NURSING TRANSFER NOTES

NURSING TRANSFER NOTES

Patient Shifted from ...........	Petient Shifted to ..................
Date ................................	Time ..................................
No.	PARAMETERS

1.            Diagnosis

2.            Reason why the patient is being shifted?

3.            Is blood cross matched and kept ready in the Blood Bank?

4.	Is the patient under restraints?	Yes	No
5.	Is the patient under vulnerable category?	Yes	No

6.            Is patient is a case of HIV/HBs Ag/HCV. If yes, give detail

_7.           Does patient requires Barrier / Reverse Barrier nursing?

8.	Is patient has pressure sore, if yes, give details
9.	Is patient on any medical equipment, if yes, give details
10.	Is there any Lines / Tubes / Drains / Catheters present, if any give details
11.	Current diet of the patient
12.	Special instruments
13.	Are all investigations including scans and	Yes	No
	reports being handed over to the next staff.
	Detail type of investigations.
	1.
	2.
14.	Pending Reports

Patient handover given by :                                              Patient handover Received by : 

Name of Staff : ..................................                                 Name of Staff : ..................................

Employee ID : ..................................                                 Employee ID : ..................................