This Nurse Report Sheet can be used by nursing staff during ward or room visits. Start by entering the patient’s general information. Next, record diagnosis and the medical history. It is also important to take note any allergy and special conditions. The template then prompts the user to record vital signs of the patient such as blood pressure, heart rate, temperature, and blood sugar. Med passes should also be recorded to ensure that medicines are dispensed accordingly. Document the patient’s food intake during breakfast, lunch, or supper. Lastly, write down any future procedure needed to inform the next nurses-on duty. Complete the report by providing a digital signature. Use SafetyCulture to perform digital patient checks with the use of your handheld device. You may also customize this template based on your needs.
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Title Page
Patient Name
Patient Room
Conducted on
Prepared by
General Information
Date of Birth
Sex
Patient Report
Diagnosis
Does the patient has allergies?
Please enter details
Patient medical history
Code status
Patient Monitoring - Vital Signs
Click + to add patient monitoring details
Patient Check
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
Nurse
Full Name and Signature of Nurse Attendee
SafetyCulture Staff
Nursing Report Sheet
This Nurse Report Sheet can be used by nursing staff during ward or room visits. Start by entering the patient’s general information. Next, record diagnosis and the medical history. It is also important to take note any allergy and special conditions. The template then prompts the user to record vital signs of the patient such as blood pressure, heart rate, temperature, and blood sugar. Med passes should also be recorded to ensure that medicines are dispensed accordingly. Document the patient’s food intake during breakfast, lunch, or supper. Lastly, write down any future procedure needed to inform the next nurses-on duty. Complete the report by providing a digital signature. Use SafetyCulture to perform digital patient checks with the use of your handheld device. You may also customize this template based on your needs.
The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions.
The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice.
You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction.
You should independently determine whether the template is suitable for your circumstances.
