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LOG BOOK PRIVILEGING & CREDENTIALING (MEDICAL OFFICER) HOSPITAL TUANKU JA’AFAR SEREMBAN NEGERI SEMBILAN DARUL KHUSUS

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LOG BOOK

PRIVILEGING &

CREDENTIALING

(MEDICAL OFFICER)

HOSPITAL TUANKU JA’AFAR

SEREMBAN NEGERI SEMBILAN DARUL KHUSUS

2

DEPARTMENT OF

REHABILITATION

NAME : -------------------------------------------

DATE OF POSTING :---------------------------

DATE OF COMPLETION :--------------------- Approved by:............................................

Date : ........................................................

3

LIST OF PROCEDURES AND REQUIREMENTS

*Bilangan prosedur adalah digunapakai pada ketika ini dan boleh berubah bergantung pada situasi semasa.

NO PROCEDURE OBSERVE CONDUCT

WITH ASSIST

PERFORM

1. Change of Supra pubic catheter 1 2 1

2. Bladder scan 2 1 1

3. Clean Intermittent Catheterization 1 2 2

4. Bedside swallowing examination – SSA ,BLUE EYE TEST

1 2 2

5. Tracheostomy care- change of trachy tube and weaning off tracheostomy

2 1 2

6. Vacuum assisted closure dressing 1 2 2

7. IDR & Family Meeting 2 2 2

8. NIHSS scoring 2 2 2

9. Berg Balance Scale 1 1 2

10. Digital evacuation / Digital stimulation 1 2 2

11. Arterial blood gas sampling 1 1 2

12. Mini Mental State Examination 1 2 2

13. Ankle Brachial Systolic Index 1 2 2

14. ASIA Charting 1 2 2

15. Agitated Behaviour Scale 1 2 2

16. Coma Recovery Scale 1 2 2

17. Flexible endoscopic examination of swallowing (FEES)

2 2

18. Amputee check out

a) Above Knee 2 2

b) Below Knee 2 2

19. Wheelchair prescription/ seating 1 2

20. Urodynamic Study 2 2

21. Botulinum toxin-A injection 2 2

4

PROCEDURE NO 1 : CHANGE OF SUPRA PUBIC CATHETER

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

1

PE

RF

OR

M

PROCEDURE NO 2 : BLADDER SCAN

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

2

1

AS

SIS

T

1

PE

RF

OR

M

5

PROCEDURE NO 3 : CLEAN INTERMITTENT CATHETERIZATION

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

1

PE

RF

OR

M

2

PROCEDURE NO 4 : BEDSIDE SWALLOWING EXAMINATION – SSA ,BLUE EYE TEST

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

1

PE

RF

OR

M

2

6

PROCEDURE NO 5 : TRACHEOSTOMY CARE- CHANGE OF TRACHY TUBE AND WEANING OFF TRACHEOSTOMY

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

2

1

AS

SIS

T

1

PE

RF

OR

M

2

PROCEDURE NO 6 : VACUUM ASSISTED CLOSURE DRESSING

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

1

PE

RF

OR

M

2

7

PROCEDURE NO 7 : IDR & FAMILY MEETING

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

2

1

AS

SIS

T

2

1

PE

RF

OR

M

2

PROCEDURE NO 8 : NIHSS SCORING

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

2

1

AS

SIS

T

2

1

PE

RF

OR

M

2

8

PROCEDURE NO 9 : BERG BALANCE SCALE

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

1

PE

RF

OR

M

2

PROCEDURE NO 10 : DIGITAL EVACUATION / DIGITAL STIMULATION

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

1

PE

RF

OR

M

2

9

PROCEDURE NO 11 : ARTERIAL BLOOD GAS SAMPLING

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

1

PE

RF

OR

M

2

PROCEDURE NO 12 : MINI MENTAL STATE EXAMINATION

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

1

PE

RF

OR

M

2

10

PROCEDURE NO 13 : ANKLE BRACHIAL SYSTOLIC INDEX

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

1

PE

RF

OR

M

2

PROCEDURE NO 14 : ASIA CHARTING

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

1

PE

RF

OR

M

2

11

PROCEDURE NO 15 : AGITATED BEHAVIOUR SCALE

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

1

PE

RF

OR

M

2

PROCEDURE NO 16 : COMA RECOVERY SCALE

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

1

PE

RF

OR

M

2

12

PROCEDURE NO 17 : FLEXIBLE ENDOSCOPIC EXAMINATION OF SWALLOWING (FEES)

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

2

1

AS

SIS

T

2

PROCEDURE NO 18 : AMPUTEE CHECK OUT a) Above Knee

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

2

1

AS

SIS

T

2

13

PROCEDURE NO 18 : AMPUTEE CHECK OUT b) Below Knee

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

2

1

AS

SIS

T

2

PROCEDURE NO 19 : WHEELCHAIR PRESCRIPTION/ SEATING

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

1

AS

SIS

T

2

14

PROCEDURE NO 20 : URODYNAMIC STUDY

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

2

1

AS

SIS

T

2

PROCEDURE NO 21 : BOTULINUM TOXIN-A INJECTION

NO

DATE

PATIENT NAME

NRIC / RN

COMMENTS OUTCOME

SUPERVISOR

1

OB

SE

RV

E

2

1

AS

SIS

T

2