PERFORMANCE APPRAISAL OF HOSPITAL STAFF

Performance appraisal is the process of evaluating the ability of an individual employee against predetermined standards usually set in the job description. Name and address of the hospital--------------------------------------------------Performance appraisal form For supervisors and other senior staff PART I (To Be Filled Up By Human Resource Department) Name-----------------------------------------------------present designation------------------------Department--------------------------------date of employment------------------------------Date of promotion to the present post, any---------------------------------------------------------Part II (To be filled up by the department) 1. Job knowledge Has he got knowledge of all aspects of his own job or does he still need much help and advice? A. B. C. D. E. Has exceptional knowledge Has sound knowledge of his work Has good knowledge but needs help occasionally Has fair knowledge Has a lot to learn about his job

2. Drive and application? Is he keen and energetic in applying himself to the job ? Does he work diligently and effectively? A. B. C. D. E. Exceptionally keen and energetic, always works hard A good industries employee Usually works diligently but could apply himself better Works but does not pay enough attention Wastes time

3. Organizing ability Does he organize the work in his department/section well? A. An extremely able the organizer B. Good organizing ability, can plan ahead

C. Efficient in normal circumstances D. Not a good organizer on the whole E. Sometimes gets in a muddle 4. Leadership Has he good working relationship with his staff? Can he maintain discipline? A. B. C. D. E. Well liked and respected. relationship excellent with seniors and subordinates Usually respected. Gets on well with subordinates Satisfactory in his relationship Does not inspire a great deal of respect Not respected

5. Constructive imagination Does he posses the ability to produce new ideas and the skill of constrictive criticism? A. B. C. D. He finds new ways of solving problems and initiates new ideas He has an open and progressive mind He is quick to recognize opportunities for improvement Does not generate new ideas or show initiative

6. Integrity Is he a man of character? Can he be relied upon in all circumstances? A. He is always frank and straight foreword B. He is frank but gives biased opinion C. He is not trustworthy 7. Verbal and written ability Does he speak/write clearly and consciously? (Can he express himself well in speech or on paper or both?) A. B. C. D. E. Excellent command of language; clear and concise He can express himself well Adequate ability to express Cannot convey ideas to others easily Difficult to understand

8. Personality What kind of habits, attitudes, traits and emotional qualities does he possess?

A. B. C. D. E.

He is adaptable to changing circumstances He is acceptable at all levels He is always confident He gives the impression of insecurity He is timed

9. Judgment Does he analyze problems decisively and accurately? Does he evaluate data objectively? A. B. C. D. E. He takes decisions boldly and quickly He understands the implications of his decision He delays decisions but always takes the right decision He gives quick decisions, but wrong ones He gives wrong and late decisions

10. Personal contacts Can he be relied upon for outside work? If not why? A. B. C. D. E. Always successful in his outside work Actively stimulates goodwill Performs outside work well Sometimes not successful in outside work Poor contacts and no success in outside work

11. Targets What is your opinion about his achievement in the current year? A. B. C. D. E. He generally overshoots his target He achieves his target easily He always needs help to achieve his target He never touches his target He absolutely fails to reach his target

12. Training What is your opinion about his training? Does he need training for (a) higher post, (b) present post (c) training others? A. B. C. D. He possess excellent training He can train others too He has adequate training He will need training some time

E. He needs urgently 13. Remarks if any ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Recommended for promotion /special increase/training. Explain --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(Signature of Department Head) Part-III (To be filled up by concerned employee) A. Please give your comments about your performance for the current year. -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------B. Do you have any suggestion to improve the functioning of your department/the hospital? ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------C. Any other information -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(Signature of concerned employee) Part IV (to be jointly by department head and concerned employee) We agree with each other. We differ slightly with each other. W e do not agree at all. Plan for next year------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(Signature of the concerned employee) (Signature of the department Head) Part V (To be filled up by Head of the institution) -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(Signature of the Head of the Institution)

Name and address of the hospital Performance appraisal form For employees (Below the Rank of Supervisor) Part-I (To be filled up by human resource department) Name ----------------------------------Present designation------------------------------------------Department ------------------------------------Date of employment-------------------------------Date of promotion to the present post, any----------------------------------------------------------------------Part II (To be filled up by Department Head) 1.Quality of work (Consider neatness and accuracy of work regardless of volume) Careless, requires maximum supervision, work needs careful inspection Very slow, never achieves target Very little knowledge of what the job requires Usuallyaccurate and through, needs minimum supervision Dependable rarely makes errors Exceptional worker

2.Quantity of work (consider volume of work produced) 3. job knowledge (consider all the requirements of the job including knowledge of the job, tools, methods, etc) 4.Ability to learn (consider mental ability to learn the new job) 5.co-operation(consider attitude toward work and fellow workers) 6.Initiative(Find new ways of doing jobs and thinks of new ideas) 7.Depandablity(Consider The manner in which he applies himself to his job, regularity of attendance)

Produces to reach Produces target sufficiently Knows only the routine job Has good working knowledge of job

Fast worker, produces beyondtarget Through grasp of job

Learns slowly requires repeated instructions Show reluctance to co-operative Never takes initiative Cannot be relied upon. Needs constant supervision

Grasps new duties slowly but retains them Usually a good team worker Takes initiatives sometimes Fairly reliable average supervision required

Learners fairly fast

Learns rapidly

Always a good team worker Generally takes initiative Applies himself well. Supervision

Goes out of the way to co-operative Always takes initiative Completely dependable on the job

Should additional training be given------------------------------------------------------------------------------------------If yes, type of training------------------------------------------------------------------------------------------------------------Does this employee possess special skills that could be used in another position to better advantage?----------------------------------------------------------------------------------------------------------------------------------------------Name that skill--------------------------------------------------------------------------------------------------------------------Appraisal shown to employee on -------------------------------------------------- and contents of discussion in brief are given below: ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Remarks Recommended for promotion/special increase/training. Explain-------------------------------------------------------------------------------------------------------------------------------(Signature of the Department head) Part-II (to be filled up by the head of the institution ) ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------(Signature of the head of the institution) Instructions for appraisers The following instructions should be given to the person making the appraisal: 1. 2. 3. 4. Please fill up this form seriously. You are Judge. Base your judgment on the entire period of appraisal and not upon isolated incidents. Place tick mark at the appropriate places. Use separate pages, if required for explanations.

PERFORMANCE APPRAISAL TOOL FOR NURSES WORKING IN COMMUNITY

Performance appraisal tool for registered nurses working in communities health service delivery area It is recommended that the appraisal tool be used to evaluate the registered nurses performance at least once prior to the end of the probationary period of employment. After this time period annual performance appraisals are advised. The performance appraisal gives the employer and registered nurse a time to reflect on the registered nurses performance, to provide/receive praise and support, to identify areas of practice that need strengthening, to address any concerns and to set mutual goals with the registered nurse for the future. An ideal time for performance appraisals would be in December or January.

Indicators
Promotes the bottom-up philosophy of community development in which the power and authority remains with the individual, the family and the community and the registered nurse acts as a facilitator and support to the process of becoming healthy. Develops trusting and respectful relationships with the community. Determines the priority health issues that the community wishes to address. Start where the community is at. Begins with the communitys felt needs and desires. Encourages maximum participation in situations where people can develop their own understandings and act on their own decisions. Works with communities to build partnerships. Acknowledges the starting differences in power that exist among health team members and community groups. Works to share power among members giving equal voice to all. Works with individuals, families and community groups to develop health programs and services to address the priority issues.

 Builds on pre-existing individual, family and community strengths and resources to develop community-based leadership skills that will enhance the planning, delivery and evaluation of health programs and services. Emphasizes selfdetermination and choice. Exceeds Expectations Meets Expectations Needs improvement

Comments: ________________________________________________________________________ ______ ________________________________________________________________________ ______ ________________________________________________________________________ ______ Health Promotion Refers to planned actions which aim to empower people to control their own health by gaining control over its determinants. These determinants include underlying factors that influence health such as food security, peace, shelter, social connectedness, a sustainable ecosystem, income and access to education and employment opportunities. Communityinspired health promotion refers to planned actions, generated by the grassroots, in which people are empowered to have greater control over the advancement of their own physical, mental, spiritual and social wellbeing. This approach acknowledges that citizens know best the strengths and challenges of their own communities. (British Columbia Coalition for Health Promotion,(2005). Indicators: Using a community development approach: Gathers information on socioeconomic determinants of health, lifestyle and behavioral changes, and develop prevention strategies to address the health priorities identified by community members. Works with community leaders and the community health team to raise awareness of factors that promote health. Works with community leaders and the community health team to identify and address barriers to health in the community.

 Supports and encourages the development of upstream programs that address the underlying factors that influence health status. Exceeds Expectations Meets Expectations Needs improvement Comments _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Cultural Safety Culturally safe practice involves recognizing negative attitudes and stereotyping of individuals because of the ethnic group that they belong to. It involves actions that recognize, respect and nurture the unique cultural identity of Aboriginal people and safely meet their needs, expectations and rights. Culturally unsafe practice includes any actions, which diminish, demean or disempower the cultural identity and the wellbeing of the individual. Indicators: Knows the importance of enhancing cultural values and social practices in the lives of individuals, families and communities and their relationship to health. Knows and understands how and when to find information to support culturally appropriate and ethical care and services. Engages in self-examination and in-depth exploration of ones own cultural background recognizing ones biases, prejudices and assumptions about people who are different. Engages in the process of becoming more culturally competent and actively seeks experiences that help one shape ones worldview and appreciate the worldview of others. Develops cultural humility and recognizes that the process of becoming culturally competent is life-long. Invests the time and commitment to foster relationships of mutual respect and mutual trust that benefit the client, family and/or community. Develops an awareness of the importance of not imposing ones cultural values on others and is non-judgmental in her words and actions. Recognizes that individuals, families, and community members must have meaningful participation in and ultimate control over decision making regarding their health.

 Recognizes that a state of best health is not merely a function of physical capacity, but is also closely related to a whole set of personal values and social resources. Has knowledge and understanding of the contexts which create dependencies on Western medical technology and acknowledges that healing in Aboriginal communities is about reclaiming their own historical practices. Is a good listener and understands the values, beliefs, concerns, resources, abilities and motivations of others. Works together with others as a team, celebrates differences and uses complimentary talents and skills in providing health services. Exceeds Expectations Meets Expectations Needs improvement Comments: _______________________________________________________________________ _______________________________________________________________________

Clinical Activities: Provides community health nursing service in accordance with policies, procedures, standards and clinical programs. Explains health care services to patients and family. Collaborates with other members of the health care team in planning and providing health care services. Has knowledge and skills required for community health nursing practice including communicable disease control (First Nations And Inuit Health Branch certification process), pre and post natal care, infant assessment, infant and preschool health, school health, adult and Elder health, leadership, CPR recertification, communication. Provides nursing care, in a way that is consistent with relevant legislation and professional standards of practice including the Canadian Community Health Nursing Standards of Practice (2003). Ensures appropriate written documentation and proper maintenance of client files/charts. Has knowledge of proper use of equipment, technology and products (includes medications and vaccines). Ensures supplies are ordered and stock maintained. Maintains current registration with RNABC and necessary certifications. Exceeds Expectations Meets Expectations Needs improvement

Comments: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Critical Thinking Critical thinking addresses the decision-making and problem-solving skills in both clinical and operational areas of community health nursing. Critical thinking represents the ability of the registered nurse to effectively anticipate the needs of the client and manage situations. Indicators: Bases decisions on nursing theory and knowledge of community health nursing, work and life experiences, and knowledge of organizational policies and practices. Seeks advice from registered nurse supervisor, the First Nations and Inuit Health Branch nursing consultant, and/or the supervising registered nurse of Interior Health, when unsure or unfamiliar with a clinical skill, a procedure, or certain clinical information. Uses knowledge from a variety of sources, using skills of observation, communication and physical assessment. Distinguishes between relevant and irrelevant information when evaluating or reporting a situation (i.e. decides if appropriate to vaccinate). Sets priorities in nursing care and program planning. Regularly evaluates nursing practice, taking necessary steps to improve personal competencies. Intervenes and reports unsafe or unethical situations or practices to the appropriate person. Exceeds Expectations Meets Expectations Needs improvement Comments: _______________________________________________________________________ _______________________________________________________________________ Human Relations The human relations aspect of community health nursing refers to the human interaction of nursing care. The registered nurse is responsible to interact effectively with clients,

their families, other health care members. Effective interaction is necessary in the delivery of health care to clients and their families. Indicators: Works with other health care workers to assist with prioritization of care and program planning. Initiates and maintains professional relationships with clients, families, community members, and members of the health care team. Provides guidance and support to members of the health care team, clients and their families. Maintains confidentiality. Works with client and family in an effort to understand who the client is, his/her interests, and needs. Maintains own physical, emotional and mental well-being. Participates in discussions and case conferencing to address issues and concerns. Manages conflict (staff and client) in an appropriate and timely manner. Liaises and interacts with other health care workers and professionals. Participates in special projects and on committees. Exceeds Expectations Meets Expectations Needs improvement Comments: ________________________________________________________________________ ____________

Assessment of Overall Performance: ________________________________________________________________________ ______ ________________________________________________________________________ ______ Nurse/Employer Plan of Action for setting goals for the future: Date to Meet Expectations by: Theme to be Addressed Plan of Action (based on mutual goal setting between registered nurse and employer) Follow-up & Outcome

_______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ I agree with this performance appraisal: ____________________________________Date: ______________________________ I disagree with this performance appraisal: _____________________________________Date: _____________________________

Performance Appraisal for staff Educational Institution

Education is process, the chief goal of which is to bring about changes in human behavior. Nursing has a practical clinical component which is integral to its educational process. A major focus of education today is the responsibility of the educational institutions to produce graduates who can perform in real life situations because education in nursing without application is meaningless

Steps in development of performance appraisal evaluation tool

Identification and defining of objectives Identification of situations Selecting and devicing evaluation tools and techniques Administration of evaluation tool and techniques and their appraisal

Types of performance appraisal tool

Checklist Rating scale Anecdotal record

Format for check list

Behaviors 1.Explains procedure 2.Collects necessary equipments 3.Arranges equipments for convenient Use 4. Prepares patients 5. Washes hands 6. Maintains aseptic techniques 7. Removes dressing 8. Observes condition of wound 9. Cleans wound Place for tick mark Remarks

10. Applies dressing 11. Removes equipments 12. Makes patient comfortable 13. Completes charting 14. Takes care of equipment

Assessment Instrument I. II. Check list: Specific clinical skills (nurse) Competences to be assessed: Clinical skills required to perform the following activities. 1. Vital signs 2. Bed making 3. Personal hygiene 4. Oxygen administration 5. Dressing procedures 6. Establishing/maintaining an airway 7. Insertion of a nasogastric tube 8. Feeding via a nasogastric tube 9. Medications 10. Catheterizations 11. Intermittent positive pressure therapy 12. Tracheostomy care III. IV. V. VI. Specific abilities to be assessed Purpose of assessment (summative) Comments Sources to contact for further information

Format for rating scale

Name of the Student Year : : Total Marks - 100

Marks Obtained -

Name of the Topic Name of the Supervisor: Date of Presentation :

Grade: Total Score 100 Excellent Above 80 Very Good 71 80 Good 61 70 Average 50 60 Below Average Below 50 KEY TO EVALUATION

Items Always, Mostly, Sometimes, Rarely, Not at all Score Sl. No. I 4 3 2 1 4 Organization of the Lesson Plan Objectives were clear, appropriate and specific Lesson Plan format is correct Organization of content is appropriate Salient, Points are mentioned Considers the level of the learner Bibliography written is correct and appropriate to the topic II Teaching Steps of the lesson plan format is followed Subject matter is explained clearly Has correct language, fluency, spontaneity, loud, clear and modulated voice Has control of the group Finished within the allotted time Participation of students 0 3 SCORES 2 1 0

Area and Items

Sl. No. III.

Area and Items 4 Use of A.V. aids: Types of A.V. aids used Organization of A.V. Aids was appropriate Timely Presentation Self-explanatory & appropriate to the topic Organization of the class-room Cleanliness Seating arrangements Lighting and Ventilation Personal Grooming Pleasantness, approachable, dignifies and self-confident Posture, Gesture and any mannerism etc., Evaluation Doubts cleared after each step Summarized at the end Concluded appropriately Assignment given appropriate to the topic 3

SCORES 2 1

IV.

V.

VI.

Special Marks for Type A.V. Aids N.B.: Special Five narks are for the type and no. of A.V. aids used Poster and Charts Flip Chart and flash card Flannel Board, Transparencies Slides Remarks Good Points Poor Points : - 1 (each) -2 -3 -4

Suggestion for Improvements SIGNATURE OF EVALUATOR

Assessment instruments for rating scale

I. II. Rating scale: Surgical nursing proficiency Competences to be assessed III. IV. V. VI. Data gathering Communication Patient management planning Reporting

Specific abilities to be assessed: Ability to meet basic and special nursing needs of adult patients Ability to communicate successfully with patients and health team members Ability to develop rapport with patients

Purpose of assessment : formative Comments : no evaluation data are available Sources to contact for further information

Format for anecdotal record

Name of the school or college ------------------------------------Name of the student observed -------------------------------------Name of the observer --------------------------Class --------Date and place ------------------Subject ----------

Objective description ----------------------------------------------------------Comments of the observer ----------------------------------------------------Signature of the observer