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58 views2 pages

Or Eval

Uploaded by

maria2czarinafranco
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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OUR LADY OF FATIMA UNIVERSITY

College of Nursing
Esperanza St., Hilltop Mansion, Lagro, Quezon City,
Tel. nos. (02) 418-0185

SUMMARY PERFORMANCE EVALUATION ACHIEVING


INTRA-OPERATIVE CARE COMPETENCY
In Accordance with PRC Board of Nursing Memorandum No.01 Series 2009
Signature over Printed Name of Student:

INTRA-OPERATIVE CARE COMPETENCIES DESIRED 1ST 2ND 3RD AVERAGE


RATING RLE RLE RLE RATING
I. SAFE AND QUALITY NURSING CARE (SQC)
1. Utilizes the nursing process in the care of OR client 4
a. Obtains comprehensive clients information by checking
complete accomplishment of the preoperative
checklist/client’s chart
b. Identifies priority needs of the client at the Operating Room 4
c. Provides needed nursing interventions based on identified 4
needs
d. Monitors client’s responses to surgery 2
2. Promotes safety and comfort of patients inside the OR 2
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, sutures and other 2
supplies in functional arrangement
d. Hands instrument, sponges, sutures and other needed 2
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 equipment 2
c. Receives client for surgery/endorses client post-operatively 2
d. Assists in skin preparation and draping of client 2
5. Administers medications and other health therapeutics safely 2
II. MANAGEMENT OR RESOURCES AND ENVIRONMENT (MRE)
1. Organizes work load to facilitate timely patient care 4
2. Utilizes adequate and appropriate resources to support the OR team 2
3. Ensures functionality of OR resources 2
4. Maintains a safe environment at the OR by observing the principles of 2
asepsis
III. HEALTH EDUCATION (HE)
1. Implements appropriate health education activities to client based on 2
needs assessment
IV. LEGAL RESPONSIBILITIES (LR)
1. Adheres to legal and institutional protocols regarding informed 2
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consent
V. ETHICO-MORAL RESPONSIBILITIES (EMR)
1. Respects the rights of the OR client 2
2. Accepts responsibilities and accountability for own decisions and 2
actions as an OR nurse
VI. PERSONAL AND PROFESSIONAL DEVELOPMENT (PPD)
1. Performs OR functions according to professional standards 4
2. Possesses positive attitude towards learning surgical and OR-related 2
knowledge and skills
VII. QUALITY IMPROVEMENT (QI)
1. Participates in quality improvement activities related to infection 2
control and successful OR operations
2. Identifies and reports variances in sterility and other OR activities 2
VIII. RESEARCH (R)
1. Disseminates results of OR-related research findings to clinical 2
IX. RECORDS MANAGEMENT (RM)
1. Maintain accurate and updated documentation of patient care 2
X. COMMUNICATION (Comm)
1. Establishes rapport with patients, significant others and members 1
of the health team
2. Uses appropriate information mechanisms to facilitate 2
communication inside the OR and with other departments in the
hospital
XI. COLLABORATION AND TEAMWORK (CTM)
1. Collaborates plan care with other members of the health team 2
TOTAL SCORE 75

When Graded RLE’s Were Performed (Specify Academic Year and Semester):

First Graded RLE : Academic Year__________1st Sem.__2nd Sem.___ Summer_____


Clinical Instructor : Name_____________________ Signature _______________________
: License Number:____________ Validity:_________________________
Second Graded RLE : Academic Year_________1st Sem.___2nd Sem.__ Summer_____
Clinical Instructor : Name_____________________ Signature _______________________
: License Number:____________ Validity:_________________________
Third Graded RLE : Academic Year__________1st Sem.___2nd Sem.___ Summer_____
Clinical Instructor : Name_____________________ Signature _______________________
: License Number:____________ Validity:_________________________

Verified True and Correct :___ ________________________________ ___ License Number__________


(Signature over printed Name) Clinical Coordinator Validity_____ ___________
Academic Year Graduated :____________________

______________________________ License Number__________________


Dean
Signature over Printed Name Validity Date:___ _________________

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