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PRC Cord Caret

This document appears to be a form from Benguet State University College of Nursing for recording procedures performed for immediate newborn cord care at Benguet General Hospital. The form includes spaces for the student's name and signature, date and time of the procedure, patient name and case number, the procedure performed, the supervising nurse on duty, and signatures of the clinical coordinator and chief nurse to concur the procedure was performed under supervision. It also includes contact information for Benguet State University College of Nursing and specifies the form is for procedures performed at Benguet General Hospital.

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Audi Kyle Saydoven
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162 views

PRC Cord Caret

This document appears to be a form from Benguet State University College of Nursing for recording procedures performed for immediate newborn cord care at Benguet General Hospital. The form includes spaces for the student's name and signature, date and time of the procedure, patient name and case number, the procedure performed, the supervising nurse on duty, and signatures of the clinical coordinator and chief nurse to concur the procedure was performed under supervision. It also includes contact information for Benguet State University College of Nursing and specifies the form is for procedures performed at Benguet General Hospital.

Uploaded by

Audi Kyle Saydoven
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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OCD FORM 1C

Cord Care
BENGUET STATE UNIVERSITY Form
College of Nursing
La Trinidad, Benguet, 2601 Philippines
Phone number: 309-3882; Fax number: 422-2281; E-mail:[email protected]; Web site:www.bsu.edu.ph
LEVEL III RE-ACCREDITED,AACCUP,December 1,2007- November 3, 2011

IMMEDIATE NEWBORN CORD CARE in BENGUET GENERAL HOSPITAL

Name of Student: Signature of student:


Date Performed Patient Name
and PROCEDURE PERFORMED PNCU Nurse On Duty SUPERVISED BY:
Case Number
Time Started

Noted by: LAWRENCE C. CARANTO,RN Concurred by: VIRGINIA B. SAGUIDIC, RN


Clinical Coordinator, PRC I.D No.: 0311507 Valid Until : September 11,2011 Chief Nurse, PRC I.D No.: 003986 Valid until: January 15,2012
PNA No.: 063312 Valid Until: December 31,2010 PNA No.: 02806 Valid until: Lifetime
Date signed: Time signed : ANSAP No.: 01376 Valid until: December 31,2010
Highest Nursing Degree Earned: Master of Arts in Nursing ( MAN) Date signed: Time Signed:
Highest Nursing degree earned: Master of arts in Nursing (MAN)
OCD FORM 1C
Cord Care
BENGUET STATE UNIVERSITY Approved by: VICENTE G.PANAGAN JR.,RN Form
College of Nursing Dean, PRC I.D. No. 296633 Valid Until: April 11,2011
La Trinidad, Benguet, 2601 Philippines
PNA No.: 063313 Valid Until:December 31,2010
Phone number: 309-3882; Fax number: 422-2281; E- mail:[email protected]; Web site:www.bsu.edu.ph
LEVEL III RE-ACCREDITED,AACCUP,December 1,2007- ADPCN NO.: 0838 Valid Until: December 31,2010 November 3, 2011
Date signed: Time signed:
IMMEDIATE NEWBORN CORD CARE in BAGUIO GENERAL Specify Highest Nursing Degree Earned: HOSPITAL AND MEDICAL CENTER, Baguio City
Name of Student: Signature of student:
Date Performed Patient Name
and PROCEDURE PERFORMED PNCU Nurse On Duty SUPERVISED BY:
Case Number
Time Started

Noted by: LAWRENCE C. CARANTO,RN Concurred by: ELENA B. TAMPICAN,RN


Clinical Coordinator, PRC I.D No.: 0311507 Valid Until : September 11,2011 Chief Nurse, PRC I.D No.: 004369 Valid until: January 27,2011
PNA No.: 063312 Valid Until: December 31,2010 PNA No.: 04718 Valid until: Lifetime
Date signed: Time signed : ANSAP No.: 01036 Valid until: December 31,2010
Highest Nursing Degree Earned: Master of Arts in Nursing ( MAN) Date signed: Time Signed:
Highest Nursing degree earned: Master of arts in Nursing (MAN)

Approved by: VICENTE G.PANAGAN JR.,RN


Dean, PRC I.D. No. 296633 Valid Until: April 11,2011
PNA No.: 063313 Valid Until:December 31,2010
ADPCN NO.: 0838 Valid Until: December 31,2010
Date signed: Time signed:
Specify Highest Nursing Degree Earned:

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