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Head Nursing Performance Evaluation Form

Head Nursing Performance Evaluation Form

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Published by: twothumbs on Jul 05, 2010
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12/21/2012

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URDANETA CITY UNIVERSITY

(formerly City Colleges of Urdaneta)
San Vicente West, Urdaneta City, Philippines-2428
COLLEGE OF NURSING


PERFORMANCE RATING FORM FOR STUDENT HEADNURSING

Name:___________________________
Area:____________________________
Shift:____________________________

Percent Required Actual Performance

I. Personality 20%

1. Appearance 5% _____________
2. Courtesy 5% _____________
3. Health & emotional
stability 5% _____________
4. Integrity & honesty 5% _____________


II. Skills in Nursing 70%

1. Quality of work 15% ______________
2. Dependability, Attendance
& Punctuality 5% ______________
3. Communication (Oral
& Written) 10% ______________
4. Leadership 10% ______________
5. Relationship with
patient 10% ______________
6. Relationship with
Co-workers 10% ______________
7. Care of Hospital Equip.
And Records 10% ______________

III. Attitude to Supervision 10%

1. Criticism 3% ______________
2. Cooperation & interest 4% ______________
3. Confidence 3% ______________


IV. Total Percent 100% Rating: ______________

V. Remarks


__________________________ __________________________
HEADNURSE NURSE SUPERVISOR



_________________________ ZOSIMA C. GARIN
CHIEF NURSE DEAN, COLLEGE OF NURSING

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