OPD Eval Tool

DE LA SALLE LIPA
COLLEGE OF NURSING
PERFORMANCE EVALUATION IN OUT-PATIENT DEPARTMENT

Name: Year / Section: Rating:
Hospital: Shift: Date of Exposure:
Rate the student’s performance by checking the appropriate box using the following criteria:
2.0 Competent (Performance is consistently done in effective and efficient means)
1.5 Satisfactory (Performance is usually effective and efficient but not always)
1.0 Developing (Progress in performance is too slow to judge satisfactorily; task
performance is not done properly for majority time)
0.5 Needs Improvement (No progress in performance has been demonstrated, and/or
performance is consistently inefficient and ineffective)
COMPETENCIES – 60 points 2.0 1.5 1.0 0.5

I. VALUE-BASED
A. Safe and Quality Care of the Clients
1. Utilizes the nursing process in obtaining clients information.
2. Assess the current condition.
3. Check the vital signs correctly.
4. Follow general guidelines in the conduct of physical examination.
5. Applies and utilizes the standard of nursing practice in the OPD.
6. Provides holistic nursing care based on individual needs.
7. Administer treatments and care to patients following hospital policies
and in accordance with Consultant protocols.
8. Follows the progress of the patient and acts accordingly with the
patient's best interests in mind.
9. Promotes patient’s safety.
10. Evaluate the standards of care within the department.
B. Ethical, Moral and Legal Practice
1. Respects the rights to privacy.
2. Respects the rights to confidentiality.
3. Respects the religious, cultural, and ethnic practices of the client.
4. Adheres to the Nursing Code of Ethics.
5. Respects and adhere to patient’s bill of rights.
C. Legal Responsibility
1. Checks individual and family record.
2. Documents all pertinent data correctly and completely.
3. Reports any abnormal findings in vital signs.
4. Evaluates and Reports pertinent data based on observations.
5. Observes and monitor client’s condition conscientiously.
II. KNOWLEDGE-BASED
A. Research
1. Identify researchable problem related to nursing care.
2. Proposed research study related to assigned case.
3. Discuss latest innovations on nursing care.
4. Discuss updates on preventions of common diseases.
B. Continual Quality Improvement
1. Performs quality care that conform to nursing practice.
2. Identify deviation of practice from the standards.
3. Performs nursing care in the OPD setting with accuracy.
C. Health Education
1.Provides health instruction to the patient the importance of a healthy
community.
2. Responds to the questions of patient and family regarding follow-up
check-up, home management and observation of signs and symptoms.
3. Provides information to the patient and the family regarding the
management of their disease condition within the scope of nursing.
4. Provide education, promote healthy practices, share their expertise,
and help patients heal.
III. OUTCOME ORIENTED
A. Communication
1. Communicates effectively with client and family plans through
receptive listening in non-judgmental approach and allowing time for
responses.
2. Maintains an open line of communication with the members of the
family.
3. Accepts criticism constructively by showing positive changes.
4. Interprets and validates clients or family body language and
expression.
5. Spend time with the client or family to facilitate conversation that
allows them to express concerns.
B. Collaboration and Teamwork
1. Function effectively as a health team in the Out-patient Department.
2. Establishes collaborative relationship with other medical team in the
OPD promote optimal patient health outcomes.
3. Provide patients with appropriate referrals for other services,
resources, and classes.
C. Records Management
1. Documents accurately.
2. Document comprehensively outcome of care.
3. Prepare and maintain clinical records of patient care in line with
institution’s standards for records and record keeping.
IV. LEADERSHIP AND GOVERNANCE
A. Personal and Professional Development
1. Accepts criticism and recommendation.
2. Performs functions according to standards
3. Shows interest in work by voluntary willingness to perform assigned
tasks
4. Observes punctuality and proper decorum
5. Wears neatly and completely the prescribed uniform and Grooming
B. Management of Resources and Environment
1. Maintains orderliness and cleanliness of the working area.
2. Observes policies, procedures and protocol in OPD set up
3. Ensures a warm and a quiet environment
KNOWLEDGE – 40 points
Pre Test / Post Test
LFD
Health Education
Comments:
Strengths:
Weaknesses:
Attendance Record:
Tardiness Absence/s
Date # of Minutes Date Remarks
Conforme: Evaluated by:

__________________________
Student’s Signature CI’s Signature over Printed Name
Date: Date: ________________

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DE LA SALLE LIPA

PERFORMANCE EVALUATION IN OUT-PATIENT DEPARTMENT

COMPETENCIES – 60 points 2.0 1.5 1.0 0.5

Date # of Minutes Date Remarks

Conforme: Evaluated by:

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