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Individual Health Assessment

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Individual Health Assessment
Individual Client Health History and Examination Grading Criteria

| Possible Points | Points Earned | Instructor’s Comments | Health History/Review of Systems: *Information is complete. *Information is appropriate, demonstrating understanding of the specified information. * No errors in spelling or grammar. | 30 Points | | | Physical Examination: *Information is complete. *Information is appropriate, demonstrating understanding of the specified physical exams. * No errors in spelling or grammar | 40 Points | | | FHP Assessment: *Information is complete. *Information is appropriate, demonstrating understanding of the assessment. * No errors in spelling or grammar | 40 Points | | | SBAR: *Information provides logical progression of assessment. * Situational data is appropriate and complete. *Background (historical) data is appropriate and complete. * Assessment is appropriate and complete. * Recommendations and planning are appropriate and complete. * No errors in spelling or grammar | 40 Points | | | TOTAL POINTS | 150 Points | | Total______%/100x150 =_______ |

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References: Gulanick, M., & Myers, J. (2007). Nursing care plans: Diagnosis, interventions, and outcomes. (6th ed.). St. Louis, Missouri: Elsevier Mosby. Jarvis, C. (2012). Physical Examination & Health Assessment (6th ed.). St. Louis, Missouri: Elsevier Saunders.
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