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. Botulium toxin-A injection 2 2
19. Amputee check out
a) Above Knee 2 2
b) Below Knee 2 2
20. Urodynamic Study 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 : BOTULINUM TOXIN-A INJECTION
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
OB
SE
RV
E
2
1
AS
SIS
T
2
13
PROCEDURE NO 19 : 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
PROCEDURE NO 19 : 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
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
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