Environmental Services House Supervisor Administrative Report Date(Required) MM slash DD slash YYYY Shift(Required)7AM - 7PM7PM - 7AM7AM - 3PM3PM - 11PM11PM - 7AMInitials(Required)1. Are there any staff/physician we should recognize or send a thank you to?(Required) Yes No Staff/physicians to recognize and why.(Required)2. Are there any issues we should be aware of?(Required) Yes No Issues.(Required)3. Any patient or staff safety concerns/injuries?(Required) Yes No Concerns/injuries.(Required)4. Were you alerted to any decline in patient status that required additional intervention (Rapid Response Process)?(Required) Yes No Describe Rapid Response Process.(Required)5. Were there any Code Blues on this shift?(Required) Yes No 6. Were there any ambulance transfers taken by a crew other than BVRMC?(Required) Yes No 7. Were there any CoVid19 patients hospitalized?(Required) Yes No Total Number of confirmed CoVid patients hospitalized.(Required)Total number of confirmed CoVid19 patients in the ICU on ICU status.(Required)Total number of confirmed CoVid19 patients on Ventilators.(Required)Total number of confirmed CoVid19 patients admitted during your shift.(Required)Total number of CoVid19 deaths during your shift.(Required)List of any CoVid19 patient city addresses Example: Newellx2, Fonda, SLx3 etc.(Required)List age of all CoVid19 patients hospitalized.(Required)[wpdatatable id=1]
