Negros Oriental Provincial Hospital

Nursing Service Department

DATE: DEATHS:
DOCTORS ON DUTY CENSUS:
Senior house: DR 1. IM-Lower Annex: __________
Medicine: DR 2. IM-Upper Annex S1: _______
Pediatrics: DR 3. IM-Upper Annex S2: ________
Obstetrics: DR
4. IM-Upper Annex S3: ________
Surgery: DR
Anesthesiology: DR 5. Isolation Ward: ____________
SPECIAL ENDORSEMENT: 6. Surgery Lower Dorm: _______
7. Surgery North Wing: ________
8. Surgery South Wing: ________
9. Surgery ICU: ______________
10. OB – North Wing: __________
Neonate: ___________
11. OB – South Wing: __________
Neonate: ___________
12. 4TH Floor North Wing: ______
13. 4TH Floor South Wing: ______
14. Pediatrics S1: _____________
15. Pediatrics S2: _____________
16. Neonatal ICU: _____________
17. Labor-Delivery Room: ______
18. OR-PACU: _______________
19. Emergency Room: _________

TOTAL: ____________

SUPERVISORY ROUNDS
AREA COMPLIANT 7-3 SHIFT 3-11 SHIFT 11-7 SHIFT
□ E-cart
IM-
Lower
Annex
□ Uniform/ ID

□ Name Stamp

IM- □ E-cart
Upper
Annex □ Uniform/ ID
S1
□ Name Stamp

IM- □ E-cart
Upper
Annex □ Uniform/ ID
S2
□ Name Stamp

IM- □ E-cart
Upper
Annex □ Uniform/ ID
S3
□ Name Stamp

□ E-cart
Isol
Ward □ Uniform/ ID

□ Name Stamp

Surgery □ E-cart
Lower
Dorm □ Uniform/ ID

□ Name Stamp

□ E-cart
Surgery
North □ Uniform/ ID
Wing
□ Name Stamp
Surgery □ E-cart
South
Wing □ Uniform/ ID

□ Name Stamp

□ E-cart
Surgical
ICU □ Uniform/ ID

□ Name Stamp

□ E-cart
OB –
North □ Uniform/ ID
Wing
□ Name Stamp

OB – □ E-cart
South
Wing □ Uniform/ ID

□ Name Stamp

□ E-cart
4TH
Floor □ Uniform/ ID
North
Wing
□ Name Stamp

□ E-cart
4TH
Floor □ Uniform/ ID
South
Wing
□ Name Stamp

□ E-cart

Pedia S1 □ Uniform/ ID

□ Name Stamp

□ E-cart

Pedia S2 □ Uniform/ ID

□ Name Stamp

□ E-cart

NICU □ Uniform/ ID

□ Name Stamp

□ E-cart
Labor
Delivery □ Uniform/ ID
Room
□ Name Stamp

□ E-cart
OR-
PACU □ Uniform/ ID

□ Name Stamp

□ E-cart

ER □ Uniform/ ID

□ Name Stamp

□ E-cart
Dialysis
Unit □ Uniform/ ID

□ Name Stamp
Checked by NSO