Region II Trauma and Medical Center IPCR Daily Score Card

Surgical Intensive Care Unit July 2019

Census Remark Code Task Q E T

LC S1 Nursing Assessment
Adm S2 Carry out Doctor’s order
Tin S3 Monitoring of Vital Signs/
Intake and Output
Tout S4 Medication Administration
Dis S5 Facilitating Diagnostic
Procedures
Death S6 Referral to Attending Physician
HAMA S7 Nurse's Documentation
THOC S8 Health Education
PC S9 Records Management
PHIC S10 Equipment Safekeeping
& maintenance
Mech Vent S11 Cleanliness and orderliness of
work area
W1 Patients Personal Hygiene
W2 Intravenous Access
W3 Admission Care
W4 Inter-department Referral
W5 Assistance during
surgical/special procedures
W6 Health Records Forwarded to
Records Section
W7 Post Mortem Care
W8 Discharge Care

R1 Supervision of nursing care/

service in the unit
R2 Staffing /Scheduling
R3 DTR Submitted
R4 Reports Submitted
R5 Mandated Committee meetings
R6 Trainings/ Seminars Attended
R7 Prepared SALN/ PDS
R8 Prepared IPCRs (Targets)
submitted
R9 Prepared IPCRs (Ratings)
submitted
\

Employee: Date: Time-in

Shift Supervisor: Date: Time-out