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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

List of master templates  
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