VIRGEN MILAGROSA COLLEGE OF

UNIVERSITY FOUNDATION NURSING

PERFORMANCE CHECKLIST
RESPIRATORY RATE

Poor Fair Goo

PERFORMANCE INDICATORS 3 + error 1-2 errors No err
(1) (3) (5)
I. KNOWLEDGE (40%)
1. Defines Respiratory Rate
2. Enumerate the special considerations in taking RR
3. State the normal RR range in both the newborn and adult
4. Identifies the materials used
5. Able to mention the rationale/principles behind
suggested action
II. SKILLS/ABILITY (40%)
1. Washes hands
2. Explain procedure to the patient
3. While the fingertips are still in place after counting the
PR, observe the patients respiration
4. Note the rise and fall of the patient’s chest with each
inspiration.
5. Using watch with the second hand, count the number
of respirations for one full minute.
6. Document the res ult
III. ATTITUDE (20%)
1. Accepts criticism well and shows effort to improve
performance
2. Answer the questions politely
3. Observes the proper decorum and behaves as a mature
student nurse.
4. Shows respect and considerations of the recipient of care.
5. Demonstrate preparedness, readiness and
confidence in the performance of the procedure.
Name of Student: ________________________ Year/ Section: _____________________

Evaluated by: Conforme:

____________________________ ______________________________
Signature over Printed Name / Date Signature over Printed Name/Date
Clinical Instructor Student