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IVT Completion Case Form Edited

Jillianne M. Bertiz completed a 3-day basic intravenous therapy training program for nurses at Queen Mary Help of Christians Hospital from February 19-21, 20110. The program covered initiating and maintaining peripheral IV infusions, administering intravenous drugs, and administering and maintaining blood and blood components. Bertiz' training included supervised practice in starting IVs, administering medications and blood products to patients of varying ages under the guidance of certified trainers.

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6K views1 page

IVT Completion Case Form Edited

Jillianne M. Bertiz completed a 3-day basic intravenous therapy training program for nurses at Queen Mary Help of Christians Hospital from February 19-21, 20110. The program covered initiating and maintaining peripheral IV infusions, administering intravenous drugs, and administering and maintaining blood and blood components. Bertiz' training included supervised practice in starting IVs, administering medications and blood products to patients of varying ages under the guidance of certified trainers.

Uploaded by

NURSETOPNOTCHER
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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3+3+2 ACCOMPLISHED REQUIREMENTS of

3-DAY BASIC INTRAVENOUS THERAPY TRAINING PROGRAM for NURSES


Name of Registered Nurse: _Jillianne M. Bertiz_____________________________________________________ PRC Number: __0594229__________________________________________
Name of Hospital offering IV Training: _Queen Mary Help of Christians Hospital__________________________ Provider No. : __218______________________________________________
Date of IV Training Program Attended _February 19-21, 20110_________________________________________ Venue: _DMDJ Audi Queen Mary Help of Christians Educational Center___

I. Initiating/ Maintaining Peripheral IV Infusions


Signature over Printed Name
Patient Name of Patient Age Date Time Kind of Infusion Site Type of Cannula Dose Rate of Certified Trainer/ License
No. Preceptor No.

II. Administering Intravenous Drugs


Signature over Printed Name
Patient Name of Patient Age Date Time Drugs incorporated Dose Diagnosis of Certified Trainer/ License
No. Preceptor No.

III. Administering and Maintaining Blood and Blood Components


Signature over Printed Name
Patient Name of Patient Age Date Time Volume/ Blood Type/ Components/ IV Insertion Type of Diagnosis of Certified Trainer/ License
No. Rate Cannula Preceptor No.

Submitted by: __Jillianne M. Bertiz____ Date Submitted:________________________ Received by: ________________________________________ Approved by: _________________________________
(Signature over Printed Name) Director of Nursing Service
(Signature over Printed Name)

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