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Audit

General Information
Date of Birth

Sex

Consults
Select which consultations the patient underwent through
Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Patient Check Report

Diagnosis

Does the patient has allergies?

Please enter details

Patient medical history

Code status

Neuro

Condition

Skin

Heart Sounds

Heart Rhythm

Lung Sounds

Bowel Sounds

Urinary

Patient Monitoring - Vital Signs
Click + to add patient monitoring details
Time Check

Blood Pressure

Heart Rate

Temperature

Oxygen Saturation

Oxygen

Respiratory Rate

Pain

Blood Sugars

Are there dispensed medications?

Time of Med Pass
Intake

Breakfast

Lunch

Supper

Other

Output

Foley

BM

Emesis

Drains

Tubes

Ostomy Bag

Labs and Needed Procedures

Labs

Needed Labs

Future Procedures

Completion
Click + to add Nurse On Duty
Full Name and Signature of Nurse Attendee

Detailed Nursing Report Sheet Checklist

Created by: SafetyCulture Staff | Industry: General | Downloads: 1

Use this comprehensive nurse report sheet to obtain more detailed patient information such as consultation details, neuro, skin and urinary conditions, heart sounds and rhythm, lung sounds, and bowel sounds. Monitor patient’s vital signs and other significant observations to be taken. All information is secured in cloud storage and can only be opened by those given access.

Signup for a free iAuditor account to download and edit this checklist. It will be added to your free account and you will be able to conduct inspections from your mobile device.

Download and edit this free checklist

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Audit

General Information
Date of Birth

Sex

Consults
Select which consultations the patient underwent through
Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Date and Time

Attending Doctors

Patient Check Report

Diagnosis

Does the patient has allergies?

Please enter details

Patient medical history

Code status

Neuro

Condition

Skin

Heart Sounds

Heart Rhythm

Lung Sounds

Bowel Sounds

Urinary

Patient Monitoring - Vital Signs
Click + to add patient monitoring details
Time Check

Blood Pressure

Heart Rate

Temperature

Oxygen Saturation

Oxygen

Respiratory Rate

Pain

Blood Sugars

Are there dispensed medications?

Time of Med Pass
Intake

Breakfast

Lunch

Supper

Other

Output

Foley

BM

Emesis

Drains

Tubes

Ostomy Bag

Labs and Needed Procedures

Labs

Needed Labs

Future Procedures

Completion
Click + to add Nurse On Duty
Full Name and Signature of Nurse Attendee