List of Master Templates in Nightingale Template Name ABDOMEN/GI (HPI)
Template Description
All Fields Reportable
Record Hx and physical findings related to the GI system
Ankle Injury AOHC - Adult Nutrition
Adult Nutrition
AOHC - Child and Youth Preventative Care
Child/Adolescent Preventative Care
AOHC - Chiropody
Chiropody
AOHC - Counselling
Counselling
AOHC - Diabetes Education Diabetes Education
AOHC - Female Preventative Care
Female Preventative Care
AOHC - Male Preventative Care
Male Preventative Care
AOHC - Paediatric Nutrition
Paediatric Nutrition
AOHC - Physiotherapy
Physiotherapy
AOHC - Quitting or Reducing Smoking
Quitting or Reducing Smoking
ASTHMA ASSESSMENT
USING THE STRING BUILDER
Back Pain Basic Note
Subjective, objective text areas, and vitals.
BCCFP Congestive Heart Failure Initial Visit
Template to collect the information that is not automatically linked from the patient's chart into the BCCFP CHF form.
BCCP Congestive Heart Failure Care Record C.N.S (HPI)
Record Hx and physical findings related to the central nervous system
CDH PRE-OP Hx & Px
Re-production of CDH pre-op form.
CDM - Asthma Care
Asthma Care
CDM - COPD Care
COPD Care
CDM - Diabetes Care
Diabetes Care
CDM - Heart Failure Care
Heart Failure Care
CDM - Hypertension Care
Hypertension Care
CHEST & RESPIRATORY (HPI)
Record Hx and physical findings related to the respiratory system
CHRONIC PAIN CLINICAL NOTE: CLINICAL NOTES - FREE TEXT
Single text box for recording clinical notes
CONSULTATION RECORD
Free Form Consultation Record
CPE-Female
Complete Physical Exam (Female)
CPE-Male
Complete Physical Exam (Male)
CPX (Female)
Review of systems, history, and physical exam findings for female patients.
CPX (Male)
Complete physical exam, male patient.
CV SYSTEMS (HPI)
Record Hx and physical findings related to the cardiovascular system
Depression
Common findings on history and objective observation in a depressed patient.
DIABETES MANAGEMENT
Diabetes Management
Dyspepsia
Common history and physical exam findings in a patient with a chief complaint of dyspepsia.
EARS (HPI)
Record Hx and physical findings related to the ear
ENDOCRINE (HPI)
Record Hx and physical findings related to the endocrine system
ENT-Adult
Ear Nose & Throat Exam (Adult)
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Reference Document for Nightingale on Demand – March 2013
List of Master Templates in Nightingale ENT-Child
Ear Nose & Throat Exam (Child)
EYE (HPI)
Record Hx and physical findings related to the eye
Free Style Entry
Different Free Style Entries
G.U. SYSTEMS (HPI)
Record Hx and physical findings related to the GU system
Gastroesophageal Reflux
Common history and physical findings in a patient suspected of having GERD.
Handwritten note
Basic note with subjective and objective spaces that will accept free form handwriting without converting to text; for use with a tablet computer.
Head Injury
History and physical exam items for a patient presenting with a complaint of head injury.
HEMATOLOGY (HPI)
Record Hx and physical findings related to hematology
Hypertension
History and physical exam for hypertension, based on CHEP 2003 Recommendations for the Management of Hypertension.
Knee injury
Common history and physical findings in a patient with a knee injury.
LAB RESULTS
Manually recording common lab result values
LIPID MANAGEMENT
Management of lipid abnormalities
Low Back Pain Migraine Mini Mental Status-String Mini-Mental Status Exam
Adapted from Folstein et al, Mini Mental State, J PSYCH RES 12:196-198 (1975)
MOUTH AND THROAT (HPI)
Record Hx and physical findings related to the mouth and throat
MSK (HPI)
Record Hx and physical findings related to the Musculoskeletal system
NOSE (HPI)
Record Hx and physical findings related to the nose
Nurse Hx/Vitals
Nurse's hx and vital signs
Otitis Media
Otitis Media history and physical findings.
PEDIATRIC EXAM
Pediatric Physical Exam
Pharyngitis
A template for assessing a patient with a complaint of pharyngitis.
PHYSICAL EXAM (Short)
Physical Examination using short PE dialogue
PLANTAR'S WART (Treatment)
Plantars warts treatment with liquid nitrogen
Prostatic Symptoms
Common history and physical findings in a patient complaining of prostatic symptoms.
PSYCHIATRY (Symptoms) Record symptoms related to psychiatry SKIN/HAIR/NAIL (HPI)
Record Hx and physical findings related to the dermatologic system
SOAP (Female) SOAP (Free form)
Record Subject & Objective notes in free form
SOAP (Male) SOAP Complete(ROS)
Complete Review of Systems
SOAP Hx Builder
SOAP format using Hx Builder with nurse notes
SOAP w/ VITALS (Free form)
Record Subject & Objective with Nurse's Notes and Vital Signs
Urinary Tract Infection
Common subjective and objective findings in a patient suspected of having a urinary tract infection.
URTI
Common history and physical items for a patient with a simple upper respiratory tract infection.
Vertigo
Common history and physical elements for a patient complaining of vertigo.
WEIGHT LOSS
Record weight loss progress
WEIGHT LOSS (Female)
Record Weight loss program
WEIGHT LOSS (Male)
Record Weight loss program
WELL BABY
Record a well baby visit
Well Baby Check (12-13
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health
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Reference Document for Nightingale on Demand – March 2013
List of Master Templates in Nightingale months)
Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Baby Check (15 months)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Baby Check (18 months)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Baby Check (2 months)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Baby Check (4 months)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Baby Check (6 months)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Baby Check 1 Month (Optional)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Baby Check 2 weeks (Optional)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Baby Check 9 months Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health (Optional) Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009. Well Baby Check Within 1 Week
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Baby Record - Guide I: 1 Week
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Baby Record - Guide Ib: 2 weeks (optional)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Baby Record - Guide Ic: 1 month
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Baby Record - Guide IIa: 2 months
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Baby Record - Guide IIc: 6 months
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Baby Record - Guide IIIb: 12-13 months
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Baby Record - Guide Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health IVa: 18 months (national) Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Baby Record - Guide IVb: 2 years
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Baby Record - Guide IVc: 3 years
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Baby Record - Guide IVd: 4 years
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Baby Record - Guide IVe: 5 years
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, and J Rourke; Revised July 2011
Well Child Check (2 Years)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Child Check (3 Years)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Child Check (4 Years)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Well Child Check (5 Years)
Adapted from the Rourke Baby Record: Evidence-Based Infant/Child Health Maintenance, by Drs. L Rourke, J Rourke and D Leduc. Revised Aug. 2009.
Baseline SF-36 Questionnaire Baseline SF-36 Questionnaire Baseline Womac Questionnaire
Baseline Womac Questionnaire
HUI-3: Baseline Questionnaire
HUI-3: Baseline Questionnaire
Physical Activity Form
Physical Activity Form
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Reference Document for Nightingale on Demand – March 2013