REGISTRATION NUMBER ……………………………………………………….

EXAMINATION NUMBER ……………………………………………

THE UNITED REPUBLIC OF TANZANIA

MINISTRY OF HEALTH

NMT 06102: CARE OF THE PATIENT WITH OBSTRETIC EMEGENCY CONDITIONS

SECTION B: ASSESSMENT OF LEARNER COMPETENCES

Instructions
 This checklist is used to assess learners’ competences on every Module during end of semester II practical examination
 The setting of practical examination is in health care facility (OPD, Maternity, Gynecological ward and Other Wards)
 This examination should not be conducted in skills laboratory
 Time allocated is 1 hour (50 minutes for procedure and 10 minutes for evaluation)
 The assessor is required to assign maximum score when sub-criteria is done/observed, if not done or done incorrectly assign zero (0) and write
comment in the comments ‘column
 Write the total score at the end of assessment
Formula:
Total sub criterion achieved in section (A + B) x 100%
Total sub-criterion in section (A+B)
 Write the final average score obtained by internal and external examiner at the top right corner after getting the average score from internal and external
examiner
 Write general comments below the checklist, if any, after the examination
 NOTE: Some of the steps/tasks may be performed simultaneously

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CHECKLIST 4: FOR CHECKING VITAL SIGNS

(To be used to assess performance)
S/N Description of criterion Sub-criterion Maximum Obtained Comments
score score
1.0 Prior preparation and 1.1 Greets patient and introduces self 01
Introduction 1.2 Tells the client (s) what is going to be done 01
2.1 Obtains client’s consent 01
2.2 Prepares hand washing/hygiene requirements 01
2.3 Performs hand washing/hygiene 02
2.4 Prepares conducive environment for medication (privacy) 01
2.5 Encourages client (s) to express any concern/physical 01
needs.
3.0 Preparation of equipment 3.1 Prepares patients file 01
and supplies 4.1 Prepares tray 01
5.1 Prepares observation chart 01
6.1 Prepares pen 01
7.1 Prepares clinical thermometer 01
8.1 Prepares gall port with swab 01
9.1 Prepares watch 01
10.1 Prepares Blood pressure machine (stethoscope and 01
sphygmomanometer)
11.1 Prepares spirit 01
12.1 Prepares receiver 01
13.0 Taking body temperature 13.1 Screen the patient 01
14.1 Places patient in a comfortable position 01
15.1 Wipes the thermometer from the stem to bulb using 02
swabs
16.1 Reads thermometer at the eyes level before inserting to 02
patient’s axilla or groin
17.1 Shakes thermometer until the mercury reads below 35 0 02
C

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18.1 Swabs the skin in the axilla or groin 02

19.1 Places thermometer in axilla or groin 01
20.1 Removes thermometer from patient’s axilla or groin after 01
5 minutes
21.1 Reads the thermometer at the eye level after removing 02
thermometer
22.1 Wipes the thermometer from the stem to bulb using 02
swabs
23.0 Taking pulse rate 23.1 Places the patient hand on the chest 02
24.1 Places the first three fingers in the radial artery 02
25.1 Places the fingers to the radial artery and feels the pulse 02
forceful against finger
26.1 Counts the beats for one minute 02
27.0 Taking respiratory rate While holding patient hand on the chest 01
27.1 Looks for chest movement
28.1 Counts the number of respirations for one minute 02
29.0 Taking blood pressure 29.1 Applies cuff correctly to the patient or client upper arm 02
above the elbow
30.1 Locates the brachial pulse at the front of elbow joint by 02
pressing three fingers over it
31.1 Pumps air into the cuff to late until pulsation is no longer 02
felt in fingers
32.1 Applies stethoscope and press at the brachial artery 02
33.1 Releases the pressure slowly while listens for the first 02
beat as the mercury descends
34.1 Notes the last beat as the mercury descends 02
35.1 Removes the stethoscope from ears 01
36.0 Refer patient for further 36.1 Ensures availability of transport 01
management 37.1 Assembles equipment to be used in caring patient 01
during transfer
38.1 Fills the referral form 02

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39.1 Identifies relative who will escort patient if applicable 01

40.1 Identifies nurse to escort patient 01
41.1 Handles the patient to the escorting nurse 01
42.0 Documentation and feedback 1.1 Gives feedback to the patient /client about the procedure 01
42.1 Documents the procedure 02
42.2 Reports to the Nurse in charge 01
43.1 Decontaminates equipment 01
Total score 0

General Comments:
…………………………………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………

Name of the Internal Examiner: ………………………………………………Signature…………………………….

Name of the External Examiner: ………………………………………………Signature……………………………