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Dadang - or Cases

This document is a surgical scrub form from Ecumenical Christian College Matatalaib in Tarlac City, Philippines. It details surgical procedures performed by nursing student Rhada Empig at Tarlac Provincial Hospital between February and September 2009. The procedures included incision and drainage, debridement, and incision and drainage with debridement. The form documents the date, time and patient for each procedure, and is signed by the student, supervising clinical instructor, nursing coordinator, chief nurse, and dean to verify the training experience.

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54 views3 pages

Dadang - or Cases

This document is a surgical scrub form from Ecumenical Christian College Matatalaib in Tarlac City, Philippines. It details surgical procedures performed by nursing student Rhada Empig at Tarlac Provincial Hospital between February and September 2009. The procedures included incision and drainage, debridement, and incision and drainage with debridement. The form documents the date, time and patient for each procedure, and is signed by the student, supervising clinical instructor, nursing coordinator, chief nurse, and dean to verify the training experience.

Uploaded by

adang1021
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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ECUMENICAL CHRISTIAN COLLEGE MATATALAIB, TARLAC CITY Telefax: (045) 982-4247, ecumcollege@yahoo.

com Accredited by: Commission on Higher Education, Level IV, January 23, 2007 SURGICAL SCRUB IN TARLAC PROVINCIAL HOSPITAL TARLAC CITY, TARLAC Hospital, Municipality/City/Province Prepared by: Name of Student: MENDOZA, RHADA EMPIG Date Performed And Time Started Patients Name Case Number Ryan P. Taedo R.N. Ryan P. Taedo R.N. Ryan P. Taedo R.N. Ryan P. Taedo R.N. Ryan P. Taedo R.N.
Noted by: __VERA A. SANTOS_ RN, MSN_ MSN__ Clinical Coordinator, PRC I.D No. 0065834 Valid Until: MAY 2013 3, 2011 PNA No. 056497 Valid Until: December 2010 Date document is signed: _______________________ Time _______________ Please specify Highest Nursing Degree Earned: Master of Science in Nursing_ Time: _______________ Science in Nursing Approved by: __EDWINA S. BASCO RN, MSN

ODC Form 1
O.R. SCRUB FORM

Signature of Student: __________________________________ PROCEDURE PERFORMED MAJOR O.R. Nurse On Duty (Name only) Supervised by Clinical Instructor Name and Signature Julius T. M.S.N. Julius T. M.S.N Julius T. M.S.N Julius T. M.S.N Julius T. M.S.N Quijano R.N., . Quijano R.N., Quijano R.N., Quijano R.N., Quijano R.N.,

Concurred by: _ERLINDA S. LAGONILLA RN, Chief Nurse, PRC I.D No. 46196 Valid Until: FEBRUARY

PNA No. 2401 Valid Until LIFETIME ANSAP No. 0106 Valid Until: LIFETIME Date document is signed: ____________________ Please specify Highest Nursing Degree Earned: Master of

Dean, PRC I.D No.0168119 Valid Until: JUNE 2012 PNA No. 17991 Valid Until LIFETIME ADCPN No. 0224 Valid Until December 2010 Date document is signed: _____________________ Time ___________ Please specify Highest Nursing Degree Earned Master of Science in Nursing______

ECUMENICAL CHRISTIAN COLLEGE MATATALAIB, TARLAC CITY Telefax: (045) 982-4247, [email protected] Accredited by: Commission on Higher Education, Level IV, January 23, 2007 SURGICAL SCRUB IN TARLAC PROVINCIAL HOSPITAL TARLAC CITY, TARLAC Hospital, Municipality/City/Province Prepared by: Name of Student: MENDOZA, RHADA EMPIG __________________________________ Date Performed And Time Started February 28. 2009 9:45 a.m. March 16, 2009 11:15 a.m March 16, 2009 2:32 p.m. September 04, 2009 8:27 a.m. Patients Name Case Number Melegrito, Vanessa Serit 121311 Avilla, Ernesto Ocampo Jr. 122319 Alfonso, Mila Banting Reyes, Marisol Sibal PROCEDURE PERFORMED MINOR Incision & Drainage Debridement Debridement Incision & Drainage, Debridement Signature of Student:

ODC Form 1
O.R. SCRUB FORM

O.R. Nurse On Duty (Name only) Ryan P. Taedo R.N. Ryan P. Taedo R.N. Ryan P. Taedo R.N. Ryan P. Taedo R.N. Ryan P. Taedo R.N.

Supervised by Clinical Instructor Name and Signature Julius T. M.S.N. Julius T. M.S.N Julius T. M.S.N Julius T. M.S.N Julius T. M.S.N Quijano R.N., . Quijano R.N., Quijano R.N., Quijano R.N., Quijano R.N.,

Noted by: __VERA A. SANTOS_ RN, MSN_ MSN__ Clinical Coordinator, PRC I.D No. 0065834 Valid Until: MAY 2013 FEBRUARY 3, 2011

Concurred by: _ERLINDA S. LAGONILLA RN, Chief Nurse, PRC I.D No. 46196 Valid Until:

PNA No. 056497 Valid Until: December 2010 Date document is signed: _______________________ Time _______________ Please specify Highest Nursing Degree Earned: Master of Science in Nursing_ Time: _______________

PNA No. 2401 Valid Until LIFETIME ANSAP No. 0106 Valid Until: LIFETIME Date document is signed: ____________________

Please specify Highest Nursing Degree Earned: Master of Science in Nursing Approved by: __EDWINA S. BASCO RN, MSN Dean, PRC I.D No.0168119 Valid Until: JUNE 2012 PNA No. _17991 Valid Until LIFETIME ADCPN No. 0224 Valid Until December 2010 Date document is signed: _____________________ Time ___________ Please specify Highest Nursing Degree Earned Master of Science in Nursing

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