name and Signature of Qualified Clinical Instructor

01 09-209Pregnancy Uterine alive baby boy single by cephalic Gravida 1 Para

1(1001) with Apgar score-7, Head circumference-36cm, Chest

circumference-34cm, Length-48cm, Weight-8.4 pounds

Janice Tanduyan 26 May 18, 2009 8:53 am Male La Suerte Lying -In Normal Spontaneous Vaginal Delivery


Prepared by:


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Tel Nos: (082) 241-1350, 241-1356

Noted by:


Signature over printed name of Clinical CoordinatorDate Signed:_______________________________ Degree: Master in Nursing___________________ a). PRC No.: 0368845_____________________Valid Until: January 28, 2011 _________________ b). PNA No. : 055100_______________________Valid Until: October 31, 2010________________

Approved by:



Concurred by:

NORMA L. ALIMPOLO , RM________



DELIVERED HANDLED


Gender of Baby


02 00-0070 Delivered NSVD to an alive Baby boy with an APGAR score of 8 and

9 Gravida 3, Parity 3

Cheril Tabacon 21 July 19, 2009 2:29 pm Male Mother’s Knows Best Normal Spontaneous Vaginal Delivery

Alberto S. Alejandre II, R.N.



Gemma Ratayan 27 August 25, 2009 6:18 pm Male Mother’s Knows Best Normal Spontaneous Vaginal Delivery




Velinda Magracia 29 December 10, 2009

10:02 pm Female Mother’s Knows Best Normal Spontaneous Vaginal Delivery


Prepared by:


SO

P

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Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Noted by:



Approved by:



Concurred by:




DELIVERIES HANDLED

No. Case No. Diagnosis Name of Patient Age Date of Delivery Time of Delivery

Gender of Baby


05 01997 Delivered Spontaneously to an alive Baby girl, Gravida 3 Para 3; Age of

Gestation 39 weeks and 3 days

Rosalie Flores 29 February 11, 2010 1:05 pm Female Guisok Lying -In Normal Spontaneous Vaginal Delivery


Prepared by:


Noted by:


Signature over printed name of Clinical CoordinatorDate Signed:_______________________________Degree: Master in Nursing ___________________a). PRC No.: 0368845________________________Valid Until: January 28, 2011__________________b). PNA No. : 055100________________________Valid Until: October 31, 2010_________________

Concurred by:



Approved by:



SO

P

9 9


Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351


DELIVERED ASSISTED


Gender of Baby


01 00-0073Pregnancy Uterine Single alive

Cephalic Baby boy Gravida 1 Parity 1

Jovelyn Quimada 23 September 4, 2009

2:11 am Male Mother’s Knows Best Normal Spontaneous Vaginal Delivery


02 00-0076 Pregnancy Uterine Single alive Cephalic Baby boyGravida 1 Parity 1

Darling Mintal 20 October 12, 2009 12:13 am Male Mother’s Knows Best Normal Spontaneous Vaginal Delivery



Elyn Layupan 24 February 01, 2010

7:55 pm Female Mother’s Knows Best Normal Spontaneous Vaginal Delivery



Alma Utbo 29 February 25, 2010

9:50 am Male Mother’s Knows Best Normal Spontaneous Vaginal Delivery


Prepared by:


MA

CO

F SOU

ILIPPI

1 9 9 3


Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Noted by:



Approved by:



Concurred by:




DELIVERED ASSISTED


Gender of Baby


05 02018 Delivered Spontaneously to an alive Baby boy, Gravida 6 Para 6; Age of

Gestation 40 weeks and 3 days

Felie Mae Pabio 32 February 26, 2010 8:50 pm Male Guisok Lying -In Normal Spontaneous Vaginal Delivery

Alberto S. Alejandre II, R.N

Prepared by:


P


Tel Nos: (082) 241-1350, 241-1356Fax No.: (082) 241-1351

Noted by:



Approved by:



Concurred by:



my prc final exhibit form

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