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BGH Case Slips

The document contains forms from the University of the Cordilleras in the Philippines for documenting experiences in assisted delivery, newborn cord care, actual delivery, minor surgery circulating, major surgery circulating, and operating room scrubbing. The forms include details about the procedure, date, time, supervising staff, and approvals.

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Loungayvan Batuyog
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280 views7 pages

BGH Case Slips

The document contains forms from the University of the Cordilleras in the Philippines for documenting experiences in assisted delivery, newborn cord care, actual delivery, minor surgery circulating, major surgery circulating, and operating room scrubbing. The forms include details about the procedure, date, time, supervising staff, and approvals.

Uploaded by

Loungayvan Batuyog
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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University of the Cordilleras ODC Form 1B

Governor Pack Road, Baguio City, Philippines 2600 ASSISTED DELIVERY


(+6374) 442-3316, 442-2564, 442-8219, 442-8256 FORM

e-mail: [email protected]
website: www.bcf.edu.ph

ASSISTED DELIVERY in BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER, Baguio City
San Fernando, La Union

Prepared by:

SUPERVISED BY
Date Performed D.R. Nurse / Midwife
Clinical Instructor
and PROCEDURE PERFORMED On Duty
Name and Signature
Time Started Case Number

Noted by: Approved by:


Clinical Coordinator, PRC I.D. No. : Valid Until: Dean, PRC I.D. No. : Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Highest Nursing Degree Earned:
University of the Cordilleras ODC Form 1C
Governor Pack Road, Baguio City, Philippines 2600 CORD CARE FORM
(+6374) 442-3316, 442-2564, 442-8219, 442-8256
e-mail: [email protected]
website: www.bcf.edu.ph

IMMEDIATE NEWBORN CORD CARE in BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER, Baguio City

Prepared by:

Date Performed SUPERVISED BY


Immediate Newborn Cord Care Nurse/Midwife On Duty
and Clinical Instructor
Time Started
PERFORMED Name and Signature
Case Number

Noted by: Approved by:


Clinical Coordinator, PRC I.D. No. : Valid Until: Dean, PRC I.D. No. : Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Highest Nursing Degree Earned:
University of the Cordilleras ODC Form 1A
Governor Pack Road, Baguio City, Philippines 2600 ACTUAL DELIVERY
(+6374) 442-3316, 442-2564, 442-8219, 442-8256 FORM

e-mail: [email protected]
website: www.bcf.edu.ph

ACTUAL DELIVERY BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER, Baguio City

Prepared by:

SUPERVISED BY
Date Performed
D.R. Nurse/Midwife On Duty Clinical Instructor
and PROCEDURE PERFORMED Name and Signature
Time Started Case Number

Noted by: Approved by:


Clinical Coordinator, PRC I.D. No. : Valid Until: Dean, PRC I.D. No. : Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Highest Nursing Degree Earned:
University of the Cordilleras CIRCULATING
Governor Pack Road, Baguio City, Philippines 2600 O.R. MINOR FORM
(+6374) 442-3316, 442-2564, 442-8219, 442-8256
e-mail: [email protected]
website: www.bcf.edu.ph

MINOR SURGICAL CIRCULATING in BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER, Baguio City

Prepared by:

SUPERVISED BY
Date Performed
Clinical Instructor
and SURGICAL PROCEDURE PERFORMED O.R. Nurse On Duty
Name and Signature
Time Started Case Number

Noted by: Approved by:


Clinical Coordinator, PRC I.D. No. : Valid Until: Dean, PRC I.D. No. : Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Highest Nursing Degree Earned:
University of the Cordilleras CIRCULATING
Governor Pack Road, Baguio City, Philippines 2600 O.R. MAJOR FORM
(+6374) 442-3316, 442-2564, 442-8219, 442-8256
e-mail: [email protected]
website: www.bcf.edu.ph

MAJOR SURGICAL CIRCULATING in BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER, Baguio City
San Fernando, La Union

Prepared by:

SUPERVISED BY
Date Performed
O.R Nurse On Duty Clinical Instructor
and SURGICAL PROCEDURE PERFORMED Name and Signature
Time Started Case Number

Noted by: Approved by:


Clinical Coordinator, PRC I.D. No. : Valid Until: Dean, PRC I.D. No. : Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Highest Nursing Degree Earned:
University of the Cordilleras ODC Form 2A
Governor Pack Road, Baguio City, Philippines 2600 O.R. SCRUB FORM
MAJOR
(+6374) 442-3316, 442-2564, 442-8219, 442-8256
e-mail: [email protected]
website: www.bcf.edu.ph

MAJOR SURGICAL SCRUB in BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER, Baguio City

Prepared by:

SUPERVISED BY
Date Performed
Clinical Instructor
and SURGICAL PROCEDURE PERFORMED O.R. Nurse On Duty
Name and Signature
Time Started Case Number

Noted by: Approved by:


Clinical Coordinator, PRC I.D. No. : Valid Until: Dean, PRC I.D. No. : Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Highest Nursing Degree Earned:
University of the Cordilleras ODC Form 2B
Governor Pack Road, Baguio City, Philippines 2600 O.R. SCRUB FORM
MINOR
(+6374) 442-3316, 442-2564, 442-8219, 442-8256
e-mail: [email protected]
website: www.bcf.edu.ph

MINOR SURGICAL SCRUB in BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER, Baguio City

Prepared by:

SUPERVISED BY
Date Performed
Clinical Instructor
and SURGICAL PROCEDURE PERFORMED O.R. Nurse On Duty
Name and Signature
Time Started Case Number

Noted by: Approved by:


Clinical Coordinator, PRC I.D. No. : Valid Until: Dean, PRC I.D. No. : Valid Until:
Date document is signed: Time: Date document is signed: Time:
Highest Nursing Degree Earned: Highest Nursing Degree Earned:

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