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Clinical Evaluation Form

The document is a clinical evaluation form used to assess nursing students during their clinical placements. It evaluates students on their assessment, planning, implementation, and evaluation of patient care, as well as personal attributes. The form contains the student's information, the clinical site and dates, and a scoring matrix with over 30 criteria divided into 5 categories - assessment, planning, implementation, evaluation, and personal. Scores are given from 1 to 5, with 1 being the lowest, and total scores are calculated. Space is provided for remarks by the evaluator and student, along with signatures.

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Andal
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1K views1 page

Clinical Evaluation Form

The document is a clinical evaluation form used to assess nursing students during their clinical placements. It evaluates students on their assessment, planning, implementation, and evaluation of patient care, as well as personal attributes. The form contains the student's information, the clinical site and dates, and a scoring matrix with over 30 criteria divided into 5 categories - assessment, planning, implementation, evaluation, and personal. Scores are given from 1 to 5, with 1 being the lowest, and total scores are calculated. Space is provided for remarks by the evaluator and student, along with signatures.

Uploaded by

Andal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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COLLEGE OF NURSING

CLINICAL EVALUATION FORM – NURSING FOUNDATION

Name of the student: Date:


Batch and Year: Hospital:
Period under evaluation: From________________ to ____________________

S.No Evaluation Criteria Rate 1 2 3 4 5 Score


A. ASSESSMENT
1. Takes complete history about the patient 1
2. Demonstrates skills in physical assessment 1
3. Identifies basic skills and problems 1
4. Formulates nursing diagnosis 1
B. PLANNING
1. Plans nursing care based on priority needs 1
2. Considers pathology of disease condition 1
3. States rationale for nursing actions 1
4. Involves patient and family in developing plan of care 1
C. IMPLEMENTATION
1. Implements nursing care based on priority within given
time 1
2. Integrates scientific knowledge and principles in giving
patient care 1
3. Demonstrate competence in technical skills 1
4. Records and Reports significant information 1
5. Assists in various therapies 1
6. Provides appropriate health teaching to the patient and
family 1
D. EVALUATION
1. Records and Reports at time 1
2. Finds reevaluation whenever possible 1
E. PERSONAL
1. Dresses neatly 1
2. Grooming 1
3. Punctuality 1
4. Control emotions 1
TOTAL

Remarks by evaluator:

Remarks by students:

Student’s Signature Evaluator’s Signature

Signature of the Principal

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