Monthly Patient and Device Utilization Census per Area

Month and year: __________________

Area:

St. Anthony Ward St. Francis Ward Surgery Ward St. Raphael Ward 3rd Floor Annex
St. Peregrine Ward Neonatal Intensive Medical Intensive Isolation Ward
Care Unit Care Unit

Date # of Patients # of Trans # of Discharges # of patients # of patients # of patients

in/Out with ventilator with urinary with central
catheter line
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31

Accomplished by: _______________________