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Palestinian National Authority ‫الســلطــــــــــة الـوطنيـــــة‬

Ministry of Education & Higher Education


General Administration of Colleges
‫الفلســطينيـــــة‬
&Vocational ,Technical Education ‫وزارة التربيــــــة والتعليــــــــــم‬
‫ االمتحان التطبيقي الشامل‬/ ‫العــــالــــي دائرة االمتحانات‬
‫م‬2015 ‫اإلدارة العامة للكليات والتعليم المهني‬
‫والتقني‬
Nursing Procedure Evaluation Sheet
Student Name:________________________.
Procedure:__________________________________________________ .
Evaluation Committee: 1. _________________. 2.__________________.

Procedure 0 1 2 3 4 5
1- Equipment prepared
2- Assure privacy
3. Explain procedure to the patient
4- Consider priorities.
5- Wash hands before and after
6. Doing procedure safely& accurately
7. Adapts in case of lack of resources & equipments.
8. Completed all steps of procedure.
9. Consider universal precautions (sterility)
10. Uses appropriate language and terminology in
documentation. Neatness and clear.

Critical Points: For every critical point violation subtract 10 marks (-10% of total grade)

Grades Signatures
1. 1.
Total Grade 60 Point
2. 2.
Average final grade:

1 ‫ من‬1 ‫الصفحة‬

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