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EVALUATION TOOL EVALUTION TOOL EVALUTION TOOL
1. EVALUATION FORMAT FOR WRITTEN ASSIGNMENT
2nd YEAR POST BASIC NURSING
MENTAL HEALTH NURSING
Name of the college:
Name/ Seat Number of the student:
Topic: Date:
Sr. No. Criteria Total marks Marks obtained
1 Relevancy of content:
• Clarity (2)
• Concise (2)
• Simplicity of language(2)
06
2 Depth of content:
• Simple to complex(2)
• Key points emphasized(3)
• Description of important
points with illustration(5)
10
3 Organization of content
• Sequential (2)
• Grammar , punctuation(2)
• Clean, neat , tidy(1)
5
4 A.V.Aids/Diagram/Tables 02
5 Bibliography /references 01
6 Submission on time 01
Total 25
Comment of Evaluator:
Signature of student: Signature of Evaluator:
2. Name of the college:
EVALUATION CRITERIA FOR NURSING CARE PLAN
2nd YEAR POST BASIC NURSING
MENTAL HEALTH NURSING
Name/ seat number of the student:
Diagnosis: Ward:
SR.
NO.
CONTENT MARKS MARKS OBTAINED
1. Introduction 1
2. History collection 4
3. MSE & Diagnosis 7
4. Investigations and treatment 2
5. Nursing care plan 7
6. Summary and conclusion 2
7. Bibliography 2
TOTAL 25
Remarks:
Signature of Student Signature of Supervisor
3. EVALUATION CRITERIA FOR NURSING CASE STUDY
2nd YEAR POST BASIC NURSING
MENTAL HEALTH NURSING
Name of the college:
Name/ seat number of the student:
Diagnosis: Ward:
SR.
NO
CONTENT MARKS MARKS OBTAINED
1. Patient’s History 02
2. MSE 03
3. Anatomy and Physiology 02
4. Incidence, Etiology 02
5. Psycho pathology 03
6. Clinical manifestations 03
7. Investigations 02
8. Complication and Prognosis 02
9.
Management –
• Medical
• Psychotherapies
• Physical therapies
06
10. Drug study 05
11. Nursing care plan 07
12. Nurses’ Notes/ prognosis 04
13. Health Education 02
14. Discharge/Rehabilitation planning 03
15. Conclusion 02
16. Bibliography 02
Total 50
Remarks:
Signature of Student Signature of Supervisor
4. 2nd YEAR POST BASIC NURSING
CLINICAL SPECIALTY-MENTAL HEALTH NURSING
EVALUATION CRITERIA FOR PSYCHIATRIC CASE HISTORY TAKING
Sr. No. Criteria
Marks
Allotted
Marks
Obtained
1 Demographic of Patient 1
2 Chief Complaints 3
3 Present psychiatric history 4
4 Past Psychiatric history 3
5 Non-Psychiatric History 1
6 Family History 2
7 Personal History 5
8 Pre-morbid personality 5
9 Summary & Clinical Diagnosis 1
10 Total 25
Remark
Signature of Student Signature of Supervisor
5. EVALUATION CRITERIA FOR MENTAL STATUS EXAMINATION
2nd YEAR POST BASIC NURSING
MENTAL HEALTH NURSING
Name of the college:
Name/ seat number of the student:
Diagnosis: Ward:
Sr. No. Criteria
Marks
Allotted
Marks
Obtained
1 Demographic Data 1
2 General appearance and behavior 3
3 Psychomotor Activity 1
4 Speech 3
5 Thought 4
6 Mood 2
7 Perception 2
8 Cognitive functions
9 Attention and concentration 1
10 Memory 1
11 Orientation 1
12 Abstraction 1
13
Intelligence & General
Information
1
14 Judgment 1
15 Insight 1
16 General Observations 1
17 Summary & Clinical Diagnosis 1
Total 25
Remarks:
Signature of Student Signature of Supervisor
6. EVALUATION CRITERIA FOR PROCESS RECORDING
2nd
YEAR POST BASIC NURSING
MENTAL HEALTH NURSING
Name of the college:
Name/ seat number of the student:
Diagnosis: Ward:
Sr. No. Criteria
Marks
Allotted
Marks
Obtained
1 Base line data 1
2 List of Nursing problems identified 4
3 List of objectives of interactions 4
4 Conservation Pattern 5
5 Communication Techniques Used 5
6 Nature of termination 3
7 Evaluation by students 3
Total 25
Remarks:
Signature of student Signature of Supervisor
7. EVALUATION FORMAT FOR DRUG STUDY
2nd YEAR POST BASIC NURSING
MENTAL HEALTH NURSING
Name of the college:
Name/ seat number of the student:
Diagnosis: Ward:
SR.No Criteria Max Marks
Marks
Obtained
1 Planning and Organisation 05
2 Content 30
3 Nursing Responsibility 10
4 Conclusion and Criteria 05
Total 50
Sign of the student: Name & Sign of the Supervisor:
Date: Date
8. EVALUATION CRITERIA FOR ECT CARE
2ND YEAR POST BASIC NURSING
MENTAL HEALTH NURSING
SR.
NO.
CRITERIA MARKS ALLOTTED MARKS OBTAINED
1 Introduction 03
2 Preparation of article and patient 04
3 Care before therapy 04
4 Care during therapy 05
5 Care after therapy 05
6 Recording 04
Total 25
Remarks:
Signature of Student Signature of Supervisor
9. EVALUATION CRITERIA FOR NURSING CASE PRESENTATION
2nd YEAR POST BASIC NURSING
MENTAL HEALTH NURSING
Name of the college:
Name/ seat number of the student:
Diagnosis: Ward:
SR.
NO.
CONTENT
MARKS
MARKS OBTAINED
Knowledge assessment
1 Orientation of History 5
2 M.S.E.with Diagnosis 8
3 Co-relation with patient and Book 03
4
Nursing care plan and Nurses’
Notes
10
5 Drug Study 03
6 Health Education 03
7 Bibliography 02
Presentation skill
8 Use of A. V. Aids 06
9 Physical arrangement 02
10 Group participation 05
11 Effectiveness of Presentation 03
50
Remarks:
Signature of Student Signature of Supervisor
10. Name of the college:
EVALUATION FORMAT FOR DRUG STUDY
2nd YEAR POST BASIC NURSING
MENTAL HEALTH NURSING
Name/ seat number of the student:
Diagnosis: Ward:
SR. NO. PARAMETERS
MARK
ALLOTTED
MARK
OBTAINED
Knowledge assessment
1 Introduction 2
2 Drug class, Available form 4
3 Mode of action 6
4 Indication, Dosage, Route 4
5 Side Effect & Contraindication 4
6
Nursing consideration & Patient
Education
8
Presentation skill
7 Eye Contact 2
8 Appearance 2
9 Classroom Management 2
10 Use of A. V. Aids 4
11 Language Fluency 2
12 Mastery over content 4
13 Group Participation 4
14 Bibliography 2
TOTAL 50
Remarks:
Sign of the student: Name & Sign of the Supervisor:
Date: Date
11. GUIDELINE FOR CLINICAL PERFORMANCE EVALUATION
PERFORMA
2nd
YEAR POST BASIC NURSING
MENTAL HEALTH NURSING
AREA:
Student’s Name: Year:
Duration: Hospital Ward :
SR.NO CONTENT 4 3 2 1
1 KNOWLEDGE, SKILL AND APPLICATION
1 Demonstrates, sound scientific knowledge and understanding in her dealings with
patient.
2 Demonstrates ability in history taking.
3 Examine the MSE
4 Demonstrate appropriate communication skill
5 Demonstrates ability to analyze and interpret the data collected for nursing care
planning.
6 Demonstrates ability to identify the needs of patients.
7 Demonstrate ability to implement the planned care to patients.
8 Attends to psycho social needs
9 Able to perform and assist in diagnostic and treatment modalities
10 Implements the procedure with skill, speed and completeness.
11 Makes relevant observations and record and reports them promptly and effectively
12 Identifies risk factors and manages emergency situations effectively and promptly
13 Works independently and makes prompt, relevant decisions in all situations
14 Able to carry out health talks and incidental health teachings effectively
15 Demonstrates sound knowledge of drug used in psychiatric ward.
16 Utilizes therapeutic communication techniques while interacting with patients &
family members.
II. PERSONALITY ASPECTS
17 Professional grooming and turn-out in uniform
18 Patient, keen and attentive listener
19 Punctuality
20 Courteous, tactful and considerate in all her dealings with colleagues, seniors,
patients and family
21 Maintains professional relationship
with health team members.
22 Enthusiastic and interested, takes interest in clinical setting
23 Follows instructions and exhibits positive behavioral changes as and when required
24 Displays emotional maturity in all her dealings in the clinical setting
25 Demonstrates evidence of self learning by additional reading of current literature
Total Marks obtained:
Signature of Student Signature of Clinical supervisor