WESLEYAN

AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

CONAMS
A.Y. 2021-2022
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

PERFORMANCE EVALUATION TOOL
NCM 107 – CARE OF MOTHER, CHILD, AND FAMILY

DIRECTIONS:
 The evaluation tool will be discussed by the clinical instructor/s.
 During the discussion, the instructor/s may demonstrate the procedures or may use
video viewing for students’ orientation.
 The students should be given sufficient time to prepare for the return demonstration.
 The students will do the return demonstration based on the checklist given.
 The following rating scale shall be used in grading student’s performance:

2 points - able to perform

Perform the procedure safely and accurately in a very consistent and
independent manner without supportive assistance from the instructors.
Perform a difficult action quickly and skillfully
Spends minimal time on task
Focuses on client while giving care

1 points - able to perform with assistance

Perform the procedure safely and accurately with frequent guidance and
supervision from the instructor.
Demonstrate incomplete skills in some part of the procedure.
Takes longer time to complete the procedure.

0 point - unable to perform

Unable to perform procedure even under close supervision of guidance
Require continuous, supportive and directive cues
Performs in unskilled manner

 At the end of each laboratory session, the instructor/s will give remarks based on the
student’s performance in accordance to the procedures indicated.
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

PERFORMANCE EVALUATION TOOL
NCM 107 – CARE OF MOTHER, CHILD, AND FAMILY

NAME OF STUDENT: _____________________

Block #______

PROCEDURE: ANTHROPOMETRICS MEASUREMENT

I. PURPOSE 2 1 0 REMARKS

1 To assess the newborn’s well being

II. ASSESSMENT RATIONALE 2 1 0 REMARKS

2 1.Check if the weighing

scale is functioning well or
not
3 2.Check for airdrafts. To prevent hypothermia.
Adjust the room’s
temperature.
4 3.Verify the procedure to To ensure accuracy and
be done through the prevent errors.
doctor’s orders in the
infant’s chart.
5 4.Check for the Identifies safety hazards
completeness and that could cause or
functionality of the potentially lead to harm.
materials needed
III. PLANNING
6 1.Gather the necessary
materials
7 a. Weighing scale with
lining on top
8 b. Tape measure
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AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

9 c. Pair of gloves
10 d. Adequate source of
light
e. Examination table

IV. PROCEDURE RATIONALE 2 1 0 REMARKS

11 1.Do hand hygiene and Hand hygiene and PPE

wear gloves. Observe prevent the spread of
appropriate infection microorganisms.
control procedures. PPE is required based on
transmission precautions.
12 2.Place the infant on top of
the flannel placed on one
side of the examination
table.
13 3.Remove infant’s clothing Infant’s clothing serves an
and place the infant on top additional weight.
of the weighing scale.
14 4.With one hand above the To prevent sudden
baby’s body, quickly note movement of the infant
for the weight. that might lead to falling.
15 5.Bring back the infant on To prevent head lag
top of the flannel,
supporting the occipital
area and buttocks.
16 6.Cover the body parts To prevent hypothermia
which are not included in
the procedure.
17 7.Start the procedure in a
cephalo-caudal technique
18 8.With the infant lying on a
supine position, measure
the head circumference
by placing the tape
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AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

measure behind the
infant’s head, running
across the infant’s most
prominent head part, which
is slightly above the brow
line
Normal Value: 34-35 cms
19 9.Measure the chest
circumference. With the
infant lying on a supine
position, bring down the
tape measure behind the
infant’s back, and run the
tape measure across the
infant’s chest, should be
along the nipple line
Normal Value:31-33 cms.
20 10.Measure the abdominal
circumference
*With the infant lying on a
supine position, bring down
the tape measure behind
the infant’s waste line and
run it across the abdominal
area slightly above the
umbilical area
Normal value: 31-33 cms
21 11.Measure the length
*Position the infant in a
lateral position (left or right)
*The length of your non
dominant arm should be
supporting the length of the
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AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

infant’s body
22 12.Place the tape measure
starting from the back of
the head, (follow the
contour of the infant’s
body)
23 13.Run the tape measure
along with the infant’s
spine, press against the
buttocks, press against the
popliteal area and press
against the heel side
Normal Value: 50cms
24 14.Make the infant warm To prevent hypothermia.
and comfortable.
25 15.Gather the materials, To maintain the
discard non-reusable and orderliness of the
rearrange reusable ones. workplace.

26 16.Remove gloves, discard Proper removal prevents

it and wash hands.
27 17.Document the
procedure and results on
the infant’s chart. Report
any abnormal findings to
the attending physician.
contact with and the
spread of microorganisms.
Provides record of the
client’s care and serves as
a baseline for further
management.

TOTAL SCORE
 WESLEYAN
AN AUTONOMOUS METHODIST UNIVERSITY

COLLEGE OF NURSING AND ALLIED MEDICAL SCIENCES

Student’s Signature:_______________ Instructor’ Signature________________
Date:_____ Date:__________

Comments/Suggestions:__________________________________________________