INDIVIDUAL PERFORMANCE COMMITENT AND REVIEW (IPCR)

Annex C

I, DARWIN A. VILLONof the Ilocos Sur Provincial Hospital- Gabriela Silang commit to deliver and agree to be rated on the
attainment of the following targets in accordance with the indicated measures for the period JANUARY-JUNE 2016_.
Rate: , DARWIN A. VILLON
Date: _______________________
Reviewed by:
Date
Approved by:

GLORIA NAVARRO
Immediate Supervisor

DR. TRINA TABBOGA- TALAGA

Head of Office

RATING

5- Outstanding
4- Very Satisfactory
3- Satisfactory
2- Unsatisfactory
1-Poor

Core Functions
Success Indicator
(Target + Measure)
Allotted Budget
Division/Individuals
Accountable
Actual
Accomplishments
Ratings
Remarks

Q
E
T
A

Assist patients in maintaining personal hygiene

Daily morning care done to patients

Daily morning care done to 20 patients per month

4
4
4
4

Receive/Endorse and checked equipments patency, linens, articles and supplies

Checked all equipment, linens, articles and supplies

Checked all equipment, linens, articles and supply 22 days/ month

4.67

Maintain cleanliness and orderliness in the ward

Daily rounds and inspection done 22 days/month

Daily rounds and inspection done 22 days/month

4.67

MPO/PAP

Assist with admission, transfer, and discharge of patients

Assisted patients during admission and discharge

Assisted patients during admission, transfer and discharge

4
4
4
4

Perform Simple Nursing Procedure as Delegated (Bed Making, V/S Monitoring, Assisting in Post-mortem care, Assisting
Patient in Turning from Side to Side)
Performed Nursing Procedure 22 days/ month

Performed Nursing Procedures 22 days/month

4
4
4
4

Assist in Preparation of Patient for Treatment Examination and Surgery

Prepared patients for treatment examination and Surgery

Prepared patients for treatment examination and Surgery

4
4
4
4

Provide a Safe and therapeutic Environment Conducts for Healing

Provided Safe and Therapeutic Environment

Provided Safe and Therapeutic Environment

4
4
4
4

Clean Used Instruments and Send them for Sterilization

Cleaned used instruments 22 days/month

Cleaned used instruments 22 days/month

4
4
4
4

Assist Physician with minor procedures and physical examination of patients.

Assisted during minor procedures and physical examination of patients

Assisted during minor procedures and physical examination of patients

4
4
4
4

4
4
4
4

Support Function:
Attend meetings lectures seminars and other hospital activities
Attended meetings lectures and seminars and other hospital activities

Attended meetings lectures and seminars and other hospital activities

4
4
4

Prepare and Submit Monthly Accomplishment reports

Prepared and Submitted Monthly Accomplishment reports On or Before Deadline

Prepared and Submitted Monthly Accomplishment reports On or Before Deadline

5
5
5
5

Attends flag raising ceremony and flag retreat

Attended flag raising ceremony and flag retreat 85% acceptability

Attended as scheduled 90% attended with 90% acceptability

4
4
4

Final Average Rating

Comments and Recommendations for Development Purposes

Average Rating
CATEGORY
MFO
RATING
Strategic Priority

Core Functions
9
4.07 x .85 = 3.45
Support Functions
3
4.66 x .15 = .69
Total Overall Rating

Final Average Rating

VS= 4.14
Adjectival Rating

Very Satisfactory

Assessed by:
Date:
Final Rating by:
Date

Head of OPMIS

COMMISSION

Discussed with
Date
Assessed by:
Approved by:
Date

DARWIN A. VILLON

TERESITA F. AGATEP, RN, MAN

TRINA TABBOGA- TALAGA, MD

Employee

Chief Nurse
Head of Office