Carlatan, San Fernando City, La Union COLLEGE OF NURSING ISO 9001:2008
STUDENT EVALUATION TOOL FOR RELATED LEARNING EXPERIENCES INTRA-OPERATIVE
Name of Student:
Year / Clinical group:
School Year:
Term: First Semester: Second Semester: Summer:
Inclusive Dates of Clinical Rotation:
LEGEND:
4-Competent (Student performs consistently in an effective and efficient manner)
3-Progress Acceptable (performance is usually effective and efficient but not always)
2-Needs Improvement (progress in performance is too slow to judge satisfactorily; task performance is not done properly for majority of the time0
1-Progress Unacceptable (no progress in performance has been demonstrated and/ or performance is consistently ineffective and inefficient)
CORE COMPETENCY
SCORE
REMARKS
A. safe and quality nursing care
1. utilizes the nursing process in the care of OR client
a. Obtains comprehensive client’s information by checking complete accomplishment of the preoperative checklist/ clients chart
b. Identifies priority needs of the client at the Operating Room
c. Provides needed nursing interventions based on identified needs
d. Monitors client’s responses to surgery
2. Promotes safety and comfort of patients inside the OR
a. Transports client safely from the unit to OR
b. Transfer client safely from the stretcher to OR bed, OR bed to stretcher, stretcher to RR bed (e.g. use of side rails)
c. Places properly grounding pad under the patient for electro-surgical equipment
d. Monitor vital signs
e. Provides physical comfort utilizing comfort devices/ techniques
f. Provides needed blankets and sheets to prevent hypothermia and provide privacy
g. Assist in proper and safe positioning of clients in preparation for surgery
h. Observes the