EVALUATION FORMATS of OBG II

K.G.M.U.
INSTITUTE OF NURSING, LUCKNOW

OBSTETRICAL & GYNECOLOGICAL NURSING
EVALUATION CRITERIA FOR NURSING CARE PLAN
Name: ________________ Roll No._______________
Topic: ___________________ Marks obtained: _____/25

S No. Criteria Marks Obtained
marks
1. Patient History 2
2. Physical Examination and Diagnosis 3
3. Assessment of priority needs and planning of care 5
4. Nursing Intervention/ Nursing Theory Application 10
5. Evaluation of care(progress note) 3
6. Health Education and Discharge planning 1
7. Bibliography 1
Total 25
REMARKS:
SIGNATURE OF EVALUATOR
SIGNATURE OF THE STUDENT
K.G.M.U. INSTITUTE OF NURSING, LUCKNOW

EVALUATION CRITERIA FOR CASE PRESENTATION
Name: ________________ Roll No._______________

marks
3. Case in Detail 06
4. Comparison of case In Book and in Book in Patient 10
6. Nursing Intervention 05
9. Style of presentation 02
10. AV aids language and Voice modulation 02
11. Bibliography 02
Total 50
REMARKS:

EVALUATION CRITERIA FOR CASE STUDY
Name: ________________ Roll No._______________

marks
3. Case in Detail 06
4. Comparison of case In Book and in Book in Patient 10
6. Nursing Intervention/ Nursing Theory application 10
9. Bibliography 02
Total 50
REMARKS:

EVALUATION CRITERIA FOR HEALTH TALK
Name: ________________ Roll No._______________
Area of experience:________________ Topic: ________________

Marks obtained: _____/25
S No. Activity Excellent Good Average Poor V. Poor
5 4 3 2 1
1. Preparation of content
2. Arrangement of group
3. Use/preparation of A.V Aids
4. Language, Voice audibility
Grooming and mannerism
5. Recap, Discussion and
conversation Response of group
Total
REMARKS:
EVALUATION CRITERIA FOR DRUG PRESENTATION
Name: ________________ Roll No._______________

Marks obtained: _________/20
S No. Criteria Marks Scored Remarks
1. Name of the Drug 1
2. Composition/Pharmacological name 1
3. Action 5
4. Indication 1
5. Contraindication 2
6. Dosage and Route 3
7. Side effects 3
8. Nursing Responsibility 2
9. Promptness and Neatness 2
Total 10
REMARKS:

EVALUATION CRITERIA FOR GROUP PROJECT
Name of Group : ________________ Year _____________
Topic: ________________ Marks obtained: _____/50
S No. Activity Excellent Very Good Fair Poor
5 Good 3 2 1
4
1. Material and theme of the project
2. Place arrangement
3. Punctuality and Group initiation
4. Group participation and discipline
5. Co-ordination among group
6. A.V. Aids
7. Explanation
8. Group control
9. Use of special attraction
10. Recap and feed back
Total
REMARKS:
SIGNATURE OF CLINICAL SUPERVISOR
SIGNATURE OF THE SUBJECT INCHARGE

EVALUATION CRITERIA FOR OBSERVATION REPORT / STUDY
Name: ________________ Roll No._______________

marks
1. Physical setup of area and Staffing Pattern 3
2. General Assessment of patient and History of present 2
condition
3. Steps of Nursing care / procedure with rationale 7
4. Evaluation of Patient condition Discharge plan 2
5. Bibliography 1
Total 15
REMARKS:

EVALUATION CRITERIA FOR PROCEDURE REPORT
Name: ________________ Roll No._______________

marks
1. Assessment of patient condition 3
2. History of present condition / disease 8
3. Indication And Contraindication of Procedure 6
4. Steps of procedure with rationale acc. to checklist 15
5. After care and Evaluation of Patient condition 6
6. Recording and Reporting 5
7. Discharge Plan 5
8. Bibliography 2
Total 50
REMARKS:

K.G.M.U. INSTITUTE OF NURSING , LUCKNOW
OBSTETRICAL & GYNECOLOGICAL NURSING II
EVALUATION CRITERIA FOR INSTRUMENT BOOK
Name: ________________ Roll No._______________

1. Area of posting 1
2. Index 2
3. Name of instrument or Trolley setup 2
4. Description of Instrument with diagrams 4
and labeling
5. Purposes and Usage of instrument 10
6. Nursing Responsibility 5
Total 25
REMARKS:

EVALUATION CRITERIA FOR CASE BOOK
Name: ________________ Roll No._______________
Area of experience:________________
1. Punctuality in submission 5
2. Punctuality in correction 6
3. Repetition of mistakes 5
4. Originality of data 5
5. Accuracy in correction and writing 6
6. Writing of logical findings 5
7. Writing of priority Nursing care plan 15
Total 50
REMARKS:

EVALUATION CRITERIA FOR LOG BOOK
Name: ________________ Roll No._______________
Area of experience:________________
1. Attendance 5
2. Punctuality and correction 10
3. Accuracy in correction and writing 15
4. Log book Completion on time 15
Total 50
REMARKS:

EVALUATION FORMATS of OBG II

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K.G.M.U.

INSTITUTE OF NURSING, LUCKNOW

Topic: ___________________ Marks obtained: _____/25

2. Physical Examination and Diagnosis 3

3. Assessment of priority needs and planning of care 5

4. Nursing Intervention/ Nursing Theory Application 10

5. Evaluation of care(progress note) 3

6. Health Education and Discharge planning 1

SIGNATURE OF THE STUDENT

K.G.M.U. INSTITUTE OF NURSING, LUCKNOW

Topic: ___________________ Marks obtained: _____/50

SIGNATURE OF THE STUDENT

Name: ________________ Roll No._______________

Topic: ___________________ Marks obtained: _____/50

SIGNATURE OF THE STUDENT

K.G.M.U. INSTITUTE OF NURSING, LUCKNOW

Name: ________________ Roll No._______________

Area of experience:________________ Topic: ________________

Name: ________________ Roll No._______________

Area of experience:________________ Topic: ________________

SIGNATURE OF THE STUDENT

K.G.M.U. INSTITUTE OF NURSING, LUCKNOW

SIGNATURE OF CLINICAL SUPERVISOR

SIGNATURE OF THE SUBJECT INCHARGE

Name: ________________ Roll No._______________

Topic: ___________________ Marks obtained: _____/15

SIGNATURE OF THE STUDENT

K.G.M.U. INSTITUTE OF NURSING, LUCKNOW

Name: ________________ Roll No._______________

Topic: ___________________ Marks obtained: _____/50

SIGNATURE OF THE STUDENT

EVALUATION CRITERIA FOR INSTRUMENT BOOK

Name: ________________ Roll No._______________

Area of experience:________________ Topic: ________________

SIGNATURE OF THE STUDENT

K.G.M.U. INSTITUTE OF NURSING, LUCKNOW

Name: ________________ Roll No._______________

SIGNATURE OF THE STUDENT

Name: ________________ Roll No._______________

SIGNATURE OF THE STUDENT

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