COLLEGE OF NURSING

Km. 23 Sumulong Hi-way Brgy. Sta Cruz, Antipolo City

Rubrics for Skills Demonstration
Name of Student:

Group No. Time: : Date of Clinical Rotation:

Name of Clinical Instructor:

CRITERIA 1 2 3 4

1. ASSESSMENT Did not perform Lacks assessment Performs Performs

• • Identification any client on the client prior assessment thorough
Route/site of assessment prior to the procedure hazardly, but assessment on
• procedure to the procedure needing full completely, on the client prior
Safety Client and did not assistance and the client prior to to the
interaction the procedure procedure
observe safety reminder on client
with minimal
precautions safety during the without any
assistance and
during the entire entire client assistance at all
inconsistently
client interaction interaction; and ensures
ensures client
unless reminded; manifests some safety during
safety during the
very hesitant. hesitation. entire client the entire client
interaction; interaction;
manifests very manifests
minimal selfconfidence
hesitation.

Rubrics for Skills Demonstration Page 1 of 6

 COLLEGE OF NURSING
Km. 23 Sumulong Hi-way Brgy. Sta Cruz, Antipolo City
Rubrics for Skills Demonstration
Name of Student:
CRITERIA 1 2 3 4

2. PLANNING Did not prepare Lacks the major Prepares the Prepares all the
• Privacy the materials materials needed materials needed materials
• Completeness of needed before for the procedure but lacks 1-2 needed before
materials going to the before going to minor supplies going to the
• Purpose of the client’s bedside. the client’s before going to client’s bedside.
Did not explain bedside. the client’s Communicates
procedure
the purpose of bedside.
• Client interaction Inconsistent and effectively and
the procedure and Inconsistent in:
needs constant explains
has no eye reminder in: communicating
correctly the
contact. Did not communicating and explaining the
purpose of the
provide any purpose of the
and explaining the procedure
privacy. procedure, eye
purpose of the having good
procedure, eye contact, and in
providing privacy eye contact.
contact, and in
to the client Provides utmost
providing privacy
during the entire privacy during
to the client
procedure. the entire
during the entire
procedure.
procedure

Rubrics for Skills Demonstration Page 2 of 6

 COLLEGE OF NURSING
Km. 23 Sumulong Hi-way Brgy. Sta Cruz, Antipolo City
Rubrics for Skills Demonstration
Name of Student:
CRITERIA 1 2 3 4
3. NTERVENTION Did not perform Performs aseptic Performs aseptic Performs
• Proper positioning aseptic technique technique and technique and appropriate
• Aseptic technique and infection implements implements aseptic
• Body mechanic control measures infection control infection control technique and
• Appropriate during the entire measures during measures during implements
sequence of the entire infection control
procedure. Did the entire
procedure procedure with measures during
not place the procedure with
full supervision. the entire
• Client interaction client in proper some supervision.
Places the client in procedure
position and did the appropriate Places the client in without
not observe position and the appropriate supervision.
proper body observes proper position and Places the client
mechanics during body mechanics observes proper in appropriate
the entire. Very with full assistance body mechanics position and
hesitant in during the entire. with minimal observes proper
accomplishing the With some supervision during body mechanics
procedure and in hesitation in the entire. With without
accomplishing the very minimal supervision
the incorrect
procedure in the during the
sequence. hesitation in
correct sequence entire.
accomplishing the
and with Accomplishes
assistance. procedure in the
the procedure
correct sequence
with ease and
and with minimal
confidence in the
assistance.
correct
sequence.

Rubrics for Skills Demonstration Page 3 of 6


Km. 23 Sumulong Hi-way Brgy. Sta Cruz, Antipolo City
Name of Student:
CRITERIA
4. EVALUATION
• Client response
• Documentation
• Proper waste
disposal
• Aseptic technique
Client interaction
Rubrics for Skills Demonstration
COLLEGE OF NURSING
Rubrics for Skills Demonstration
1 2 3 4
Did not evaluate Evaluates the Evaluates the Evaluates client
client response to client response to client response to response to the
the procedure and the procedure and the procedure procedure and
intervention(s). intervention(s) and intervention(s)
Did not dispose with full intervention(s) without
any of the soiled supervision and with some
supervision.
materials assistance. Needs supervision and
Disposes soiled
properly. Did not assistance.
reminder on the materials in the
perform hand Needs some
proper disposal of appropriate bin
hygiene at all and reminder on the
soiled materials and performs
any proper disposal of
into the soiled materials proper hand
documentation of
appropriate bin into the hygiene.
the
and in performing appropriate bin Performs
intervention(s).
proper hand and in performing complete and
hygiene. proper hand accurate
Performs hygiene. documentation
incorrect Performs of the
documentation of documentation of
intervention(s).
the the
intervention(s). intervention(s)
with minimal
error.
Page 4 of 6
 COLLEGE OF NURSING
Km. 23 Sumulong Hi-way Brgy. Sta Cruz, Antipolo City
Rubrics for Skills Demonstration
Name of Student:
CRITERIA 1 2 3 4
Dress Code Frank violation of 2 or more 1 component of Uniform follows
Uniform neat and clean, clinical dress code. components of clinical uniform is the university
white shoes, watch, post clinical uniform are missing. policy & its
earring, no piercing jewelry, missing. expected
hair neat and pulled back, components
short nails

Electronic Devices Warning 3: Student

Use of electronic devices is 0 Points. Warning 2: Warning 1: compliant with
prohibited. Attention was Warned once by following
called regarding the instructor. electronic
non-compliance. devices policy
and procedure.

GRADING:
To compute: Example:
1-4, Criteria= 80% NGT: Score 16pts.
5, criteria-20% 16 X 60 =960/16= 60 + 40 = 100
DRESS CODE: 4pts
4 X 60= 240/4= 60 + 40= 100
NGT= 100 x 80%= 80
DRESS CODE- 100 x 20%= 20
NGT SCORE= 100

Rubrics for Skills Demonstration Page 5 of 6

 COLLEGE OF NURSING
Km. 23 Sumulong Hi-way Brgy. Sta Cruz, Antipolo City
Rubrics for Skills Demonstration
Name of Student:

No. PROCEDURE DATE SCORE CI. Signature

Should be completed at the last day of laboratory rotation No. of Make-up Duty

Date(s) of Tardiness

Date(s) of Absences

Comments:

Instructor Signature:

Student Signature: _

Date:

Reviewed by: Approved by:

NORBERT LEWIN SOLIVEN LPT, MAN, RN EVANGELINE M. TERUEL MAN, RN

Practicum Coordinator Dean, College of Nursing
OLFU – Antipolo Campus OLFU – Antipolo Campus

Rubrics for Skills Demonstration Page 6 of 6