Clinical Efficiency Evaluation Tool for Ward
Student Name: ________________________________________
Clinical Area: _________________________________________
Competency
1. Assess the patient condition
completely
2. Explain rationale for every
procedure done to the client.
3. Demonstrates knowledge of
principles of aseptic/sterile
technique for every procedure
done
4. Utilize therapeutic
communication in relating with
patient, staff, family, clinical
instructor and other students
5. Performs basic nursing
procedures previously learned
6. Applies principles of safety (e.g.
Side rails, performs correct
identification of patient)
4 3
Consistently demonstrates
knowledge in completing a full
body assessment. Demonstrate
above average level of
competence in assessment skills
Consistently demonstrate the
ability to explain why a procedure
is done with minimal instructor
assistance or cueing
Consistently demonstrate
knowledge on aseptic and sterile
technique. Able to verbalize and
perform technique with minimal
instructor assistance or cueing
Consistently demonstrate
knowledge on therapeutic
communication with patient, staff,
family, clinical instructor and
other students
Consistently demonstrate ability
to perform basic nursing
procedures with minimal or no
assistance
Consistently demonstrate
knowledge on patient safety
during patient care with minimal
or no assistance from clinical
instructor
Demonstrates knowledge in
completing a full body
assessment. Requires a moderate
level of assistance from instructor
to complete assessment skills
Demonstrate the ability to explain
why a procedure is done with
moderate instructor assistance
and cueing
Consistently demonstrate
knowledge on aseptic and sterile
technique. Able to verbalize and
perform technique with moderate
instructor assistance or cueing
Demonstrate knowledge on
therapeutic communication with
patient, staff, family, clinical
instructor and other students with
moderate assistance from
instructor
Demonstrate ability to perform
basic nursing skills with moderate
assistance from the clinical
instructor
Demonstrate knowledge on
patient safety during patient care
with moderate assistance from
clinical instructor
Year/Section: ______________
Date of Exposure: __________
2 1 Score
Has below average knowledge Does not have basic knowledge
and skills in completing body on body assessment
assessment. Requires maximum
level of assistance from
instructor to compete
assessment
Inconsistently demonstrate the Inability to explain rationale in
ability to explain why a procedure every procedure done
is done. Requires maximum
instructor assistance and cueing
Inconsistently demonstrate Has no knowledge on
knowledge on aseptic and sterile aseptic/sterile technique.
technique. Not able to verbalize
and perform technique, requires
maximum instructor assistance
or cueing
Inconsistently demonstrate Has no knowledge on
knowledge on therapeutic therapeutic communication skills
communication with patient, staff,
family, clinical instructor and
other students. Requires
maximum supervision from
instructor
Inability to perform basic nursing Has no ability to recall basic
skills without maximum nursing procedure previously
assistance from the clinical learned
instructor
Inconsistently demonstrate Has no ability to recall basic
knowledge on patient safety. patient safety principles
Requires maximum assistance
from the clinical instructor
 7. Maintains accurate, complete
and clear recording
8.Carries out work thoroughly and
prioritize nursing care
9. Administer oral medications
within the 10 rights
10. Reports to duty regularly and
on time with complete
paraphernalia
11. Dress accordingly to policy
12. Accepts criticisms and
suggestions positively in a
responsible manner. Displays
positive attitude
Legend:
4- Excellent
3- Very Satisfactory
2- Satisfactory
1- Poor
Clinical Instructor: _____________________________
Student Signature: ____________________________
Consistently record and
document findings completely at
above average level with minimal
or no assistance from clinical
instructor
Consistently demonstrate above
average ability to carry out work
and knows prioritization of
nursing care with minimal or no
assistance from clinical instructor
Consistently demonstrate above
average knowledge and
competence in medication
administration with minimal
supervision from clinical
instructor
Consistently report to duty on
time with complete paraphernalia
with no absences
Consistently dress accordingly in
complete uniform, with cap/pin,
clean white shoes and socks
Consistently accepts suggestion
and make improvements
accordingly at an above average
level of competence. Conducts
self in a mature and responsible
manner
Record and document findings
completely at an average level
with moderate assistance from
clinical instructor
Demonstrate above ability to carry
out work and knows prioritization
of nursing care with moderate
assistance from clinical instructor
Demonstrate average knowledge
and competence in medication
administration with moderate
supervision from clinical instructor
Consistently report to duty on time
with paraphernalia. Notifies
clinical instructor on absences.
Consistently dress accordingly in
uniform, with minimal lacking
either of cap/pin, clean white
shoes and socks
Accepts suggestion and make
improvements accordingly at an
average level of competence.
Conducts self in a mature and
responsible manner
Inconsistently record and
document findings. Requires
maximum assistance and
intervention from the clinical
instructor
Inconsistently demonstrate below
average ability to carry out work
and knows prioritization of
nursing care. Requires maximum
assistance from clinical instructor
Inconsistently demonstrate below
average knowledge and
competence in medication
administration with maximum
supervision from clinical
instructor
Inconsistently reports on duty
and inconsistently notify the
clinical instructor on absences
Inconsistent with dressing of
uniform with many lacking
accessories such as pin/cap,
shoes and socks
Inconsistent in acceptance of
suggestions and demonstrate
below average level of
competence. Does not conduct
self in a mature and responsible
manner
Has no ability to document
findings. Performance needs to
go back to low level competency.
Has no ability in prioritizing
nursing care. Tasks are not
completed
Does not know the 10 rights of
giving medications and no
knowledge on medications given
Consistently arrives late. Does
not notify clinical instructor on
absences. Absence is
unexcused.
Needs constant reminders to
dress according to policy
Consistently irresponsible and
immature. Demonstrate below
average level in attitude.
Total: ________________
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