Tribhuwan University

Institute of Medicine

Maharajgung Nursing Campus

Post basic Bachelors of Nursing Programme

Leadership & Management Hospital Practicum (Hospital Major)

Student’s Name: Nirmala Niraula

Year: Second
Evaluation tool for assessing Performance of staff nurse

Name;
Date employed;
Total mark; 100
Check the block that best fits this employee’s work performance and indicate marks in last
column

S. Criteria Behaviors and Marks Mark

No
5 4 3 2 1
1. Attendance Always Regular in Usually on Uncertain Unreliable
and comes on attendance, very time in in
punctuality time seldom absent or occasionally attendance attendance
is late absent with and often late,
good reason punctuality leaves early
2. Patient Patients Patients are at Listen to the Sometimes Speaks
relationship wants to ease to speak to patients irritated rudely to the
speak to her when patient
her of their patients
problems speak to
her
3. Staff On Good rapport Courteous Occasional Difficult
relationship excellent with the staff, and gets difficulties and
terms with sincere and along with uncooper-
almost pleasant other staff ative
everyone

4. Personal Always Mostly Neat, clean Sometimes Never tidy

 cleanliness neat, clean, neat,clean,tidy but not in full untidy and cheerful
and dress tidy, in full and cheerful uniform
uniform
and
cheerful
5. Knowledge Has Thorough Adequate Insufficient Seems to
of job remarkable knowledge of knowledge of knowledge understand
skills mastery of most areas of the the work of the work little
all areas of world
the work
6. Work Always Mostly alert to Does regular Needs to be Always
initiative seeks and opportunities for work without motivated needs to be
sets for self improvement waiting for told exactly
additional learning directions what to do
task to do
above
assigned
work
7. Accepts Always Mostly fulfills Fulfills Sometimes Avoid
responsibil seeks to given given willing to responsibi-
-ities fulfill responsibility responsibility take lity
responsibili under responsibi-
ty direction lity
8. Loyalty to Very Above average Average or Uncertain Untrustwor-
organizati- committed reasonable about thy
on trustworthy loyalty
9. Adapts to Sees Flexible Accepts Uncertain, resistant to
new work benefit of change in reluctant to change
method change in work method change
work though lacks
method enthusiasm
10 Initiative in Always Asks questions Attentive but Never asks inattentive
learning seeks to and reads rarely asks questions
learn new occasionally does not
things by read charts
asking
question
and reading
charts
11 Participati- Enthusiasti Willingly attends Attends Has to be Usually
on cally join teaching /learning when it suits pushed absent
in teaching activities
learning
activities

12 Ability to Has very Has reasonable Little insight Recognizes Lacks

 assess own good insight into own mistakes insight
performa- insight performance
nce
13 Coping Copes well Mostly copes Tries to cope Tries to Rigid and
with with with situation with situation avoid such insecure
stressful situation quite reasonably and makes situation
situation effort to
improve it
14 Care of Always Usually uses Sometimes Uses Overuses
supplies uses supplies carefully uses supplies supplies supplies and
and supplies and care for carefully and and handles
equipment carefully equipment cares for equipment equipment
and care equipment with care carelessly
for when told
equipment
15 Flexibility Initiates Accepts changes Accepts Sometimes Refuses to
change of in work change in refuse to change
work place place/duties/shifts work accept
duties/shift when requested places/duties change in
s as need shifts but workplace/
arises unhappily duties
/shifts
16 Acceptance Accepts Accept criticism Sometimes Is Resents any
of feedback criticism correction accept defensive criticism
positively criticism correction
and tries to /correction
improve
17 Recording Always Mostly keeps Sometimes keeps Don’t keep
and keep records and gives keeps records records and any records
reporting records and report and gives gives and gives
gives report report report
report when told
Write N/A (not applicable) to any criteria that do not apply to your department.

Percentage evaluation: full marks pass marks

Comments: written test: 15 7

Evaluation: 85 42
Obtained mark:

Signature of Evaluation:

Date:
 Tribhuwan University
Institute of Medicine
Maharajgunj Nursing Campus
Maharajgunj, Kathmandu

Post Basic Bachelor of Nursing 2nd year

Leadership and Management Practicum Hospital Major

Development of Nursing Procedure

Student's Name: Nirmala Niraula Year : Second

Course : : Management Practicum in Hospital (Hospital Major)

Dressing
1. Definition:

 Dressing is defined as protective covering applied to the wound. Dressing plays a very
important role in wound care.
 Dressing is the process of cleaning a wound and applying a sterile covering with or without
medication.
 A process of changing a clean or sterile covering of a wound. The dressing may be wet or dry
and open or close.
2. Terms used in procedure

 Sterile:

3. Purpose of dressing:

 To maintain cleanliness of the wound

 To absorb drainage.
 To apply a sterile protective covering.
 To apply medicine for healing of the wound.
 To prevent infection
 To promote the patient’s physical and mental comfort.
 To control bleeding by application of pressure on the blood vessels.
 To provide pressure on the wound and minimizes the collection of fluid and edema of tissue.
 To keep the area moist or dry, depending on the dressing.
 To prevent from further injury.
4. Prepare patient before the procedure:

When a person has a surgery, he/she as well as visitor / family may feel anxious worried about the
condition, prognosis of patient. So at that time the nurses must be tactful and courteous to patient to
release their worries. So, it is important to provide sterile dressing and psychological support to the
person.

5. Points to Remember:

 Assess and record the condition of wound including its appearance, presence of swelling,
bruising, odors and if the skin is together or separated. Also record if there is any discharge
from the wound including the amount, color and odor.
 Record how the patient tolerates the procedure.
.6. Essential equipments and materials for the procedure:

A trolley containing:

 Sterile dressing set ( gauze pieces, cotton balls, a small bowl, tooth forceps, and artery forceps)
 Sterile cheatle forceps
 Additional sterile cotton balls, gauze pieces, and dressing pads as needed
 Sterile gloves
 Scissors
 Adhesive tape
 Bandage
 Rubber sheet
 Betadine or antiseptic solution
 Normal saline / Hydrogen peroxide
 Kidney tray, waste box
 Sterile culture bottle
 Neosporin powder / Betadine ointment etc.
 Screen
 Doctors order if necessary
 Patient's chart

7. Criteria of good dressing

Certain criteria have to be applied to all kinds of dressing. These includes-

 The assurance of positive sterilization of material and the correct techniques of their
application.
  Economy in the use of time and material.
 Durability of the material, so that dressing will hold up even under the stress of motion
including early ambulation.
 Simplicity in the mode of packing for the easy application without disturbing the principles of
strict precaution.
 physical and mental satisfaction of the patient with minimum pain and comfort.
 Availability of materials in sufficient quantity in the ward at all times considering the facts that
over stocking of the sterile goods will increase the risk of loss of sterilization.
 Adequate means for the easy and safe disposal of used contaminated dressing.
 Adequate facilities for the proper hand washing for the protection of both the patient and the
nurse.

8. Preliminary assessment of the patient and environment

 Check the doctor's order for specific instruction to note the type of dressing to be applied, about
the types of lotion to be used, application of medicine, to be applied etc.
 Identify the patient by name and bed number.
 Check the nurses record to note the condition of wound in previous dressing.
 Check the diagnosis and general condition of patient and the purpose of dressing.
 Get the instruction from the seniors.
 Get the assistance if required.

9. Observation during procedure

 Physical condition of the patient

 Mental status of the patient
 Check for healing process
 Check for signs of infection
 Swelling, tenderness, redness or warmth around the wound
 Thick, yellow or green pus
 A bad smell from the wound
10. Steps of Procedure:

S Steps of Procedure SN Rationale

N

1 Explain the procedure to the 1. An explanation about the procedure encourages

patient/caregiver client cooperation and reduces apprehension.

2. Collect equipment and articles needed 2. This provides for organized approach to task.
for dressing.

3 Check physician order for dressing. 3 This clearifies type of dressing.

4 Wash hands 4 Hand washing reduces the spread of infection.

5 Put all equipments on right side of 5

patients.

6 Assist the patient to a comfortable 6 It reduces risk of deformity or injury.

position to expose the wound. Place a
rubber sheet under the patient to
prevent soiling the linen. Drape the
patient for privacy.

7 Place opened, cuffed plastic bag near 7 Soiled dressing may be placed in disposable
working area. bag without contaminating outside surface of
the bag.

8 Open the sterile dressings, the 8

irrigation and cleaning solution, and
the instrument set to provide a sterile
field

9 Wear a protective apron when caring 9 Reduces transmission of micro organisms,

for a patient with a draining wound. gloves protect the nurse from exposure to
Use nonsterile gloves. blood or micro organinism.

10 Gently remove and discard the old 10 Reduces stress on suture line or wound edges
tape and soiled dressing in a plastic and reduces irritation and discomfort.
trash bag. If the dressing sticks to the
wound, moisten with sterile normal
saline and then remove.
 11 With clean gloves, remove dressings 11 It determines dressings needed for replacement.
one layer at a time observing More or less may be appropriate depending on
appearance and drainage to the degree of saturation.
dressing.

12 Inspect wound for appearance, size, 12 It indicates status of healing.

depth, drainage, integrity and
granulation tissue.

13 Use sterile gloves or non touch 13 Sterile gloves may be used for more complex
techniques with sterile forceps which situation with extensive drainage.
maintain sterility of all items in direct
contact with wound.

14 Pour antiseptic solution in the bowl 14 Growth of microorganism may be retarded and
for cleansing the wound. healing process is improved.

15 Clean the wound from inside to 15 Wound must be clean from least contaminated
outside, centre to periphery gently area to most contaminated area.
and repeat again if the wound is dirty.

16 Dry the wound with dry cotton and 16 Moisture provides medium for growth of
apply the ordered medicine gently if microorganism.
necessary.

17 Cover the wound with sterilized 17 This provides for increased absorption of
gauze or apply the dressing according drainage and wound is protected from
to the type of dressing. microorganism in environment.

18 Put a bandage or adhesive tape over 18 It keeps the dressing in position.

the dressing.

19 Remove the rubber sheet and pull of 19

gloves.

20. Replace the equipment and 20 To place the articles in right place when we
instruments. needed this articles, to find easily.

21 Report on patient’s chart or record on 21 Quality documentation enhances continuity of

patient’s chart.Eg, date, time, type of nursing care and provides accurate
drainage,pus blood, type of dressing documentation of procedure.
applied and signature.

11. Responsibilities of the nurse.

  Record and reporting
 Write full name/ signature
 Complete handover to next shift staff.

12. Care of the equipment after procedure :-

After completing the procedure keep the tray/trolly and other articles used during procedure keep on
its proper place.

13. Patient’s teaching

 Keep cleanliness of the clothes and surrounding environment.

 Keep nail short and don’t scratch the wound.
 Take diet high in protein.
 Don’t wet wound while bathing.
Bibliography:

 Caral Taylor, Corol, Fundamental of Nursing, The Arts & science of Nuring Care, 3rd edition,
,1997, pg. 707-712
 Elkin Perry Potter, Nursing Intervention and Clinical Skills, 3rd edition, Mosby 2004, pg. no.
272-275
 JB Lippincott Company, The Lippincott Manual of Nursing Practice, 5 th Edition, 1991, pg. no.
483 to 486.
 Ministry of Health, Division of nursing, Nursing Procedure Manual, September 1987, pg. no.
69
 Smith and duel,1996,Clinical Nursing Skills, 4th edition Appleton and Lange,pg.no.669-673
 Http:/www.medscape.com/view article/493949 online, 09/28/2010
 Http:/www.freepatents online.com/6979324.html,online 09/28/2010

TRIBHUVAN UNIVERSITY
 INSTITUTE OF MEDICINE

MAHARAJGUNJ NURSING CAMPUS

BACHELOR OF NURSING SECOND YEAR

LEADERSHIP AND MANAGEMENT

CRITERIA FOR EVALUATING STAFF PERFORMANCE

Department / Ward: Name of Staff:

Date: Full Marks: 50

Obtained Marks:

Direction: A Staff Nurse is responsible to provide direct nursing care applying nursing process.
Supervises ANM and co-workers, gives health education to patients/relatives and helps sister in ward
management. This tool will be used to evaluate the staff’s performance in the different units of the
hospital according to the following expected criteria.

Key for Marking

Poor Fair Good Very good Excellent

1 2 3 4 5

Where,

1) “Poor” means rarely performs the expected behavior.

2) “Fair” means sometimes performs the expected behavior.
3) “Good” means usually performs the expected behavior.
4) “Very good” means most of the time performs the expected behavior.
5) “Excellent” means demonstrates highly consistently qualitative working performance.

RESPONSE REMAR
S.N CRITERIA 1 2 3 4 5 KS

A. CLINICAL ACTIVITIES

1 Arives in time and takes bed to bed handover of the

Patients.
2 Check essential supplies, equipments, emergency trolley,
Narcotic drugs etc.
3 Carried out responsibilities assigned by sister / ward
Incharge
4 Plans and provides the basic nursing care according to
the needs of the patients applying nursing process.
5 Prepares and takes round with doctor.
6 Carries out instructions appropriately. (Collection of
Specimens, investigations and medications etc.)
7 Maintains personal hygiene of patient to prevent
Infection.
8 Gives medicine by applying six rights.
9 Takes responsibility of admission and discharge
procedure of the patient.
10 Maintains interpersonal relationship with seniors, juniors,
co-workers, patients and families.

B. COMMUNICATION ACTIVITIES

1 Communication politely and effectively with team

member, patient and the families.
2 Recognizes verbal and nonverbal behaviours while
communicating with patient and families.
3 Communicates by respecting the cultural beliefs and
 health practices of the patient and families.
4 Encourage patient and the families to express their
feelings and answers their queries and clear their doubts.
5 Accepts patients and the families as they are.
6 Reports relevant changes in client’s condition to the
supervisors/concerned authority(e.g. ward sister, doctors
etc ).
7 Records appropriately and correctly the client’s problem,
action taken to relieve the problem, the client’s response
to care and any modification needed in the care.
8 Orients the patient and the families about:
 Rules and regulations of the ward.
 Doctor’s round
 Visiting hour
 Facilities available in the hospital
 Payment system like bills and charges.
9
Maintains good interpersonal relationship with the
patient, family, seniors, co-workers and staffs of other other
department.
10.
Collects necessary information to identify patient’s
problem.

C. APPLICATION OF NURSING PROCESS

1
Collects health history, which is complete and relevant.
2
Uses appropriate methods in examining the patient.
3
Identifies and prioritizes the client’s needs according to
Maslow Hierarchy of basic needs.
4
Writes patient’s problem by identifying actual and
potential problems from the assessment.
5
Formulates appropriate nursing diagnosis based on
 identified problems.
6 Plans nursing care by developing goals and nursing
actions with client and the family whenever possible.
7 Implements the nursing care plans in logical sequence
according to the priority of the patients and by using
available resources and involving the client and family
as far as possible.
8 Evaluates the care given and reassess whether the goal
is met, partially met or not met.
9 Records all pertinent information of the patient’s
problem, his response to illness, the care given and any
revision of plan made in a clear and concise form.

D. PERFORMING NURSING PROCEDURE

1 Explains the purpose of any procedure (Diagnostic or

Other) to the clients and visitor before starting procedure
2 Sets up the equipments in an organized way.
3 Places the patient in proper and comfortable position for
procedure.
4 Maintains privacy of the patient.
5 Performs the procedure completely using appropriate
techniques.
6 Leaves the patient clean and comfortable after the
procedure.
7 Shares the outcome of the procedure with the patient
and the family.
8 Takes care of the equipments after the procedure and
replaces properly.

9 Records and reports the procedure appropriately

 including the condition of the patient and his reaction to
the performed procedure.
10 Evaluates her own procedure.

E. ACTIVITIES FOR PROFESSIONAL

DEVELOPMENT.

1 Seeks new knowledge for professional and personal

growth by showing curiosity on new subject, asking
question, and collecting information.
2 Shows respect to supervisors, co-workers and others.
3 Demonstrates professional behavior by being neat, tidy,
polite and punctual.
4 Demonstrates responsibility for the patient care by
completing his/her assignment before giving off duty.
5 Demonstrates ability to cope with stressful situation.
6 Shows professional responsibility by being accountable
for the responsibility assigned.
7 Works co-operatively with peers and health team
members in meeting the needs of the patients.
8 Shows maturity by evaluating own strengths and
limitations.
9 Attends pre and post conference of the ward when
conducted.

F. ADMINISTRATIVE ACTIVITIES

1 Keeps adequate supplies ( medicine, injection, linen etc)

and does inventory regularly.

2 Keeps custody of drugs and maintains record of its

 administration.
3 Checks all emergency drugs and equipments daily.
4 Takes special attentions about police case and
absconded patients (medical, legal, dead body).
5 Creates safe environment to prevent accidents in the
ward.

G. EDUCATIVE ACTIVITIES

1 Identifies the learning needs of the patient and families.

2 Plans and provides health education to patient and
families.
3 Gives incidental teaching to the co-worker or junior
staffs.
4 Participates in in-service education programme.
5 Helps students in learning activities.

H. SUPERVISORY ACTIVITIES

1 Supervises and guides ANMs and juniors.

2 Supervises patients and visitors for maintenance of
health promotion.

I. RESEARCH ACTIVITES

1 Identifies the areas for nursing research.

2 Helps and participates in nursing research activities.

J. COUNSELLING ACTIVITIES
1 Counsels the junior staffs, students, patients and family
members whenever need arises.

K. RECORDING & REPORTING

ACTIVITIES

1 Reports critical patients’ condition promptly to the

concerned person in verbal as well as in written form.
2 Reports immediately any absconded patient.
3 Records and reports of nursing care, treatment
given, medicine administered in a correct and prompt
manner.
4 Reports any absenteeism of staff.
5 Reports and records any loses and breakage in the unit.

L. EVALUATIVE ACTIVITIES

1 Does self evaluation regularly.

2 Evaluates patients’ condition and nursing care process.
3 Assists sister in staff appraisal.
4 Takes part in students evaluation.

JOB DESCRIPTION OF MATRON

Job title: Matron/nursing director

Place of work: Hospital

Class/level: Gazetted 1st class 2nd class

Minimum qualification: R.N./B.N./B.Sc. Nursing

Experience: According to civil service act

Responsible to: Assist. Matron, supervisors and sisters

Responsible with: Heads of various department of hospital other NGOS and INGOS

relating to particular hospital

Role:

Matron will work as a nursing administrator, educator, supervisor/leader, facilitator, counselor and
evaluator in an organization.

A. ADMINISTRATIVE ACTIVITIES

1. Assess requirement of the different level of staff and their need in the work situation
2. Assess the different clinical available
3. Plans and delegates responsibilities to the different level staff according to the need of the
situation and their ability
4. Makes schedule for Assistant Matron, supervisors and sisters
5. Participate in the preparation of annual budget to run the nursing department efficiently
when needed
6. Prepares the annual report of the nursing department as required in the board, when needed
7. Maintains effective communication within the organization and outside the organization
8. Recommends to hospital director and board of director of management committee on the
developing, modifying the hospital practices to deliver an effective nursing skill
9. Plans and processes through appropriate channel for necessary supplies and equipment
10. Sanctions and forwards level for the nursing and supporting staff
11. Arranges for condemnation of supplies and equipment
12. Helps in maintaining safe and clean environment
13. Helps and maintains good public relations
14. Participates in recruitment of nursing and non-nursing personnel
15. Assists the hospital director in administrative work related to nursing
16. Plans, conducts and participates in staff meeting with nurses and others
 17. Attend symposium, seminar and workshop at national and international level on behalf of
nurses’ forums
18. Plans and organizes for disaster situation

B. EDUCATIVE ACTIVITIES

1. Plans and prepares in service education training program on the basis of need identified for
nursing personnel and supporting staff
2. Plans and organizes health education for clients as needed
3. Encourages staff for utilization of nursing process
4. Assists in promoting desirable teaching/learning environment in the hospital

C. SUPERVISORY ACTIVITIES

1. Plans, conduct (ward and OPD/Emergency, CSSD/OT environment) daily and grand rounds
for supervision and follow up
2. Supervises in service education/training program periodically
3. Supervises subordinates periodically for helping and guiding
4. Provides feedback to nursing personnel on their clinical performance

D. RESEARCH ACTIVITIES

1. Identifies priorities areas for nursing research in the hospital

2. Plans, conduct, guides, co-operates and participates in the research activities
3. Implements the funds as needed in the clinical situation
4. Explores the funds for research activities

E. COUNSELING ACTIVITIES

1. Provides counseling to her subordinates as required

F. EVALUATIVE ACTIVITIES

1. Develops and implements the system for staff performance regularly

2. Plans and evaluates he nursing activities of the situation
3. Maintains, records and reports of nursing personnel in complete and accurate forms
4. Recommends for reward and punishment as needed
5. Gives feedback to staffs as needed
6. Re plans and develops programs as evaluation reports and results