VISION

“MABINI COLLEGES shall

cultivate a CULTURE of
EXCELLENCE in Education.”

PERFORMANCE
CHECKLIST
Care and Dressing of Wound

Name of Student______________________________________________________________________
Year/ Group : _____________________ School Year : ___________________________________
Semester /Term : First Semester _____________ Second Semester __________ Summer
____________

Competency Rate

1 - Unsatisfactory (75- 80) 4 - Very Satisfactory ( 91 – 95)

2 - Fair (81 – 85) 5 - Outstanding (96 – 100)
3 - Satisfactory (86 – 90)

Performance Points 5 4 3 2 1 CI’s Remarks

I – KNOWLEDGE (40%)
1. Defines wound dressing
2. State the purposes of wound dressing
3. Enumerate special considerations.
4. Identify materials/equipments needed.
5. State preparation of the patient.
6. State the principles/rationale behind specific
action.
II – SKILLS / ABILITY (40%)
1. Perform hand hygiene.
2. Prepare needed equipments/supplies.
3. Check doctor’s order
4. Position patient according to site of the
wound.
5. Undo materials (binders/adhesives) securing
the dressing. Lift dressing off by touching the
outside portion only. If it is soiled, use individual
forceps.
6. Clean the wound with an antiseptic
prescribed as necessary. Discard the gauze or
the cotton used for cleansing after each stroke
over the wound.
a. Aseptic wound – start from incision
(consider the cleanest part) then away from it.
b. Septic wound – start from surrounding
area going towards the wound classified as the
dirtiest part)
7. Apply the ointment prescribed, if any, on the
wound and on the skin if drainage is present.
8. Cover the wound with sterile dressings and
secure in place with adhesive applied at edges.
 9. Clean and return all equipment, instrument
used.
10. Chart: time, dressing, appearance of wound,
character of drainage, observations and any
treatment (such as removal or insertion of
drains, packing or sutures).
III – ATTITUDE (20%)
1. Demonstrate preparedness, readiness and
confidence in the performance of the
procedure.
2. Accepts corrections/suggestions and shows
willingness to improve performance.
3. Answers questions politely and tactfully.
4. Shows respect and consideration of the
recipient of care.
5. Observe proper decorum and behave as a
mature student nurse.

Evaluated by: Conforme:

_____________________________ ______________________________
Signature over Printed Name / Date Signature over Printed
Name/Date
Clinical Instructor Student