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    IV Therapy Format

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    GLen DaLe
    Rocelyn Y. Eltagon, RN completed a 3-day intravenous therapy training program from January 23-25, 2012 at Mindanao Sanitarium Hospital. The program covered initiating and maintaining peripheral IV infusions on 3 patients, administering IV drugs to 3 patients, and administering and maintaining blood and blood components to 1 patient. Eltagon submitted documentation of completing the training requirements and the director of nursing services approved the documentation.

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    IV Therapy Format

    Uploaded by

    GLen DaLe
    119 views2 pages
    Rocelyn Y. Eltagon, RN completed a 3-day intravenous therapy training program from January 23-25, 2012 at Mindanao Sanitarium Hospital. The program covered initiating and maintaining peripheral IV infusions on 3 patients, administering IV drugs to 3 patients, and administering and maintaining blood and blood components to 1 patient. Eltagon submitted documentation of completing the training requirements and the director of nursing services approved the documentation.

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    Rocelyn Y. Eltagon, RN completed a 3-day intravenous therapy training program from January 23-25, 2012 at Mindanao Sanitarium Hospital. The program covered initiating and maintaining peripheral IV infusions on 3 patients, administering IV drugs to 3 patients, and administering and maintaining blood and blood components to 1 patient. Eltagon submitted documentation of completing the training requirements and the director of nursing services approved the documentation.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    119 views2 pages

    IV Therapy Format

    Uploaded by

    GLen DaLe
    Rocelyn Y. Eltagon, RN completed a 3-day intravenous therapy training program from January 23-25, 2012 at Mindanao Sanitarium Hospital. The program covered initiating and maintaining peripheral IV infusions on 3 patients, administering IV drugs to 3 patients, and administering and maintaining blood and blood components to 1 patient. Eltagon submitted documentation of completing the training requirements and the director of nursing services approved the documentation.

    Copyright:

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    of 2

    3+3=1 ACCOMPLISHED REQUIREMENTS of 3-DAY INTRAVENOUS THERAPY TRAINING PROGRAM FOR NURSES Name of Registered Nurse: ROCELYN Y.

    ELTAGON, RN Name of Hospital offering IV Training: Mindanao Sanitarium Hospital Date of IV Program Attended: January 23-25, 2012 I.
    Patient No.

    PRC Number: 0623829 Provider No: 142 Venue: Conference Room, Mindanao Sanitarium Hospital

    Initiating/Maintaining Peripheral IV Infusions


    Name of Patient Age Date Time Kind of Infusion Site Type of Cannula Dose Rate Signature of Certified Trainer/Preceptor/M.D.,RN License No.

    Sarilana, Sinay R. 204231 Manoza, Ronib P. 150748 Gineno, Fatima Leah Astrea R. 204278 II. Administering Intravenous Drugs
    Name of Patient

    74y.o 49y.o 2mos

    January 26, 2012 January 26, 2012 January 26, 2012

    09:48am 11:35am 02:20pm

    PNSS D5NSS D5IMB

    Left arm, Cephalic Vein Left arm, Metacarpal Vein Left Foot, Metatarsal Vein

    Gauge 18 Gauge 22 Gauge 24

    1000cc 1000cc 1000cc

    15gtts/min 10gtts/min 10gtts/min

    Genevieve F. Lapura, RN Genevieve F. Lapura, RN Genevieve F. Lapura, RN

    001848 001848 001848

    Patient No.

    Age

    Date

    Time

    Drugs Incorporated

    Dose

    Diagnosis

    Signature of Certified Trainer/Preceptor/M.D.,RN

    License No.

    Castillon, Robejayl P. 204219 204214 204058 Lariosa, Natividad III. Ladores, Jon Elvin

    18y.o 8 days

    January 26,2011 January 27, 2012

    12:00nn 02:00pm

    Hyosine N-Butyl Bromide (Buscopan) PNSS 50cc+Vancomycin 500mg D5NM 1L+KCl

    4mg 34mg

    Pregnancy Uterine Full Term Sepsis Neonaturum

    Genevieve F. Lapura, RN Genevieve F. Lapura, RN

    001848 001848

    65y.o

    January 27, 2012

    12:00nn

    15mcg

    Metabolic Encepalopathy

    Genevieve F. Lapura, RN

    001848

    Administering and Maintaining Blood and Blood Components


    Name of Patient Age Date Time Volume/Blood Type/Component /Rate IV Insertion Type of Cannula Diagnosis Signature of Certified Trainer/Preceptor/M.D.,RN License No.

    Patient No.

    T3474904

    Maguindanao, Mamintal L.

    42y.o

    January 26, 2012

    05:00pm

    350cc/O+/PRBC /30gtts/min

    Right Metacarpal Vein

    Gauge 18

    End Stage Renal Disease

    Genevieve F. Lapura, RN

    001848

    Submitted by: ROCELYN Y. ELTAGON, RN Signature over Printed Name

    Date submitted: January 27, 2012

    Received by: ________________________

    Approved by: SHIRLEY M. BACUS, MAN, MPH, RN Director of Nursing Service (Signature over Printed Name)

    3+3=1 ACCOMPLISHED REQUIREMENTS of 3-DAY INTRAVENOUS THERAPY TRAINING PROGRAM FOR NURSES Name of Registered Nurse: RICHIEL MAE Y. ELTAGON, RN Name of Hospital offering IV Training: Mindanao Sanitarium Hospital Date of IV Program Attended: January 23-25, 2012 I.
    Patient No.

    PRC Number: 720369 Provider No: 142 Venue: Conference Room, Mindanao Sanitarium Hospital

    Initiating/Maintaining Peripheral IV Infusions


    Name of Patient Age Date Time Kind of Infusion Site Type of Cannula Dose Rate Signature of Certified Trainer/Preceptor/M.D.,RN License No.

    204234 193384 204265

    Babao, Lota B. Dayok, Jianna Marie R. Panganting , Ansary G.

    39y.o 5y.o 42y.o

    January 26, 2012 January 26, 2012 January 27, 2012

    11:00`am 01:00pm 08:45am

    PNSS D50.3NaCl PNSS

    Right arm, Metacarpal Vein Right arm, Cephalic Vein Right Arm, Cephalic Vein

    Gauge 22 Gauge 24 Gauge 18

    1000cc 500cc 1000cc

    10gtts/min 70cc/hr 20gtts/min

    Genevieve F. Lapura, RN Genevieve F. Lapura, RN Genevieve F. Lapura, RN

    001848 001848 001848

    II.

    Administering Intravenous Drugs


    Name of Patient Age Date Time Drugs Incorporated Dose Diagnosis Signature of Certified Trainer/Preceptor/M.D.,RN License No.

    Patient No.

    168101 204265 154758 III.

    Caete, Lamberto S. Ramos, Camilo A. Cabtalan, Lorenzo

    92y.o 84y.o 90y.o

    January 26,2011 January 27, 2012 January 27, 2012

    12:00nn 08:42am 02:00nn

    Ceftazidime D5NSS 1L+ D50W PNSS 20cc+Ticarcillin Clavulanic Acid (Triclav)

    1 gram 50cc 3.2gms

    Urinary Bladder Cancer Diabetes Mellitus Severe Pneumonia

    Genevieve F. Lapura, RN Genevieve F. Lapura, RN Genevieve F. Lapura, RN

    001848 001848 001848

    Administering and Maintaining Blood and Blood Components


    Name of Patient Age Date Time Volume/Blood Type/Component /Rate IV Insertion Type of Cannula Diagnosis Signature of Certified Trainer/Preceptor/M.D.,RN License No.

    Patient No.

    T3474904

    Maguindanao, Mamintal L.

    42y.o

    January 26, 2012

    03:00pm

    350cc/O+/PRBC /30gtts/min

    Right Metacarpal Vein

    Gauge 18

    End Stage Renal Disease

    Genevieve F. Lapura, RN

    001848

    Submitted by: RICHIEL MAE Y. ELTAGON, RN Signature over Printed Name

    Date submitted: January 27, 2012

    Received by: ________________________

    Approved by: SHIRLEY M. BACUS, MAN, MPH, RN Director of Nursing Service (Signature over Printed Name)

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