Free Nursing Progress Note Template & AI Progress Note Maker

A Nursing Progress Note, created with Template.net's AI-powered progress note builder, is a dated record one nurse writes after a shift or encounter, showing patient identification, the date of the entry, and a table to document detailed observations. It is used for recording vital signs, skin condition, behavior changes, and other key care details by nurses, healthcare practitioners, and care teams across residential, hospital, and community settings.

A Nursing Progress Note, created with Template.net's AI-powered progress note builder, is a dated record one nurse writes after a shift or encounter, showing patient identification, the date of the entry, and a table to document detailed observations. It is used for recording vital signs, skin condition, behavior changes, and other key care details by nurses, healthcare practitioners, and care teams across residential, hospital, and community settings.

How to Create a Nursing Progress Note for Free?

Creating a professional Nursing Progress Note is quick and straightforward.
  1. Customize a Free Template
    Start with this free editable and printable nursing progress note template and personalize it online for shift observations, behavior tracking, or wound care reports. (or )
  2. Generate an On-Brand Nursing Progress Note with AI
    Describe the encounter you just finished or upload your existing care plan or shift summary, and AI will build the actual editable note with patient identification and a dated table, drafted from your input, ready to review, correct, and sign.
  3. Edit in the HTML5 Editor
    Adjust the patient name and date of birth, the date of the entry, and the table with dated observations and signatures; rename observation rows or change note options to suit your facility’s documentation style.
  4. Download a Printable PDF
    Download the completed note as a printable PDF to file in the patient record, hand over at shift end, or keep a copy for your own documentation.

Nursing Progress Note Observations and How Each One Is Recorded

This template already lays out a practice name and logo, the title bar with “Progress Note,” and a patient identification row, and the list below sets out how each entry is actually recorded.
Document these observations the way each one is normally recorded — vital signs (measured values with the time they were taken), pain level (rated on a 0-10 scale), skin integrity (described by site and appearance), mobility status (noted as yes/no with a follow-up description), mental status (checked from a set of options indicating alertness or confusion), fluid intake (logged with amounts and times), medication administration (timed entry naming medication given and dose), wound care observations (described by site, size, and appearance), behavioral changes (narrative sentence in the free-text box), appetite and nutrition (noted as a percentage of meals eaten or narrative), oxygen saturation (measured percentage with time taken), bowel movements (yes/no with follow-up details on frequency and consistency), sleep patterns (described or rated by duration and quality), emotional state (rated or described in options or narrative), and family or visitor interactions (timed entry naming who was contacted and their response).

Free Nursing Progress Note Template & AI Progress Note Builder

By Template.net

Progress Note Generator