OUR LADY OF FATIMA UNIVERSITY

College of Nursing-Valenzuela City

STUDENT NAME
PROGRAM Bachelor of Science in Nursing
YEAR & SECTION
NCM 104
INSTRUCTOR
Care of Clients with Alteration
COURSE
in Perception and Coordination
DATE
(SKILLS LABORATORY)

PROCEDURE : TEACHING THE PATIENT HOW TO WALK WITH CANE

EXPECTED OUTCOME : The student should have properly and efficiently teach the patient how to walk
with cane
ASSESSMENT TASK : Return Demonstration
Assessment Exceptional Good Average Poor
SCORE
Dimension (3) (2) (1) (0)
Greeted and identified Performed at Performed at least Failed to greet
1. patient by asking his/her least two (2) one (1) way of and identify
Identifying the name and checking ways of identifying patient
Patient his/her ID band and bed identifying patient.
tag. patient.
Procedure was Details of the Clear explanation Procedure was
2. explained clearly and procedure was of the procedure not explained.
Explaining the completely. explained but in was observed but
procedure an unclear lacks details.
manner.
Safety was observed by: Followed at least Followed only 1 Failed to provide
3.1. Lowering the height 2-3 out of 4 steps step of the safety during the
of the bed of the procedure. procedure procedure
3.
3.2. Dangle the client
Providing
3.3. Assess for vertigo
Safety
3.4. Apply gait belt
around client’s waist, if
needed
Thorough assessment of Assessment was Very limited Thorough
client’s strength, partly done. assessment was assessment was
4.
mobility, range of done. not done.
Assessing the
motion, visual acuity,
Client
perception difficulties,
and balance was done.
Adeptly demonstrated Demonstrated 3- Demonstrated Failed to follow
correct positioning. 4 out of 5 steps only 1 – 2 out of the steps of the
5.1. Have the client of the procedure the 5 steps of the procedure
hold the cane in the procedure
hand opposite the
affected leg
5.2. Have the client
push up from sitting
5.
while pushing down
Starting
on the bed with the
Position
arms
5.3. Let client stand at
bedside for a few
moments
5.4. Assess the height
of the cane
5.5. Walk to side and
slightly behind client
6. Competently Demonstrated Demonstrated Did not
Cane gait and demonstrated both cane both gait correctly 1 out of demonstrate
Sitting with a gait patterns. patterns 2 gait patterns. either of the 2
cane carelessly. gait patterns.
Principles of medical Hand washing Hand washing was Hand washing
7.
hand washing was was done with done with was not done.
Hand washing
observed. minimal errors. maximal errors.
8. Information about the Some of the Most of the Documentation
Documenting procedure was properly details of details of was not done
the documented. procedure were procedure were
Procedure not documented. not documented.

OVERALL SCORE: ______________

Target Raw Score: 18 out of 24. If raw score is less than 18, repeat the return demonstration.

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FACULTY SIGNATURE OVER PRINTED NAME