Prokalite | ACİL DURUM YÖNETİMİ HASTANE GİRİŞ KAYIT FORMU

Örnek Doküman

Afet ve Acil Durum Yönetimi - Form

AD.FR.008 - ACİL DURUM YÖNETİMİ HASTANE GİRİŞ KAYIT FORMU

PDF Dokümanı Gör

Paylaş

DİKKAT! Buradaki bilgiler sağlık profesyonelleri için hazırlanmıştır.
Arama motorları vs. ile bu sayfadaki bilgilere ulaştıysanız, sağlık profesyonellerine danışmadan, sadece buradaki bilgiler ile hareket etmeyiniz.

(Logonuz Burada)

Demo Hastanesi (Prokalite.Com) ACİL DURUM YÖNETİMİ HASTANE GİRİŞ KAYIT FORMU

Doküman Kodu: AD.FR.008

Yayın Tarihi: 08.12.2016

Revizyon Tarihi: 21.01.2022

Revizyon No: 1

Sayfa: Otomatik

Olay Adı:
Hasta Kayıt No	Tarih	Saat	Protokol	Tc Kimlik	Adı -Soyadı/Eşgal	Cinsiyeti/Yaşı	Geliş Şekli (Ayaktan, Ambulans vb.)	Triyaj Kodu	Yapılan İlk Müdahale	Yönlendirilen Bölüm











1) Operasyon aşamasında kullanılacaktır.Olay adı değiştiğinde Hastane Giriş Kayıt Formu yeniden oluşturulacaktır. 2) Triyaj alanında doldurulacaktır. 3) Tüm ilgili birim ve kişilere gönderilir.

<meta charset="utf-8"/>
<table style="border-collapse:collapse; width:1292px" class=" cke_show_border" cellspacing="0" cellpadding="5" bordercolor="#ccc" border="1"><tbody><tr><td style="height:41px; text-align:left; vertical-align:middle; width:73px"><strong>Olay Adı:</strong></td><td rowspan="1" colspan="10" style="text-align:left; width:1133px"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:62px; text-align:center; vertical-align:middle; width:73px"><strong>Hasta Kayıt No</strong></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:middle; width:62px"><strong>Tarih </strong></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:middle; width:44px"><strong>Saat</strong></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:middle; width:56px"><strong>Protokol</strong></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:middle; width:93px"><strong>Tc Kimlik</strong></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:middle; width:147px"><strong>Adı -Soyadı/Eşgal</strong></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:middle; width:116px"><strong>Cinsiyeti/Yaşı</strong></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:middle; width:129px"><strong>Geliş Şekli (Ayaktan, Ambulans vb.)</strong></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:center; vertical-align:middle; width:103px"><strong>Triyaj Kodu</strong></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong>Yapılan İlk Müdahale</strong></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:center; vertical-align:middle"><strong>Yönlendirilen Bölüm</strong></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td style="border-color:#000000; border-style:solid; border-width:1px; height:38px; text-align:left; width:73px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:62px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:44px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:56px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:93px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:147px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:116px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:129px"><br></td><td style="border-color:#000000; border-style:solid; border-width:1px; text-align:left; width:103px"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td><td style="border-bottom:1px solid #000000; border-left:1px solid #000000; border-right:1px solid #000000; border-top:1px solid #000000; text-align:left"><br></td></tr><tr><td colspan="11" style="height:59px; text-align:left; vertical-align:middle">1) Operasyon aşamasında kullanılacaktır.Olay adı değiştiğinde Hastane Giriş Kayıt Formu yeniden oluşturulacaktır.<br>2) Triyaj alanında doldurulacaktır.<br>3) Tüm ilgili birim ve kişilere gönderilir.</td></tr></tbody></table>