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    New OR ScrubCirculating Nurse Record

    Uploaded by

    Havier Esparaguera
    This document contains operating room case records from Mountain View College School of Nursing. It includes sections for scrub nurses and circulating nurses in major surgical operations. For each case, it records information such as the case number, date, patient name, diagnosis, surgical procedure performed, type of anesthesia, surgeon name, hospital name, names and signatures of the scrub nurse and clinical instructor who supervised. Space is provided for 4 cases for each nurse role. At the bottom are spaces for the student and dean signatures.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    New OR ScrubCirculating Nurse Record

    Uploaded by

    Havier Esparaguera
    21 views2 pages
    This document contains operating room case records from Mountain View College School of Nursing. It includes sections for scrub nurses and circulating nurses in major surgical operations. For each case, it records information such as the case number, date, patient name, diagnosis, surgical procedure performed, type of anesthesia, surgeon name, hospital name, names and signatures of the scrub nurse and clinical instructor who supervised. Space is provided for 4 cases for each nurse role. At the bottom are spaces for the student and dean signatures.

    Original Description:

    OR/DR

    Original Title

    New-OR-ScrubCirculating-Nurse-Record

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    © © All Rights Reserved

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    This document contains operating room case records from Mountain View College School of Nursing. It includes sections for scrub nurses and circulating nurses in major surgical operations. For each case, it records information such as the case number, date, patient name, diagnosis, surgical procedure performed, type of anesthesia, surgeon name, hospital name, names and signatures of the scrub nurse and clinical instructor who supervised. Space is provided for 4 cases for each nurse role. At the bottom are spaces for the student and dean signatures.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    21 views2 pages

    New OR ScrubCirculating Nurse Record

    Uploaded by

    Havier Esparaguera
    This document contains operating room case records from Mountain View College School of Nursing. It includes sections for scrub nurses and circulating nurses in major surgical operations. For each case, it records information such as the case number, date, patient name, diagnosis, surgical procedure performed, type of anesthesia, surgeon name, hospital name, names and signatures of the scrub nurse and clinical instructor who supervised. Space is provided for 4 cases for each nurse role. At the bottom are spaces for the student and dean signatures.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 2

    Mountain View College

    School of Nursing
    College Heights, Mt. Nebo, 8709 Valencia City, Bukidnon

    OPERATING ROOM CASE RECORD


    SCRUB NURSE IN MAJOR SURGICAL OPERATIONS
    No. Case # Date & Name of Patient Diagnosis Surgical Type of Name of Name & Address Name & Signature of Supervised by:
    Time Procedure Anesthesia Surgeon of Hospital OR Scrub Nurse on Duty Clinical Instructor’s
    Started Performed Name & Signature

    1 _____________________ ___________________
    Name & Signature Name & Signature
    _______________ ________________
    Date Signed Date Signed

    2 _____________________ ___________________
    Name & Signature Name & Signature
    _________________
    Date Signed _________________
    Date Signed

    3 _____________________ ___________________
    Name & Signature Name & Signature
    _________________
    Date Signed _________________
    Date Signed

    4 _____________________ ___________________
    Name & Signature Name & Signature
    _________________
    Date Signed _________________
    Date Signed

    _________________________ ___________________________________________
    Name & Signature of Student Name & Signature of Dean/ Date Signed
    Degree: ____________________________________
    PRC #:_____________ Valid Until: ______________
    PNA #: ____________ Valid Until: _______________
    L3 Form 08-2016
    Mountain View College
    School of Nursing
    College Heights, Mt. Nebo, 8709 Valencia City, Bukidnon

    OPERATING ROOM CASE RECORD


    CIRCULATING NURSE IN MAJOR SURGICAL OPERATIONS
    No Case # Date & Name of Patient Diagnosis Surgical Type of Name of Name & Address Name & Signature of Supervised by:
    . Time Procedure Anesthesia Surgeon of Hospital OR Scrub Nurse on Duty Clinical Instructor’s
    Started Performed Name & Signature

    1 _____________________ ___________________
    Name & Signature Name & Signature
    _______________ ________________
    Date Signed Date Signed

    2 _____________________ ___________________
    Name & Signature Name & Signature
    _________________ ________________
    Date Signed Date Signed

    3 _____________________ ___________________
    Name & Signature Name & Signature
    _________________ ________________
    Date Signed Date Signed

    4 _____________________ ___________________
    Name & Signature Name & Signature
    _________________ ________________
    Date Signed Date Signed

    _________________________ ___________________________________________
    Name & Signature of Student Name & Signature of Dean/ Date Signed
    Degree: ____________________________________
    PRC #:_____________ Valid Until: ______________
    PNA #: ____________ Valid Until: _______________
    L3 Form 08-2016

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