Wesleyan University - Philippines

Mabini Extension, Cabanatuan City, Nueva Ecija, Philippines 3100

Tel Nos.: (044) 463-2162 / 2074 Loc. 122
Telefax: (044) 463-0596
www.wesleyan.edu.ph
Accreditation Level: III April 2017 – April 2021

IMMEDIATE NEWBORN CORD CARE CASES

______________________________
Prepared By: MADAYAG, RACHEL BALTAZAR

DATE PERFORMED PATIENT’S INITIALS IMMEDIATE NEWBORN

CORD CARE NURSE ON DUTY SUPERVISED BY
AND TIME STARTED CASE NUMBER PERFORMED IN

_____________________________ __________________________
October 2, 2017 Baby Boy N
Delivery Room Analyn J. Mendoza, RN Jocelyn S. Carvajal, MAN, RN
7:11 PM 507303
Dr. Paulino J. Garcia Memorial Research
and Medical Center

_____________________________ __________________________
October 23, 2017 Baby Boy T
Delivery Room Analyn J. Mendoza, RN Jocelyn S. Carvajal, MAN, RN
2:53 PM 512578
Dr. Paulino J. Garcia Memorial Research
and Medical Center

_____________________________ __________________________
October 23, 2017 Baby Girl B
Delivery Room Analyn J. Mendoza, RN Jocelyn S. Carvajal, MAN, RN
7:31 PM 512633
Dr. Paulino J. Garcia Memorial Research
and Medical Center

Concurred by: Noted by: Approved by:

PINKY MIRIAM D. CANLAS, MAN, RN MA. CORAZON S. SALVADOR, PhD, RN JOSEPHINE O. SAMONTE, MAN, RN
Chief Nurse Program Head, Nursing OIC-Dean, College of Nursing & Allied Medical Sciences
Dr. PJGMRMC Wesleyan University – Philippines Wesleyan University – Philippines
Degree: Masters of Arts in Nursing Degree: Doctor of Philosophy Degree: Masters of Arts in Nursing
PRC No.: 0075648 Valid Until: September 22, 2018 PRC No.: 0116922 Valid Until: June 17, 2020 PRC No.: 0163005 Valid Until: December 25, 2020
PNA No.: 09873 Valid Until: Lifetime PNA No.: 17506 Valid Until: Lifetime PNA No.: 029647 Valid Until: December 31, 2018
Date Signed: _______________________ Date Signed: __________________________ ADPCN No.: 17-726 Valid Until: 2017-2018
Date Signed: _____________________
 Wesleyan University - Philippines
Mabini Extension, Cabanatuan City, Nueva Ecija, Philippines 3100
Tel Nos.: (044) 463-2162 / 2074 Loc. 122
Telefax: (044) 463-0596
www.wesleyan.edu.ph
Accreditation Level: III April 2017 – April 2021

SURGICAL SCRUB CASES (MAJOR)

______________________________
Prepared By: MADAYAG, RACHEL BALTAZAR

DATE PERFORMED PATIENT’S INITIALS MAJOR SURGICAL PROCEDURE

NURSE ON DUTY SUPERVISED BY
AND TIME STARTED CASE NUMBER PERFORMED

_________________________ ______________________________
March 5, 2018 ECD Total Abdominal Hysterectomy Bilateral
Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
11:20 AM 1196 Salphingo Oophorectomy
Eduardo L. Joson Memorial Hospital

_________________________ ______________________________
March 20, 2018 LGLF
Low Cervical Caesarean Section Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
12:10 PM 1491
Eduardo L. Joson Memorial Hospital

_________________________ ______________________________
March 21, 2018 BAB
Cholecystectomy Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
12:24 PM 1494
Eduardo L. Joson Memorial Hospital

,
Concurred by: Noted by: Approved by:

ALEXANDER P. MALUBAG, RN MA. CORAZON S. SALVADOR, PhD, RN JOSEPHINE O. SAMONTE, MAN, RN

Chief Nurse Program Head, Nursing OIC-Dean, College of Nursing & Allied Medical Sciences
ELJMH Wesleyan University – Philippines Wesleyan University – Philippines
Degree: Bachelor of Science in Nursing Degree: Doctor of Philosophy Degree: Masters of Arts in Nursing
PRC No.: 0119925 Valid Until: December 31, 2020 PRC No.: 0116922 Valid Until: June 17, 2020 PRC No.: 0163005 Valid Until: December 25, 2020
PNA No.: 029501 Valid Until: December 31, 2018 PNA No.: 17506 Valid Until: Lifetime PNA No.: 029647 Valid Until: December 31, 2018
Date Signed: _______________________ Date Signed: __________________________ ADPCN No.: 17-726 Valid Until: 2017-2018
Date Signed: _____________________
 Wesleyan University - Philippines
Mabini Extension, Cabanatuan City, Nueva Ecija, Philippines 3100
Tel Nos.: (044) 463-2162 / 2074 Loc. 122
Telefax: (044) 463-0596
www.wesleyan.edu.ph
Accreditation Level: III April 2017 – April 2021

SURGICAL SCRUB CASES (MINOR)

______________________________
Prepared By: MADAYAG, RACHEL BALTAZAR

DATE PERFORMED PATIENT’S INITIALS MINOR SURGICAL

NURSE ON DUTY SUPERVISED BY
AND TIME STARTED CASE NUMBER PROCEDURE PERFORMED

_________________________ ______________________________
March 6, 2018 EFD
Marsupialization Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
8:28 PM 1226
Eduardo L. Joson Memorial Hospital

_________________________ ______________________________
March 7, 2018 RCDC
Excision and Incision Biopsy Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
2:59 PM 1227
Eduardo L. Joson Memorial Hospital

_________________________ ______________________________
March 19, 2018 GAS
Bilateral Tubal Ligation Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
12:05 PM 1417
Eduardo L. Joson Memorial Hospital

Concurred by: Noted by: Approved by:

ALEXANDER P. MALUBAG, RN MA. CORAZON S. SALVADOR, PhD, RN JOSEPHINE O. SAMONTE, MAN, RN

Chief Nurse Program Head, Nursing OIC-Dean, College of Nursing & Allied Medical Sciences
ELJMH Wesleyan University – Philippines Wesleyan University – Philippines
Degree: Bachelor of Science in Nursing Degree: Doctor of Philosophy Degree: Masters of Arts in Nursing
PRC No.: 0119925 Valid Until: December 31, 2020 PRC No.: 0116922 Valid Until: June 17, 2020 PRC No.: 0163005 Valid Until: December 25, 2020
PNA No.: 029501 Valid Until: December 31, 2018 PNA No.: 17506 Valid Until: Lifetime PNA No.: 029647 Valid Until: December 31, 2018
Date Signed: _______________________ Date Signed: __________________________ ADPCN No.: 17-726 Valid Until: 2017-2018
Date Signed: _____________________
 Wesleyan University - Philippines
Mabini Extension, Cabanatuan City, Nueva Ecija, Philippines 3100
Tel Nos.: (044) 463-2162 / 2074 Loc. 122
Telefax: (044) 463-0596
www.wesleyan.edu.ph
Accreditation Level: III April 2017 – April 2021

DELIVERY CASES (ACTUAL)

_____________________________
Prepared By: MADAYAG, RACHEL BALTAZAR

DATE PERFORMED PATIENT’S INITIALS

PROCEDURE PERFORMED D.R. NURSE ON DUTY SUPERVISED BY
AND TIME STARTED CASE NUMBER

_________________________ ______________________________
March 12, 2018 MADL
Normal Spontaneous Delivery Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
10:35 AM 1336
Eduardo L. Joson Memorial Hospital

_________________________ ______________________________
March 14, 2018 MJNDL
Normal Spontaneous Delivery Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
8:29 AM 1379
Eduardo L. Joson Memorial Hospital

_________________________ ______________________________
March 19, 2018 RBD
Normal Spontaneous Delivery Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
8:13 AM 1467
Eduardo L. Joson Memorial Hospital

Concurred by: Noted by: Approved by:

ALEXANDER P. MALUBAG, RN MA. CORAZON S. SALVADOR, PhD, RN JOSEPHINE O. SAMONTE, MAN, RN

Chief Nurse Program Head, Nursing OIC-Dean, College of Nursing & Allied Medical Sciences
ELJMH Wesleyan University – Philippines Wesleyan University – Philippines
Degree: Bachelor of Science in Nursing Degree: Doctor of Philosophy Degree: Masters of Arts in Nursing
PRC No.: 0119925 Valid Until: December 31, 2020 PRC No.: 0116922 Valid Until: June 17, 2020 PRC No.: 0163005 Valid Until: December 25, 2020
PNA No.: 029501 Valid Until: December 31, 2018 PNA No.: 17506 Valid Until: Lifetime PNA No.: 029647 Valid Until: December 31, 2018
Date Signed: _______________________ Date Signed: __________________________ ADPCN No.: 17-726 Valid Until: 2017-2018
Date Signed: _____________________
 Wesleyan University - Philippines
Mabini Extension, Cabanatuan City, Nueva Ecija, Philippines 3100
Tel Nos.: (044) 463-2162 / 2074 Loc. 122
Telefax: (044) 463-0596
www.wesleyan.edu.ph
Accreditation Level: III April 2017 – April 2021

DELIVERY CASES (ASSIST)

_____________________________
Prepared By: MADAYAG, RACHEL BALTAZAR

DATE PERFORMED PATIENT’S INITIALS

PROCEDURE PERFORMED D.R. NURSE ON DUTY SUPERVISED BY
AND TIME STARTED CASE NUMBER

_________________________ ______________________________
November 21, 2017 MDGG
Normal Spontaneous Delivery Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
1:26 PM 6763
Eduardo L. Joson Memorial Hospital

_________________________ ______________________________
November 27, 2017 GPM
Normal Spontaneous Delivery Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
12:47 PM 6871
Eduardo L. Joson Memorial Hospital

_________________________ ______________________________
November 28, 2017 LDP
Normal Spontaneous Delivery Ma. Cristina T. Salazar, RN Ma. Corazon S. Salvador, PhD, RN
11:25 AM 6895
Eduardo L. Joson Memorial Hospital

Concurred by: Noted by: Approved by:

ALEXANDER P. MALUBAG, RN MA. CORAZON S. SALVADOR, PhD, RN JOSEPHINE O. SAMONTE, MAN, RN

Chief Nurse Program Head, Nursing OIC-Dean, College of Nursing & Allied Medical Sciences
ELJMH Wesleyan University – Philippines Wesleyan University – Philippines
Degree: Bachelor of Science in Nursing Degree: Doctor of Philosophy Degree: Masters of Arts in Nursing
PRC No.: 0119925 Valid Until: December 31, 2020 PRC No.: 0116922 Valid Until: June 17, 2020 PRC No.: 0163005 Valid Until: December 25, 2020
PNA No.: 029501 Valid Until: December 31, 2018 PNA No.: 17506 Valid Until: Lifetime PNA No.: 029647 Valid Until: December 31, 2018
Date Signed: _______________________ Date Signed: __________________________ ADPCN No.: 17-726 Valid Until: 2017-2018
Date Signed: _____________________