A rating scale is a closed-ended survey question used to represent respondent feedback in a comparative form for specific features.

1. NAME OF UNIVERSITY
ADDRESS
Student’s name: Full marks: 10
Year: Pass marks: 6
Level: Obtained marks:
Date:
Clinical Area:
Criteria for evaluating on oral medication
Direction: Students should be responsible performing oral medication.
Evaluation will be done by following criteria:
1 2 3 4 5
Fair Good Very Good Excellent Outstanding
(Total marks divided by 8) Total marks obtained:
S.
N.
Steps 1
Fair
2
Good
3
V.good
4
Excellent
5
Outstanding
1. Check the patient’s identification and verify the
medication order
2. Prepare needed articles
3 Check written order, patient’s name, drug’s
name, dose, route and time of administration.
4 Explain the purpose of medication to patient.
5. Wash hands.
6. Calculate correct dose
7. Perform 2nd
check before preparing medicine
8 Assist patient to sitting or side lying position.
9 Transfer capsules/ tablets to medication cup
without touching with fingers.
10 Administer only one drug at a time
11 Offer a glass of water with the drug to be
administer
12 Stay with the patient until each tablet is
swallowed to make sure medicines are
swallowed.
13 Assist patient to comfortable position
14 Replace articles
15 Record the drug administration date, time and
signature

2. FEEDBACK
Strength: Areas to be improved: