Intraoperative Competency Summary Performance Evaluation 4

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ILOILO DOCTORS’ COLLEGE

College of Nursing
West Avenue, Molo, Iloilo City

SUMMARY PERFORMANCE EVALUATION


INTRAOPERATIVE COMPETENCY
Outcomes- Based Education Curriculum CMO – 15 Series of 2017

Student’s Name:_______________________________ Year/ Section:_______________________


Area of Exposure:______________________________ Inclusive Dates:______________________

PROGRAM OUTCOMES LEARNING OUTCOMES 1 2 3 4 5


1. Apply knowledge of physical, a. Integrate principles and concepts of human behavior in a given
social, natural and health health and nursing situation.
sciences and humanities in the b. Apply the appropriate nursing concepts holistically and
practice of nursing. comprehensively.
c. Correlates knowledge of anatomy, physiology of system involved for
surgery
2. Provide safe, appropriate and a. Identifies priority needs of the client in the Operating Room
holistic care to individuals, b. Provides needed nursing interventions based on identified needs
families, population groups and c. Monitors client’s responses to surgery
community utilizing the nursing d. Promotes safety, comfort and privacy of patients inside the OR
process.
e. Performs the functions of the SCRUB NURSE 1 2 3 4 5
i. Performs surgical scrub correctly
ii. Dons sterile gowns and gloves aseptically
iii. Prepares surgical instruments, sponges, sutures and other
supplies in functional arrangement
iv. Hands instruments, sponges, sutures and other needed
materials according to surgeon’s preference
v. Performs surgical count accurately
f. Performs the functions of the CIRCULATING NURSE 1 2 3 4 5
i. Anticipates the needs of the surgical team
ii. Sets up the OR room and needed equipment
iii. Receives client for surgery / endorses client post-operatively
iv. Assists in skin preparation and draping of client
v. Administers medications and other health therapeutics safely
3. Apply guidelines and principles a. Obtains comprehensive information of the patient’s condition
of evidence- based practice in b. Accomplishes the preoperative patient checklist prior to the start of
the delivery of care the operation
c. Identifies nursing problems based on evidences
d. Establishes plan of care according to patient needs
e. Perform interventions basing on priority problems
f. Evaluates effectiveness of interventions basing on presenting
evidences
4. Practice nursing in accordance a. Adheres to legal and institutional protocols regarding the informed
with existing laws, legal, ethical consent
and moral principles and b. Follow standards and protocols according to institutional policies.
standards. c. Upholds ethical standards in the care of the patient
d. Respects the rights of the patient, religious affiliation, cultural and
ethnical practices.
5. Communicate effectively in a. Establishes rapport with client and/or support system.
speaking, writing, and b. Communicates effectively both in oral and written form.
presenting using culturally c. Collaborates with the patient, significant others and members of the
appropriate language. health team
d. Listens attentively to clients’ and family requests and queries.
e. Utilizes appropriate communication language when dealing with
patients, families and members of the surgical team.
6. Work effectively in collaboration a. Discusses the plan of care with the other members of the health
with inter-, intra- and multi- team
disciplinary and multi- cultural b. Establishes harmonious relationships with members of the health
teams. team.
c. Refers patient to allied team partners.
d. Respects the role of other members of the health team.
7. Report and document up-to- a. Adheres to the principles of confidentiality of records and other
date client care, accurately and information.
comprehensively. b. Documents pertinent data briefly and completely with accuracy.
c. Updates patient information on the effectiveness of care.
d. Demonstrates effective and complete documentation of care of the
postoperative client
8. Practice beginning a. Exhibit ways in carrying out responsibilities in a defined time
management and leadership b. Carries out own initiative in performing work assignments
skills in the delivery of client c. Demonstrates involvement in effective decision making in the care of
care using a systems patients for surgery
approach. d. Utilizes the nursing process in developing a plan of care of the
patient for surgery
e. Recognizes team members contribution in the care of the patient
9. Conduct research with an a. Identifies research problems related to the care and management of
experienced researcher. the patient
b. Participates in research study/ case discussions in the care and
management of the patient undergoing surgery.
c. Disseminates results of OR-related research findings to clinical
ILOILO DOCTORS’ COLLEGE
College of Nursing
West Avenue, Molo, Iloilo City

group and other members of the OR team.


10. Engage in life-long learning a. Updates oneself with the latest trends and developments in the care
with a passion to keep current of surgery patients.
with national and global b. Reflects on actions during clinical experiences for self- improvement
development in general and c. Accepts constructive criticisms and make appropriate changes for
nursing and health professional growth and maturity.
development in particular. d. Identifies the need for self-direction, improvement and further
learning
11. Demonstrate responsible a. Maintains professionalism throughout the clinical exposure.
citizenship and pride of being a b. Performs and function according to Filipino professional nursing
Filipino. standards.
12. Apply techno- intelligent care a. Implements system of informatics to support the delivery of
systems and process. healthcare.
b. Maintains an organized system of filing and keeping records of
client.
c. Maintains an accurate and updated documentation of patient care
13. Uphold the nursing core values a. Project the positive professionalism image of a Filipino nurse.
in the practice of the b. Demonstrate caring as the core of nursing, love of God, love of
profession. country and love of people.
14. Apply entrepreneurial skills in a. Seeks opportunity and take initiatives in learning new skills.
the delivery of nursing care. b. Exhibits persistence in finishing work
c. Demonstrates independence and confidence in the performance of
tasks.
TOTAL
AVERAGE RATING

Rating Description:
5 Consistently demonstrates excellent performance. Exceeds the performance standards.
4 Performs adequate performance. Tasks consistently meet expectations.
3 Performs tasks inconsistently. Inadequate performance and quality of work.
2 Performs tasks with difficulty. Needs to be reminded to execute the task.
1 Unable to perform task as required. Performance is below the expected standard criteria.

Certified True and Correct:

(Signature over Printed Names)

______________________________________________ _______________________________________
Clinical Instructor Clinical Coordinator
License Number: _______________________________ License Number: ________________________
PRC Card – Validity Date: ________________________ PRC Card – Validity Date: _________________

______________________________________________
DEAN _______________________________________
License Number: _______________________________ Academic Year Graduated
PRC Card – Validity Date: ________________________

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