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PRC (SN&CN)

The document contains 3 forms from Our Lady of Fatima University for reporting on newborn cord care, actual deliveries, and deliveries assisted that were performed at Valenzuela Medical Center. The forms require information on the date, patient initials, procedure performed, supervising nurse or midwife, and are noted and approved by the Clinical Coordinator and Dean of the university.

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Apple Grace Oclarit Morales
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146 views

PRC (SN&CN)

The document contains 3 forms from Our Lady of Fatima University for reporting on newborn cord care, actual deliveries, and deliveries assisted that were performed at Valenzuela Medical Center. The forms require information on the date, patient initials, procedure performed, supervising nurse or midwife, and are noted and approved by the Clinical Coordinator and Dean of the university.

Uploaded by

Apple Grace Oclarit Morales
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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OUR LADY OF FATIMA UNIVERSITY 120 McArthur Highway, Valenzuela City Tel.

432-6026/293-2703 to 06 PACUCOA Level III Accredited IMMEDIATE NEWBORN CORD CARE in Valenzuela Medical Center

Prepared by: Printed Name and Signature of Student____________________________________________

Date Performed and Time Started

Patient's INITIAL Only Case Number

Immediate Newborn Cord Care PERFORMED Indicate where performed e.g. D.R., Nursery, NICU or Home

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature not required)

SUPERVISED BY Clinical Instructor Name and Signature

Noted by: ____________________________________ Potenciana A. Maroma, PhD Clinical Coordinator, PRC I.D. No. 0083736 Valid Until MAY, 2014 Date document is signed: _______________ Time __________ Degree Earned: Doctor of Philosophy

Approved by: ____________________________________________________ Lurceli L. Santos, RM RN MAN Dean, PRC I.D. No. 0010878 Valid Until 2014 Date document is signed: _______________ Time _______ Degree Earned: Master of Arts in Nursing

OUR LADY OF FATIMA UNIVERSITY 120 McArthur Highway, Valenzuela City Tel. 292-1124 PACUCOA Level III Accredited ACTUAL DELIVERY in Valenzuela Medical Center

Prepared by: Printed Name and Signature of Student____________________________________________

Date Performed and Time Started

Patient's INITIAL Only Case Number

PROCEDURE PERFORMED

D.R. Nurse On Duty (Name and Signature) (If Midwife on duty, Signature Not Required)

SUPERVISED BY Clinical Instructor Name and Signature

Noted by: ____________________________________ Potenciana A. Maroma, PhD Clinical Coordinator, PRC I.D. No. 0083736 Valid Until MAY, 2014 Date document is signed: _______________ Time __________ Degree Earned: Doctor of Philosophy

Approved by: ____________________________________________________ Lurceli L. Santos, RM RN MAN Dean, PRC I.D. No. 0010878 Valid Until 2014 Date document is signed: _______________ Time _______ Degree Earned: Master of Arts in Nursing

OUR LADY OF FATIMA UNIVERSITY 120 McArthur Highway, Valenzuela City Tel. 432-6026/293-2703 to 06 PACUCOA Level III Accredited DELIVERIES ASSISTED in Valenzuela Medical Center

Prepared by: Printed Name and Signature of Student____________________________________________

Date Performed and Time Started

Patient's INITIAL Only Case Number

PROCEDURE PERFORMED ASSISTED DELIVERY

D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required)

SUPERVISED BY Clinical Instructor Name and Signature

Noted by: ____________________________________ Potenciana A. Maroma, PhD Clinical Coordinator, PRC I.D. No. 0083736 Valid Until MAY, 2014 Date document is signed: _______________ Time __________ Degree Earned: Doctor of Philosophy

Approved by: ____________________________________________________ Lurceli L. Santos, RM RN MAN Dean, PRC I.D. No. 0010878 Valid Until 2014 Date document is signed: _______________ Time _______ Degree Earned: Master of Arts in Nursing

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