Score Obtained: .. Name of Examiner: Signature: . Date

KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY
DEPARTMENT OF NURSING
INDEX NUMBER: ……………………………………. STUDENT SIGN: ………………….

CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: MAKING AN ADMISSION BED
RATING KEY: 0 - This step was omitted.

1 - The basic technique was not done well.
2 - The technique was performed correctly but with hesitation.
3 - The technique was performed correctly and without hesitation.
4 - Technique, speed and style excellent.
INSTRUCTION: Rate each step by circling around the number that best indicates the student’s level
of performance.
NO COMPONENT TASK RATING

1 Collects, arranges items on trolley and sends to bedside 0 1 2 3 4
2 Arranges items in order of use on a chair or cardiac table 0 1 2 3 4
3 Places bottom sheet evenly on the bed 0 1 2 3 4
4 Tucks the sheet evenly under the mattress at the top and bottom 0 1 2 3 4
using envelope corners
5 Places draw mackintosh across bed and covers with draw sheet 0 1 2 3 4
6 Places long mackintosh on the bed 0 1 2 3 4
7 Uses one bath blanket or sheet over and tucks in all around or folds 0 1 2 3 4
under itself
8 Puts in hot water bottle if necessary 0 1 2 3 4
9 Places second bath blanket over the bed 0 1 2 3 4
10 Puts on top bed clothes 0 1 2 3 4
11 Places counterpane loosely over the top bed clothes 0 1 2 3 4
12 Tucks in the bed clothes on the other side 0 1 2 3 4
13 Folds the bed clothes on the other side nearest to the door, leaving it 0 1 2 3 4
open
SCORE OBTAINED: ……………….. NAME OF EXAMINER: …………………………………………………………………
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: MAKING A SIMPLE UNOCCUPIED BED

of performance.

3 Places bottom sheet evenly on the bed 0 1 2 3 4
4 Tucks the sheet evenly under the mattress at the top and bottom 0 1 2 3 4
5 Pulls sheet tight so that there are no creases and tucks in at the sides 0 1 2 3 4
7 Places pillows on bed with open ends away from the ward door 0 1 2 3 4
8 Places top sheet on bed with the wrong side uppermost 0 1 2 3 4
9 Folds over at the bottom and tucks in loosely 0 1 2 3 4
10 Places bed cover/counterpane loosely over the bed 0 1 2 3 4
11 Tucks bed cover/counterpane into the bottom ends using envelope 0 1 2 3 4
corners
12 Folds top sheet over the counterpane at the top end 0 1 2 3 4
13 Tucks in sides under mattress 0 1 2 3 4
14 Removes trolley and chairs 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: MONITORING A WOMAN IN THE FIRST STAGE OF LABOUR UNDER THE FOLLOWING
HEADINGS:
a) Timing of contractions
b) Counting the foetal heart rate
c) Assessing descent of foetal head per-abdomen

INSTRUCTION: Rate each step by circling around the number that best indicates the
student’s level of performance
4 Stilla)onTiming
a chairof by
Contractions
client and expose client’s abdomen only 0 1 2 3 4
and place palm over fundus
1
5 Explain
Note time procedure
of onset to client
each contraction and when 0
0 1
1 2
2 3
3 4
4
6 Report and record, the number and length of each 0 1 2 3 4
2 Ask client toinempty
contraction bladderstarting
10 minutes, and provide privacy-
from the if of the
beginning 0 1 2 3 4
necessary
1st contraction
3 Wash b) and dry hands
Counting Foetal and
Heartassist client to adopt a comfortable 0 1 2 3 4
position in bed
7 Put client in dorsal position 0 1 2 3 4
8 Stand by the right side of client and palpate the abdomen to 0 1 2 3 4
determine where the foetal back lies
9 Locate the position of the shoulders 0 1 2 3 4
10 Warm the foetal stethoscope and listen to foetal heart sound 0 1 2 3 4
11 Count the beats for one full minute noting the volume and 0 1 2 3 4
rhythm and differentiating it from the maternal pulse.
c) Assessing Descent of foetal head
12 Locate the anterior shoulder and keep two fingers over it 0 1 2 3 4

13 Locate symphysis pubis and place the ulna border of the 0 1 2 3 4
right hand just above the symphysis pubis
14 Note the number of finger breadths that can occupy the 0 1 2 3 4
space between the symphysis pubis and the anterior
shoulder
15 Cover client’s abdomen and communicate findings to her, 0 1 2 3 4
showing gratitude
16 Wash and dry hands and record findings on partograph 0 1 2 3 4
SCORE OBTAINED: ……………….. NAME OF EXAMINER: ……….…………………………………………………………
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: CONDUCTING ABDOMINAL EXAMINATION ON A PREGNANT WOMAN

INSTRUCTION: Rate each step by circling around the number that best indicates the student’s level of
performance.

1 Explain procedure to client and ask client to empty bladder 0 1 2 3 4
2 Provide privacy and put client in recumbent position 0 1 2 3 4
3 Wash , dry and warm hands 0 1 2 3 4
4 Stand by the right side of the woman and expose abdomen 0 1 2 3 4
only
5 Perform inspection and measure symphysio-fundal height 0 1 2 3 4
6 Perform fundal palpation 0 1 2 3 4
7 Perform lateral palpation 0 1 2 3 4
8 Instruct client to bend her knees slightly and breathe slowly 0 1 2 3 4
through her mouth
9 Perform pelvic palpation and assess head descent 0 1 2 3 4
10 Listen to and count foetal heart beats 0 1 2 3 4
11 Assist client out of bed to redress and communicate findings 0 1 2 3 4
to client
12 Wash and dry hands and record findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: ADMINISTRATION OF MIXTURE

of performance.

1 Identifies and checks for the right patient, right drug and right time, 0 1 2 3 4
dose and route
2 Establishes rapport, explains procedure to patient and sends tray to 0 1 2 3 4
bedside
3 Identifies patient by mentioning the name and checks with treatment 0 1 2 3 4
sheet
4 Reads and compares the label on the bottle with patient’s treatment 0 1 2 3 4
sheet
5 Shakes the bottle well 0 1 2 3 4
6 Removes the cork and holds it with the little or ring finger, compares 0 1 2 3 4
label on the bottle a second time with patient’s treatment sheet
7 Picks the medicine glass and with the thumb nail marks the level of 0 1 2 3 4
the measure to be taken
8 Pour out the prescribed dose at eye level in bright light, holding the 0 1 2 3 4
bottle with the label upper most
9 Replaces the cork, reads the label a third time, compares with 0 1 2 3 4
patient’s treatment sheet and dose in the glass
10 Carries medicine to the patient on tray or saucer, a teaspoon may be 0 1 2 3 4
added for stirring if it is a suspension
11 Supervises patient to drink the medicine and serves water if 0 1 2 3 4
necessary
12 Congratulates patient and makes him comfortable in bed 0 1 2 3 4
13 Discards tray, washes and dries hands 0 1 2 3 4
14 Documents procedure and signs treatment sheet 0 1 2 3 4

SIGNATURE: …………………………. DATE: ………………………………….

CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: ADMINISTRATION OF TABLET

of performance.

1 Checks for the right patient, right drug, right time, right dose, ensures 0 1 2 3 4
patient’s right to consent or to refuse
2 Establishes rapport, explains procedure to patient and sends tray to 0 1 2 3 4
the bedside
3 Identifies patient by mentioning the name and checks treatment 0 1 2 3 4
sheet against doctor’s order
4 Reads label on the container and compares with patient’s treatment 0 1 2 3 4
sheet
5 Assesses patient’s condition and level of consciousness and checks 0 1 2 3 4
vital signs where necessary e.g. Digoxin
6 Removes lid of container, checks label on container and compares 0 1 2 3 4
with patient’s treatment sheet for the third time
7 Pours out water into a drinking glass or cup 0 1 2 3 4
8 Takes the tablet with a spoon 0 1 2 3 4
9 Gives the tablet to the patient in a spoon and ensures that patient 0 1 2 3 4
swallows it
10 Congratulates patient and makes him comfortable in bed 0 1 2 3 4
11 Discards tray, washes and dries hands and documents procedure 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: ADMISSION OF A CHILD (AMBULANT)

of performance.

1 Welcomes child and parents into nurses’ station, establishes rapport 0 1 2 3 4
and makes them comfortable. Asks child’s name and introduces self
and other staff present to them and reassure them for your support
during admission
2 Gets patients records from accompanying nurse, confirms patient 0 1 2 3 4
name and diagnosis and applies identification band
3 Sends child to the prepared cot/bed with side rails and introduces 0 1 2 3 4
other patients near him when necessary
4 Administers urgent prescribed drugs 0 1 2 3 4
5 Checks vital signs, weight, height and record and collects specimen if 0 1 2 3 4
ordered
6 Assists patient to change into pyjamas or hospital wear 0 1 2 3 4
7 Orientates patient and parents to the unit e.g. playroom, television 0 1 2 3 4
room, bathroom and toilet room as well as snack room if available
8 Educates child on how to call the nurse and emphasizes the 0 1 2 3 4
willingness to meet his needs at all times
9 Explains the hospital ward policies e.g. visiting time, National Health 0 1 2 3 4
Insurance policies, etc. to parents
10 Ensures parents/Legal guardian sign consent form for treatment, etc. 0 1 2 3 4
11 Encourages parents to bring child’s favourite toys to make child feel at 0 1 2 3 4
home
12 Informs parents to bring learning materials e.g. school books, etc. 0 1 2 3 4
13 Enters patient’s name into admission and discharge book and onto 0 1 2 3 4
Daily Ward State and documents on nurses notes
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: ADMISSION OF A PATIENT (AMBULANT)

of performance.

1 Welcomes patient and relatives to the nurses’ station and makes 0 1 2 3 4
them comfortable
2 Introduces herself and any staff present 0 1 2 3 4
3 Collects necessary documents, admission notes and any other 0 1 2 3 4
information from accompanying nurse
4 Identifies and confirms patient’s name, particulars and reassures 0 1 2 3 4
patient and relatives
5 Sends patient to bedside and introduces him to other patients near 0 1 2 3 4
him (Be in bed or sit on bed)
6 Check vital signs and records and collects specimen if ordered 0 1 2 3 4
7 Administer urgent prescribe drugs if necessary 0 1 2 3 4
8 Assist patient to change into his night dress or pyjamas 0 1 2 3 4
9 Takes care of patients valuable according to the institution’s policy 0 1 2 3 4
10 Lets patient or legal guardian sign consent form for treatment etc. 0 1 2 3 4
where necessary
11 Explains National Health Insurance System to patient and relatives 0 1 2 3 4
12 Inform relatives about visiting time and all other important protocols 0 1 2 3 4
13 Allow relatives to see patient and say good-bye 0 1 2 3 4
14 Orientates patient to ward and its annexes 0 1 2 3 4
15 Enter patient’s name into admissions and discharges book and on to 0 1 2 3 4
daily ward state
16 Document in Nurses notes 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: ADMISSION OF A SERIOUSLY ILL CHILD

of performance.

1 Welcomes child and parents and establishes rapport, receives folder 0 1 2 3 4
from accompanying nurse
2 Checks and confirms patient’s name and diagnosis and immediate 0 1 2 3 4
treatment
3 Puts child into cot and directs parents to sit in the day room while 0 1 2 3 4
taking care of child
4 Administers immediate treatment or performs the necessary 0 1 2 3 4
resuscitation
5 Checks vital signs, weight and records 0 1 2 3 4
6 Takes a brief history of patient’s condition from parents 0 1 2 3 4
7 Allows parents to see where child is lying and orientates parents to 0 1 2 3 4
the unit and its annexes
8 Explains ward and hospital policies, visiting time, National Health 0 1 2 3 4
Insurance Scheme, meal time, etc. to them
9 Encourages parents to bring child’s favourite toys, etc. and finds out 0 1 2 3 4
child’s likes and dislikes
10 Guides parent to sign consent form for treatment, etc. if necessary 0 1 2 3 4
11 Enters patient name into admission and discharge book and Daily 0 1 2 3 4
Ward State
12 Documents on nurses notes 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….

CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: ADMINISTRATION OF I.V. MEDICATION (AMPOULE RECONSTITUTED DRUG)

of performance.

1 Establishes rapport and explains procedure 0 1 2 3 4
2 Checks the physician’s order for the type of medication and the ten 0 1 2 3 4
rights of drug administration
3 Checks medication label and be sure before reconstituting as per 0 1 2 3 4
manufacturer instructions especially expiry date
4 Washes hands, reconstitutes and examines for cloudiness, sediments 0 1 2 3 4
5 Draws medication and expels air from the barrel of the syringe 0 1 2 3 4
6 Protects bed linen with a dressing mackintosh and towel and positions 0 1 2 3 4
patient comfortably
7 Washes hands, wears gloves and cleans entry port of cannula with 0 1 2 3 4
methylated spirit and cotton wool swab
8 Fixes syringe into the entry port of cannula and pushes medication 0 1 2 3 4
slowly using the push-stop-push-stop technique till administration is
completed whiles observing patient
9 Continues observing patient even after injecting medication 5 to 10 0 1 2 3 4
minutes later
10 Encourages patient to inform the nurse for any adverse reaction 0 1 2 3 4
11 Thanks patient and makes him comfortable in bed 0 1 2 3 4
12 Removes dressing mackintosh and towel and discards used items 0 1 2 3 4
13 Washes and dries hands and record procedure on treatment chart 0 1 2 3 4
and on the nurses notes
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: GIVING AN ASSITED BATHROOM BATH

of performance.

1 Establishes rapport and explain procedure to patient 0 1 2 3 4
2 Prepares bathroom, collects the necessary articles and arranges them 0 1 2 3 4
for easy reach
3 Sends patient to the bathroom 0 1 2 3 4
4 Ensures water temperature is of patient preference 0 1 2 3 4
5 Provide privacy 0 1 2 3 4
6 Assists or encourages patient to undress 0 1 2 3 4
7 Assists patient o bath when necessary, washing the back, feet as the 0 1 2 3 4
case may be
8 Assist patient to dry with towel 0 1 2 3 4
9 Assist patient to groom and wear new clothes if necessary 0 1 2 3 4
10 Sends patient beside and sits him comfortably in a chair as desired 0 1 2 3 4
11 Makes patient bed and discards dirty clothing and makes patient 0 1 2 3 4
comfortable
12 Collects toiletries, tidies bathroom, washes and dries hands 0 1 2 3 4
13 Documents procedure and report findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: ASSISTED BED BATH

of performance.

1 Establishes rapport explains procedure to patient 0 1 2 3 4
2 Prepares Requirements and arranges them in a position where patient 0 1 2 3 4
can easily reach them and provides privacy
3 Removes bed clothes and uncovers patient with a sheet of cloth and 0 1 2 3 4
protects bed
4 Helps Patient into a suitable position 0 1 2 3 4
5 Allows Patient to do as much as his condition permits and completes 0 1 2 3 4
the procedure for him e.g. washing patient’s back, feet etc.
6 Assists patient to groom himself and makes him comfortable 0 1 2 3 4
7 Collects toiletries and puts them away 0 1 2 3 4
8 Puts bowls etc. away, washes and dries hands 0 1 2 3 4
9 Documents procedure and reports finding 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: ASSISTED MOUTH CARE

of performance.

1 Establishes rapport and explain procedure to patient 0 1 2 3 4
2 Arranges requirement for patients and provides privacy 0 1 2 3 4
3 Assist patient into a suitable and comfortable position 0 1 2 3 4
4 Places towel under chin for protection 0 1 2 3 4
5 Gives brush with paste/chewing sponge or stick to him 0 1 2 3 4
6 Encourages patient to brush the teeth or the nurse brushes patient 0 1 2 3 4
teeth
7 Ensures that the mouth is thoroughly cleaned gently from inside the 0 1 2 3 4
cheek, both sides of gums, teeth, tongue and palate
8 Gives water or mouth wash and void content into a receiver 0 1 2 3 4
9 Makes patient comfortable in bed 0 1 2 3 4
10 Clears used item 0 1 2 3 4
11 Washes and dries hand, records procedure and reports finding 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: BED BATHING

INSTRUCTION: Rate each step by circling around the number that best indicates the student’s
level of performance.

1 Establish rapport and explain procedure 0 1 2 3 4
2 Prepare and take trolley to bedside and provide privacy 0 1 2 3 4
3 Offer bedpan or urinal if required 0 1 2 3 4
4 Loosen and remove top bed clothes and arrange on a chair or bed table 0 1 2 3 4
5 Remove patient’s clothes and cover him with a bath sheet or cloth 0 1 2 3 4
6 Protect bed and pillow with long mackintosh or plastic sheet and draw 0 1 2 3 4
sheet
7 Ask patient if he would like soap on the face and clean his genitals 0 1 2 3 4
himself
8 Ask patient for his preference and check temperature of water 0 1 2 3 4
9 Wash, rinse and dry patient’s face beginning from inner to outer cantus 0 1 2 3 4
of each eye
10 Wash, rinse and dry the rest of the face, ear and neck 0 1 2 3 4
11 Wash, rinse and dry patient’s arm farther away from the nurse then 0 1 2 3 4
wash, rinse and dry patient’s arm near to the nurse
TASK: BED BATHING
12 Wash, rinse and dry the chest and abdomen paying attention to the skin 0 1 2 3 4
folds
13 Wash, rinse and dry the legs in the same way as the arms 0 1 2 3 4
14 Turn patient on his side and wash, rinse and dry the back 0 1 2 3 4
15 Examine and treat pressure areas 0 1 2 3 4
16 Change bottom linen and roll patient on his back 0 1 2 3 4
17 Clean patient’s genitalia (perform vulva toileting if a female ) 0 1 2 3 4
18 Groom and dress patient in clean clothes 0 1 2 3 4
19 Make patient comfortable and thank him 0 1 2 3 4
20 Discard trolley, wash and dry hands 0 1 2 3 4
21 Document procedure and report any abnormality 0 1 2 3 4
SCORE OBTAINED: ……………….. NAME OF EXAMINER: ………………………………………………………………..
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: SERVING A BEDPAN TO A HELPLESS PATIENT

of performance.

1 Establishes rapport and explains procedure to the patient 0 1 2 3 4
2 Provides privacy 0 1 2 3 4
3 Brings a clean, warm and covered bedpan to the bedside 0 1 2 3 4
4 Stands at the right side of the bed with assistant on the other side 0 1 2 3 4
5 Lifts patient with the assistant onto bedpan 0 1 2 3 4
6 Lifts patients again with assistant to remove the bedpan after use, 0 1 2 3 4
covers the bedpan immediately
7 Cleans patient 0 1 2 3 4
8 Arranges bedclothes and leaves patient comfortable in bed 0 1 2 3 4
9 Allows patients to wash hands with soap and water when necessary 0 1 2 3 4
and dries hands
10 Takes bedpan to the sluice and room and inspect content before 0 1 2 3 4
emptying it.
11 Empties bedpan, decontaminates, washes and sterilizes it 0 1 2 3 4
12 Washes and dries hands and removes screen 0 1 2 3 4
13 Documents procedure and findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: BLAADER IRRIGATION (FUNNEL AND TUBING)

of performance.

1 Informs patient and ensures privacy 0 1 2 3 4
2 Assembles necessary items for irrigation sterile tray containing sterile 0 1 2 3 4
jug for lotion
a. Lotion thermometer
b. Sterile receiver container
c. Funnel, tubing
d. Irrigation fluid e.g. Normal saline at temperature 36.5 - 37.5°C
e. Glass connection
f. Clip
g. Receiver for used swabs
h. Receiver to receive used fluid
3 Assists patient to desired position 0 1 2 3 4
4 Turns back the top bed clothes to expose the retention catheter 0 1 2 3 4
5 Protects bed with mackintosh and dressing towel 0 1 2 3 4
6 Washes and dries hands, wears sterile gloves 0 1 2 3 4
7 Puts sterile towel under the end of the catheter 0 1 2 3 4
8 Cleans the lumen of the catheter and connects the irrigating 0 1 2 3 4
apparatus
9 Clamps the drainage tube distal to the catheter 0 1 2 3 4
10 Infuses 100-300mls of solution slowly into the catheter and siphones 0 1 2 3 4
back
11 Repeats process until purpose of the irrigation is accomplished 0 1 2 3 4
12 Observes patient for any discomfort during process 0 1 2 3 4
13 Empties the receiver and records the output 0 1 2 3 4
14 Removes gloves, washes and dries hands 0 1 2 3 4
TASK: BLADDER IRRIGATION (FUNNEL AND TUBING)

16 Decontaminates and sterilise used equipment if not disposable 0 1 2 3 4
17 Washes and dies hands and documents procedure 0 1 2 3 4

SIGNATURE: …………………………. DATE: ………………………………….

CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: MAKING A CARDIAC BED

of performance.

3 evenly on the bed and tucks the sheet under the mattress at the top 0 1 2 3 4
and bottom using envelope corners
4 Pulls sheet evenly so that there are no creases. Tucks in at the sides 0 1 2 3 4
5 Places draw mackintosh across bed and covers with draw sheet and 0 1 2 3 4
tucks in
6 Places back-rest is on top of bed, raises top-ends and arranges pillows 0 1 2 3 4
at the back
7 Places covered air ring on bed 0 1 2 3 4
8 Places top sheet on bed with the wrong side upper most and folds 0 1 2 3 4
sheets over at the bottom
9 Places foot rest in position 0 1 2 3 4
10 Places heart table with covered pillows in position 0 1 2 3 4
11 Places sputum mug and bell within reach of patient 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: CARING FOR A PATIENT WITH UNDER WATER-SEALED DRAINAGE
RATING KEY:
0 - This step was omitted.
INSTRUCTION: Rate each step by circling around the number that best indicates the
student’s level of performance.

1 Reassures patient and puts patient in a fowler’s or semi-fowler’s 0 1 2 3 4
position
2 Checks vital signs and records (baseline data) 0 1 2 3 4
3 Washes hands and puts on gloves 0 1 2 3 4
4 Places the bottle below the chest level in a receptacle 0 1 2 3 4
5 Checks the rate and depth of respiration, chest movements 0 1 2 3 4
auscultates his lungs
6 Observes dressing sites for bleeding and dislodgement of tube and 0 1 2 3 4
inspects air vent in the system
7 Checks fluid level fluctuation and bubbling in the drainage system 0 1 2 3 4
8 Checks tube for kinking or perforations 0 1 2 3 4
9 Encourages patient to cough frequently and breathe deeply 0 1 2 3 4
10 Assesses patency of drainage system 0 1 2 3 4
11 Tells patient to report any difficulty immediately 0 1 2 3 4
12 Checks and changes the chest tube dressing when necessary and 0 1 2 3 4
palpates the area surrounding the dressing for crepitus
13 Observes the volume, colour consistency and odour of the drainage 0 1 2 3 4
14 Washes hands and administers pain medication 0 1 2 3 4
15 Assist patient with range of motion (R.O.M.) exercise 0 1 2 3 4
16 Thanks patient for co-operation 0 1 2 3 4
17 Washes hands again and documents procedure 0 1 2 3 4
SCORE OBTAINED:……………….. NAME OF EXAMINER: …………………………………………………………………
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: CATHETER CARE FOR FEMALES

of performance.

1 Establish rapport and explain procedure 0 1 2 3 4
2 Assemble necessary equipment and supplies 0 1 2 3 4
3 Ensure privacy 0 1 2 3 4
4 Wash hands and put patient in the supine position 0 1 2 3 4
5 Place mackintosh and towel under patient 0 1 2 3 4
6 Cover patient up so that only vulva area is exposed , wash hands and 0 1 2 3 4
wear gloves
7 Remove anchor device o free catheter tubing 0 1 2 3 4
8 Clean vulva using cotton wool swab and antiseptic lotion towards 0 1 2 3 4
anus, clean meatus for discharge
9 Reassess urethral meatus for discharge 0 1 2 3 4
10 Use cotton wool swab soaked in antiseptic lotion, wipe in a circular 0 1 2 3 4
motion along the length of catheter and anchor back into position
11 Apply antibiotic ointment at urethral meatus and along 2.5cm of 0 1 2 3 4
catheter if ordered by physician
12 Place patient in a safe and comfortable position 0 1 2 3 4
13 Dispose all contaminated items, remove gloves and wash hands 0 1 2 3 4
14 Record and report findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: CATHETER CARE FOR MALE PATIENTS

of performance.

1 Establishes rapport and explains procedure to patient 0 1 2 3 4
2 Assembles necessary equipment and supplies 0 1 2 3 4
3 Ensures Privacy 0 1 2 3 4
4 Washes and dries hands and puts patient in the supine position 0 1 2 3 4
5 Places mackintosh and towel under patient 0 1 2 3 4
6 Covers patient up so that only genital area is exposed 0 1 2 3 4
7 Removes anchor device to free catheter tubing, washes hands and 0 1 2 3 4
wears gloves
8 Retracts foreskin if present to expose urethral meatus, cleans around 0 1 2 3 4
catheter first, and wipes in circular motion around meatus and glans
9 Reassess urethral meatus for discharge 0 1 2 3 4
10 Uses Cotton swab soaked in antiseptic lotion, wipes in circular motion 0 1 2 3 4
along the length of catheter and anchors it back
11 Applies antibiotics ointment at urethral meatus and along 2.5cm of 0 1 2 3 4
catheter if ordered by Physician/Surgeon
12 Places patient in a safe and comfortable position 0 1 2 3 4
13 Disposes all contaminated items, removes gloves and washes hands 0 1 2 3 4
14 Records and reports finding 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: CHANGING BOTTOM SHEET FROM TOP TO BOTTOM

of performance.

2 Collects and arranges items on trolley 0 1 2 3 4
3 Arranges sheets in order of use on chairs or heart tables and provide 0 1 2 3 4
privacy
4 Loosens sheet at the side of bed, leaves patient with only one pillow 0 1 2 3 4
and covers him with a top sheet
5 Turns patient to one side of the bed supported by another nurse; and 0 1 2 3 4
draws mackintosh and sheet
6 Rolls dirty bottom sheet under patient 0 1 2 3 4
7 Covers the bed with a clean rolled bottom sheet halfway of the bed 0 1 2 3 4
8 Places draw mackintosh and draw sheet across bed tucking in greater 0 1 2 3 4
part nearest to door
9 Removes dirty bottom sheet and places it in a receptacle 0 1 2 3 4
10 Pulls tight and tucks in bottom sheet 0 1 2 3 4
11 Covers patient with top sheet and bed cover, leaves him comfortable 0 1 2 3 4
12 Clears equipment and removes screen 0 1 2 3 4
13 Washes and dries hand and document procedure 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: CHANGING BOTTOM SHEET FROM TOP TO BOTTOM

of performance.

2 Assembles the necessary equipment and materials and provide 0 1 2 3 4
privacy
3 Places 2 chairs at the foot end of the bed 0 1 2 3 4
4 Loosens sheet from all sides of the bed 0 1 2 3 4
5 Leaves patient covered with the top sheet 0 1 2 3 4
6 Holds top sheet over patient’s shoulder with hand nearest to the head 0 1 2 3 4
of bed
7 Moves patient to foot end of bed with the help of an assistant and 0 1 2 3 4
lets him lean on heart table with a pillow
8 Supports patient and removes pillows and places on chair 0 1 2 3 4
9 Removes draw sheet and places it in dirty linen bin 0 1 2 3 4
10 Makes top half foundation of bed with clean sheets and arranges 0 1 2 3 4
pillows at top half of bed
11 Helps patient back to position keeping him covered. 0 1 2 3 4
12 Instruct assistant to lift the patient’s legs while she removes the soiled 0 1 2 3 4
bottom sheet
13 Pulls down the clean bottom and the draw sheet tight and tucks in 0 1 2 3 4
14 Completes bed making and makes patient comfortable 0 1 2 3 4
15 Clears items and removes screen 0 1 2 3 4
16 Washes, dries hands and documents any observations made 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: CHECKING VITAL SIGNS- TEMPERATURE, PULSE, RESPIRATION, BLOOD PRESSURE (NON-
DIGITAL THERMOMETER)

of performance

1 Explains procedure to patient and provide privacy 0 1 2 3 4
2 Prepares and sends tray to patient’s bedside 0 1 2 3 4
3 Makes patient comfortable by lying or sitting up in bed 0 1 2 3 4
4 Rinse thermometer I cold water 0 1 2 3 4
5 Dries thermometer with cotton wool from bulb towards the stem 0 1 2 3 4
6 Shakes thermometer until mercury falls below 350C 0 1 2 3 4
7 Dries axilla with clean cotton wool and discards 0 1 2 3 4
8 Inserts thermometer in the axilla between two folds of skin and leaves 0 1 2 3 4
in position for 2-3 minutes whiles thermometer is in axilla
9 whiles thermometer is in axilla, checks and records pulse 0 1 2 3 4
10 checks and records respiration 0 1 2 3 4
11 Removes thermometer and wipes from stem towards the bulb 0 1 2 3 4
12 checks and records temperature, replaces thermometer in container 0 1 2 3 4
13 Stretches patient’s arm and places sphygmomanometer besides arm 0 1 2 3 4
at the same level
14 Wounds cuff around arm above the elbow 0 1 2 3 4
15 Inflates cuff, palpate radial artery and notes level of mercury at which 0 1 2 3 4
pulse disappears
16 Wears and places stethoscope on brachial artery 0 1 2 3 4
17 Releases pressure slowly and listens to sound with stethoscope 0 1 2 3 4
18 Removes cuff and reassemble apparatus 0 1 2 3 4
19 Thanks patient, and makes patient comfortable 0 1 2 3 4
20 Records reading on vital signs chart and nurses notes 0 1 2 3 4
.
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: CHECKING VITAL SIGNS- TEMPERATURE, PULSE, RESPIRATION, BLOOD PRESSURE

(USING THE INDIVIDUAL ELECTRONIC THERMOMETER)
of performance
2 Washes hands and presses knob to ensure thermometer is 0 1 2 3 4
functioning
3 Prepares and sends tray to patient’s bedside 0 1 2 3 4
4 Makes patient comfortable by lying or sitting up in bed 0 1 2 3 4
5 Presses knob again to show reading on the screen, exposes axilla, 0 1 2 3 4
dries with clean cotton wool and discards
6 Inserts thermometer into the axilla between two skin folds, leaves it 0 1 2 3 4
in place until it beeps
7 Checks and records pulse and respiration whiles thermometer is in 0 1 2 3 4
axilla
8 Removes thermometer after beep, reads and record findings 0 1 2 3 4
9 Cleans thermometer from stem to the bulb and inserts into its cover 0 1 2 3 4
10 Stretches patient’s arm and places sphygmomanometer beside arm at 0 1 2 3 4
the same level
11 Applies cuff around arm above elbow 0 1 2 3 4
12 Inflates cuff, palpate radial artery and notes level of mercury at which 0 1 2 3 4
pulse disappears
13 Inserts ear piece and places diaphragm of stethoscope on brachial 0 1 2 3 4
artery
14 Releases pressure slowly and listens to sound with stethoscope 0 1 2 3 4
15 Removes cuff and reassemble apparatus records reading 0 1 2 3 4
16 Thanks patient, makes him/her comfortable and communicates 0 1 2 3 4
findings to him/her
17 Washes and dries hands and documents findings 0 1 2 3 4
18 Reports to the ward in-charge 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: CONTINUOUS BLADDER IRRIGATION

of performance.

1 Establishes rapport and explains procedure to the patient and ensure 0 1 2 3 4
privacy
2 Assembles necessary items for irrigation 0 1 2 3 4
3 Assists patient to desired position 0 1 2 3 4
4 Turns back the top bed clothes to exposed the retention catheter 0 1 2 3 4
5 Protects bed with mackintosh and dressing towel 0 1 2 3 4
6 Washes and dries hands, wears sterile gloves 0 1 2 3 4
7 Puts sterile towel under the end of the catheter 0 1 2 3 4
8 Cleans the lumen of the catheter and connects the irrigating 0 1 2 3 4
apparatus
9 Infuses 40 – 60 drops of irrigant per minute or as prescribed 0 1 2 3 4
10 Continues process until purpose of the irrigation is accomplished 0 1 2 3 4
11 Observes patient for any discomfort during process 0 1 2 3 4
12 Empties the receptacle and records the output and observations 0 1 2 3 4
made
15 Decontaminates and sterilise used equipment if not disposable 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: DISCHARGING A PATIENT FROM THE HOSPITAL

of performance.

1 Ensures that discharge papers are duly signed by discharging doctor 0 1 2 3 4
2 Informs patient about discharge 0 1 2 3 4
3 Ensures that patient’s hospital bill is assessed and settled 0 1 2 3 4
4 Educates patient and relatives on need for continuing treatment and 0 1 2 3 4
follow up care
5 Records all receipts numbers in admission and discharge book and 0 1 2 3 4
hands over receipts to patient or relative
6 Collects drugs for patient from the pharmacy 0 1 2 3 4
7 Explains how drugs should be taken 0 1 2 3 4
8 Helps patient to pack his belongings 0 1 2 3 4
9 Hands over any valuables in the nurse’s custody to the patient or 0 1 2 3 4
relatives and this is recorded, witness and signed
10 Reminds patient and relatives of the review date and stresses on its 0 1 2 3 4
importance
11 Thanks and bids them good-bye 0 1 2 3 4
12 Documents in the admission and discharge book, daily ward state 0 1 2 3 4
nurse notes
13 Ensures linen are removed, bed and lockers decontaminated 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: DRESSING OF WOUND (SIMPLE OR UNCOMPLICATED)

INSTRUCTION:Rate each step by circling around the number that best indicates the student’s level
Of performance.

2 Puts on mask, prepares and takes trolley to bedside and provides 0 1 2 3 4
privacy
3 Asks assistant to put patient into desired position, protect bed clothes 0 1 2 3 4
and expose area
4 Asks assistant to pour out lotions into gallipots and remove plaster or 0 1 2 3 4
bandage
5 Washes and dries hands and wears sterile gloves or uses sterile 0 1 2 3 4
forceps
6 Removes soiled dressings using dissecting forceps or disposable gloves 0 1 2 3 4
and discards
7 Cleans wound with swabs soaked in normal saline using sterile forceps 0 1 2 3 4
or sterile gloves starting from the wound outward using one swab at a
time
8 Cleans wound with series of swabs until clean 0 1 2 3 4
9 Applies sufficient sterile dressings and secures into position 0 1 2 3 4
10 Informs patient about state of wound 0 1 2 3 4
11 Thanks and makes him comfortable in bed 0 1 2 3 4
12 Discards trolley, decontaminates used items and removes gloves 0 1 2 3 4
13 Washes and dries hands, and removes screen 0 1 2 3 4
14 Documents and reports state of wound 0 1 2 3 4
SCORE OBTAINED: ……………….. NAME OF EXAMINER: …………………………………………………
SIGNATURE: ………………………….DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: GIVING HEALTH EDUCATION ON EXERCISE, REST AND SLEEP TO A

PREGNANT WOMAN DURING HER FIRST ANTENATAL VISIT


1 Establish rapport with woman 0 1 2 3 4
2 Provide a comfortable environment and ensure privacy 0 1 2 3 4
3 Explain to the woman the need to attend antenatal clinic and 0 1 2 3 4
procedures involved
4 Inform her to visit antennal clinic at least four times before 0 1 2 3 4
labour begins
5 Inform the woman about the various aspects of physical 0 1 2 3 4
examination, laboratory investigation, scan etc
6 Find out about the daily activities of the woman 0 1 2 3 4
7 Educate her on the importance of exercise, rest and sleep 0 1 2 3 4
during pregnancy
8 Inform her about some of the exercises that the pregnant 0 1 2 3 4
woman can perform eg. sweeping, fetching water, brisk
walking, bed making
9 Educate her on the importance of Kegel’s exercise and how 0 1 2 3 4
to perform them
10 Educate her against strenuous exercise such as lifting of 0 1 2 3 4
heavy objects, long standing, stretching to reach objects at a
height
11 Inform her about the need of adequate rest and sleep during 0 1 2 3 4
the day and night
,
12 Encourage the woman to ask questions and give appropriate 0 1 2 3 4
answers
13 Dispel any rumours concerning exercise rest and sleep 0 1 2 3 4
during pregnancy
14 Emphasise on the need of the woman to adhere to the 0 1 2 3 4
information received and given
15 Record all information received and given, the time, date and 0 1 2 3 4
signs
16 Thank the woman and see her off in a friendly manner 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: EDUCATING A PATIENT ON MEDICATION PRIOR TO DISCHARGE

of performance.

1 Identifies client’s treatment chart and medication 0 1 2 3 4
2 Establishes rapport with patient 0 1 2 3 4
3 Uses language client understands 0 1 2 3 4
4 Involves client’s or a significant others 0 1 2 3 4
5 Speak audibly to patient 0 1 2 3 4
6 Explains procedure to client and family 0 1 2 3 4
7 Assesses patient’s previous knowledge on medication 0 1 2 3 4
8 Shows type of drug(s) to patient 0 1 2 3 4
9 Informs patient about method of administration 0 1 2 3 4
10 Instructs patient on dosage of drugs to take at a time 0 1 2 3 4
11 Explains action of the drug 0 1 2 3 4
12 Describes the side effects of the drug 0 1 2 3 4
13 Instructs client to report to hospital when serious side effects occur 0 1 2 3 4
14 Demonstrates to patient how to store drugs at home safely 0 1 2 3 4
15 Allows patient to repeat instructions and ask questions 0 1 2 3 4
16 Responds to questions appropriately 0 1 2 3 4
17 Thanks patient for co-operation and document procedure 0 1 2 3 4
SIGNATURE: ………………………….DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: EDUCATING PATIENT ON CONDITION

level
of performance.

1 Establishes rapport and explains the need for education on condition 0 1 2 3 4
to patient
2 Makes patient comfortable either sitting or lying down 0 1 2 3 4
3 Sits comfortably by patient’s side 0 1 2 3 4
4 Ensures enabling and relaxed environment and maintains privacy 0 1 2 3 4
5 Finds patient’s level of awareness of condition 0 1 2 3 4
6 Builds on what the patient knows with scientific data of condition in 0 1 2 3 4
language that patient understands
7 Explains to patient the rationale for treatment and possible outcome 0 1 2 3 4
8 Ensures patient understands the teaching and co-operates with health 0 1 2 3 4
team
9 Allows patient to ask questions for clarification 0 1 2 3 4
10 Provides patient with clear simple pamphlets if available 0 1 2 3 4
11 Thanks patient and documents education 0 1 2 3 4
SIGNATURE: ………………………….DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: EXAMINING HEAD AND HAIR

of performance.

1 Establishes rapport explains procedure to patient and provide privacy 0 1 2 3 4
2 Sits patient up in bed or assumes comfortable position 0 1 2 3 4
3 Protects Patients shoulders with towel 0 1 2 3 4
4 Protects bed and pillows 0 1 2 3 4
5 Washes and dries hands, wear disposable gloves where necessary 0 1 2 3 4
6 Removes hair accessories if female 0 1 2 3 4
7 Combs hair carefully to remove tangles 0 1 2 3 4
8 Parts hair into several parts and examines the scalp 0 1 2 3 4
9 Starts from top of head down to end of nape 0 1 2 3 4
10 Examines for lice, dandruff, rashes, ringworm etc 0 1 2 3 4
11 Repeats process taking special care to examine behind ears, nape of 0 1 2 3 4
neck and along hair line
12 Combs and styles hair to suit patient 0 1 2 3 4
13 Thanks patient for her co-operation 0 1 2 3 4
14 Clears tray and decontaminates comb 0 1 2 3 4
15 Washes and dries hands and documents procedure and findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: EXAMINING PATIENT FROM HEAD TO TOE

of performance.

1 Establishes rapport, explains procedure to patient 0 1 2 3 4
2 Provides privacy and washes and dries hands 0 1 2 3 4
3 Observes patient’s general appearance and body built, in relation to 0 1 2 3 4
the patient’s age and health
4 Observe the skin for lesions, pallor and texture 0 1 2 3 4
5 Examines the size and shape of the head. The eyes for discharge, 0 1 2 3 4
pallor, jaundice, colour of the eye and photophobia
6 Examines the ear for shape , size and discharge 0 1 2 3 4
7 Inspects the nose for patency, discharges and abnormalities, palpates 0 1 2 3 4
and percusses sinuses
8 Inspects the lips for cracks, soreness, pallor, jaundice and any 0 1 2 3 4
abnormalities
9 Inspects the teeth for artificial or natural dentition, dental caries and 0 1 2 3 4
bleeding gums
10 Examines mouth for coated or furred tongue and foul breath, sores of 0 1 2 3 4
the palates
11 Inspects the throat for inflamed tonsils, sore throat and swallowing 0 1 2 3 4
reflexes
12 Examines the neck size and palpate for cervical lymph nodes and 0 1 2 3 4
swelling e.g. goitre
13 Inspects the breast size, shape, nipple cracks and discharge, and 0 1 2 3 4
palpates for lumps and axillae for swollen lymph nodes
TASK: INSERTION OF AN INDWELLING CATHETER (FEMALE)

14 Examines the chest for shape, size and auscultates for any 0 1 2 3 4
abnormalities
15 Inspects the abdomen for scars, lesions, linear alba and palpate for 0 1 2 3 4
distension, retraction, rigidity and observes for visible peristalsis
16 Inspects the back for scars and kyphosis 0 1 2 3 4
17 Inspects the genitalia for inflammation, discharges, swellings and 0 1 2 3 4
lesions and examines for pubic lice, warts and anus for growth
18 Examines the lower extremities for motor reflexes, fingertips for 0 1 2 3 4
clubbing, and nails for pallor
19 Observes for the functions of various senses, touch, smell, taste, sight
and hearing
20 Thanks patient, makes patient comfortable, washes and dries hands
and document findings
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: EXAMINING THE BREAST OF A FEMALE PREGNANT WOMAN


1 Greet the woman, make her comfortable and introduce 0 1 2 3 4
herself
2 Explain procedure to client and ensure privacy 0 1 2 3 4
3 Assist client to undress and wear a gown 0 1 2 3 4
4 Help her into dorsal position on a couch 0 1 2 3 4
5 Wash ,dry and warm hands 0 1 2 3 4
6 Expose both breast and inspect 0 1 2 3 4
7 Cover one breast and expose the other 0 1 2 3 4
8 Ask woman to put the hand of the part to be examined under 0 1 2 3 4
her head
9 Support heavy breast 0 1 2 3 4
10 Palpate the breast systemically in a circular e inner aspect 0 1 2 3 4
using the inner aspect of the fingers and teach client breast
self-examination
TASK: EXAMINING THE BREAST OF A FEMALE PREGNANT WOMAN
11 Squeeze the nipple gently for fluid and clean with swab 0 1 2 3 4
12 Examine the fluid 0 1 2 3 4
13 Repeat the same process for other breast 0 1 2 3 4
14 Assist client to redress 0 1 2 3 4
15 Communicate findings to client and thank her 0 1 2 3 4
16 Wash, dry hands record and report findings
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: FEEDING A PATIENT PER NASO-GASTRIC TUBE

of performance.

1 Establish rapport and explain procedure to patient 0 1 2 3 4
2 Send prepared feed in a tray to the patient’s bedside and 0 1 2 3 4
provide privacy
3 Make patient comfortable and protect patient’s clothing 0 1 2 3 4
4 Check for proper placement of tube in the stomach 0 1 2 3 4
5 Wash and dry hands 0 1 2 3 4
6 Check temperature of feed by dropping a little amount on 0 1 2 3 4
the back of hand
7 Pinch tube and remove spigot of naso-gastric tube, push 10- 0 1 2 3 4
15 mls of water through the tube just before the feed is
introduced
8 Connect syringe with the feed to tube, release the pinch and 0 1 2 3 4
allow the feed to run by gravity
9 Ensure tube is never allowed to empty completely to prevent 0 1 2 3 4
air from entering patient’s stomach
10 Continue feeding till the prescribed amount is finished 0 1 2 3 4
11 Flush the tube with 10-15 mls of water at the end of feeding 0 1 2 3 4
12 Pinch tube and remove syringe and replace spigot 0 1 2 3 4
13 Remove protective clothing and make patient comfortable, 0 1 2 3 4
clear tray, wash and dry hands
14 Document procedure on intake and output and nurses note 2 3
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: FEEDING A HELPLESS PATIENT

of performance.

2 Ensures clean environment and provides privacy 0 1 2 3 4
3 Puts patient in the sitting position if patient’s condition allows. 0 1 2 3 4
4 Places prepared tray with patient’s choice of meal on the cardiac table 0 1 2 3 4
or patient’s locker
5 Washes patient’s hand s with soap and water and dry with a clean 0 1 2 3 4
towel
6 Washes hands before serving meals (the nurse) 0 1 2 3 4
7 Places mackintosh and napkin/serviette across the chest to protect 0 1 2 3 4
bed linen and patient’s dress
8 Sits as the bedside of the patient if convenient to make patient feel 0 1 2 3 4
relaxed
9 Cuts feed into bite sizes(e.g. Yam) and feeds patient with levelled 0 1 2 3 4
spoonful a little at a time
10 Allows him enough time to chew and swallow 0 1 2 3 4
11 Observes the rates at which the patient eats 0 1 2 3 4
12 Co-ordinates the opening of the mouth and introduction of food into 0 1 2 3 4
the mouth
13 Places the spoon or fork accurately into the mouth i.e. not too far 0 1 2 3 4
back to produce gagging
14 Serves water in between feeding and at the end of the meal using a 0 1 2 3 4
spoon or flexible straw
15 Serves water to rinse mouth 0 1 2 3 4
TASK: FEEDING A HELPLESS PATIENT

16 Wipes patients lips and chin when necessary 0 1 2 3 4
17 Removes used napkin/serviette and clear tray 0 1 2 3 4
18 Congratulates patient for efforts made in eating 0 1 2 3 4
19 Encourages patient to comment on the food served/procedure 0 1 2 3 4
20 Documents in the nurses notes/fluid intake and output chart 0 1 2 3 4
21 Makes patient comfortable 0 1 2 3 4
22 Washes hands with soap and water and dry with clean towel 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: GIVING HEALTH EDUCATION ON EXERCISE, REST AND SLEEP TO A PREGNANT WOMAN DURING
HER FIRST ANTENATAL VISIT

performance.

1 Establish rapport with mother 0 1 2 3 4
2 Provide a comfortable environment and ensure privacy 0 1 2 3 4
3 Explain to the woman the need to attend antenatal clinic and 0 1 2 3 4
procedures involved
4 Inform her to visit antenatal clinic at least four times before 0 1 2 3 4
labour begins
5 Inform the woman about the various aspects of physical 0 1 2 3 4
examination, laboratory investigation, scan
6 Find out about the daily activities of the woman 0 1 2 3 4
7 Educate her on importance of exercise, rest and sleep during 0 1 2 3 4
pregnancy
8 Inform her about some of the exercises that the pregnant 0 1 2 3 4
woman can perform e.g. sweeping, fetching water, brisk
walking, bed making.
9 Educate her on the importance of Kegel’s exercise and how 0 1 2 3 4
to perform them
10 Educate her against strenuous exercises such as lifting heavy 0 1 2 3 4
objects, long standing, stretching to reach objects at a height.
11 Inform her about the need of adequate rest and sleep during 0 1 2 3 4
the day and night
TASK: GIVING HEALTH EDUCATION ON EXERCISE, REST AND SLEEP TO A PREGNA NT WOMAN DURING
HER FIRST ANTENATAL VISIT
12 Encourage the woman to ask questions and give appropriate 0 1 2 3 4

answers
13 Dispel any rumours concerning exercise, rest and sleep 0 1 2 3 4
during pregnancy
14 Emphasise the need for the woman to adhere to the 0 1 2 3 4
information received and given
15 Record all information received and given, the time, date and 0 1 2 3 4
signs
16 Thank the woman and see her off in a friendly manner. 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: GIVING INTRAMUSCULAR INJECTION

of performance.

1 Identifies and checks for the right patient, right drug, right route and 0 1 2 3 4
right time
2 Establishes rapport, explains procedure to patient and provides 0 1 2 3 4
privacy
3 Prepares and takes tray to patient’s bedside 0 1 2 3 4
4 Checks details again with patient’s treatment sheet 0 1 2 3 4
5 Washes and dries hands 0 1 2 3 4
6 Assembles syringe and needle using aseptic technique 0 1 2 3 4
7 Files and breaks ampoule or removes metal cap of vial with a clean 0 1 2 3 4
swab, draws drug and discards ampoule or vial
8 Replaces needle with a new one and expels air (if drawn from a vial) 0 1 2 3 4
9 Assists patient into comfortable position and exposes site of injection 0 1 2 3 4
10 Cleans site with swab dipped in antiseptic lotion (upper outer 0 1 2 3 4
quadrant of buttocks if buttocks is used and outer aspect if thigh is
used)
11 Inserts the needle quickly and firmly deep into the muscle at right 0 1 2 3 4
angle
12 Withdraws piston a little to ensure needle is not in a blood vessel (if 0 1 2 3 4
blood appears withdraws needle, and repeat step 10)
13 Pushes to release drug into the tissue 0 1 2 3 4
14 Withdraws the syringe and needle quickly and with a swab gently 0 1 2 3 4
applies pressure to the site of injection
15 Discards syringe and needle into a “safety box” or container 0 1 2 3 4
16 Thanks patient and leaves him comfortable in bed 0 1 2 3 4
17 Washes and dries hands, signs treatment sheet and documents any 0 1 2 3 4
findings
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: HANDING OVER THE WARD

of performance.

1 Welcomes the incoming staff 0 1 2 3 4
2 Gives ward report on patients to in-coming nurse to read 0 1 2 3 4
3 Enquires from in-coming nurse if she needs further explanation on 0 1 2 3 4
issues
4 Hands over sensitive information about patient at the nurse’s office 0 1 2 3 4
e.g. Condition of Patient
5 Interacts with patient while handing over 0 1 2 3 4
6 Checks and confirms information about patients’ chart 0 1 2 3 4
7 Checks with in-coming staff that gadgets on patients are functioning 0 1 2 3 4
e.g. Cardiac monitor, intravenous line, Oxygen flow metre etc.
8 Checks and hands over controlled drugs and any other relevant 0 1 2 3 4
resources available
9 Hands over ward annexes for in-coming nurse to ensure they are 0 1 2 3 4
clean
10 Reports on any defects on equipment and requests made for urgent 0 1 2 3 4
repairs
11 Reports on departmental instructions and other important 0 1 2 3 4
information in the ward diary
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: HELPING TO FIX AND BREASTFEED BABY

performance.

1 Explain procedure to mother and ensure that she washes her 0 1 2 3 4
hands
2 Put mother in a comfortable position 0 1 2 3 4
3 Wash hands, dry them and sit by the mother 0 1 2 3 4
4 Help mother to position baby so that the abdomen touches 0 1 2 3 4
mother’s abdomen
5 Allow baby’s buttocks to rest in mother’s palm, supporting 0 1 2 3 4
baby’s back
6 Assist mother to ensure baby’s shoulder and hip are in 0 1 2 3 4
alignment
7 Assist mother to adjust baby’s position to enable baby’s chin 0 1 2 3 4
to touch the breast
8 Teach the mother to elicit rooting reflex 0 1 2 3 4
9 Assist mother to insert nipple and areola of the breast into 0 1 2 3 4
baby’s well opened mouth
10 Instruct mother to admire and talk to baby as it suckles 0 1 2 3 4
11 Educate mother to allow baby to empty one breast 0 1 2 3 4
completely before offering the other
12 Allow the baby to release the breast after feeding 0 1 2 3 4
13 Teach the mother to wind the baby after feeding 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: IMMEDIATE POST OPERATIVE CARE OF PATIENT FROM THEATRE

of performance.

1 Ensures that all necessary items are available and ready for use
a. Operation bed with side rails
b. Resuscitation tray
c. Oxygen cylinder
d. Suction machine
e. Vital signs tray
f. Infusion stand
g. Mouth care tray 0 1 2 3 4
2 Receives patient gently in bed and reassures him if conscious 0 1 2 3 4
3 Places patient flat on his bed with the head turned to one side on in 0 1 2 3 4
the appropriate position according to the operation performed
4 Raises bed rails for safety if necessary 0 1 2 3 4
5 Reads through the patient’s case notes for post-operative instructions 0 1 2 3 4
6 Observes for level of consciousness by the use of stimulus e.g. pin or 0 1 2 3 4
by calling him by name
7 Monitors vital signs for 15-30 minutes for the first hour 0 1 2 3 4
8 Observes for bleeding from operational site and reports for possible 0 1 2 3 4
reinforcement
9 Checks the flow rate of the intravenous fluid and regulates as ordered 0 1 2 3 4
and ensures cannula is in situ
10 Checks and ensures that all drainage tubes e.g. nasogastric tube and 0 1 2 3 4
catheter are in situ and are functioning well
11 Records intake and output accurately 0 1 2 3 4
12 Observes for pain and gives prescribed analgesics and records 0 1 2 3 4
13 Maintains oral hygiene 0 1 2 3 4
14 Checks and administers all prescribed drugs 0 1 2 3 4
TASK: IMMEDIATE POST OPERATIVE CARE OF PATIENT FROM THEATRE

15 Observes any abnormality in the patient’s condition and documents
findings and nursing interventions 0 1 2 3 4
16 Puts patient in a comfortable position or as ordered by surgeon 0 1 2 3 4
when he is fully conscious
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………

of performance.

1 Washes, dries hands and prepares a trolley with all needed items 0 1 2 3 4
2 Establishes rapport and explains procedure to patient, provides 0 1 2 3 4
privacy and ensures adequate lighting
3 Protects bed with mackintosh and towel 0 1 2 3 4
4 Washes and dries hand and puts on a sterile gloves 0 1 2 3 4
5 Instructs assistant to place patient in the supine position with knees 0 1 2 3 4
flexed and legs separated
6 Inserts bedpan under patient and washes perineum thoroughly with 0 1 2 3 4
soap and water
7 Removes bedpan and drapes with a sterile towel 0 1 2 3 4
8 Removes the gloves, wear another sterile glove and cleans the vulva 0 1 2 3 4
with an antiseptic lotion
9 Lubricates catheter with xylocaine jelly 0 1 2 3 4
10 Uses the non-dominant hand to part the labia and establishes a firm 0 1 2 3 4
but gentle position
11 Picks a cotton wool ball soaked in antiseptic with forceps in the 0 1 2 3 4
dominant hand and swab one side of the labia majora from top to
bottom, uses a new ball for opposite side
12 Repeats procedure for the labia minora, uses another cotton wool ball 0 1 2 3 4
to clean over the meatus
13 Inserts catheter into the urethra gently about 5cm 0 1 2 3 4
14 Inflates the balloon of the catheter with the sterile water according to 0 1 2 3 4
manufacturer’s direction
15 Collects a urine specimen if needed and allows 20-30mls to flow into 0 1 2 3 4
bottle without bottle touching the catheter

16 Connects catheter to urine bag, hangs to bed and secures in position 0 1 2 3 4
17 Observes colour and notes amount of urine 0 1 2 3 4
18 Removes drape, makes patient comfortable in bed 0 1 2 3 4
19 Thanks patient and discards trolley 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………

of performance.

1 Wash, dry hands and prepare trolley with needed items 0 1 2 3 4
2 Establish rapport and explain procedure ton patient, provide 0 1 2 3 4
privacy and ensure adequate lighting
3 Protect bed with mackintosh and towel 0 1 2 3 4
4 Wash and dry hands and put on sterile gloves 0 1 2 3 4
5 Instruct assistant to place patient in the supine position with 0 1 2 3 4
knees flexed and legs separated
6 Insert bedpan under patient and wash perineum thoroughly 0 1 2 3 4
with soap and water
7 Remove bedpan and drape with a sterile towel 0 1 2 3 4
8 Remove gloves, wear another sterile glove and clean the 0 1 2 3 4
vulva with an antiseptic
9 Lubricate catheter with xylocaine jelly 0 1 2 3 4
10 Use the non-dominant hand to part the labia and establish a 0 1 2 3 4
firm but gentle position
11 Pick a cotton wool ball soaked in antiseptic with forceps in 0 1 2 3 4
the dominant hand and swab one side of the labia majora
from top to bottom, use a new ball for opposite side
12 Repeat procedure for labia minora, use another cotton wool 0 1 2 3 4
ball to clean over the meatus
13 Insert catheter into the urethral gently about 5cm 0 1 2 3 4
14 Inflate the balloon of the catheter with sterile water 0 1 2 3 4
according to manufacturer’s direction
15 Collect urine specimen if need andallow20-30 mls to flow 0 1 2 3 4
into bottle
Without bottle touching the catheter
16 Connect catheter to urine bag, hang to bed and secure in 0 1 2 3 4
position
17 Observe colour and note amount of urine 0 1 2 3 4
18 Remove drape, make patient comfortable in bed 0 1 2 3 4
19 Thank patient and discard trolley 0 1 2 3 4
20 Wash and dry hands and document findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: LAST OFFICES

performance.
N COMPONENT TASK RATING

O
1 Prepare trolley and provide privacy 0 1 2 3 4
2 Turn body to lateral position with a receiver to collect oral 0 1 2 3 4
secretions
3 Turn body to supine position and apply gentle pressure over 0 1 2 3 4
the lower abdomen to empty the bladder into a receiver
4 Ensure that the eyes are closed and clean the body 0 1 2 3 4
5 Clean nostril, ears and mouth and replace dentures if any and 0 1 2 3 4
remove all tubes
6 Trim the nails, shave male patient’s beard and save for the 0 1 2 3 4
relatives
7 Remove all jewellery including wedding rings and beads, 0 1 2 3 4
record and hand over to the next of kin or wasrd in-charge
8 Re-dress wound if any, secure dressing with tape or loose 0 1 2 3 4
bandage
9 Pack orifices- nostrils, ears, rectum and vagina with cotton 0 1 2 3 4
wool using forceps to prevent leakage
10 Put a label on the arm or body bearing the following 0 1 2 3 4
a. Full name
b. Age
c. Sex
d. Ward
e. Diagnosis
f. Date and Time Of Admission
g. Date and Time Of Death
11 Wrap ensuring body in a sheet that the face and feet are 0 1 2 3 4
covered and all limbs held securely in position
12 Make arrangement to transfer the body to the mortuary 0 1 2 3 4
13 Check properly with a second nurse 0 1 2 3 4
a. Lists property in a valuable or property book, lock the
property in a safe place or
b. Hand them over to the next of kin if available and ask
this person to sign the book
14 Clear away any equipment used and observe infection 0 1 2 3 4
prevention protocol
15 Clear the bed, locker and all appliances 0 1 2 3 4
16 Document in admission and discharge book and Daily Ward 0 1 2 3 4
State
17 Take patient’s folder to the revenue office for assessment of

hospital bill
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: MAKING AN OPERATION BED

of performance.

1 Prepares trolley and sends to bedside 0 1 2 3 4
3 Places bottom sheet evenly on bed and tucks it under the mattress 0 1 2 3 4
6 Places dressing mackintosh and towel at top end of bed 0 1 2 3 4
7 Leaves pillow on the chair or cardiac table by the bed 0 1 2 3 4
8 Spreads blanket on bed 0 1 2 3 4
9 Places top sheet on bed with the wrong side uppermost and turns 0 1 2 3 4
back at the bottom end
10 Folds the top bed clothes at the open side in three parts over the bed 0 1 2 3 4
for easy admission of patient
11 Places a post anaesthetic tray by bed side containing vomit bowl, 0 1 2 3 4
dressing towel, kidney dish containing swab holding forceps,
dissecting forceps, tongue holding forceps and spatula
12 Arranges other bed accessories by bedside – drip stand, bed rail, 0 1 2 3 4
blood pressure apparatus
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: MOUTH CARE FOR SERIOUSLY ILL/UNCONSCIOUS PATIENT

of performance.

2 Prepares tray and takes it to the patient’s bedside and provide privacy 0 1 2 3 4
3 Puts patient in lateral position with head of bed lowered 0 1 2 3 4
4 Protects patient’s gown and bed linen with mackintosh and towel 0 1 2 3 4
5 Pours lotion into gallipots, washes and dries hands 0 1 2 3 4
6 Cleans lips and outer part of teeth 0 1 2 3 4
7 Opens mouth with padded spatula 0 1 2 3 4
8 Inspects mouth for any abnormalities and removes dentures if any 0 1 2 3 4
9 Takes swab with forceps, dips into cleansing lotion and squeezes out 0 1 2 3 4
excess OR uses brush and paste
10 Cleans moth thoroughly but gently i.e. from inside the cheeks, both 0 1 2 3 4
sides of gums, tongue and palate changing swabs frequently
11 Controls movement of tongue with spatula 0 1 2 3 4
12 Uses tooth pick to clean in between teeth 0 1 2 3 4
13 Cleans mouth with water or any mouth wash into a receiver 0 1 2 3 4
14 Cleans lips and applies Vaseline 0 1 2 3 4
15 Makes patient comfortable in bed and removes screen 0 1 2 3 4
16 Discards tray, decontaminates, washes and sterilizes instruments 0 1 2 3 4
17 Washes hands and documents procedure and findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: EXAMINING A NEW BORN BABY IN THE LABOUR WARD

performance.

1 Wash and dry hands 0 1 2 3 4
2 Position baby on a safe flat surface 0 1 2 3 4
3 Unwrap the baby, do general observation and cover with a 0 1 2 3 4
clean sheet
4 Examine baby’s head, face and neck 0 1 2 3 4
5 Examine the chest, abdomen and cord 0 1 2 3 4
6 Examine arms and hand 0 1 2 3 4
7 Examine the genitalia and test patency of rectum 0 1 2 3 4
8 Examine the hip and lower extremities 0 1 2 3 4
9 Examine the back of the baby 0 1 2 3 4
10 Wrap and place baby back into cot or send to mother 0 1 2 3 4
11 Wash and dry hands and record findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: MAKING AN OPERATION BED

of performance.

1 Prepares trolley and sends to bedside 0 1 2 3 4
3 Places bottom sheet evenly on the bed and tucks it under the 0 1 2 3 4
mattress using envelope corners
6 Places dressing mackintosh and towel at top of bed 0 1 2 3 4
7 Leaves pillow on chair by the bed 0 1 2 3 4
8 Spreads blanket on bed 0 1 2 3 4
9 Places top sheet on bed with wrong side uppermost and tucks back 0 1 2 3 4
the bottom end
10 Folds the top bed clothes at the open side in three parts over the bed 0 1 2 3 4
11 Places a post anaesthetic tray by bed side containing vomit bowl, 0 1 2 3 4
dressing towel, kidney dish containing swab holding forceps,
dissecting forceps, tongue holding forceps and spatula
12 Arranges other bed accessories by bedside – drip stand, bed rail, BP 0 1 2 3 4
apparatus
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: ORIENTATION OF PATIENT TO WARD ENVIRONMENT (AMBULANT)

of performance.

1 Establishes rapport with patient 0 1 2 3 4
2 Mentions the name of the ward to him 0 1 2 3 4
3 Introduces patient to ward staff around and other patients 0 1 2 3 4
4 Shows patient the nurse’s office 0 1 2 3 4
5 Shows patient his bed 0 1 2 3 4
6 Shows patient the bathroom and toilet 0 1 2 3 4
7 Shows Patient Kitchen and day room 0 1 2 3 4
8 Shows patient his cupboard and bed locker 0 1 2 3 4
9 Informs patient of ward activities 0 1 2 3 4
10 Informs patient whom to contact for any information 0 1 2 3 4
11 Encourages patient to ask questions and answer correctly and 0 1 2 3 4
tactfully
12 Thanks Patient and put him to ed 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: TAKING THE PAST OBSTETRICAL HISTORY OF A PREGNANT WOMAN

4 - Technique, speed and style excellent
.
performance.

1 Establish rapport, explain procedure to client and ensure 0 1 2 3 4
client is comfortably seated
2 Ask about the number of previous pregnancies for client and 0 1 2 3 4
what happened in each case
3 Ask dates or intervals between pregnancies 0 1 2 3 4
4 Ask about any ill health in each pregnancy 0 1 2 3 4
5 Enquires about number of tetenol injections received in life 0 1 2 3 4
time
6 Ask about the mode, place of delivery and duration of each 0 1 2 3 4
child
7 Enquire if delivery of placenta for each child was normal 0 1 2 3 4
and the amount of blood loss in each
8 Ask about all ill health following each delivery 0 1 2 3 4
9 Enquire about the conditions of the babies at birth 0 1 2 3 4
10 Ask about sex and weight of each baby at birth 0 1 2 3 4
11 Ask about any ill health of babies and at what age 0 1 2 3 4
12 Ask if babies were breast fed and how long 0 1 2 3 4
TASK: TAKING THE PAST OBSTETRICAL HISTORY OF A PREGNANT WOMAN
13 Ask type of Family Planning method used 0 1 2 3 4

14 Enquire about immunization of babies 0 1 2 3 4
15 Ask about family support and record findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: PREPARATION AND CARE OF PATIENT DURING AND AFTER LUMBER

PUNCTURE

of performance.

1 Establishes rapport and explains the procedure to the patient and 0 1 2 3 4
reassures him
2 Prepares trolley for procedure with necessary requirements 0 1 2 3 4
3 Ensures consent form has been signed 0 1 2 3 4
4 Provides privacy and instructs patient to void before the procedure 0 1 2 3 4
5 Prepares skin as for surgery 0 1 2 3 4
6 Washes hands, dries and puts on gloves 0 1 2 3 4
7 Opens the pack taking care not to contaminate it 0 1 2 3 4
8 Provides adequate lighting at the puncture site 0 1 2 3 4
9 Assists patient into a required position i.e. lying or sitting and 0 1 2 3 4
supports him
10 Continues to support , observes and reassures patient throughout the 0 1 2 3 4
procedure
11 Applies firm strapping when needle is withdrawn 0 1 2 3 4
12 Allows patient to lie flat on back and makes him comfortable 0 1 2 3 4
13 Observes patient for leakage from puncture sites, headache and 0 1 2 3 4
backache
14 Checks and records vital signs
15 Expresses appreciation to patient, removes and disposes off
equipment
16 Documents procedure and ensures specimen is labelled and sent to
the laboratory
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: PREPARATION FOR AND ASSISTING DURING WARD ROUNDS

of performance.
Preparation of the rounds trolley
1 Requirements
Rounds trolley with two or more shelves and attached collapsible 0 1 2 3 4
writing top
Top Shelf
Adequate supply of ward stationary: diary or note book, continuation 0 1 2 3 4
sheet, treatment sheets, X-ray forms, laboratory form, prescription
pads, investigation request forms, clips, pins and stapler
2 Bottom Shelf
Sphygmomanometer and stethoscope
Temperature chat
Diagnostic set
Pocket touch light
Measuring tape
Disposable tongue depressors/spatula 0 1 2 3 4
3 Neuro tray containing
Tendon hammer, cotton swabs in a gallipot
Pins
Salt 0 1 2 3 4
Sugar
Powdered pepper
Perfume
Receiver for used articles
4 Other trays may be set depending on specific needs of patients 0 1 2 3 4
TASK: PREPARATION FOR AND ASSISTING DURING WARD ROUNDS

Steps
5 Ensures the ward and its annexes are clean
6 Conducts charge nurses round
7 Classifies patients according to needs of the patients OR depending on
the protocol of the unit
8 Ensures all reports are duly filed and records are up to date
9 Arranges patients case notes in the correct sequence for the rounds
(in the racks provided on the trolley if applicable)
10 Ensures patients are clean, comfortable, ready for the rounds and all
visitors are out of the ward
11 Assists when doctor is examining the patients
12 Facilitates rounds; present patient’s problems, patients progress and
successes
13 Give patients opportunities to ask questions receive answers
14 Records any changes made in patient’s treatment
15 Ensures patients notes are returned to their proper places on the rack
16 Documents findings detected in the patient
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: PREPARING PATIENT AND TROLLEY FOR LUMBER PUNCTURE

of performance.

1 Washes and dries hands and prepares the trolley 0 1 2 3 4
2 Top shelf 0 1 2 3 4
Sterile fenestrated drape, sterile gallipot with cotton wool swabs,
antiseptic cleansing agent in a sterile gallipot
3 Bottom shelf 0 1 2 3 4
Dressing pack, mask and two sterile glove packs
4 Receiver for soiled swabs and 2ml syringe for local anaesthetic agent 0 1 2 3 4
5 18G or 20G three spinal needles, three way stop cock, manometer 0 1 2 3 4
and adhesive strapping
6 Three sterile collection tubes with stoppers, laboratory request forms 0 1 2 3 4
labels and light source (touch light)
7 Counter scissors, receiver for used instruments and BP apparatus and 0 1 2 3 4
temperature tray
8 Establishes rapport and explains procedure to patient and ensures his 0 1 2 3 4
co-operation

9 Bring trolley to bed side and provides privacy, and washes hands and 0 1 2 3 4
open equipment trolley
10 Assist patient to lie on his side at the edge of the bed with his chin 0 1 2 3 4
tucked to his chest and knees drawn up to abdomen
11 Places one hand behind his neck and the other behind his knees or 0 1 2 3 4
sitting up position leaning over table or chair to flex spine
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: PREPARING TRAY AND GIVING INTRAMUSCULAR INJECTION

of performance.

1 Identifies and checks for the right patient, right drugs, right route and 0 1 2 3 4
right time
2 Explains procedure to patient and provides privacy 0 1 2 3 4
3 Prepares and takes tray to patient’s bedside 0 1 2 3 4
4 Checks details again with patient’s treatment sheet 0 1 2 3 4
6 Assembles syringe and needle using sterile technique 0 1 2 3 4
7 Files and breaks ampoule or removes metal cap of vial with a clean 0 1 2 3 4
swab, draws drug and discards
8 Replaces needle with a new one and expels air 0 1 2 3 4
9 Assists patient into a required position and exposes site for injection 0 1 2 3 4
10 Cleans site with swab dipped in antiseptic lotion (upper outer 0 1 2 3 4
quadrant of buttocks if buttocks is used and outer aspect if thigh is
used)
11 Inserts the needle quickly and firmly deep into the muscle at right 0 1 2 3 4
angle
12 Withdraws piston a little to ensure needle is not in the blood vessel (if 0 1 2 3 4
blood appears withdraw needle)
13 Pushes to release drug into the tissue 0 1 2 3 4
14 Withdraws the syringe and needle quickly ad with a swab gently 0 1 2 3 4
applies pressure to the point of injection
15 Discards syringe and needle into a container 0 1 2 3 4
16 Thanks patient and leaves him comfortable in bed 0 1 2 3 4
17 Washes and dries hands and documents any findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: PROCESSING INSTRUMENTS AFTER USE


1 Prepare a fresh 0.5% chlorine solution in a bowl or bucket 0 1 2 3 4
2 Wears protective clothings as required e.g. utility gloves and plastic 0 1 2 3 4
apron
3 Immerse all used instruments into solutions for at least 10 minutes 0 1 2 3 4
4 Puts on utility gloves and removes instruments from chlorine solution 0 1 2 3 4
after 10 minutes
5 Rinse instruments in warm or cool water 0 1 2 3 4
6 Scrubs instruments using a soft brush with liquid detergent, paying 0 1 2 3 4
attention to the crevices/ serrated ends under water in a bowel
7 Rinse instruments thoroughly with clean water to remove all 0 1 2 3 4
detergent
8 Boils for 20 minutes in a boiler covered with well fitting lid 0 1 2 3 4
OR
Dries by air or with a clean towel if to be sterilized in CSSD
9 Document instruments and sends them to CSSD 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: REMOVAL OF AN INDWELLING CATHETER

of performance.

2 Prepares and takes and tray to bedside and provides privacy 0 1 2 3 4
3 Position patient as for Catheterization 0 1 2 3 4
4 Places mackintosh and dressing towel beneath the patient and around 0 1 2 3 4
genital area
6 Wears gloves and place towel between legs of the female patients/on 0 1 2 3 4
the thighs of the male patient
7 Inserts the syringe into the injection part of catheter and withdraws 0 1 2 3 4
water from the balloon
8 Gently withdraws the Catheter and places in the waste receptacle 0 1 2 3 4
9 Dries the genital area with towel 0 1 2 3 4
10 Measures urine in the drainage bag and removes gloves 0 1 2 3 4
11 Thanks patient and discard used items 0 1 2 3 4
12 Washes and dries hands and document findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: REMOVAL OF CLIPS

of performance.

1 Establishes rapport and explain procedure to the patient 0 1 2 3 4
2 Wears mask, prepares dressing trolley and takes to bedside and 0 1 2 3 4
provides privacy
3 Puts patient into desired position, adjusts bed clothes to expose area 0 1 2 3 4
to be dressed and protects bed linen
4 Pours out lotion into gallipots and removes plaster or bandage 0 1 2 3 4
5 Washes and dries hands and puts on gloves 0 1 2 3 4
6 Removes soiled dressing with dissecting forceps and discards 0 1 2 3 4
7 Swabs wound with antiseptic lotion using another sterile forceps and 0 1 2 3 4
places sterile swab near the wound
8 Takes clip removing forceps and dissecting forceps, steadies the clip 0 1 2 3 4
with the dissecting forceps and inserts one blade of the clip remover
on top of it
9 Presses the blade together and then frees the clip from the skin on 0 1 2 3 4
either sides and places it on the swab,noting number of clips removed
10 Cleans wound, applies dressing and secures into position 0 1 2 3 4
11 Thanks and makes patient comfortable in bed 0 1 2 3 4
12 Discards trolley and decontaminates instruments
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: REMOVAL OF STITCHES

of performance.

1 Establishes rapport and procedure to the patient 0 1 2 3 4
2 Wears mask, prepares and takes trolley to bedside and provides 0 1 2 3 4
privacy
Ask assistant to:
3 Put patient into comfortable position, protects bed clothes and 0 1 2 3 4
expose area to be dressed only
4 Pours out lotion into gallipots and remove plaster or bandages 0 1 2 3 4
6 Removes soiled dressing with dissecting forceps and discards 0 1 2 3 4
7 Cleans wound with series of swabs soaked in antiseptic lotion, places 0 1 2 3 4
sterile swab near the wound
8 Takes dissecting forceps and stitch removing scissors, grasps ends of 0 1 2 3 4
the stitch with dissecting forceps and pulls gently to expose an area
between the knot and the skin
9 Cuts stitch between the knot and the skin, pulls out suture gently and 0 1 2 3 4
slowly
10 Inspects carefully to make sure sutures are removed and discarded on 0 1 2 3 4
a piece of gauze, noting number of sutures removed
11 Cleans wounds, applies dressing and secures into position
12 Thanks and makes patient comfortable in bed
13 Discards trolley and contaminates instruments 0 1 2 3 4
14 Removes gloves, washes and dries hands and removes screen 0 1 2 3 4
15 Documents and reports state of wound 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: SETTING UP I. V. INFUSIONS

of performance.

1 Establish rapport and explain procedure and its purpose to patient and 0 1 2 3 4
reassure him
2 Check the physician’s order for the type of solution and check the 1 0 1 2 3 4
rights of drug administration
3 Ensure quality of the infusion ( check for cloudiness, sediments, other 0 1 2 3 4
particles and expiry date)
4 Send prepared trolley and other equipment to the patient’s bedside 0 1 2 3 4
5 Encourage patient to use bedpan and check vital signs 0 1 2 3 4
6 Select and inspect sites and shave if necessary giving 0 1 2 3 4
7 Place infusion stand at the side of the bed and prepare plaster 0 1 2 3 4
strips/tape
8 Insert the piercing needle of giving set into the rubber seal of the 0 1 2 3 4
infusion bag/ bottle and hangs the bottle/bag on the drip stand
9 Remove the cap from the other end of the giving set and attach needle 0 1 2 3 4
to it
10 Protect the bed with dressing mackintosh 0 1 2 3 4
11 Expels air from the giving set 0 1 2 3 4
12 Wash hands, dry and wear sterile gloves and clean the site with 0 1 2 3 4
antimicrobial solution (methylated spirit) with cotton swab

13 Ask assistant to apply tourniquet to locate the vein 0 1 2 3 4
14 Introduce the cannula into the vein and release the tourniquet 0 1 2 3 4
15 Connect the giving set to the cannula and regulate the flow rate as 0 1 2 3 4
ordered
16 Secure cannula into position and check for infiltration or haematoma 0 1 2 3 4

SIGNATURE: …………………………. DATE: ………………………………….

CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: SKIN PREPARATION FOR SURGERY

of performance.

2 Sends prepared tray to bedside, provides privacy and puts patient into 0 1 2 3 4
desired position
3 Washes hands and exposes the area to be prepared only and protects 0 1 2 3 4
the bed clothes
4 Washes wide area around the operation site with soap and water 0 1 2 3 4
5 Washes and dries hands and puts on gloves 0 1 2 3 4
6 Cleans the area with antiseptic solution 0 1 2 3 4
7 Applies sterile dressing towel or paper towel and secures into position 0 1 2 3 4
8 Thanks patient, removes and discards tray 0 1 2 3 4
9 Decontaminates the items used, removes gloves, washes and dries 0 1 2 3 4
hands
SCORE OBTAINED: ……………….. NAME OF EXAMINER: ………………………………………………… ………………
SIGNATURE: ………………………….DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: SPOON FEEDING OF AN ADULT ILL PATIENT

of performance.

1 Establishes rapport, explains procedure to patient, washes hands and 0 1 2 3 4
prepares meal tray with food, spoon, a jug of drinking water, cup and
napkins
2 Offers bedpan if required before feeding is started 0 1 2 3 4
3 Puts patient in a comfortable position, washes and dries hands 0 1 2 3 4
4 Gives patient a mouth wash 0 1 2 3 4
5 Brings food in a tray to patient’s bedside and protects patient’s 0 1 2 3 4
clothing with the napkin
6 Places herself in a comfortable position and asks patient if prayer is 0 1 2 3 4
preferred
7 Takes food by spoon in small bits into patient’s mouth 0 1 2 3 4
8 Allows patient time to chew and swallow 0 1 2 3 4
9 Continues feeding until patient is satisfied 0 1 2 3 4
10 Gives water intermittently as required by patient and after feeding 0 1 2 3 4
11 Cleans patient’s lips and gives a mouth wash 0 1 2 3 4
12 Removes napkin and makes patient comfortable 0 1 2 3 4
13 Congratulates patient and discards tray 0 1 2 3 4
14 Washes and dries hands and documents procedure in nurses notes 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: TAKING OVER A WARD

of performance.

1 Greets staff on duty 0 1 2 3 4
2 Asks for oral information on major happenings on the ward from the 0 1 2 3 4
outgoing nurse
3 Reads written ward report 0 1 2 3 4
4 Enquires sensitive information about patients at the nurses office 0 1 2 3 4
5 Takes over ward from bed to bed verifying the state of all patients; 0 1 2 3 4
especially very ill patients
6 Establishes rapport with patients during taking over and asks about 0 1 2 3 4
state of health
7 Conducts inspection of ward with the outgoing staff 0 1 2 3 4
8 Ensures resources needed for work are available and adequate and 0 1 2 3 4
takes over controlled drugs
9 Counter-signs written ward report 0 1 2 3 4
10 Notes important issues in the ward diary 0 1 2 3 4
11 Congratulates out-going staff 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: TEPID SPONGING

of performance.

1 Explains procedure to patient and provides privacy 0 1 2 3 4
2 Prepares trolley and sends to the bedside 0 1 2 3 4
4 Takes patient’s temperature, pulse and respiration and records 0 1 2 3 4
5 Arranges top bed clothes leaving top sheet 0 1 2 3 4
6 Protects bottom sheet and undresses the patient 0 1 2 3 4
7 Washes and dries face to refresh patient 0 1 2 3 4
8 Leaves a flannel rung out of cold water on the patient’s forehead 0 1 2 3 4
9 Places 6 pieces of flannel into basin or tepid water 0 1 2 3 4
10 Places a wet flannel in each axilla and groin, squeezes out excess 0 1 2 3 4
water
11 Changes the wet flannel frequently to keep them tepid 0 1 2 3 4
12 Sponges upper arms, trunk, lower limbs and back in strokes leaving 0 1 2 3 4
small drops of water on the skin
13 Changes water as often as necessary 0 1 2 3 4
14 Leaves patient for 15-20 minutes 0 1 2 3 4
15 Dresses patient up and rechecks temperature and records 0 1 2 3 4
16 Thanks and makes patient comfortable 0 1 2 3 4
17 Washes and dries hands and serves cold drink if necessary 0 1 2 3 4
18 Documents procedures and reports findings 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: TREATMENT OF PRESSURE AREAS

performance.

1 Establish rapport and explain procedure to patient 0 1 2 3 4
2 Prepare lukewarm water for the procedure 0 1 2 3 4
3 Set trolley and send to patient beside and cover with a sheet 0 1 2 3 4
4 Remove patient’s bedclothes and cover with a sheet 0 1 2 3 4
5 Protect bed with a mackintosh and a draw towel 0 1 2 3 4
6 Roll patient onto the side 0 1 2 3 4
7 Examine and note any abnormality 0 1 2 3 4
8 Clean all pressure areas with soap and water in a soft towel 0 1 2 3 4
with gloved hands
9 Knead all pressure areas with pads of finger, one area at a 0 1 2 3 4
time
10 Rinse and dry skin with a soft dry towel 0 1 2 3 4
11 Apply moisturizing cream or alcohol-free barrier 0 1 2 3 4
cream/films
12 Groom and make patient comfortable in bed 0 1 2 3 4
13 Thank patient and discard trolley 0 1 2 3 4
14 Wash and dry hands and document procedure and findings 0 1 2 3 4
15 Inform charge –nurse of any abnormality 0 1 2 3 4
SIGNATURE: …………………………. DATE: ………………………………….


CENTRE: ……………………………………………..…. DATE: …………………………………
TASK: WASHING OF PATIENT’S HAIR IN BED

of performance.

2 Prepares and sends trolley to bedside and provides privacy 0 1 2 3 4
3 Puts patient in a suitable position 0 1 2 3 4
4 Arranges long mackintosh into a trough, fashion under the patient’s 0 1 2 3 4
shoulders, neck and head and extends it down into a bowl or bucket
5 Covers mackintosh with a bath towel under the patient’s neck and 0 1 2 3 4
6 Combs, remove tangles from hair, covers eyes with towel and plugs 0 1 2 3 4
ears with cotton balls
7 Wets hair and applies soap/shampoo 0 1 2 3 4
8 Messages scalp systematically starting at the front to the back of the 0 1 2 3 4
head, rinses and repeats till clean
9 Wipes any moisture around eye, face and neck 0 1 2 3 4
10 Squeezes hair gently and ties hair up in a towel and dries thoroughly 0 1 2 3 4
with a towel or a hand drier
11 Applies pomade, combs and styles hair to patient’s liking 0 1 2 3 4
12 Removes mackintosh and towel and leaves patient dry and 0 1 2 3 4
comfortable in bed
13 Discards trolley, washes and dries hands 0 1 2 3 4
14 Documents procedure and type of washing agent and report findings 0 1 2 3 4
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KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY

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