NURSING CARE PLAN EVALUATION FORM
NAME OF THE INSTITITUTE:
NAME OF THE STUDENT:
RATINGG SCALE
Sr. Content NCP 1 NCP 2 NCP 3 NCP 4 NCP 5
No
A. ASSESSMENT (9)
1. Collects complete data about patient
2. Identifies basic needs / problems
3 Formulates complete Nursing diagnosis
B. PLANNING (12)
Considers the patients problems priority wise
2 States the objective
3 Plans suitable Nursing actions for the stated
problems
4 States rationale for Nursing care plan
C IMPLEMEMNTATION (18)
1. Implements nursing care competently, safely
and accurately withina given time
2. Maintains safe and comfortable environment
for the patient
3 Applies scientific principles
4. Meets the nutritional needs of patient as
planned.
5. Gives health instructions to patient and family
as planned.
6 Accurate in recording and reporting patients
information to the appropriate personnel
D EVALUATION (6)
1 Evaluates the patients response to nursing care
2 Re-examines and modifies patients care plan
E, OVERALL PERFORAMANCE (5)
Remarks:
Grade:
Signature of Student Signature of Teacher