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Nursing Report Sheet Template

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

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Audit
General Information
Date of Birth
Sex
Consults
Select which doctors the patient consulted with
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
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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.

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