CU-QMS-NURSING-0013

CAPITOL UNIVERSITY
COLLEGE OF NURSING
EVALUATION OF CLINICAL PERFORMANCE IN THE OPERATING ROOM
Name:______________________________________
Date of Assignment:_________________________

Year: _______________________
Final Rating:_________________

I:

Knowledge and Understanding

----------------------------------------------------------------------35%
At the end of 4 weeks, the student is expected to:
1. Explain the important scientific principles in the nursing care plan
Pre-operative and post operative patients in O.R.
--------------------------------------- 5%
2. Explain intelligently the Pathophysiology of the disease
condition of the patients ----------------------------------------------------------------------10%
3. Identify correctly signs and symptoms of impending complications
referable to the disease condition of the pre-operative patients
----------------- 5%
4. State the action, contraindications, usual dosage, and side effects if
Anesthetic agents and other drugs are used by the patient ------------------------------ 5%
5. State the correct surgical aseptic techniques in the performance
of nursing procedure in the O.R.
-----------------------------------------------------------10%

II:

Skills and Activities --------------------------------------------------------------------------------40%

1. Implements planned nursing care inside the O.R. by
a. preparing the patient physical and emotional
-------------------------------------- 5%
b. preparing the necessary instruments and articles needed for
the operation
---------------------------------------------------------------------5%
2. Perform effectively the duties and responsibilities
of the scrub nurse
------------------------------------------------------------------------------5%
3. Perform effectively the duties and responsibilities of the circulating
nurse
-----------------------------------------------------------------------------------------5%
4. Carries out physicians order accurately
----------------------------------------------- 5%
5. Writes accurate, concise and legible recording -----------------------------------5%
6. Communicates effectively with the operative team regarding
Patients condition in the O.R.
---------------------------------------------------------- 5%
7. Anticipates the needs of the operative team before, during
and after course of the operation
---------------------------------------------------------- 5%

III:

Professional and personal Assets

------------------------------------------------ 25%
1. Attitudes, appreciations and interest
a. Accept nursing service responsibilities with interest
and eagerness to work and to use learning opportunities ---------------------b. Accept constructive criticism and profit form it
---------------------------

5%
5%

c. Establishes good relationship with the patient,

Family and other health team members
--------------------------------------- 5%
d. Finishes work load and submits report on time
---------------------------- 5%
2. Personal Habits
a. Neat clean in appearance, and mindful of personal hygiene -------------------- 2%
b. Honest courteous and respectful
--------------------------------------------------3%
Total

100%

Instructor. Head nurse remark

_________________________
Student Signature

_____________________________
Instructor/Head nurses signature

Issue: 05 April 2006

Revision Code: 003