Name:

Student number:

Score:

Date:

Activity

Evaluating Staff Performance

Instruction: During your clinical exposure, observe and interview a staff nurse or nurse manager and complete the performance evaluation sheet.

Employee Performance Evaluation Form

Employee Name:

Position: Registered Nurse

Department

Hire Date:

Evaluation Review Period:

Manager Reviewer:

This appraisal contains a five$-$point scale that each performance expectation is rated on$.$ The description of each number ranking on the five point scale is:

$\backslash$table$[[5,\backslash$table$[[$Significantly$],[$Exceeds$],[$Expectations$]],\backslash$table$[[$Staff member consistently goes above and beyond ordinary$],[$expectations$.$ Staff member is the pillar role model of excellence$],[100\%$ of the time.$]]],[4,\backslash$table$[[$Exceeds$],[$Expectations$]],\backslash$table$[[$Staff member frequently does things that are beyond their$],[$ordinary expectations. Peers and patients comment that staff$],[$member goes beyond others and routine expectations.$]]],[3,$Meets Expectations,Staff member always meets expectation as expected.$],[2,\backslash$table$[[$Usually Meets$],[$Expectations$]],\backslash$table$[[$Staff member is able to demonstrate meeting performance$],[$expectations at times.$]]],[1,\backslash$table$[[$Does Not$],[$Consistently Meet$],[$Expectations$]],$In this category, remediation work is necessary$]]$