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  • Case Slips 2019 PDF

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    neil floyd ventura
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    Case-Slips-2019.pdf

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    3 views1 page

    Case Slips 2019 PDF

    Uploaded by

    neil floyd ventura

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    SURGICAL SLIP SURGICAL SLIP

    Name of Student:___________________________________ Name of Student:___________________________________


    Date :________________Time Started: ________ Date :________________Time Started: ________
    Case Number :________________ Case Number :________________
    Hospital :___________________________________ Hospital :___________________________________
    ___________________________________ ___________________________________
    Surgical procedure performed: Surgical procedure performed:
    ____________________________________ ____________________________________
    ____________________________________ ____________________________________
    ____________________________________ ____________________________________

    Classification of Operation: Minor Major Classification of Operation: Minor Major

    Type of Experience: Scrub Nurse Circulating Nurse Type of Experience: Scrub Nurse Circulating Nurse

    O.R. Nurse: ___________________________________ O.R. Nurse: ___________________________________


    (Name & Signature) (Name & Signature)

    Clinical Instructor:_________________________________ Clinical Instructor:_________________________________


    (Name & Signature) (Name & Signature)
    Forms Control #: SLU-SON-Slips 001 Forms Control #: SLU-SON-Slips 001

    NURSERY SLIP DELIVERY SLIP

    Name of Student:___________________________________ Name of Student:___________________________________


    Date :_____________Time of Delivery: _______ Date :_____________Time of Delivery: _______
    Case Number :________________ Case Number :________________
    Hospital :___________________________________ Hospital :___________________________________
    ___________________________________ ___________________________________

    Immediate newborn care Performed: Diagnosis: ____________________________________


    DR Nursery OR
    ____________________________________
    Type of Delivery: NSD CS Forceps

    Type of Delivery: NSD CS Forceps

    Nurse on Duty: ___________________________________


    (Name & Signature) Nurse on Duty: ___________________________________
    (Name & Signature)
    Clinical Instructor:_________________________________
    (Name & Signature) Clinical Instructor:_________________________________
    (Name & Signature)

    Forms Control #: SLU-SON-Slips 002 Forms Control #: SLU-SON-Slips 003

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