Patient report sheet

Who this sheet is for

One full page for one patient. It suits a heavy patient, a new admission you are still getting to know, or a nursing student following one patient through a clinical day.

Fill in the top half during report: why the patient is here, precautions and mobility, the problem list, access, drips and patches. Mark anything on the skin outline, number it, and describe it in the numbered rows beside the figure.

Keep it folded in your pocket and add to it as the shift goes. Vitals and glucose go in the timed rows, intake and output as it happens, and anything that changes goes in the box at the bottom with the time. At the end of the shift, read the sheet from top to bottom and you have given report.

Blocks worth knowing

Ask in report

questions you want answered before the off-going nurse leaves

Procedures · pending

tests, consults and results you are still waiting on

Changes this shift

what happened and when, so you do not have to rebuild the day from memory

Every sheet here prints on one US Letter page and comes as a free PDF with no sign-up. It is blank working paper, not a medical record: shred it at the end of the shift. Compare all the sheets or build your own layout.