Sheet telemetry is a type of telemetry that uses paper forms to collect data. This can be an effective way to collect data from a large number of people in a short amount of time. The collected data can then be analyzed to find patterns or trends. There are many different types of sheet telemetry, and each has its own advantages and disadvantages. In general, however, sheet telemetry is a low-cost, easy-to-use method of collecting data.
Before you decide to fill in sheet telemetry, you will need to know more about the type of form you'll work with.
| Question | Answer |
|---|---|
| Form Name | Sheet Telemetry |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | nursing report sheet templates, sbar report sheet, nurse report template, telemetry nursing report sheet pdf |
NURSE BRAIN SHEET – TELEMETRY UNIT SBAR
|
S |
Patient name Age |
|
allergies |
|
Physician |
|||
|
|
|
|
Room number Admit date |
|
|
|
Attending |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Code status |
|
|
|
|
|
|
1 Dx 2 Dx |
|
|
|
Consultants |
|
|
|
|
|
|
|
|
Advanced directive on |
|
|
|
|
|
|
C/O |
|
|
chart? |
|
Pgr/# |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
B |
History |
|
|
|
Isolation Core Measures |
|||
|
|
|
|
Surgery: Surgeon |
|
|
Restraints CHF MI PNA |
||
|
|
|
|
Anesthesia Anesthesiologist EBL |
|
|
Fall risk Vaccine‐ PNA Flu |
||
|
|
|
|
|
|
||||
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
||
|
A |
Cardiac: BP/HR/Peripheral pulses/Edema/Heart sounds |
|
|
Pain/sedation |
||||
|
|
|
|
Current rhythm |
|
|
|
Pain scale |
|
|
|
|
|
Daily wt? |
|
|
|
Location |
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
DVT prophylaxis |
|
|
|
Meds type and last dose |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
Pulmonary: Breath sounds/Secretions/ SpO2/UPAs/PIP/ |
Vent/bipap etc |
Accu checks A1C |
|||
|
|
|
|
Spontaneous VT & VE |
|
|
|
|
|
|
|
|
|
|
|
settings |
Frequency |
||
|
|
|
|
|
|
|
|
Last Results |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
GI NG/OGT |
|
|
|
Skin |
|
|
|
|
|
|
|
|
|
Wounds/Drainage |
|
|
|
|
|
BS Last BM |
Diet GI Prophylaxis |
|
|
||
|
|
|
|
|
|
|
|
Staples |
|
|
|
|
|
|
|
|
|
Drains |
|
|
|
|
|
GU Foley/void |
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Location |
|
|
|
|
|
Output |
|
|
|
|
|
|
|
|
|
|
|
|
|
Ducub photo on admission |
|
|
|
|
|
|
|
|
|
||
|
|
|
|
IV Date inserted |
|
|
Psych Social |
||
|
|
|
|
Fluids Gtts |
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Meds |
|
|
|
Pending orders |
|
|
|
|
Na |
Cl |
Bun |
gluc |
mg |
BNP |
Coags |
|
UA |
CT |
|
|
|
|
|
|
|
|
|
|
INR |
|
|
CXR |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
K |
Co |
Cr |
Ca |
Phos |
DDimer |
|
|
Cultures |
|
|
||
|
|
|
|
|
|
PTT |
|
|
MRI |
||||
|
|
|
|
|
|
|
Next lab |
|
|
Echo |
|||
Cardiac enz |
1 2 3 |
|
|
||||||||||
|
|
|
|
|
|
|
|
|
|||||
R DC Plan. Is pt informed of plan___ 24 hour orders reviewed____ |
|
Shift goals |
|
|
|||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|