4 pts
3 pts
2 pts
1 pts
1. Prepares for patient contact ppe/handwashing 2. Introduces him/herself to the patient. 3 identifies his/herself to bedside nurse/doctor
1. Obtain information regarding patients history/ entrance complaint 2. Observe the patients vital signs displayed on the monitor. 3. check position of the patient 4. Chest auscultation 5. Checking urine output
1. Prioritizing actions. 2. ABC & LOC Assess patient airway, breathing and circulation, and level of consciousness . 3. Focus assessment of systems based on patient's presentation, s/s.
Identify actual and /or possible medical problems or nursing problems that presenting with all assessment performed Discuss finding with lead nurse/charge nurse or /and instructor .
Initiate the priority interventions , transcribe and incorporate providers orders , question orders that are not clear. Delegate tasks to supportive personnel. Communicate with the provider in the timely manner.