EMILIO AGUINALDO COLLEGE

School of Nursing and Midwifery

In Partial Fulfillments of the Requirements in N105

NURSING MANAGEMENT

(Intensive Practicum)

DOCUMENTATION IN HEADNURSING

Submitted by:

Luna, Michelle P.

Submitted to:

Amparo Lim, RN, RM, MAN

Clinical Instructor

December 2011
 MEDICAL CENTER MANILA 6TH MAIN

December 2, 2011 (6:00am 2:00pm)

ORGANIZATIONAL CHART

JUDITH R. GUANLAO
Clinical Instructor

Lima, Jessica Paula Lozano, Rhodora

Student Head Nurse Student Head Nurse

Facelo, Jhimver Jabasa, Kevin Marquez, Diana Lucero, Hyacinth

Medication Nurse Staff Nurse Medication Nurse Staff Nurse

Jaramillo, Bernadette Kashim, Adawiya Lum, James Albert Manalaysay, Jan Ivan
Staff Nurse Staff Nurse Staff Nurse Staff Nurse

Lauz, Florizza Marasigan, Michael Khevin

Staff Nurse Staff Nurse
 MEDICAL CENTER MANILA 6TH MAIN

December 2, 2011 (6:00am 2:00pm)

SCHEDULE OF ACTIVITIES

TIME ACTIVITIES

Prepared By: Noted By:

Luna, Michelle P. Amparo Lim, RN, RM, MAN

Student Head Nurse Clinical Instructor
 MEDICAL CENTER MANILA 6TH MAIN

December 2, 2011 (6:00am 2:00pm)

ATTENDANCE SHEET

STUDENT NAME TIME-IN SIGNATURE TIME-OUT SIGNATURE

Prepared By: Noted By:

Luna, Michelle P. Amparo Lim, RN, RM, MAN

Student Head Nurse Clinical Instructor
 MEDICAL CENTER MANILA 6TH MAIN

December 2, 2011 (6:00am 2:00pm)

PATIENT CLASSIFICATION SHEET

CATEGORY l Self care or Minimal Care

CATEGORY ll Moderate care or Intermediate Care

CATEGORY lll Total, Complete of Intensive Care

CATEGORY lV Highly Specialized Critical Care

ROOM NO. PATIENTS AGE DIAGNOSIS CATEGORY OF

INITIAL CARE

Prepared By: Noted By:

Luna, Michelle P. Amparo Lim, RN, RM, MAN

Student Head Nurse Clinical Instructor
 MEDICAL CENTER MANILA 6TH MAIN

December 2, 2011 (6:00am 2:00pm)

STUDENT ASSIGNMENT SHEET

ROOM NO. PATIENTS AGE DIAGNOSIS STAFF NURSE

INITIAL

Prepared By: Noted By:

Luna, Michelle P. Amparo Lim, RN, RM, MAN

Student Head Nurse Clinical Instructor
 MEDICAL CENTER MANILA 6TH MAIN

December 2, 2011 (6:00am 2:00pm)

8 HOURS NURSING SHEET

AM PM NOC AM PM
CENSUS POST-OP

ADMISSION PRE-OP
DISCHARGE
TRANSFER
TOTAL TOTAL

SPECIAL PROCEDURE

ROOM PATIENTS PROCEDURE SCHEDULE

NO. INITIAL

Prepared By: Noted By:

Luna, Michelle P. Amparo Lim, RN, RM, MAN

Student Head Nurse Clinical Instructor
 MEDICAL CENTER MANILA 6TH MAIN

December 2, 2011 (6:00am 2:00pm)

NARRATIVE REPORT

Prepared By: Noted By:

Luna, Michelle P.

Medication Nurse Student Head Nurse

 MEDICAL CENTER MANILA 6TH MAIN

December 2, 2011 (6:00am 2:00pm)

NARRATIVE REPORT

Prepared By: Noted By:

Luna, Michelle P. Amparo Lim, RN, RM, MAN

Student Head Nurse Clinical Instructor
 MEDICAL CENTER MANILA 6TH MAIN

December 2, 2011 (6:00am 2:00pm)

NARRATIVE REPORT

Prepared By: Noted By:

 Amparo Lim, RN, RM, MAN
Staff Nurse Clinical
Instructor

MEDICAL CENTER MANILA 6TH MAIN

December 2, 2011 (6:00am 2:00pm)

PERFORMANCE EVALUATION TOOL

STAFF NURSE
NAME:

CRITERIA Standa Actual

rd Grade
Grades s
l. KNOWLEDGE
a. Assessed health condition accurately 3
b. Identifies need/problems of client before, during and after 3
the procedure
c. Properly intervenes the identified nursing problems by 3
performance of independent and dependent nursing
functions with minimum supervision
d. Explain rationale for each intervention 3
e. Evaluates the effectiveness of nursing intervention 3
f. Assumes the independence and responsibility over assign 3
task
g. Needs the least supervision when doing assigned task 3
h. Document pertinent observation and cases 3
i. Gives appropriate health teaching instruction to client 3
according to needs
ll. SKILLS
a. Applies the principles of asepsis when preparing materials 5
and equipment
b. Prepares and set up need supplies and equipment 5
c. Uses/ operates tools and equipment 5
d. Maintained the equipment and supplies used in good 5
working condition and in order of care
e. Reports and records data are complete and accurate 5
lll. ATTITUDE
a. Established good intrapersonal relationship with clients 3
family, co-worker, staff, leader, and CI
b. reports to duty in complete uniform with paraphernalia 3
and properly groomed and on time
c. has initiative, responsible and efficient 3
d. show respect to himself and others 3
e. shows interest and enthusiasm in his work 3
f. submits requirements on time 5
TOTAL
Attendance: 10%

Attitude: 10%

Requirements: 10%
Quiz: 20%

Performance Evaluation: 40%

Total: 100%

Prepared By: Noted By:

Luna, Michelle P. Amparo Lim, RN, RM, MAN

Student Head Nurse Clinical Instructor