ARELLANO UNIVERSITY
COLLEGE of NURSING
2600 Legarda St., Sampaloc, Manila
7347371 LOC. 210, [Link]
PACUCOA Level III Re-Accredited Status (September 2015 to September 2020)
SURGICAL SCRUB in ARMED FORCES OF THE PHILIPPINES MEDICAL CENTER, QUEZON CITY, METRO MANILA__
Hospital/Home/Lying-in Clinic, Municipality/City/Province
Prepared by:
Printed Name and Signature of Student IRENE URBINO FAJARDO__
Date Performed
and
Time Started
Patients INITIAL
Only
SURGICAL PROCEDURE
PERFORMED
O.R. Nurse On Duty
(Name and Signature)
SUPERVISED BY
Clinical instructor
Name and Signature
Case Number
JULY 11, 2016
0830H
R.C.A.
164124
OPEN REDUCTION INTERNAL
FIXATION (PLATE)
RADIUS-ULNA LEFT
2LT CRISTINA P MARQUEZ
NC
YOLANDA A. QUETUA, RN,
MAN
JULY 12, 2016
1135H
P.E.B.
164496
PHACOEMULSIFICATION with
POSTERIOR CHAMBER
INTRAOCULAR LENS/ BOTH
EYE
CPT ARIEL M PASCUA NC
YOLANDA A. QUETUA, RN,
MAN
JULY 14, 2016
0730H
R.J.C.F.
164271
CAESARIAN SECTION I
JAMES D MANUEL RN
YOLANDA A. QUETUA, RN,
MAN
Noted by: RUHIYYIH C. BARNACHIA, RN, MAN
Clinical Coordinator: PRC I.D. No. 364772 Valid Until September 21, 2020
2020
Date document is signed: ________________ Time: ______________
_____________
Approved by: LEONORA P. BORROMEO, RN, MAN
Dean: PRC I.D. No.0295254 Valid Until April 16,
Date document is signed: ________________ Time:
ARELLANO UNIVERSITY
COLLEGE of NURSING
2600 Legarda St., Sampaloc, Manila
7347371 LOC. 210, [Link]
PACUCOA Level III Re-Accredited Status (September 2015 to September 2020)
SURGICAL CIRCULATING in ARMED FORCES OF THE PHILIPPINES MEDICAL CENTER, QUEZON CITY, METRO MANILA
Hospital/Home/Lying-in Clinic, Municipality/City/Province
Prepared by:
Printed Name and Signature of Student IRENE URBINO FAJARDO_
Date Performed
and
Time Started
Patients INITIAL
Only
SURGICAL PROCEDURE
PERFORMED
O.R. Nurse On Duty
(Name and Signature)
SUPERVISED BY
Clinical Instructor
Name and Signature
Case Number
JULY 12, 2016
0854H
A.E.D
164290
PHACOEMULSIFICATION
WITH
POSTERIOR CHAMBER
INTRAOCULAR LENS RIGHT
EYE
CPT ARIEL M PASCUA NC
YOLANDA A. QUETUA, RN,
MAN
JULY 12,2016
1300H
R.F.P.
163827
OPEN REDUCTION INTERNAL
FIXATION (MULTIPLE SCREW
FIXATION) MEDIAL
MALLEOLUS LEFT
1LT CATHERINE JOY E ABAGA
NC
YOLANDA A. QUETUA, RN,
MAN
JULY 14, 2016
0947H
C.V.P.A.
164095
CORRECTIVE OSTEOTOMY
ULNA RIGHT
1LT JENIFER M AGPALO
NC
YOLANDA A. QUETUA RN,
MAN
Noted by: RUHIYYIH C. BARNACHIA, RN, MAN
Clinical Coordinator: PRC I.D. No. 364772 Valid Until September 21, 2020
2020
Approved by: LEONORA P. BORROMEO, RN, MAN
Dean: PRC I.D. No.0295254 Valid Until April 16,
Date document is signed: ________________ Time: ______________
_____________
Highest Nursing Degree Earned: BSN, MAN
Date document is signed: ________________ Time:
Highest Nursing Degree Earned: BSN, MAN
ARELLANO UNIVERSITY
COLLEGE of NURSING
2600 Legarda St., Sampaloc, Manila
7347371 LOC. 210, [Link]
PACUCOA Level III Re-Accredited Status (September 2015 to September 2020)
ACTUAL DELIVERY in QUIRINO MEMORIAL MEDICAL CENTER, QUEZON CITY, METRO MANILA_
Hospital/Home/Lying-in Clinic, Municipality/City/Province
Prepared by:
Printed Name and Signature of Student _IRENE URBINO FAJARDO_
Date Performed
and
Time Started
Patients INITIAL Only
Case Number
PROCEDURE
PERFORMED
D.R. Nurse On Duty
(Name and Signature)
(If Midwife on Duty, Signature
Not Required)
SUPERVISED BY
Clinical Instructor
Name and Signature
(not applicable for
Birthing/Lyingin Clinic/Home)
DECEMBER 10, 2015
7:45 AM
R.B.A
1010350
NORMAL SPONTANEOUS
DELIVERY
LUZVIMINDA M. ARCILLA RM
ELIZABETH V. ENDAYA RN,
MAN
DECEMBER 10,2015
2:53 PM
S.D.M.
682275
NORMAL SPONTANEOUS
DELIVERY
LUZVIMINDA M. ARCILLA RM
ELIZABETH V. ENDAYA RN,
MAN
DECEMBER 16, 2015
2:57 PM
C.F.R
978566
NORMAL SPONTANEOUS
DELIVERY
LUZVIMINDA M. ARCILLA RM
ELIZABETH V. ENDAYA RN,
MAN
Noted by: RUHIYYIH C. BARNACHIA, RN, MAN
Clinical Coordinator: PRC I.D. No. 364772 Valid Until September 21, 2020
2020
Approved by: LEONORA P. BORROMEO, RN, MAN
Dean: PRC I.D. No.0295254 Valid Until April 16,
Date document is signed: ________________ Time: ______________
_____________
Highest Nursing Degree Earned: BSN, MAN
Date document is signed: ________________ Time:
Highest Nursing Degree Earned: BSN, MAN
ARELLANO UNIVERSITY
COLLEGE of NURSING
2600 Legarda St., Sampaloc, Manila
7347371 LOC. 210, [Link]
PACUCOA Level III Re-Accredited Status (September 2015 to September 2020)
IMMEDIATE NEWBORN CORD CARE in QUIRINO MEMORIAL MEDICAL CENTER, QUEZON CITY, METRO MANILA
Hospital/Home/Lying-in Clinic, Municipality/City/Province
Prepared by:
Printed Name and Signature of Student IRENE URBINO FAJARDO_
Patients INITIAL Only
Date Performed
and
Time Started
Immediate Newborn
Cord Care
PERFORMED
Case Number
(not applicable for
Birthing/Lyingin Clinic/Home)
Indicate where performed e.g.
D.R.,
Nursery, NICU, or Home
D.R. Nurse On Duty
(Name and Signature)
(If Midwife on Duty, Signature
Not Required)
SUPERVISED BY
Clinical Instructor
Name and Signature
DECEMBER 09,2015
4:03 PM
BABY BOY S.
1010076
NEONATAL INTENSIVE CARE
UNIT
BABY ROSE N. ALBERTO RM
ELIZABETH V. ENDAYA RN,
MAN
DECEMBER 10, 2015
3:49 PM
BABY BOY P.
656381
NEONATAL INTENSIVE CARE
UNIT
BABY ROSE N. ALBERTO RM
ELIZABETH V. ENDAYA RN,
MAN
DECEMBER 16, 2015
6:21 PM
BABY GIRL F.
1011445
NEONATAL INTENSIVE CARE
UNIT
BABY ROSE N. ALBERTO RM
ELIZABETH V. ENDAYA RN,
MAN
Noted by: RUHIYYIH C. BARNACHIA, RN, MAN
Clinical Coordinator: PRC I.D. No. 364772 Valid Until September 21, 2020
2020
Date document is signed: ________________ Time: ______________
_____________
Highest Nursing Degree Earned: BSN, MAN
Approved by: LEONORA P. BORROMEO, RN, MAN
Dean: PRC I.D. No.0295254 Valid Until April 16,
Date document is signed: ________________ Time:
Highest Nursing Degree Earned: BSN, MAN
