OUR LADY OF FATIMA UNIVERSITY
College of Nursing-Valenzuela City
STUDENT NAME
PROGRAM Bachelor of Science in Nursing
YEAR & SECTION
NCM 104
INSTRUCTOR
Care of Clients with Alteration in
COURSE
Perception and Coordination
DATE
(SKILLS LABORATORY)
PROCEDURE : TRANSFERRING PATIENT FROM BED TO WHEELCHAIR
EXPECTED OUTCOME : The student should properly and efficiently transfer a patient from bed to
Wheelchair considering his/her comfort and safety.
ASSESSMENT TASK : Return Demonstration
Assessment Exceptional Good Average Poor
SCORE
Dimension (3) (2) (1) (0)
Washed hands Washed hands Washed hands Failed to wash
properly and skillfully following the following the hands properly
1. following the steps steps required steps required
Handwashing required by the DOH by the DOH with by the DOH with
minimal error maximum error
Greeted and identified Performed at Performed at Failed to greet and
patient by asking least two (2) least one (1) way identify patient
2. his/her name and ways of of identifying
checking his/her ID identifying patient.
Identifying the band and bed tag. patient.
patient
Explained procedure Explained Explained Failed to explain
to the client clearly procedure but procedure but in procedure
3.
Explaining the and completely with lacks details. an unclear
procedure client’s approval manner.
4.1. Lowered bed to Performed Performed Failed to
level of wheelchair correctly at correctly at demonstrate any
seat.
4.2. Positioned least 2-3 out of least 1 out of 4 of the steps
4. wheelchair next to 4 steps of the steps of the procedures.
Positioning the bed procedure. procedure
bed and 4.3. Locked the wheels
wheelchair of the wheelchair and
bed.
4.4. Raised footrest
pedals and leg
supports.
5. Assisted patient to Assisted patient Assisted patient Failed to assist
Assisting sitting position in bed to sitting to sitting patient to a sitting
patient to properly and position in bed position in bed position in bed
sitting position efficiently with minor with more errors
in bed errors
6.1. Assisted patient Performed Performed Failed to
6. with robe and slippers correctly at correctly at demonstrate any
Assisting 6.2. Placed patient’s
patient to feet and legs on least 2 out of 3 least 1 out of 3 of the steps
wheelchair support steps of the steps of the procedures.
6.3. Used a good body
mechanics throughout procedure. procedure
the procedure
Properly and skillfully Properly Positioned client Failed to ensure
positioned client positioned client in wheelchair client comfort
7.
comfortably in the in the with maximum after the
Providing
client’s comfort wheelchair wheelchair with supervision procedure
less supervision
Washed hands Washed hands Washed hands Failed to wash
8. properly and skillfully following the following the hands properly
Handwashing following the steps steps required steps required following the steps
after the required by the DOH by the DOH with by the DOH with required by the
procedure minimal error maximum error DOH
Documented the Failed to Failed to Failed to document
9. information about the document some document most the procedure
Documenting procedure properly details of the of the details of
the procedure and completely procedure the procedure.
OVERALL SCORE: ______________
Target Raw Score: 20 out of 27. If raw score is less than 20, repeat the return demonstration.
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FACULTY SIGNATURE OVER PRINTED NAME