log book privileging & credentialing (medical...
TRANSCRIPT
LOG BOOK
PRIVILEGING &
CREDENTIALING
(MEDICAL OFFICER)
HOSPITAL TUANKU JA’AFAR
SEREMBAN NEGERI SEMBILAN DARUL KHUSUS
2
DEPARTMENT OF
RADIOLOGY
NAME : -------------------------------------------
DATE OF POSTING :---------------------------
DATE OF COMPLETION :--------------------- Approved by:............................................
Date : ........................................................
3
NO PROCEDURE OBSERVE/
ASSIST
REPORT /PERFORM
WITH SUPERVISION
1. CXR – Reporting
- 100
2. Reporting of other plain radiographs - 100
3. Basic Abdominal Ultrasound and reporting
20 100
4. Doppler Ultrasound and reporting (for DVT only)
10 50
5. CT Brain and reporting (Trauma & Stroke only)
50 100
6. CT of other parts, and reporting 50 100
7. Fluoroscopy 20 30
8. Mammogram – Reporting 3 5
9. MRI – Reporting 3 5
10. Interventional Procedures 5 10
4
PROCEDURE NO 1 : CXR – REPORTING
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
RE
PO
RT
WIT
H S
UP
ER
VIS
ION
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
5
38
39
40 R
EP
OR
T W
ITH
SU
PE
RV
ISIO
N
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
67
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
6
79 R
EP
OR
T W
ITH
SU
PE
RV
ISIO
N
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
PROCEDURE NO 2 : REPORTING OF OTHER PLAIN RADIOGRAPHS
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
RE
PO
RT
WIT
H S
UP
ER
VIS
ION
2
3
4
5
6
7
8
9
10
11
12
13
7
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
RE
PO
RT
WIT
H S
UP
ER
VIS
ION
41
42
43
44
45
46
47
48
49
50
51
52
53
54
8
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
RE
PO
RT
WIT
H S
UP
ER
VIS
ION
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
9
96
97
98
99
100
PROCEDURE NO 3 : BASIC ABDOMINAL ULTRASOUND AND REPORTING
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
OB
SE
RV
E/A
SS
IST
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
1
2
3
4
5
6
7
8
9
10
11
10
12
13
14
15
16
17
18
19
20
21
PE
RF
OR
M/R
EP
OR
T W
ITH
SU
PE
RV
ISIO
N
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
11
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
12
94
95
96
97
98
99
100
PROCEDURE NO 4 : DOPPLER ULTRASOUND AND REPORTING (FOR DVT ONLY)
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
OB
SE
RV
E
2
3
4
5
6
7
8
9
10
1
PE
RF
OR
M/R
EP
OR
T W
ITH
SU
PE
RV
ISIO
N
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
13
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
41
42
43
44
45
46
47
48
49
50
PROCEDURE NO 5 : CT BRAIN AND REPORTING (TRAUMA & STROKE ONLY)
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
OB
SE
RV
E
2
3
4
5
6
14
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
OB
SE
RV
E
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
15
48
49
50
1
PE
RF
OR
M/R
EP
OR
T U
ND
ER
SU
PE
RV
ISIO
N
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
16
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
17
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
PROCEDURE NO 6 : CT OF OTHER PARTS, AND REPORTING
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
OB
SE
RV
E
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
18
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
1
2
3
4
5
6
7
19
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
PE
RF
OR
M/R
EP
OR
T
WIT
H S
UP
ER
VIS
ION
42
43
44
45
46
47
48
20
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
21
90
91
92
93
94
95
96
97
98
99
100
PROCEDURE NO 7 : FLUOROSCOPY
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
OB
SE
RV
E/A
SS
IST
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
1
PE
RF
OR
M/R
EP
O
RT
WIT
H
SU
PE
RV
ISO
N
2
3
4
5
6
22
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
PROCEDURE NO 8 : MAMMOGRAM – REPORTING
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
OB
SE
R
VE
2
3
1
RE
PO
RT
WIT
H
SU
PE
RV
ISIO
N
2
3
4
5
23
PROCEDURE NO 9 : MRI – REPORTING
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
OB
SE
R
VE
2
3
1
RE
PO
RT
WIT
H
SU
PE
RV
ISO
N
2
3
4
5
PROCEDURE NO 10 : INTERVENTIONAL PROCEDURES
NO
DATE
PATIENT NAME
NRIC / RN
COMMENTS OUTCOME
SUPERVISOR
1
OB
SE
RV
E
2
3
4
5
1
PE
RF
OR
M/R
EP
OR
T W
ITH
SU
PE
RV
ISIO
N
2
3
4
5
6
7
8
9
10