EMILIO AGUINALDO COLLEGE School of Nursing and Midwifery
In Partial ul!ll"ents of the #e$uire"ents in N%&' NU#SING MANAGEMEN( )Intensi*e Practicu"+
DOCUMEN(A(ION IN ,EADNU#SING
Su-"itted -y. Luna/ Michelle P0
Su-"itted to. A"1aro Li"/ #N/ #M/ MAN Clinical Instructor
Dece"-er 2&%%
MEDICAL CEN(E# MANILA 3 4 (, MAIN Dece"-er 2/ 2&%% )4.&&a" 3 2.&&1"+
ORGANIZATIONAL CHART
JUDITH R. GUANLAO Clinical Instructor
Lima, Jessica Paula
Lozano, Rhodoa
Student Head Nurse
Student Head Nurse
!acelo, Jhim"e Medication Nurse
Jaamillo, )enade((e Staff Nurse
Ja#asa, $e"in Staff Nurse
$ashim, Ada*i'a Staff Nurse
Lauz, !loizza Staff Nurse
%a&uez, Diana
Luceo, H'acin(h
Medication Nurse
Lum, James Al#e(
Staff Nurse
%anala'sa', Jan I"an
Staff Nurse
Staff Nurse
%aasi+an, %ichael $he"in Staff Nurse
MEDICAL CEN(E# MANILA 3 4 (, MAIN Dece"-er 2/ 2&%% )4.&&a" 3 2.&&1"+
SCHEDULE OF ACTIVITIES
(IME
Pre1ared 6y.
AC(I5I(IES
Noted 6y.
Luna, %ichelle P.
Amao Lim, RN, R%, %AN
Student Head Nurse
Clinical Instructor
MEDICAL CEN(E# MANILA 3 4 (, MAIN Dece"-er 2/ 2&%% )4.&&a" 3 2.&&1"+ A((ENDANCE S,EE(
STUDENT NAME
TIME-IN
Pre1ared 6y.
SIGNATURE
TIME-OUT
SIGNATURE
Noted 6y.
Luna, %ichelle P.
Amao Lim, RN, R%, %AN
Student Head Nurse
Clinical Instructor
MEDICAL CEN(E# MANILA 3 4 (, MAIN Dece"-er 2/ 2&%% )4.&&a" 3 2.&&1"+ PA(IEN( CLASSIICA(ION S,EE(
CA(EGO#7 l 3 Self care or Mini"al Care CA(EGO#7 ll 3 Moderate care or Inter"ediate Care CA(EGO#7 lll 3 (otal/ Co"1lete of Intensi*e Care CATEGORY lV – Highly Specialized Critcal Care
ROOM NO.
PATIENT’S INITIAL
Pre1ared 6y.
AGE
DIAGNOSIS
CATEGORY OF CARE
Noted 6y.
Luna, %ichelle P.
Amao Lim, RN, R%, %AN
Student Head Nurse
Clinical Instructor
MEDICAL CEN(E# MANILA 3 4 (, MAIN Dece"-er 2/ 2&%% )4.&&a" 3 2.&&1"+ S(UDEN( ASSIGNMEN( S,EE(
ROOM NO.
PATIENT’S INITIAL
Pre1ared 6y.
AGE
DIAGNOSIS
STAFF NURSE
Noted 6y.
Luna, %ichelle P.
Amao Lim, RN, R%, %AN
Student Head Nurse
Clinical Instructor
MEDICAL CEN(E# MANILA 3 4 (, MAIN Dece"-er 2/ 2&%% )4.&&a" 3 2.&&1"+ HOURS !URSI!G SHEET
AM
PM
NOC
AM
CENSUS
POS(8OP
ADMISSION DISC,A#GE (#ANSE# (O(AL
P#E8OP
PM
(O(AL
S"ECIAL "ROCEDURE
#OOM NO0
PA(IEN(9S INI(IAL
P#OCEDU#E
Pre1ared 6y.
SC,EDULE
Noted 6y.
Luna, %ichelle P.
Amao Lim, RN, R%, %AN
Student Head Nurse
Clinical Instructor
MEDICAL CEN(E# MANILA 3 4 (, MAIN Dece"-er 2/ 2&%% )4.&&a" 3 2.&&1"+
NA##A(I5E #EPO#(
Pre1ared 6y.
Noted 6y. Luna/ Michelle P0
Medication Nurse
Student ,ead Nurse
MEDICAL CEN(E# MANILA 3 4 (, MAIN Dece"-er 2/ 2&%% )4.&&a" 3 2.&&1"+ NA##A(I5E #EPO#(
Pre1ared 6y. Luna/ Michelle P0 Student ,ead Nurse
Noted 6y. Amao Lim, RN, R%, %AN
Clinical Instructor
MEDICAL CEN(E# MANILA 3 4 (, MAIN Dece"-er 2/ 2&%% )4.&&a" 3 2.&&1"+ NA##A(I5E #EPO#(
Pre1ared 6y.
Noted 6y.
Amao Lim, RN, R%, %AN
Sta: Nurse
Clinical
Instructor
MEDICAL CEN(E# MANILA 3 4 (, MAIN Dece"-er 2/ 2&%% )4.&&a" 3 2.&&1"+ PE#O#MANCE E5ALUA(ION (OOL S(A NU#SE !A#E$
C#I(E#IA
l0 ;NO1ro-le"s of client -efore/ during and after the 1rocedure c0 Pro1erly inter*enes the identi!ed nursing 1ro-le"s -y 1erfor"ance of inde1endent and de1endent nursing functions with "ini"u" su1er*ision d0 E?1lain rationale for each inter*ention e0 E*aluates the e:ecti*eness of nursing inter*ention f0 Assu"es the inde1endence and res1onsi-ility o*er assign tas@ g0 Needs the least su1er*ision when doing assigned tas@ h0 Docu"ent 1ertinent o-ser*ation and cases i0 Gi*es a11ro1riate health teaching instruction to client according to needs ll0 S;ILLS a0 A11lies the 1rinci1les of ase1sis when 1re1aring "aterials and e$ui1"ent -0 Pre1ares and set u1 need su11lies and e$ui1"ent c0 Uses> o1erates tools and e$ui1"ent d0 Maintained the e$ui1"ent and su11lies used in good wor@ing condition and in order of care e0 #e1orts and records data are co"1lete and accurate lll0 A((I(UDE a0 Esta-lished good intra1ersonal relationshi1 with client9s fa"ily/ co8wor@er/ sta:/ leader/ and CI -0 re1orts to duty in co"1lete unifor" with 1ara1hernalia and 1ro1erly groo"ed and on ti"e c0 has initiati*e/ res1onsi-le and ecient d0 show res1ect to hi"self and others e0 shows interest and enthusias" in his wor@ f0 su-"its re$uire"ents on ti"e (O(AL
Attendance: Attt!de: Re"!#e$ent:
10% 10% 10%
Standa rd Grades = = =
= = = = = =
' ' ' ' ' = = = = = '
Actual Grade s
&!':
(0%
Pe#)*#$ance E+a,!at*n: T*ta,:
0%
100%
Pre1ared 6y. Luna, %ichelle P. Student Head Nurse
Noted 6y. Amao Lim, RN, R%, %AN Clinical Instructor
