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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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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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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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