WEEKLY WORK COMMITMENT AND ACCOMPLISHMENT REPORT

FOR _MAY (dates of work from home)

NAME OF STAFF:
POSITION: NURSE I
AREA OF ASSIGNMENT: COVID ICU

Date / Expected Output Target Activities Actual Remarks

Time Accomplishments (if any)
Frame
May Nursing Service Directory Revision to Pending
Organizational Chart Pictures to by
Format
other
departments
May Prepared a Health Develop a Created a pamphlet for
Education and Promotion teaching and COVID areas.
Material in Print Format interactive
learning
materials
May Crafted a Nursing Care Prepare nursing
Plan care plans

Submitted a Quality Develop a

Improvement Plan comprehensive
Proposal quality
improvement
plan
- Submit an
innovation
project proposal

I commit to perform the above activities within the date/s indicated.

To be returned to staff for filling out of accomplishment

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To be filled by staff if additional output/ accomplishments are delivered but are not targeted above:
1.

2.

Date submitted: _____________________

To be filled and/ or signed by Immediate Supervisor upon accomplishment of targets:
Remarks if any:
_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
Reviewed and Noted by:

___________________________________ _____________
Signature over printed name of Supervisor Date