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Record patient information with a nurse shift report sheet

This Nurse Shift Report template can be used and customized to record vital patient information either in the ICU or virtually any other nurse’s station. Outgoing nurses use a nurse shift report to keep track of a patient's diagnosis, attending doctor, consults, critical lab values, and medication history and pass it on to the oncoming nurse. This digital template allows the attachment of photos, assignment of tasks, and digital sign-offs to help streamline the nurse shift reporting process.

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Record patient information with a nurse shift report sheet

Audit

General Information

Date of Birth
Sex
Admitted

Patient Report

Diagnosis
Procedure
Does the patient has allergies?
Please enter details
Patient medical history
Code status

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

Other

Discharge Plan
Variance to Discharge Plan: Barrier
Resolution
Consults

Completion

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