BROKENSHIRE COLLEGE

Madapo, Davao City

OFFICE OF THE DEAN OF NURSING & ALLIED HEALTH

MAN 124 NURSING ADMINISTRATION

Performance Evaluation Tool for Level 1 Administrative Experience
SELF EVALUATION PERFORMANCE CHECKLIST
Graduate Student: ________________________________________

Direction: These statements relate to the administrative functions of the Clinical Instructor. Actual exposure or performance to the
tasks is determined based on the opportunity allowed to experience in order to fulfill the functions as stated therein.
Administrative Functions Done Not Remarks
Done
PLANNING AND ORGANIZING
 Interprets the philosophy and objectives of the school, nursing division and unit to
students
 Participates in planning for the programs, schedules and activities of the unit. Explain
how these will be implemented
 Participates in the development of unit policies and procedures including standards of
quality nursing education
 Interprets policies, rules, regulations, memos, circular. Provides feedback re- problems
in implementation
 Plans for faculty and student development programs and researches to be conducted
within the year for recommendation as applicable in the level of assignment
 Explains the organizational structure to new students emphasizing lines of authority
and responsibility
 Recommends the number of nursing care hours needed in assigned units, based on
acuity of patient’s illness and other factors
 Schedules assignments of students considering previous experience, training, interest
and nursing concepts threaded through nursing education
 Schedules off-duties, admin time, consultation periods with students, leaves and
holidays taking into account special requests. Submits to Dean for approval
 Participates with nursing team in planning for the management of patient care in the
assigned unit
 Reviews job description to facilitate performance as necessary
DIRECTING
 Supervises the performance of students. Provides assistance & incidental
reinforcement as necessary.
 Demonstrates new techniques, procedures to students & colleagues
 Coordinates nursing care services with members of the health team during RLE & to
various departments/ services when needed
 Maintains therapeutic environment by coordinating with housekeeping services and
teaching of patient’s relatives, watchers, and personnel.
 Coordinates need for supplies, repair, maintenance, equipment with the Dean or
Senior Nurse.
 Reports unusual occurrence in the unit through channels, especially those which may
be legal in nature
 Participates in conducting student development programs within the department that
are designed to improve quality of nursing education and patient care. Disseminates
results
 Coordinates with Clinical Instructors in the selection of learning experience of
students if there are any. Participates in learning activities as needed
 Provides health teachings to patients, relatives, watchers, significant others with
particular emphasis on self care through close student follow up and supervision in
RLE
 Allows the students to assists in discharge planning and in referrals to agencies when
needed. Arranges for return visits to OPD per MGH order
 Submits necessary reports on time to the right authority
CONTROLLING
 Assesses work performance of students under
 Counsels/ guides students on strengths and weaknesses. Recommends disciplinary
action when needed
 Analyzes course problems with students utilizing participative problem solving.
Elevates to superiors those that cannot be solved at the level
 Evaluates quality of nursing care done in the units and students academic
performance. Discusses result with students including measures necessary for
improvement
 Analyzes utilization of material resources through inventories and/ or cost/
utilization review
Form RMU MAN 124-1 SY 2018-2019

Certified by:_______________________________________ _____________________

Signature Over Printed Name & Designation Date