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Saint Thomas Aquinas University Tanauan City, Batangas, Phils.

COLLEGE OF NURSING __________________________________________________________________________ Performance Evaluation Tool (Head Nursing) Name: Date: Yr/Sec: Group: Area: Rating: Instructor: Scale 5 4 3 2 1 Description Outstanding: Competent and Carries out expected tasks with very minimal supervision. Very satisfactory: Carries out expected tasks and responsibilities with minimal supervision and guidance Satisfactory: Carries out expected tasks and responsibilities with frequent supervision and guidance Needs improvement: Needs close guidance and supervision Unsatisfactory: Does not carry out expected tasks even with close guidance



A. ASSESSMENT AND PLANNING 1. Establishes effective communication with his/her subordinates. 2. Formulate plans for daily activities 3. Assess the knowledge and skills of subordinates regarding nursing skills and patients care. 4. Involves patient in plan of care 5. Gathers data using interview, observations and records. 6. Punctual and prompt in all activities 7. Assess patients by facilitating nursing rounds prior to actual handling.

Competencies B. IMPLEMENTATION 1. Shows initiative in performing tasks 2. Conducts appropriate and effective health teachings to the patient and to his/her subordinates 3. Follows principles of time management 4. Carries out assigned tasks efficiently 5. Equipped with proper and adequate paraphernalia for daily activities 6. Conduct beside conference with subordinates 7. Check the daily written requirements and paraphernalia of subordinates 8. Participate in the endorsement done by staffs of the hospital
9. Initiate a pre and post conference with subordinates


10. Delegates and discuss tasks effectively to his/her subordinates

11. Guides subordinates in carrying out tasks regarding

patients care 12. Check the activities conducted by subordinates such as charting and medication administration. 13. Promotion of professional responsibility,accountability and behaviour. 14. Provide leadership in the assessment, planning and evaluation of activities anbd programs in the area. Competencies C. Evaluation 1. Evaluates the learnings of subordinates throughout the the span of clinical exposure 2. Makes revisions in the plan of care/action as necessary 3. Conduct strategies/activities that will evaluate the learnings of subordinates 4. Notify instructors about problems related to the activities in the area and regarding to patients care 5. Accepts supervisions and criticisms 6. Participate in the endorsement done by staffs of the hospital Rating

Competencies D. ETHICOLEGAL CONSIDERATIONS 1. Respects subordinates and superiors 2. Demonstrates honestly at all times
3. Conducts self in tactful manner.


4. Observes the 11 core competencies 5. Respect staffs in the area 6. Follows the policies in the working area at all times


Evaluated by:

Actual score ______________X 100 Total Score

_______________________________________ Signature over Printed Name

_______________________________________ MM/DD/YY