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FM – NUR – 070
Department of Health
Revision No.
EAST AVENUE MEDICAL CENTER 0
East Avenue, Quezon City Date: Effective
OCT. 1, 2013
INSTRUCTIONS : This evaluation is made to appraise the strengths and weaknesses of an orientee
in the orientation phase. Kindly encircle the number that best describes your evaluation of the orientee.
Your responses will help in determining periodically the progress/efficiency of the orientee.
A. Performance Skills 5 4 3 2 1
C. Organization of Work 4 3 2 1
D. Adaptability 4 3 2 1
E. Interpersonal Relationship 4 3 2 1
A. Assessment Skills 4 3 2 1
B. Intervention Skills 4 3 2 1
C. Evaluation Skills 4 3 2 1
Conforme:
________________________
Orientee’s Signature
RATIONALE:
Each orientee must be periodically advised of his/her progress as he/she goes through
the different stages of the Orientation phase so as to provide opportunity for self-motivated
growth and development. However, the problem of accurately evaluating the progress of an
orientee is extremely difficult for evaluators. It is essential then for evaluators (Sr. Nurse,
Supervisors, NI’s) to consider the concept that evaluation is an emotionally charged area, and
that its interpretation by the orientee can have a strong impact on their self-esteem and
subsequent performance. The evaluation therefore, must b e objective enough to both conserve
the integrity of the orientee and provide for competent delivery of care.
It is for this reason that an evaluation tool was formulated in order that a device for the
use of evaluating orientees shall be objective, specific and uniform in all the units.
OBJECTIVES:
The use of the Orientee Evaluation Tool hopes to achieve the following :
IMPLEMENTING GUIDELINES:
1. Each orientee shall be periodically appraised of his progress during the entire
duration of the Orientation phase.
2. The evaluation shall be made on the prescribed form (Orientee Evaluation Sheet)
and submitted to the Nursing Training Office at the end of each week for the
duration of the orientation period.
3. The Orientee shall be rated by his immediate superior, subject to review or
concurrence by the next higher superior.
4. The orientee shall affix his/her signature in the “Conforme” part after he/she has
seen and discussed the evaluation with the evaluator.
5. Comments/remarks are essential to an appraisal and are of particular importance to
both the evaluator and the orientee, hence, the filling up of this part of the form is
encouraged. Comments may be used to explain ratings or to make suggestions for
improvement.
ORIENTEE EVALUATION TOOL
* INDICATORS *
A. PERFORMANCE SKILLS:
5 – shows proficiency in accomplishing the task way above the expected performance
5- Never had to be told what to do. Highly creative and constructive; plans & suggests
improvements in assigned or related duties.
4- Rarely had to be told what to do. Resourceful and alert; shows constructive thinking in
the performance of routine duties or assignments.
2- Frequently had to be told what to do. Needs guidance or direction in the performance of
majority of duties or assignment.
1- Always had to be told what to do. Lacks confidence and ability to proceed alone.
C. ORGANIZATION OF WORK:
E. INTER-PERSONAL RELATIONSHIPS:
* INDICATORS:
A. ASSESSMENT SKILLS:
B. INTERVENTION SKILLS:
3- Needs minimum guidance in carrying out nursing interventions, with consideration for
patient’s safety and comfort
D. EVALUATION SKILLS:
4- Interprets patients’ reactions to the therapeutic regimen
OVER-ALL EVALUATION
26 Outstanding
18-23 Satisfactory
6-11 Unsatisfactory
12 Excellent
6-8 Good
3-5 Poor