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STI COLLEGE GLOBAL CITY

STI Academic Center, University Parkway Drive, Bonifacio Global City, Taguig City

Name of Student: Eleanor Joy L. De Guzman _______________________________________________________________________________________________________________________

Accreditation Level: (if any) _____________________________________ Year Granted _____________________________________________________________________________________

Date School/Program was recognized: February 6, 2008___________ Number: 002 ______________________________________ Year: 2008 _______________________________________

First Course (if any): Licensed Vocational Nursing __________________ School Graduated From: Healthcare College of California Year 2006-2007_________________________________

Year of Admission in the Bachelor of Science in Nursing Program: 2009___________________________________________________________________________________________________

Year Graduated (BSN Program): 2010-2011_________________________________________________________________________________________________________________________

I. Major Operations

NoDate of

OperationCase No.

Name of Patient DiagnosisOperation Performed

Type of Anesthesia

Name of Surgeon/ Residents

Name of Hospital

Name O.R. Scrub Nurse

Name and Signature of

Qualified Clinical

Instructor

1. August 10, 2010

1004633

Vallicier, RicardoRuptured Appendicitis with General peritonitis

Exploratory + Laparotomy and Appendectomy

General Anesthesia

Dr. Allan Joel

Morales, MD

Taguig Pateros District Hospital Michelle

Agravante, RNLita Bacudio RN,

RM, MAN

2.August 20,

2010100464

0Lorenzo, Melina Chronic Anal Fissure

HemorrhoidEctomy

Spinal Anesthesia

Block

Dr. Joseph Fuentes, MD

Taguig Pateros District Hospital Michelle

Agravante, RNLita Bacudio RN,

RM, MAN

Prepared by: Noted by: Concurred by: Approved by:

ELEANOR JOY L. DE GUZMAN___ PETER V. AGRUDA_________________________ JOEL U. BERNABE, RN, MAN_______ MIGUEL E. MANGADA __________Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of College Dean

Date Signed: _____________________________ Date Signed: _________________________ Date Signed: __________________________Degree: R.N., M.A.N._____________________ Degree: RN, D.P.A . _ __________________ Degree: R.N., R.P.T., PhD_______________a.) P.R.C. No.:0241249____________________ a.) P.R.C. No. 0242578________________ a.) P.R.C. No.: 105251__________________

Valid Until :March 13, 2013____________ Valid Until: November 31, 2013____ Valid Until: September 29,2014______b.) P.N.A. No.:045107_____________________ b.) P.N.A. No. :01793___________________ b.) P.N.A. No.: 18289____________________

Valid Until: October 31, 2012__________ Valid Until: October 31, 2011_______ Valid Until: Lifetime__________________c.) ANSAP No.: 00817___________________ c.) ADPCN No.: 1203____________________

Valid Until: _December 31,2011_____ Valid Until: May 26, 2012____________

STI COLLEGE GLOBAL CITYSTI Academic Center, University Parkway Drive, Bonifacio Global City, Taguig City







I. Major Operations

NoDate of

OperationCase No. Name of Patient Diagnosis

Operation Performed

Type of Anesthesia

Name of Surgeon/ Residents

Name of Hospital



Qualified Clinical

Instructor

1.July 29,

201116467 Rafael, Sheryl

G8P5 (5002) Pregnancy Uterine Full-

Term, Cephalic

Lower Segment Caesarean Section 4 + Bilateral Tubal

Ligation

Subarachnoid Block

Alexis Uy, MD

Rizal Medical Center

Jerome Tinte, RN Teresita Llamas, RN, MAN

2.July 29,

2011A098179 De Leon, Gianna

LopeG2P2 (2012)

Pregnancy Uterine Footling Breech

Lower Segment Caesarean Section

1

Subarachnoid Block

Allan Joel Morales, MD


Enrico Reyes, RN Teresita Llamas, RN, MAN

3.July 29,

201158056 Carlos, Bhingo

Elenozano Chronic Cholecystitis

and CholelithiasisOpen

CholecystectomyContinuous

Lumbar Epidural Anesthesia

Reigelson Mariano, MD


Grace Rivera, RN Teresita Llamas, RN, MAN


ELEANOR JOY L. DE GUZMAN___ PETER V. AGRUDA_________________________ Louise Marie D. Flores_______ MIGUEL E. MANGADA __________Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of College Dean


Valid Until :March 13, 2013____________ Valid Until: March 31, 2012____ Valid Until: September 29,2014______b.) P.N.A. No.:045107_____________________ b.) P.N.A. No. :10355__________________ b.) P.N.A. No.: 18289____________________

Valid Until: October 31, 2012__________ Valid Until: Lifetime ______ Valid Until: Lifetime__________________c.) ANSAP No.: 0316 _________________ c.) ADPCN No.: 1203____________________

Valid Until: _Lifetime _____ Valid Until: May 26, 2012____________



Accreditation Level: (if any) __________________________________ Year Granted: ________________________________________________________________________________________

Date School/Program was recognized: February 6, 2008 Number: 002____________________________________ Year: 2008____________________________________________

First Course (if any): Licensed Vocational in Nursing____________ School Graduated From: Healthcare College of California Year: 2006-2007______________________________________

Year of Admission in the Bachelor of Science in Nursing Program: 2009 ____________________________________________________________________________________________________

Year Graduated (BSN Program): 2010 -2011_________________________________________________________________________________________________________________________

II. Minor Operations

NoDate of

OperationCase No.


Type of Anesthesia

Name of Surgeon

Name of Hospital



Qualified Clinical

Instructor

1.September19, 2010

3563 Tagalog, Michael Gunshot Suture Local Anesthesia

Reigelson Mariano, MD

Rizal Medical Center/

Emergency Room

Benjamin Gutierrez, RN

Ingrid Caspillo RN, MSN

2.July 8, 2011

A097835

Acedo, VanessaG2P1 (1001)

Pregnancy Uterine 171/2 weeks AOG x

LMP Missed Abortion

Exploratory + Laparotomy and

Curettage

General Anesthesia

Dalmacion, MD


Maria Casbel Crisostomo, RN

Ingrid Caspillo, RN, MSN

3.

July 29, 2011

24247 Golloso, Kens Lean Left Pyogenic Granuloma

Excision Biopsy General Endotracheal Anesthesia

Samio Lazaro, MD

Rizal Medical Center/Operating

Room

Lourdes Mozo, RN Teresita Llamas, RN,

MAN

4.July 29,

201153213 Martinez, Tilda

AustriaAdhesive Capsulitis

Right Shoulder + Hypertrophic Scar

on Right Breast

Close Manipulation +

Steroid Injection Right Shoulder +

Revision of Hypertrophic Scar

Right Breast

General Endotracheal Anesthesia

Jonadav Martinez, MD

Rizal Medical Center/ Operating

Room

JeromeTinte, RN Teresita Llamas, RN,

MAN


ELEANOR JOY L. DE GUZMAN___ PETER AGRUDA_________________________ Louise Marie D. Flores_______ MIGUEL E. MANGADA __________Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of College Dean

Date Signed: _____________________________ Date Signed: _________________________ Date Signed: __________________________Degree: R.N., M.A.N._____________________ Degree: RN, D.P.A . _ __________________ Degree: R.N., R.P.T., PhD_______________c.) P.R.C. No.:0241249____________________ a.) P.R.C. No. 0086759________________ a.) P.R.C. No.: 105251__________________

Valid Until :March 13, 2013____________ Valid Until: March 31, 2012____ Valid Until: September 29,2014______d.) P.N.A. No.:045107_____________________ b.) P.N.A. No. :10355__________________ b.) P.N.A. No.: 18289____________________










II. Minor Operations

NoDate of

OperationCase No.


Type of Anesthesia

Name of Surgeon

Name of Hospital



Qualified Clinical

Instructor

1.April 18,

2011OP 8 Aurelia, Justin Excess Profuse Circumcision Local

AnesthesiaDr. Rogelio Catapang,

MD

Air force General Hospital

Yolanda Toribio, RN

Marriane Tejada Corpuz

RN, MAN


ELEANOR JOY L. DE GUZMAN___ PETER V. AGRUDA______________________ _____________________________ MIGUEL E. MANGADA __________Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of College Dean

Date Signed: _____________________________ Date Signed: _________________________ Date Signed: __________________________Degree: R.N., M.A.N._____________________ Degree: ________________________ Degree: R.N., R.P.T., PhD_______________a.) P.R.C. No.:0241249____________________ a.) P.R.C. No. ___________________ a.) P.R.C. No.: 105251__________________

Valid Until :March 13, 2013____________ Valid Until: ____ ____________ Valid Until: September 29,2014______b.) P.N.A. No.:045107_____________________ b.) P.N.A. No. : __________________ b.) P.N.A. No.: 18289____________________

Valid Until: October 31, 2012__________ Valid Until: _________________ Valid Until: Lifetime__________________c.) ANSAP No.: _________________ c.) ADPCN No.: 1203____________________

Valid Until: _ _________________ Valid Until: May 26, 2012__________


Name of Student: _Eleanor Joy L. De Guzman ______________________________________________________________________________________________________________________

Accreditation Level: (if any) _________________________________________ Year Granted: _________________________________________________________________________________

Date School/Program was Recognized: February 6, 2008_________________ Number :002_____________________________________ Year: 2008____________________________________

First Course (if any): Licensed Vocational in Nursing____________________School Graduated From: Healthcare College of California Year: 2006-2007______________________

Year of Admission in the Bachelor of Science in Nursing Program: 2009____________________________________________________________________________________________________

Year Graduated (BSN Program): 2010-2011__________________________________________________________________________________________________________________________

III. Actual Deliveries

NoDate of

OperationCase No.


Type of Anesthesia

Name of Surgeon

Name of Hospital



Qualified Clinical

Instructor

1.July 7, 2011

A097817

Cabito, Micah

G2P1(1001) Pregnancy

Uterine 40 weeks 6/7 days

Normal Spontaneous

DeliveryLocal

Anesthesia

Frederick Diamante, MD


Amy Curangon,RN


2. July 8, 2011

32240 Rodil, Jhoanna G5 P4 (4004) Pregnancy Uterine 37

weeks

Normal Spontaneous

Delivery

Local Anesthesia

Jo Ann Vivar, MD


Amy Curangon,RN


3.July 13,

2011A09792

6Jayah, Margie G1P0 Pregnancy

UterineNormal

Spontaneous Delivery

Local Anesthesia

Jo Ann Vivar, MD


Renato Caray, RN


4.August 20,

2010A09782

0Escao, Lulu II G5 P2 Pregnancy

Uterine 37 weeksNormal


Local Anesthesia



Ma. Casbel Crisostomo,

RN

Ingrid Caspillo,

RN, MSN

5.August 20,

20101004642 Samaniego, Fraces

J.

G4 P4 (4004)

Pregnancy Uterine, 38-39 weeks Age of Gestation, Breech

Presentation in Labor

Normal Spontaneous

Delivery

Local Anesthesia




RN



ELEANOR JOY L. DE GUZMAN___ PETER V. AGRUDA_________________________ Louise Marie D. Flores_______ MIGUEL E. MANGADA __________Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of College Dean

Date Signed: _____________________________ Date Signed: _________________________ Date Signed: __________________________Degree: R.N M.A.N._____________________ Degree: RN, D.P.A . _ __________________ Degree: R.N., R.P.T., PhD_______________c.) P.R.C. No.:0241249____________________ a.) P.R.C. No. 0086759________________ a.) P.R.C. No.: 105251__________________

Valid Until: March 13, 2013____________ Valid Until: March 31, 2012________ Valid Until: September 29,2014______d.) P.N.A. No.:045107_____________________ b.) P.N.A. No. :10355__________________ b.) P.N.A. No.: 18289____________________





Accreditation Level: (if any) _______________________________________ Year Granted _________________________________________________________________________________

Date School/Program was recognized: February 6, 2008_______________ Number: 002____________________________________Year: 2008_____________________________________

First Course (if any): Licensed Vocational in Nursing_____________________School Graduated From: Healthcare College of California Year: 2006-2007__________________________


Year Graduated (BSN Program): 2010 -2011_________________________________________________________________________________________________________________________

IV. Deliveries Assisted

NoDate of

OperationCase No. Name of Patient Diagnosis

Operation Performed

Type of Anesthesia

Name of Surgeon / Residents

Name of Hospital



Qualified Clinical

Instructor

1.July 7, 2011

A097820 Escaloi, Lulu IIG5P2, Pregnancy Uterine

37 weeks Age of Gestation, Cephalic in

Labor

Normal Spontaneous

Delivery

LocalAnesthesia




RN

Ingrid Caspillo, RN,

MSN

2.July 7, 2011

A097815 Cotas, Regina Mae

G2 P1 (1001) Pregnancy Uterine 40 weeks Age of

Gestation

Normal Spontaneous

Delivery

Local Anesthesia

Czarina Artienda, MD


Mary Jean Panes, RN


MSN

3.July 8, 2011

A097824 Diaz, Severina G2 P1 (1001) Pregnancy Uterine, 39-40 weeks Age

of Gestation

Normal Spontaneous

Delivery

Local Anesthesia

Jo Ann C. Vivar, MD



RN


MSN

4.July 18,

201110-04630 Quintana,

SharonG6 P6, 38-39 weeks Age

of Gestation,Normal


Local Anesthesia

Gabaldon, MD Rizal Medical Center


RN


MSN

5. July 18, 2011

A0978218

Pajamosan, Jaymaylyn

G1 P0 Pregnancy Uterine, 38 weeks 6/7 days, 2.8kgs

Normal Spontaneous

Delivery

Local Anesthesia

Dr. Jo Ann C. Vivar, MD



RN


MSN


ELEANOR JOY L. DE GUZMAN___ PETER V. AGRUDA___________________ Louise Marie D. Flores_______ MIGUEL E. MANGADA __________Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of College Dean

Date Signed: _____________________________ Date Signed: _________________________ Date Signed: __________________________Degree: R.N., M.A.N._____________________ Degree: RN, D.P.A . _ __________________ Degree: R.N., R.P.T., PhD_______________e.) P.R.C. No.:0241249____________________ a.) P.R.C. No. 0086759________________ a.) P.R.C. No.: 105251__________________

Valid Until :March 13, 2013____________ Valid Until: March 31, 2012____ Valid Until: September 29,2014______f.) P.N.A. No.:045107_____________________ b.) P.N.A. No. :10355__________________ b.) P.N.A. No.: 18289____________________




Name of Student: Eleanor Joy L. De Guzman ______________________________________________________________________________________________________________________

Accreditation Level: (if any) _______________________________________ Year Granted: _________________________________________________________________________________

Date School/Program was Recognized: February 6, 2008 ___________________ Number: 002__________________________________ Year: 2008________________________________

First Course (if any): Licensed Vocational Nurse ______________ School Graduated From: Healthcare College of California__ Year: 2006-2007___________________________


Year Graduated (BSN Program): 2010 -2011__________________________________________________________________________________________________________________________

V. Cord Dressing

NoDate of

OperationCase No. Name of Patient

Operation Performed

Name of Surgeon / Residents

Name of HospitalName O.R. Scrub

Nurse

Name and Signature of Qualified Clinical

Instructor

1.July 6, 2011

42625 Baby Girl Tapalce Cord CareJo Ann C. Vivar, MD Rizal Medical Center Mary Jean Panes, RN Ingrid Caspillo, RN, MSN

2.July 7, 2011

098707 Baby Girl Reyes Cord CareIluminada Dizon, MD Rizal Medical Center Mary Jean Panes, RN Ingrid Caspillo, RN, MSN

3. July 8, 2011

10-04526 Baby Girl Basario Cord CareJonadav Martinez, MD Rizal Medical Center /

Delivery RoomMaria Casbel

Crisostomo, RNIngrid Caspillo, RN, MSN

4. July 8, 2011

A097825 Baby Girl Bilo Cord CareJo Ann C. Vivar, MD Rizal Medical Center / Maria Casbel

Crisostomo, RNIngrid Caspillo, RN, MSN

5.July 13,

2011A097912 Baby Boy Cellada Cord Care Jo Ann C. Vivar, MD Rizal Medical Center Renato Caray, RN Ingrid Caspillo, RN, MSN


ELEANOR JOY L. DE GUZMAN___ PETER V. AGRUDA___________________ Louise Marie D. Flores_______ MIGUEL E. MANGADA __________Signature Over Printed Name of Student Signature Over Printed Name of Clinical Coordinator Signature Over Printed Name of Chief Nurse Signature Over Printed Name of College Dean


Valid Until :March 13, 2013____________ Valid Until: March 31, 2012____ Valid Until: September 29,2014______b.) P.N.A. No.:045107_____________________ b.) P.N.A. No. :10355__________________ b.) P.N.A. No.: 18289____________________



Name POSITION PRC # VALID UNTIL PNA VALID UNTIL ADPCN VALID UNTIL ANSAP VALID UNTILMiguel E. Mangada Dean 105251 September 29, 2011 18289 Lifetime 1203 May 26, 2012 May 26, 2012Peter V. Agruda, RN, MAN Clinical Coordinator 0241249 March 13, 2013 045107 October 31, 2012 October 31, 2012

Joel U. Bernabe, RN, MANChief Nurse Taguig

Pateros District Hospital

0242578 November 30, 2013 01793 October 31, 2011 00817 December 31, 2011

Louise Marie D. Flores, RN, DPA Chief Nurse Rizal Medical Center 0086759 March 31, 2012 10355 Lifetime 0316 Lifetime

Luz P. Padua, RN, MAN, Ph.D.Chief Nurse Quirino Memorial Medical

Center0187482 July 25, 2012 11959 Lifetime 00004 Lifetime

Date School/Program was recognized: February 6, 2008No. 002 Series of 2008

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