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  • Patient Label Template-Least Restrictive

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    Coty Free
    14 views3 pages
    First Name Last Name 00-00000 Patient Observation Record Precautions: Observations: Fall Risk Behavi or LOS Date Seizure Precaution. Sexual Precautions. Location 1) Patient room 5) Dining room 9) Quiet room 13) Smoking 17) With Staff 2) Dayroom / lounge 6) Outside 10) Watching TV 14) Phone 18) Other 3) Bathroom 7) Hall 11) Therapy 19) Other 4) nurse's station 8) Group 12) Pass 16)

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    Original Title

    Patient Label Template-least Restrictive

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    First Name Last Name 00-00000 Patient Observation Record Precautions: Observations: Fall Risk Behavi or LOS Date Seizure Precaution. Sexual Precautions. Location 1) Patient room 5) Dining room 9) Quiet room 13) Smoking 17) With Staff 2) Dayroom / lounge 6) Outside 10) Watching TV 14) Phone 18) Other 3) Bathroom 7) Hall 11) Therapy 19) Other 4) nurse's station 8) Group 12) Pass 16)

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    14 views3 pages

    Patient Label Template-Least Restrictive

    Uploaded by

    Coty Free
    First Name Last Name 00-00000 Patient Observation Record Precautions: Observations: Fall Risk Behavi or LOS Date Seizure Precaution. Sexual Precautions. Location 1) Patient room 5) Dining room 9) Quiet room 13) Smoking 17) With Staff 2) Dayroom / lounge 6) Outside 10) Watching TV 14) Phone 18) Other 3) Bathroom 7) Hall 11) Therapy 19) Other 4) nurse's station 8) Group 12) Pass 16)

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    First Name Last Name 00-00000

    Allergies: NKDA

    Name 02-00000
    7/31/08 DOB: 00/00/00
    Age M/F
    Dr.

    Patient Observation Record


    Precautions:
    Observations:
    ___________________________________________

    Fall
    Risk

    Behavi
    or

    Elopeme
    nt

    LOS

    Suicid
    e

    1: 1

    Assaul
    t

    Date

    Seizure
    Precautions

    Sexual
    Precautions

    Location

    1) Patient
    room

    5) Dining
    room

    9) Quiet
    room

    13)
    Smoking

    17) With
    Staff

    2) Dayroom /
    lounge

    6) Outside

    10)
    Watching TV

    14) Phone

    18)
    Other

    3) Bathroom

    7) Hall

    11) Outing

    15)
    Therapy

    19)
    Other

    4) Nurses
    station

    8) Group

    12) Pass

    16) School

    Time

    Code

    Initial

    715
    730
    745
    800
    815
    830
    845
    900
    915
    930
    945
    1000
    1015
    1030
    1045
    1100
    1115
    1130
    1145
    1200
    1215
    1230
    1245
    1300

    Time

    Code

    1315
    1330
    1345
    1400
    1415
    1430
    1445
    1500
    1515
    1530
    1545
    1600
    1615
    1630
    1645
    1700
    1715
    1730
    1745
    1800
    1815
    1830
    1845
    1900

    Initial

    Time

    Code

    Initia
    l

    1915
    1930
    1945
    2000
    2015
    2030
    2045
    2100
    2115
    2130
    2145
    2200
    2215
    2230
    2245
    2300
    2315
    2330
    2345
    2400
    15
    30
    45
    100

    Time

    Code

    Initia
    l

    115
    130
    145
    200
    215
    230
    245
    300
    315
    330
    345
    400
    415
    430
    445
    500
    515
    530
    545
    600
    615
    630
    645
    700

    Staff Identification Signature and Initial


    Name

    Initia
    ls

    Name 02-00000
    7/31/08 DOB: 00/00/00
    /opt/scribd/conversion/tmp/scratch2621/79756983.doc

    Name

    Initial
    s

    Age M/F

    Dr.

    /opt/scribd/conversion/tmp/scratch2621/79756983.doc

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