Republic of the Philippines

Department of Health
EAST AVENUE MEDICAL CENTER
East
Reference Code:
Avenue, Quezon City FM – NUR – 070
Revision No.
0
Date: Effective
OCT. 1, 2013
ORIENTEE EVALUATION
SHEET

NAME OF ORIENTEE : ___________________ POSITION: ________________

AREA OF ASSIGNMENT: ____________________INCLUSIVE DATES: ________
EVALUATED BY : ___________ ________ POSITION: N II

INSTRUCTIONS : This evaluation is made to appraise the strengths and weaknesses of an orientee
in the orientation phase. Kindly encircle the number that best describes your evaluation of the
orientee. Your responses will help in determining periodically the progress/efficiency of the orientee.

PART I Job Factors: (For Nurse and NA Orientee)

A. Performance Skills 5 4 3 2 1

B. Work Attitude & Initiative 5 4 3 2 1

C. Organization of Work 4 3 2 1

D. Adaptability 4 3 2 1

E. Interpersonal Relationship 4 3 2 1

F. Punctuality & Attendance 4 3 2 1

TOTAL SCORE _________________

PART II Nursing Care Abilities: (For Nurse Orientee only)

A. Assessment Skills 4 3 2 1

B. Intervention Skills 4 3 2 1

C. Evaluation Skills 4 3 2 1

TOTAL SCORE _________________

COMMENTS / OTHER REMARKS:

Conforme:

________________________
“ISO tayo.. serbisyong de kalidad at siguraDOH”
Page 2 of 1

Orientee’s Signature

ORIENTEE EVALUATION TOOL

RATIONALE:

Each orientee must be periodically advised of his/her progress as he/she goes through
the different stages of the Orientation phase so as to provide opportunity for self-motivated
growth and development. However, the problem of accurately evaluating the progress of an
orientee is extremely difficult for evaluators. It is essential then for evaluators (Sr. Nurse,
Supervisors, NI’s) to consider the concept that evaluation is an emotionally charged area, and
that its interpretation by the orientee can have a strong impact on their self-esteem and
subsequent performance. The evaluation therefore, must b e objective enough to both
conserve the integrity of the orientee and provide for competent delivery of care.

It is for this reason that an evaluation tool was formulated in order that a device for
the use of evaluating orientees shall be objective, specific and uniform in all the units.

OBJECTIVES:

The use of the Orientee Evaluation Tool hopes to achieve the following :

1. Determine the orientee’s level of performance / abilities at various stages of the

orientation phase.
2. Determine the orientee’s strengths and areas of needs.
3. Serve as a basis for the counseling / guidance of the oreintee by the evaluator (Sr.
Nurse, Supervisor, NI)

IMPLEMENTING GUIDELINES:

1. Each orientee shall be periodically appraised of his progress during the entire
duration of the Orientation phase.
2. The evaluation shall be made on the prescribed form (Orientee Evaluation Sheet)
and submitted to the Nursing Training Office at the end of each week for the
duration of the orientation period.
3. The Orientee shall be rated by his immediate superior, subject to review or
concurrence by the next higher superior.
4. The orientee shall affix his/her signature in the “Conforme” part after he/she has
seen and discussed the evaluation with the evaluator.
5. Comments/remarks are essential to an appraisal and are of particular importance
to both the evaluator and the orientee, hence, the filling up of this part of the form
is encouraged. Comments may be used to explain ratings or to make suggestions
for improvement.
 ORIENTEE EVALUATION TOOL

PART I JOB FACTORS

* INDICATORS *

A. PERFORMANCE SKILLS:

5 – shows proficiency in accomplishing the task way above the expected performance

4 – can successfully perform the task based on standards

3 – can perform the task on an average level

2 – tries to accomplish the task with the help of reinforcements

1 – require individual assistance and close monitoring to accomplish the task

B. WORK ATTITUDE AND INITIATIVE:

5- Never had to be told what to do. Highly creative and constructive; plans & suggests
improvements in assigned or related duties.

4- Rarely had to be told what to do. Resourceful and alert; shows constructive thinking in
the performance of routine duties or assignments.

3- Able to proceed alone in the performance of routine duties or assignments.

Occasionally had to be told what to do.

2- Frequently had to be told what to do. Needs guidance or direction in the performance
of majority of duties or assignment.

1- Always had to be told what to do. Lacks confidence and ability to proceed alone.

C. ORGANIZATION OF WORK:

4- Is adept in organizing work according to priority of patients’ needs/ problems.

3- Organizes work according to priority of patients’ needs/ problems with minimum

guidance.

2- Organizes work according to priority of patients’ needs/ problems with maximum

guidance

1- Has difficulty in organizing work according to priority of .patients’ needs/ problems

D. ADAPTABILITY:

4 – Adjust readily to any situation with little follow-up.

3 – Needs occasional assistance in new situations

2- Needs considerable help and guidance

1- At a loss in a new situation and does not known how to adapt

E. INTER-PERSONAL RELATIONSHIPS:

4 – Very cooperative, thoughtful, sensitive to other`s needs

3 – Help others. Pleasant to work with

2 – Makes little effort to work with others

1 – Inconsiderate to others. Leaves unpleasant tasks to others

PART II- NURSING CARE ABILITIES

* INDICATORS:

A. ASSESSMENT SKILLS:

4- Is keen and alert in observation; interprets changes in patient’s condition

3- Recognizes and tries to analyze changes in patient’s condition

2- Is observant but needs occasional assistance in recognizing changes in patient’s

condition

1- Observant but failed to recognize changes in patient’s condition

B. INTERVENTION SKILLS:

4- Is adept and shows competence in the performance of different nursing interventions

based on patients/ needs.

3- Needs minimum guidance in carrying out nursing interventions, with consideration for
patient’s safety and comfort

2- Does different nursing procedures with minimum guidance

1- Shows difficulty in doing different nursing procedures

D. EVALUATION SKILLS:

4- Interprets patients’ reactions to the therapeutic regimen

3- Does not need guidance in evaluating effectiveness of nursing care

2- Needs minimum guidance in evaluating effectiveness of nursing care

1- Needs maximum guidance in evaluating effectiveness of nursing care

OVER-ALL EVALUATION

PART I JOB FACTORS:

SCORE RATING DESCRIPTION

26 Outstanding

24-25 Very satisfactory

18-23 Satisfactory

12-17 Needs Improvement

6-11 Unsatisfactory

PART II NURSING CARE ABILITIES:

SCORE RATING DESCRIPTION

12 Excellent

9-11 Very Good

6-8 Good

3-5 Poor