Research Tool

This questionnaire is distributed in order to gather information

regarding the extent of utilization of Level III students in the Nursing Care

Plan based on the appropriateness, applicability, and effectiveness of

interventions being rendered. Through your participation, the study will be

able to make possible recommendations that will highlight the functions of

nursing care plan and the guidelines for its appropriate utilization. Kindly

check the number of your choice in answering this questionnaire. Please

answer the questions as honestly as possible. Thank you very much for your

cooperation.

Part I. Profile of the Respondent

Direction: Kindly fill up the following with the correct details about yourself.

Please don’t leave any item unanswered.

1.1 Age:__________

1.2 Year level:_______________

1.3 Gender

Male ( ) Female ( )
Part II. Extent of Utilization of the Nursing Care Plan Questionnaire

Direction: Kindly check the number of your choice in answering this

questionnaire. Please answer honestly.

Legend: 5 – always, 4 – often, 3 – occasional, 2 –sometimes, 1 -never

 5 4 3 2 1
A. Planning

1. I gather relevant data through

observation.

2. I gather relevant data through

interacting with my patient and the

significant others.

3. I utilize Physical Assessment as part

of my data gathering.

4. During Assessment, I don’t draw

conclusion and judgment but I focus

on comprehensive data base that

reflects the health status of my client.

5. I review my data for any

inconsistencies.

6. I determine the relationships that

exist between the data gathered.

7. I determine if the client’s perception

of the problem I collected needs

immediate intervention.

8. I formulate my nursing diagnoses by

reviewing the problem focus that is

identified.

9. In my planning, I consider my clients

family resources for care.