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    This document contains forms from Pines City Colleges College of Nursing in Baguio City related to various clinical procedures including: - An actual delivery form documenting a normal spontaneous delivery at Benguet General Hospital - An immediate newborn care form - Surgical scrub forms for the operating room - A form for assisting a delivery The forms include fields for student and supervisor signatures and details of the procedures.

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    PRC New2

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    59 views6 pages
    This document contains forms from Pines City Colleges College of Nursing in Baguio City related to various clinical procedures including: - An actual delivery form documenting a normal spontaneous delivery at Benguet General Hospital - An immediate newborn care form - Surgical scrub forms for the operating room - A form for assisting a delivery The forms include fields for student and supervisor signatures and details of the procedures.

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    This document contains forms from Pines City Colleges College of Nursing in Baguio City related to various clinical procedures including: - An actual delivery form documenting a normal spontaneous delivery at Benguet General Hospital - An immediate newborn care form - Surgical scrub forms for the operating room - A form for assisting a delivery The forms include fields for student and supervisor signatures and details of the procedures.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    59 views6 pages

    PRC New2

    Uploaded by

    thomasfinley44
    This document contains forms from Pines City Colleges College of Nursing in Baguio City related to various clinical procedures including: - An actual delivery form documenting a normal spontaneous delivery at Benguet General Hospital - An immediate newborn care form - Surgical scrub forms for the operating room - A form for assisting a delivery The forms include fields for student and supervisor signatures and details of the procedures.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 6

    Pines City Colleges

    College of nursing
    Magsaysay Ave. Baguio City 2600 Tel. nos.: (074) 445-2210, 445-2209 Fax: (074) 445-2208 www.pcc.edu.ph

    ACTUAL DELIVERY in BENGUET GENERAL HOSPITAL ECONOMIC ENTERPRISE, LA TRINIDAD, BENGUET Hospital/Home/Lying-In Clinic, Municipality/City/Province D.R. Form ACTUAL DELIVERY Prepared by: FORM Printed Name and Signature of Student __RODANTE P. DANGPA___ Date Performed and Time Started Patients INITIAL Only Case Number (not applicable for Birthing/Lying-In Clinics/Homes) A.D. 386328 Normal Spontaneous Delivery PROCEDURE PERFORMED D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required) SUPERVISED BY Clinical Instructor Name and Signature

    April 28, 2013 9:30 pm April 29, 2013 5:05 pm May 01. 2013 10:35 pm

    Ms. Gemma Basatan

    Ms. Fe L. Bartolome

    J.O. 388667 R.S. 404855

    Normal Spontaneous Delivery

    Ms. Gemma Basatan

    Ms. Fe L. Bartolome

    Normal Spontaneous Delivery

    Ms. Julia Marzan

    Ms. Fe L. Bartolome

    Pines City Colleges


    College of nursing
    Magsaysay Ave. Baguio City 2600 Tel. nos.: (074) 445-2210, 445-2209 Fax: (074) 445-2208 www.pcc.edu.ph

    ACTUAL DELIVERY in BENGUET GENERAL HOSPITAL ECONOMIC ENTERPRISE, LA TRINIDAD, BENGUET Hospital/Home/Lying-In Clinic, Municipality/City/Province ICNB Form IMMEDIATE CARE OF THE NEWBORN Prepared by: FORM Printed Name and Signature of Student __RODANTE P. DANGPA___ Date Performed and Time Started Patients INITIAL Only Case Number (not applicable for Birthing Homes/LyingIn Clinics/Homes) Immediate Newborn Cord Care PERFORMED Indicate where performed e.g. D.R., Nursery, NICU, or Home Nurse On Duty (Name and Signature) (If Midwife on Duty, signature not required) SUPERVISED BY Clinical Instructor Name and Signature

    Pines City Colleges


    College of nursing
    Magsaysay Ave. Baguio City 2600 Tel. nos.: (074) 445-2210, 445-2209 Fax: (074) 445-2208 www.pcc.edu.ph

    SURGICAL SCRUB in ________________________________________________________________________ O.R. Form 1A Hospital, Municipality/City/Province O.R. SCRUB FORM Prepared by: Printed Name with Signature of Student ______________________________________________ Date Performed and Time Started Patients INITIALS (only) Case Number SURGICAL PROCEDURE PERFORMED O.R. Nurse On Duty (Name AND Signature) Major

    SUPERVISED BY Clinical Instructor Name and Signature

    Pines City Colleges


    College of nursing
    Magsaysay Ave. Baguio City 2600 Tel. nos.: (074) 445-2210, 445-2209 Fax: (074) 445-2208 www.pcc.edu.ph

    SURGICAL SCRUB in ________________________________________________________________________ O,R, Form 1B Hospital, Municipality/City/Province O.R. CIRCULATING Prepared by: Printed Name and Signature of Student ______________________________________________ Date Performed and Time Started Patients INITIALS Only Case Number SURGICAL PROCEDURE PERFORMED O.R. Nurse On Duty (Name and Signature) FORM

    SUPERVISED BY Clinical Instructor Name and Signature

    Pines City Colleges


    College of nursing
    Magsaysay Ave. Baguio City 2600 Tel. nos.: (074) 445-2210, 445-2209 Fax: (074) 445-2208 www.pcc.edu.ph

    O,R, Form 1C O.R. MINOR FORM Prepared by: Printed Name and Signature of Student ______________________________________________ Date Performed and Time Started Patients INITIALS Only Case Number SURGICAL PROCEDURE PERFORMED O.R. Nurse On Duty (Name and Signature) SUPERVISED BY Clinical Instructor Name and Signature

    Pines City Colleges


    College of nursing
    Magsaysay Ave. Baguio City 2600 Tel. nos.: (074) 445-2210, 445-2209 Fax: (074) 445-2208 www.pcc.edu.ph

    ASSIST DELIVERY in ________________________________________________________________________ Hospital/Home/Lying-In Clinic, Municipality/City/Province D.R. Form ASSIST DELIVERY Prepared by: FORM Printed Name and Signature of Student ______________________________________________ Date Performed and Time Started Patients INITIAL Only Case Number (not applicable for Birthing/Lying-In Clinics/Homes) PROCEDURE PERFORMED D.R. Nurse On Duty (Name and Signature) (If Midwife on Duty, Signature Not Required) SUPERVISED BY Clinical Instructor Name and Signature

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