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Nursing Student Evaluation Form

This document provides an evaluation format for nursing students' operating theatre experience. It contains 20 criteria across 3 categories: personal and professional behavior, knowledge, and skills. Students are evaluated on a scale of 1 to 5 for each criteria, such as wearing proper theatre attire, arriving on time, knowledge of anatomy and procedures, preparing equipment, and following infection control measures. The total marks are recorded to assess their performance in the operating theatre.

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1K views1 page

Nursing Student Evaluation Form

This document provides an evaluation format for nursing students' operating theatre experience. It contains 20 criteria across 3 categories: personal and professional behavior, knowledge, and skills. Students are evaluated on a scale of 1 to 5 for each criteria, such as wearing proper theatre attire, arriving on time, knowledge of anatomy and procedures, preparing equipment, and following infection control measures. The total marks are recorded to assess their performance in the operating theatre.

Uploaded by

shiva
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Godavari Foundation’s

GODAVARI COLLEGE OF NURSING, JALGAON


SECOND YEAR BASIC B.Sc., NURSING
MEDICAL SURGICAL NURSING – I

EVALUATION FORMAT FOR THE OPERATION THEATRE EXPERIENCE

NAME OF THE STUDENT : …………………………………………………………………………………


BATCH : …………………………………………………………………………………
ACADEMIC YEAR : …………………………………………………………………………………
DATE OF EVALUATION : …………………………………………………………………………………..
NAME OF THE EVALUATOR : ……………………………………………………………………………………

Sr. No Content 5 4 3 2 1
I Personal & professional Behavior
1. Wears theatre correctly
2. Arrives and leaves punctually
3. Notably poised & effective even in stressful situation
4. Work with interest & willingness
5. Show’s respect to co-works well as a team member
II Knowledge
6. Anatomy & Surgical Procedure
7. Equipment & articles
8. Anesthesia, microbiology, legal responsibilities
III Skill
9. Collect & received all preoperative information about patient
10. Follows principals scrubbing growing & gloving
11. Arranges trolley according to procedure
13. Works efficiently as a circulating nurse
14. Assists the anesthetist operation theater environment
15. Follows strict infection control measures
16. Maintains therapeutic operation theatre environment
17. Checks adequacy of equipment & supplies
18. Records & reports immediately
19. Provides appropriate postoperative care
20. Follows cleaning packing & sterilization of equipment
TOTAL MARKS

SIGN OF STUDENT SIGN OF TEACHER

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