Arellano University 3058 Jose Abad Santos Campus, Pasay City College of Nursing

EVALUATION TOOL NURSING PROCESS

Name:_______________________________________________ Evaluator _____________________________________________ DIRECTION: Rate the learner based on the competencies listed below. Key: 4 - COMPETENT 3 - ACCEPTABLE 2 - NEEDS IMPROVEMENT
1 - UNACCEPTABLE

Rating_________ Date __________

( Task was done thoroughly and precisely) (Task was done well enough ) ( Task was done with some difficulty)
(

Criterion
4 3 2 1

I. ASSESSMENT
A. History/POF/ P A data are: 1. Complete/comprehensive 2. Accurate 4. Analyses are relevant & comorehensive

B. Laboratory and Diagnostic Examinations:
1. Complete/comprehensive 2. Analysis is relevant to disease process

C. Drug Analysis:
1. Complete lists 2. Comprehensively analyzed D. Ecologic Model: 1. Correct model 2. Correct and complete identification of predisposing factors 3. Comprehensive analysis 4. Adequate thera[peautic recommendations

Categorized as to Development. Attainable/realistic 5. Correct format 3. Nursing Care Plan 4 3 2 1 A. Rationale 1. Analysis 1. Objective 1. Supplemental. implications are arranged from minor to major a. Timebounded E. Relevant/ appropriate 2. Relates to the cause of the problem 2. Prioritized 3. Evaluation 1.Criterion II. Supported by complete relevant cues according to IOM B. Primary cause C. Reference 1. All analysis are well documented 2. appropriateness. Diagnosis 1.4 where 4 = very satisfactory: exhibits competency independently 3 = satisfactory: exhibits competency with minimal supervision 2 = fair : exhibis competency fairly with close supervision. Goal 1. Books used are recent & relevant to the subject matter TOTAL Rate the students from 1 . Measurable 4. Time bounded D. priority problem is correctly identified based on jurisdiction. Stated correctly 2. adequacy. III. Interventions 1. Problem List 1. efficiency. Relates to the problem 2. acceptability IV. Scientific and Documented 2. Evaluates if objective was met based on criteria stated ( effectiveness. problems identified are correct & supported by relevant cues 3. Intermediate cause c. Immediate cause b. Specific 3. Scientific analysis contains general cause of the problem 2. centered on the client 3. Facilitative F. Precisely explains the why/ how of the interventions G. Analysis/ norms are appropriate to data collected 2. Supplemental. 1 = needs improvement : needs to develop competency 0 = no competency : not performed Grading System: Raw Score/Perfect Score x 50+50 Perfect Score = 128 4x 3x 2x 1x = = = = ______________ ______________________ . Invove members of the family 4.

Student's Signature ________________________________ Instructor's signature and date .

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