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  • Preoperative Checklist: Ilocos Sur Provincial Hospital-Gabriela Silang

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    Hanna La Madrid
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    The document is a preoperative checklist from the Ilocos Sur Provincial Hospital-Gabriela Silang in Vigan City, Philippines. It contains 19 items to be checked for a patient before surgery, including obtaining consent, medical clearance, preparing materials/medicines, cross-matching blood, preparing the operative area, administering pre-op medications, and notifying the operating room. The checklist is to be filled out with the patient's name, hospital number, ward, and vital signs and signed by a nurse and OR personnel to confirm completion.

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    09 Pre-Operative Checklist

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    The document is a preoperative checklist from the Ilocos Sur Provincial Hospital-Gabriela Silang in Vigan City, Philippines. It contains 19 items to be checked for a patient before surgery, including obtaining consent, medical clearance, preparing materials/medicines, cross-matching blood, preparing the operative area, administering pre-op medications, and notifying the operating room. The checklist is to be filled out with the patient's name, hospital number, ward, and vital signs and signed by a nurse and OR personnel to confirm completion.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    85 views1 page

    Preoperative Checklist: Ilocos Sur Provincial Hospital-Gabriela Silang

    Uploaded by

    Hanna La Madrid
    The document is a preoperative checklist from the Ilocos Sur Provincial Hospital-Gabriela Silang in Vigan City, Philippines. It contains 19 items to be checked for a patient before surgery, including obtaining consent, medical clearance, preparing materials/medicines, cross-matching blood, preparing the operative area, administering pre-op medications, and notifying the operating room. The checklist is to be filled out with the patient's name, hospital number, ward, and vital signs and signed by a nurse and OR personnel to confirm completion.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
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    Republic of the Philippines

    Province of Ilocos Sur


    ILOCOS SUR PROVINCIAL HOSPITAL-GABRIELA SILANG
    Vigan City

    PREOPERATIVE CHECKLIST

    SURNAME:_________________________________ AGE: ______________ HOSP NO._________________________

    GIVEN NAME:______________________________ M.I._______ SEX:________ WARD:_______________________

    AM PM NIGHT REMARKS
    1. Kind of operation/procedure
    2. Consent for the Operation signed
    3. Medical clearance updated
    4. Materials and medicines completed
    5. Available blood properly cross-matched
    6. Operative area prepared
    7. Bowel prep done
    8. With pre-op orders
    9. NPO post-midnight maintained
    10. Hair prepared, combed if necessary
    11. Oral hygiene don
    12. Nail polish/make-up/contact lens removed
    13. Jewelries removed
    14. Dentures removed
    15. Dressed in gown/camisa
    16. Underwear removed
    17. With wrist identification tag
    18. Vital signs taken before and after pre-op medications
    ______BP ______PR _______RR ______Temp. _______Wt.

    19. Pre-op medication administered


    20. OR notified

    Confirmed by:

    _________________________________ _________________________________
    Nurse Signature over Printed Name OR Personnel

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