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  • Edited CORD CARE FORM 1

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    Angelica Suguilon
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    This document is an immediate newborn cord care form from Dr. Pablo O. Torre Memorial Hospital in Bacolod City, Negros Occidental. It documents the cord care performed on a newborn baby boy with initials H. in the delivery room at 6:57 PM on April 18, 2022. The care was supervised by Rene Rose A. Clariones, RN, MN and performed by Jonalyn B. Jimenea, RN. The form was noted by Laarni Mae L. Sotomil, RN, MN and approved by Dinah A. Tanalgo, RN, MN, PhD.

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    Readings about cord coil

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    edited-CORD-CARE-FORM-1

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    This document is an immediate newborn cord care form from Dr. Pablo O. Torre Memorial Hospital in Bacolod City, Negros Occidental. It documents the cord care performed on a newborn baby boy with initials H. in the delivery room at 6:57 PM on April 18, 2022. The care was supervised by Rene Rose A. Clariones, RN, MN and performed by Jonalyn B. Jimenea, RN. The form was noted by Laarni Mae L. Sotomil, RN, MN and approved by Dinah A. Tanalgo, RN, MN, PhD.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    6 views1 page

    Edited CORD CARE FORM 1

    Uploaded by

    Angelica Suguilon
    This document is an immediate newborn cord care form from Dr. Pablo O. Torre Memorial Hospital in Bacolod City, Negros Occidental. It documents the cord care performed on a newborn baby boy with initials H. in the delivery room at 6:57 PM on April 18, 2022. The care was supervised by Rene Rose A. Clariones, RN, MN and performed by Jonalyn B. Jimenea, RN. The form was noted by Laarni Mae L. Sotomil, RN, MN and approved by Dinah A. Tanalgo, RN, MN, PhD.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 1

    ICNB Form

    IMMEDIATE CARE OF THE


    NEWBORN FORM

    DR. PABLO O. TORRE MEMORIAL HOSPITAL


    IMMEDIATE NEWBORN CORD CARE in Ø Bacolod City, Negros Occidental
    Hospital/Home/Lying – In Clinic,
    Municipality/City/Province

    Prepared by:
    Printed Name and Signature of the Student Ø ANGELICA B. SUGUILON

    Date Performed Patient’s INITIALS (only) Nurse on Duty SUPERVISED BY:


    IMMEDIATE NEWBORN CORD CARE PERFORMED (Name and Signature)
    and Case Number Clinical Instructor
    Indicate where performed e.g. D.R., Nursery, NICU or Home (If Midwife on Duty, Signature Not
    Time Started (not applicable for Birthing/Lying-In
    Required)
    Name and Signature
    Clinics/Homes)

    April 18, 2022 RENE ROSE A.


    Baby Boy H. 186475 Delivery Room JONALYN B. JIMENEA, RN
    6:57 PM CLARIANES RN, MN

    Noted by: _________________________________________________________ Approved by: _________________________________________________________


    LAARNI MAE L. SOTOMIL, RN, MN DINAH A. TANALGO, RN, MN, PhD
    Clinical Coordinator Dean, College of Nursing

    PRC No Ø 0286079 Valid Until Ø Oct. 20, 2023 PRC No Ø 0247858 Valid Until Ø Nov. 10, 2022
    Date document is signed Ø Time Ø Date document is signed Ø Time Ø
    Highest Nursing Degree Earned Ø Master in Nursing Highest Nursing Degree Earned Ø Master in Nursing

    (STRICTLY NO DESIGNATES)

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