Kingdom of Saudi Arabia ‫المملكة العربية السعودية‬

Ministry of Health ‫وزارة الصحة‬

Western 1 Cluster, Makkah ‫التجمع الصحي بمكة المكرمة‬
Al-Noor Specialist Hospital ‫مستشفى النور التخصصي‬

FORM
FM Departmental Nursing Orientation Checklist
Issue Date 01/09/2020 Activation Date 01/11/2020 Revision Date 01/09/2023
Manar Alharby
Employee Name:__________________________ Computer No.: 117728 Akc
____________ Department: ______________
Nurse Specialist
Job Title:_________________________________ Joining Date: _____________

Instruction: Put (√) tick on the variables you have completed.

Introduction to Nursing Service Department Pharmacy Service
• Mission/Vision/Goals/Values • Dispensing Medication
• Nursing Scope of Service ✔ • Narcotics and Controlled Drugs ✔
• Nursing Chain of Command • Handling hazardous and other materials
Nursing Quality Plan (KPI's and Audit) ✔ CPR Training according to Hospital Standards
✔
International Patient Safety Goal (IPSG) ✔ • Nurse's Role in CPR
Job Description ✔ Infection Control
Nursing Policies and Procedures • Hand Washing ✔
• Nursing Assessment and Reassessment ✔ • Standard Precaution ✔
• Management of occupational exposure
• IV Therapy ✔ ✔
to blood and other body fluids
• Medication Preparation and Administration ✔ Fire Training and Emergency Plan ✔
• Blood and Blood Products Transfusion ✔ Calling a Code:
• Fall Prevention Program ✔ • Code Blue ✔
• Pressure Sore Prevention and Management ✔ • Code Brown ✔
• Pain Management ✔ • Code Red ✔
• Nursing Documentation ✔ • Code Yellow ✔
• Basic hygiene and skin care ✔ • Code Grey ✔
• Positioning patient in bed ✔ • Code Pink ✔
• Suctioning ✔ • Code Orange ✔
• Patient's Nutrition ✔ • Code Black ✔
Patient and Family Rights/ Patient and Family • Code White ✔
Education ✔
• Code Silver ✔

Manar Alharby
I, ___________________________________, certify that I have successfully completed the Departmental Nursing
Orientation Program on ________________
and agree to practice my profession based on the policies, procedures, and guidelines of Al-Noor Specialist Hospital.

Signature: _________________ Date: ____________

Code: XXX-XX-FM- 000– 0 Issue No: 0 Page 1 of 2
 Kingdom of Saudi Arabia ‫المملكة العربية السعودية‬
Ministry of Health ‫وزارة الصحة‬
Western 1 Cluster, Makkah ‫التجمع الصحي بمكة المكرمة‬
Al-Noor Specialist Hospital ‫مستشفى النور التخصصي‬

FORM
FM Departmental Nursing Orientation Checklist
Issue Date 01/09/2020 Activation Date 01/11/2020 Revision Date 01/09/2023

Approved By:

NPD Staff : Marwa M Hassan

___________________________ Signature: _________________ 4/5/21
Date: __________

CND/Head of NPD : ____________________________ Signature: _________________ Date: __________

Executive Director of Nursing: Ms. Zainab Awali RN, MSN Signature: _________________ Date: __________

Code: XXX-XX-FM- 000– 0 Issue No: 0 Page 2 of 2