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Lipa City Colleges College of Nursing (G.A. Solis St. , Lipa City, (043)756-5974, www.lipacitycolleges.net) PERFORMANCE EVALUATION
Lipa City Colleges College of Nursing (G.A. Solis St. , Lipa City, (043)756-5974, www.lipacitycolleges.net) PERFORMANCE EVALUATION

Lipa City Colleges College of Nursing (G.A. Solis St. , Lipa City, (043)756-5974, www.lipacitycolleges.net) PERFORMANCE EVALUATION ACHIEVING INTRA-OPERATIVE CARE COMPETENCY In Accordance with PRC Board of Nursing Memorandum No. 01 Series 2009

Name of Student: Magbuhat, Michael Angelo J. Year/Clinical Group: 4 th year/ Group 4 School Year: 2013-2014

Semester:/ Term: ______

First

Semester

__

__

Second

Semester _______

Summer

Inclusive Dates of Clinical Rotation: November 25, 26, 27, 28, 2013

 

INTRA-OPERATIVE CARE COMPETENCIES

DESIRED

AVERAGE

 

RATING

RATING

I.

SAFE AND QUALITY NURSING CARE (SQC)

1.

Utilizes the nursing process in the care of OR

4

 

client

  • a. Obtains comprehensive client’s information

by checking complete accomplishment of

the preoperative checklist/client’s chart

  • b. Identifies priority needs of the client at the

4

Operating Room

  • c. Provides needed nursing interventions

4

based on identified needs

  • d. Monitors client’s responses to surgery

2

  • 2. Promotes safety and comfort of patients inside

2

 

the OR

  • 3. Performs the functions of the scrub nurse

4

  • a. Performs surgical scrub correctly

  • b. Wears sterile gowns and gloves aseptically

2

  • c. Prepares surgical instruments, sponges,

2

 

sutures and other supplies in functional arrangement

  • d. Hands instruments, sponges, sutures and

2

 

other needed materials according to

surgeon’s preference

  • e. Performs surgical count accurately

2

4.

Performs the functions of the circulating nurse

2

a.

Anticipates the needs of the surgical team

b.

Sets up the OR room and needed

2

equipment

c.

Receives client for surgery / endorses client

2

post –operatively

 

INTRA-OPERATIVE CARE COMPETENCIES

d.

Assists in skin preparation and draping of

2

client

  • 5. Administers medications and other

2

health therapeutics safely

II. MANAGEMENT OF RESOURCES, ENVIRONMENT AND EQUIPMENT (MRE)

 
  • 1. Organizes work load to facilitate timely patient Care

4

  • 2. Utilizes adequate and appropriate resources to

2

support the OR team

  • 3. Ensures functionality of OR resources

2

  • 4. Maintains a safe environment at the OR by

2

observing the principles of asepsis

III. HEALTH EDUCATION (HE)

 
  • 1. Implements appropriate health education

2

activities to client based on needs assessment

IV. LEGAL RESPONSIBILITIES (LR)

 
  • 1. Adheres to legal and institutional protocols

2

regarding informed consent

V.

ETHICO-MORAL RESPONSIBILITIES (EMR)

1.

Respects the rights of the OR client

2

  • 2. Accepts responsibility and accountability for own

2

decisions and actions as an OR nurse

VI. PERSONAL AND PROFESSIONAL DEVELOPMENT (PPD)

  • 1. Performs OR functions according to professional

4

standards

  • 2. Possesses positive attitude towards learning

2

surgical and OR-related knowledge and skills

VII. QUALITY IMPROVEMENT (QI)

2

  • 1. Participates in quality improvement activities

2

 

related to infection control and successful OR operations

  • 2. Identifies and reports variances in sterility and

2

other OR activities

INTRA-OPERATIVE CARE COMPETENCIES

VIII. RESEARCH (R)

  • 1. Disseminates results of OR-related research

2

 

findings to clinical group and other members of

the OR team as appropriate

IX. RECORDS MANAGEMENT (RM)

  • 1. Maintain accurate and updated documentation of

1

patient care

X. COMMUNICATION (Comm)

  • 1. Establishes rapport with patients, significant

2

others and members of the health team

  • 2. Uses appropriate information mechanisms to

2

 

facilitate communication inside the OR and with

other departments in the hospital

XI. COLLABORATION AND TEAMWORK (CTM)

  • 1. Collaborates plan of care with other members of

2

the health team

TOTAL SCORE

75

Evaluated By:

CHRISTY D. SANDOVAL Clinical Instructor License Number: 0362563 PRC Card - Validity Date: March 2016

Conforme:

MAGBUHAT, MICHAEL ANGELO J.

Signature over Printed Name

Student