[UPDATED] PRC OR Forms

Instructions:

  • Print and bring a copy of Form 2A, B and ODC Form __
  • Guidelines for filling out the form:
    • Use BLACK ink
    • Date Performed: Use MM/DD/YYYY format;
    • Time started: Based on the introp record, this is the CUTTING TIME not anesthesia time
    • Surgical procedure: NO ABBREVIATIONS in the procedure and site (e.g. write 'Left' in full no 'L')
    • OR nurse on duty: Self-inking pad of nurse-in-charge then signature
      • If you are doing a procedure as a scrub, NIC signature needed is scrub nurse; if as circulating, NIC signature needed is that of the circulating nurse
      • Special circumstance: If NIC assigned is an affiliate (ie. not an employee of PGH, e.g. those rotating in PGH for added experience), let the circulating PGH nurse sign this portion
      • Supervised by: Self-inking pad and signature of PRECEPTOR (ie. Ms. Elena Dizon - OPD OR; Mr. Emil Geronimo - Main OR)
      • This should be done DAILY. You are NOT allowed to go inside the ORs AFTER your rotations so make sure that you have the correct details.
  • Print and fill up the SUMMARY PERFORMANCE EVALUATION ACHIEVING INTRA-OPERATIVE CARE COMPETENCY form.
    • This is for SELF-RATING
    • Use BLACK ink
    • 1st RLE (1st rotation, either OPD or Main OR)
    • 2nd RLE (2nd rotation, either OPD or Main OR)
    • 3rd RLE (leave blank)
    • Last day of duty: Submit then let PRECEPTOR sign under the total score
    • If it is your LAST OR schedule, let the PRECEPTOR sign under the total score AND on the Clinical Instructor (page 6, left hand side)
  • These should be submitted to A/P Banayat's pigeonhole on Monday following your LAST assigned OR schedules