EMILIO AGUINALDO COLLEGE School of Nursing and Midwifery

In Partial Fulfillments of the Requirements in N105 NURSING MANAGEMENT (Intensive Practicum)

DOCUMENTATION IN HEADNURSING

Submitted by: Luna, Michelle P.

Submitted to: Amparo Lim, RN, RM, MAN Clinical Instructor

December 2011

MEDICAL CENTER MANILA 6TH MAIN December 2, 2011 (6:00am 2:00pm)

ORGANIZATIONAL CHART

JUDITH R. GUANLAO Clinical Instructor

Lima, Jessica Paula Student Head Nurse

Lozano, Rhodora Student Head Nurse

Facelo, Jhimver Medication Nurse

Jabasa, Kevin Staff Nurse

Marquez, Diana Medication Nurse

Lucero, Hyacinth Staff Nurse

Jaramillo, Bernadette Staff Nurse

Kashim, Adawiya Staff Nurse

Lum, James Albert Staff Nurse

Manalaysay, Jan Ivan Staff Nurse

Lauz, Florizza Staff Nurse

Marasigan, Michael Khevin Staff Nurse

MEDICAL CENTER MANILA 6TH MAIN December 2, 2011 (6:00am 2:00pm)

SCHEDULE OF ACTIVITIES
TIME ACTIVITIES

Prepared By: Luna, Michelle P. Student Head Nurse

Noted By: Amparo Lim, RN, RM, MAN Clinical Instructor

MEDICAL CENTER MANILA 6TH MAIN December 2, 2011 (6:00am 2:00pm) ATTENDANCE SHEET

STUDENT NAME

TIME-IN

SIGNATURE

TIME-OUT

SIGNATURE

Prepared By: Luna, Michelle P. Student Head Nurse

Noted By: Amparo Lim, RN, RM, MAN Clinical Instructor

MEDICAL CENTER MANILA 6TH MAIN December 2, 2011 (6:00am 2:00pm) PATIENT CLASSIFICATION SHEET

CATEGORY l Self care or Minimal Care CATEGORY ll Moderate care or Intermediate Care CATEGORY lll Total, Complete of Intensive Care CATEGORY lV Highly Specialized Critical Care ROOM NO. PATIENTS INITIAL AGE DIAGNOSIS CATEGORY OF CARE

Prepared By: Luna, Michelle P. Student Head Nurse

Noted By: Amparo Lim, RN, RM, MAN Clinical Instructor

MEDICAL CENTER MANILA 6TH MAIN December 2, 2011 (6:00am 2:00pm) STUDENT ASSIGNMENT SHEET

ROOM NO.

PATIENTS INITIAL

AGE

DIAGNOSIS

STAFF NURSE

Prepared By: Luna, Michelle P. Student Head Nurse

Noted By: Amparo Lim, RN, RM, MAN Clinical Instructor

MEDICAL CENTER MANILA 6TH MAIN December 2, 2011 (6:00am 2:00pm) 8 HOURS NURSING SHEET
AM CENSUS ADMISSION DISCHARGE TRANSFER TOTAL PM NOC POST-OP PRE-OP AM PM

TOTAL SPECIAL PROCEDURE

ROOM NO.

PATIENTS INITIAL

PROCEDURE

SCHEDULE

Prepared By: Luna, Michelle P. Student Head Nurse

Noted By: Amparo Lim, RN, RM, MAN Clinical Instructor

MEDICAL CENTER MANILA 6TH MAIN December 2, 2011 (6:00am 2:00pm)

NARRATIVE REPORT

Prepared By:

Noted By: Luna, Michelle P.

Medication Nurse

Student Head Nurse

MEDICAL CENTER MANILA 6TH MAIN December 2, 2011 (6:00am 2:00pm) NARRATIVE REPORT

Prepared By: Luna, Michelle P. Student Head Nurse

Noted By: Amparo Lim, RN, RM, MAN Clinical Instructor

MEDICAL CENTER MANILA 6TH MAIN December 2, 2011 (6:00am 2:00pm) NARRATIVE REPORT

Prepared By: Staff Nurse Instructor

Noted By: Amparo Lim, RN, RM, MAN Clinical

MEDICAL CENTER MANILA 6TH MAIN December 2, 2011 (6:00am 2:00pm) PERFORMANCE EVALUATION TOOL STAFF NURSE
NAME:
CRITERIA l. KNOWLEDGE a. Assessed health condition accurately b. Identifies need/problems of client before, during and after the procedure c. Properly intervenes the identified nursing problems by performance of independent and dependent nursing functions with minimum supervision d. Explain rationale for each intervention e. Evaluates the effectiveness of nursing intervention f. Assumes the independence and responsibility over assign task g. Needs the least supervision when doing assigned task h. Document pertinent observation and cases i. Gives appropriate health teaching instruction to client according to needs ll. SKILLS a. Applies the principles of asepsis when preparing materials and equipment b. Prepares and set up need supplies and equipment c. Uses/ operates tools and equipment d. Maintained the equipment and supplies used in good Standa rd Grades 3 3 3 3 3 3 3 3 3 5 5 5 5 Actual Grade s

working condition and in order of care e. Reports and records data are complete and accurate lll. ATTITUDE a. Established good intrapersonal relationship with clients family, co-worker, staff, leader, and CI b. reports to duty in complete uniform with paraphernalia and properly groomed and on time c. has initiative, responsible and efficient d. show respect to himself and others e. shows interest and enthusiasm in his work f. submits requirements on time TOTAL

5 3 3 3 3 3 5

Attendance: Attitude: Requirements: Quiz: 20% 10%

10%

10%

Performance Evaluation: Total: 100%

40%

Prepared By: Luna, Michelle P. Student Head Nurse

Noted By: Amparo Lim, RN, RM, MAN Clinical Instructor