红棉天使护理记录表

广州护理学会-社区老人延续护理技术服务

  • 一、服务者基本信息

  • Q1.服务者工号和姓名
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
  • Q2.护理服务日期

    _______________________________________

  • 一、服务对象基本信息

  • Q3.您的姓名

    _____________________________________________________________________________________________________

  • Q4.您的性别

  • Q5.您的电话

    _____________________________________________________________________________________________________

  •  二、当前健康状况

  • Q6. 基本情况

    _____________________________________________________________________________________________________

    _____________________________________________________________________________________________________

    _____________________________________________________________________________________________________

    _____________________________________________________________________________________________________

    _____________________________________________________________________________________________________

    _____________________________________________________________________________________________________

    _____________________________________________________________________________________________________

    _____________________________________________________________________________________________________

    _____________________________________________________________________________________________________

    _____________________________________________________________________________________________________

  • Q7.实施特殊护理
    __________________________________________________________________________________
  • Q8.实施健康教育和护理指导
    __________________________________________________________________________________
  • 使用耗材及数量

  • Q9.呼吸系统护理
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
  • Q10.消化系统护理
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
  • Q11.泌尿系统护理
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
  • Q12.皮肤护理
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
  • Q13.特殊敷料
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
  • Q14.其它耗材
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
    __________________________________________________________________________________
  • Q15.本次护理服务时长(分钟)

    _____________________________________________________________________________________________________

  • Q16.自我评价护理服务质量
    __________________________________________________________________________________
  • Q17.服务对象评价护理服务质量
    __________________________________________________________________________________
  • Q18.社区老人延伸护理技术服务服务作业证明(请拍照书面作业证明并在图库中选择照片上传)

    选择文件

    支持文件类型:.jpg/.jpeg/.gif/.bmp/.png/.pdf (限制大小:5M)

体验答题

问卷属性及操作

红棉天使护理记录表

创建于 2017-07-15 17:55:58

1318 个问题

问卷分类:活动展会

57人 体验答题

复制问卷
体验答题 查看结果

相关新闻

问卷专题