College of Nursing

Individual Record of Skills Return Demonstration

Community Health Nursing
1st
Semester SY______________

Course Title: Community Health Nursing (34 hours)

PROCEDURE TIME CLINICAL INSTRUCTOR

ALLOTMENT (printed name and signature)

1. Bag Technique

2. Wound Dressing

3. Leopold’s Maneuver

4. Hemo Gluco Test

5. Urine Testing for Protein (CHON)

7. Urine Testing for Glucose

8. Practical Examination

Name of student:_______________________________

Certified by:

_____________________ _________________________
Area Head Clinical Coordinator

Noted:

_____________________
Dean
 College of Nursing

Individual Record of Skills Return Demonstration

Nursing Care Management 101
1st Semester SY______________

Course Title: Care of Mother Child and Family (51 hours)

PROCEDURE TIME CLINICAL INSTRUCTOR

ALLOTMENT (printed name and signature)
1. Open Gloving
2. Shaving the Perineum
3. Perineal Care – Intra Partum
4. Perineal Care – Post Partum
5. Assisting in Normal Spontaneous Vaginal Delivery
6. Attending in Normal Spontaneous Vaginal Delivery
7. Care of the New Born – Essential New Born Care
90 minutes after birth
* immediate Drying
* skin to- skin contact
* proper cord clamping and cutting
* non separation of new born from mother,
Initiation of Breast feeding
8. Care of the New Born – Non Timed Bound
* eye prophylaxis
* Anthropometric Measurements
* Administering Vit K
* Administering BCG vaccine
* administering Hep B vaccine

9. other New Born Care Protocol

* Oro nasal suctioning
* Bathing
* Cord Care
* Obtaining foot prints
10. Clothing and Swaddling
11. Changing Diapers
12. Hot Sitz Bath
13. Catheterization

14. Practical Examination

Name of Student: _________________________________________________

Certified by:
__________________ ____________________

Area Head Clinical Coordinator

Noted:

___________________
 College of Nursing

Individual Record of Skills Return Demonstration

Nursing Care Management 103
1st Semester SY______________

Dean
Course Title: Care of Clients with Problems in Oxygenation, Fluids and Electrolyte
Balance, Metabolism, and Endocrine (51hours)

PROCEDURE TIME CLINICAL INSTRUCTOR

ALLOTMENT (printed name and signature)
1. Eye Irrigation

2. Ear Irrigation

3. Application of Transdermal Patch

4. Electrocardiogram (ECG)

5. Chest Physiotherapy
* drainage position
* bronchial tapping
* nebulization
6. Chest Tube Care and Chest Drainage

7. Assisting in Insertion and Removal of Chest Tube

8. Incentive Spirometry

9. Tracheostomy Care

10. Suctioning Tracheostomy Tube

11. Suctioning

12. Changing and emptying an ostomy appliance

13. Ostomy Care
13. Inserting Rectal Suppository

14. Enema

15. Practical Examination

Name of Student:____________________________________________

Certified by:

____________________ _____________________

Area Head Clinical Coordinator

Noted:

_____________________
 College of Nursing

Individual Record of Skills Return Demonstration

Nursing Care Management 106
1st Semester SY______________

Dean

Course Tittle : Care of the Clients with Problems in Cellular Aberrations, Acute Biologic
Crisis including Emergency and Disaster (51)

PROCEDURE TIME CLINICAL INSTRUCTOR

ALLOTMENT (printed name and signature)
1. Papanicolaou Smear test

2. Digital Rectal Examination

3. Inserting an IV fluid using a Dummy Arm

4. IV Push through an IV port

5. IV Push through a Heparin lock

6. Administering Blood Transfusion

7. Cardio Respiratory Resuscitation (Child and

Adult)
* Advanced Cardiac Life Support
8. ER Disaster Nursing
* Triage Nursing
* Codes
9. Drags and Carries

10. Practical Examination

Name of Student: _________________________________________

Certified by:

_____________________ ___________________

Area Head Clinical Coordinator

Noted:

___________________

Dean
 College of Nursing

Individual Record of Skills Return Demonstration

Nursing Care Management 100
2nd Semester SY______________

Course Title: Fundamentals of Nursing Practice (102 hours)

PROCEDURE TIME CLINICAL INSTRUCTOR

ALLOTMENT (printed name and signature)

1. Hand Washing

2. Proper Body Mechanics

3. Bed Making
* Occupied
* Unoccupied
4. Positioning Client in Bed

5. Complete Bed Bath

6. Perineal Care

7. Shampooing Patient in Bed

8. Performing Back Massage

* Effleurage
* Tapotement
* Petrissage
9. Foot Care

10. Oral Hygine

* Conscious Client
* Unconscious Client
11. Tepid Sponge Bath

12. Obtaining Vital Signs

* Temperature
*Respiration
*Pulse
* Oxygen Saturation (Pulse Oxymetry)
* Blood Pressure
13. Administering Oral Medications

14. Reconstituting and Withdrawing Medications

from ampules and vials
15. Parenteral Medication Administration
* Intra Muscular Injection
* Subcutaneous injection
 * Intra Dermal injection
16. Priming IV fluids

17. Changing IV fluids

18. Discontinuing IV fluids and shifting IV line into a

Heparin Lock

19. Practical Examination

Name of Student : _______________________________________

Certified by:

_____________________ ___________________

Area Head Clinical Coordinator

Noted:

____________________

Dean
 College of Nursing

Individual Record of Skills Return Demonstration

Nursing Care Management 102
2nd Semester SY______________

Course Title: Care of Mother, Child, and Population Group at risk or with problem
(51hours)

PROCEDURE TIME CLINICAL INSTRUCTOR

ALLOTMENT (printed name and signature)

1. Infant Resuscitation

2. infant OroNasogastric Tube

* insertion
* feeding
* removal
3. wound Care with Drainage Device

4. Preparing an Ether Bed (Recovery Bed)

5. Transferring patient from bed to

wheelchair/chair, from wheel chair/chair to bed
5. Instillation of Drugs
* eyes
* ears
* nose
* vagina
6. Peri Operative Nursing
* open and closed gloving
* surgical scrubbing
* serving gloves
* gowning
* serving the gown
* instrumentation
7. Practical Examination

Name of Student : ______________________________________

Certified by:

_____________________ _____________________

Area Head Clinical Coordinator

Noted:

____________________
 College of Nursing

Individual Record of Skills Return Demonstration

Nursing Care Management 104
2nd Semester SY______________

Dean

Course Title: Care of Clients with Problems in Inflammatory and Immunologic Responses,
Perception, and Coordination (51hours)

PROCEDURE TIME CLINICAL INSTRUCTOR

ALLOTMENT (printed name and signature)

1. Neurologic Examination

2. Glasgow Coma Scale

3. Application of Binders
* Many tailed/ scultetus binder
* Abdominal
4. Application of Bandages
* recurrent bandaging
* figure of eight
* spiral bandaging
* circular bandaging
* triangular bandaging
5. Application of Slings and Splint

6. Caring Patients with Cast

7. Transferring Patient from Bed to stretcher, from

stretcher to Bed
8. Assisting with Ambulation and Safe walking

9. Crutch Walking

10. Gait

11. Range of Motion

12. Post Mortem Care

13. Practical Examination

Name of Student: __________________________________________

Certified by:

_____________________ ____________________
Area Head Clinical Coordinator

Noted:
 College of Nursing

Individual Record of Skills Return Demonstration

Health Assessment
Summer Term SY______________

____________________

Dean

Course Title: Health Assessment (51hours)

PROCEDURE TIME CLINICAL INSTRUCTOR

ALLOTMENT (printed name and signature)

1. General Survey

2. Assessment of the:
* Hair and scalp
* skin
* nails
* Head and Neck
* Eye, Ear, Nose, mouth and Throat
* Sinuses

3. Assessment of the Chest and Lungs

* Inspection
* percussion
* Palpation
* auscultation
4. General Assessment of the Breast

5. Breast Self Examination using different methods

6. Assessment of the Extremities

7. Assessment of the Abdomen

* Inspection
* auscultation
* percussion
* palpation
8. Assessment of the Male and Female Genitalia

9. Practical Examination

Name of student: _______________________________________

Certified by:
____________________ ___________________

Area Head Clinical Coordinator

Noted:
___________________

Dean