Registered Nurse-Employee Assessment

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Sample Form Registered Nurse – Employee Assessment Assessment Score
Name: Job Title: Department: Review Date: Overall Score: / 5.0

Part I. Performance Criteria
Evaluation Criteria: 5 - Outstanding Performance: Performance is clearly far above an acceptable level and goes well beyond normal expectations. • Continually applies ever-increasing job knowledge/skills to address challenges and lead new initiatives. • Routinely seeks, accepts and achieves extraordinary success on additional responsibilities. • Contributes and leads innovative, workable solutions to projects/problems. • Accomplishes high work quality and productivity even amidst obstacles. • Demonstrates constant commitment to continuous improvement in customer service relationships. • Strongly exhibits positive leadership behavior which enhances co-workers'/workgroups’ performance. • Advice and counsel is regularly sought by work team members and others in the organization. 4 - Exceeds Expectations: Performance is noticeably better than required, and consistently exceeds expectations. • Customarily increases job knowledge/skills to accomplish objectives. Often seeks, accepts and achieves noteworthy success on additional responsibilities. • Actively supports and embraces changing situations and additional work assignments. • Regularly develops approaches and implements solutions to projects/problems. • Produces superior work quality and productivity beyond standards. • Regularly seeks/implements improvements in customer service relationships. • Strongly exhibits positive behavior, which promotes and influences cooperation from others. 3 - Meets Expectations: Performance meets standard requirements and is consistent with expectations. • Effectively applies and pursues opportunities to increase job knowledge/skills to complete objectives. • Demonstrates pro-active problem solving to improve and/or adjust work processes. • Produces results dependably, on time and accurately. • Effectively meets the needs of customer service relationships. Exhibits expected workplace courtesy and respect. Behavior positively influences working relationships. • Displays regular attendance to meet organizational needs.

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2 - Needs Improvement: Performance does not meet standard requirements and shows a noticeable need for improvement. A corrective performance improvement plan is warranted. • Performs inconsistently, possibly leading to some inaccurate, untimely and/or unacceptable results. • May fail to pursue developmental opportunities and/or apply new skills to meet standards • Behaviors reflect difficulty adjusting to changing situations or work assignments. • At times, displays actions that are detrimental to customer service relationships. • Excessive direction is required to carry out tasks and closer than normal supervision is the rule rather than the exception. 1 - Unacceptable Performance: Fails to meet expectations, requirements or standards. A corrective performance improvement plan must be outlined and monitored or termination process must be initiated. Performance is consistently below established expectations, requirements or standards. • Ineffectively applies or lacks job knowledge/skills to meet standards. • Demonstrates failure to initiate improvement to complete objectives. • Delivers inaccurate and generally unacceptable results. • Displays behaviors and actions which are detrimental to co-workers, teamwork and/or customers.

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A. Essential Functions
Competency Evaluation Criteria

Score:

/ 5.0 (30%)

Evaluation Criteria: O-Outstanding Performance; E-Exceeds Expectations; M-Meets Expectations; N-Needs Improvement; UUnacceptable Performance; NA-Not Applicable Comments Score /5.0

Portrays Hospital Cultural Expectations Communicate Effectively: Communicate effectively with everyone you come in contact with at the hospital by: • Listening to and respecting others in all requests • Providing information in a timely manner • Following through with commitments • Expressing yourself in a positive and respectful manner Make this Your Place: Take ownership. If you see something that needs to be done, do it. Accept Diversity: Keep an open mind to ideas and cultures that are different from your own. Know, Understand and Own the Responsibilities: Know, understand and own the responsibilities of your role in the patient’s health experience. Learn from each encounter to exceed expectations and increase everyone's satisfaction. Greet Everyone with a Friendly Smile: Create a positive experience for co-workers and guests. Foster a Team Environment: Treat everyone with respect and value his or her contribution. Recognize others for a job well done. Embrace and Support Change: Listen with a willingness to be influenced. Be Proud of your Calling: • Have pride in yourself and your appearance • Wear your name badge at work • Be on time • Dress appropriately for your role • Take good care of yourself and others Assessment: • Collects and organizes pertinent patient assessment data. • Seeks information from patient, family, health care providers and environment on an ongoing basis. • Uses established assessment forms to document assessment of patient's emotional, spiritual and physical care needs. • Completes admission assessment within time frame identified in admission policy.

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Diagnosis: • Analyzes assessment data to identify expected outcomes unique to the patient. • Expected outcomes are mutually formulated with patient, family and health care team. • Formulates measurable expected outcomes using patient profile, pathways and standards of care as guides. • Identifies expected outcomes which are realistic in respect to patient's present and potential capabilities. Identification of Outcomes: • Develops plan of care consistent with assessment data. Involves patient, family and healthcare providers to identify outcomes. • Incorporates cultural needs/diversity in individualized patient outcome identification. • Defines outcomes with attainable timeframes. • Documents outcomes as measurable goals. Planning: • Develops a plan to provide direct nursing care to attain outcomes. • Individualizes plan based upon identified patient needs, such as economic impact, cultural concerns. • Prioritizes implementation of diagnoses and interventions based on patient condition. • Utilizes standardized terminology to communicate to others. Implementation: • Implements the interventions identified in the plan of care. • Carries out interventions in a safe and timely manner. • Incorporates evidenced-based treatments in care of patient. • Uses resources and collaborates with others to implement plan. • Documents intervention implementation, noting exceptions/modifications

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Evaluation: • Evaluates the patient's progress toward attainment of outcomes. • Utilizes an organized ongoing process to determine outcome attainment based on the plan of care. Includes patient, family, health care providers involved in patient care in evaluation process. • Documents evaluation findings. Utilizes evaluation data to revise as necessary, diagnoses, outcome, plan and implementation process. • Communicates results to patient and those involved in care. Quality of Care: • Systemically evaluates the quality and effectiveness of nursing practice. • Documents in a responsible, accountable and ethical manner. • Uses results of quality improvement activities to initiate change. • Implements creativity and innovation to improve care delivery. • Participates in quality improvement activities. Performance Appraisal: • Evaluates his/her own nursing practice in relation to professional practice standards and relevant statues and regulation. Engages in self evaluation on regular basis, identifies strengths and weaknesses. • Obtains informal feedback on performance from patients, peers, colleagues, others. • Acts to achieve identified performance goals. • Provides rationale for practice behaviors. Education: • Acquires and maintains current knowledge in nursing practice. • Participates in ongoing educational related activities. • Demonstrates commitment to lifelong learning. • Seeks experiences to maintain skills and competence for role performance. • Maintains records to support competency and lifelong learning.

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Collegiality: • Contributes to the professional development of peers, colleagues and others. • Shares knowledge and skills with others (patient conference, meeting presentations, precept/mentoring). • Provides peer feedback in constructive manner. • Engages in direct one-to-one communication. • Interacts with peers and colleagues to enhance performance. • Contributes in a positive manner to the environment, making it conducive to education and learning.

B. Success Factors
Competency Evaluation Criteria

Score:

/ 5.0 (30%)

Evaluation Criteria: O-Outstanding Performance; E-Exceeds Expectations; M-Meets Expectations; N-Needs Improvement; UUnacceptable Performance; NA-Not Applicable Comments Score /5.0

Analytical Factors: Approaches a complex task or problem by breaking it down and • Approaches a situation or problem by defining the issue, determining its significance, collecting data and using logic and intuition to arrive at a conclusion. • Applies a global perspective when solving problems. • Sees most of the forces, events, entities, and people that are affecting (or are being affected by) the situation at hand. • Notices discrepancies and inconsistencies in available information. • Weighs the costs, benefits, risks, and opportunities for success when making a decision.

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Clinical/Technical Expertise Clinical/Technical Expertise Applies and improves in-depth specialized knowledge, skills, and judgment to reach a result or to perform one's job effectively. • Understands technical aspects of one's job by continuously building knowledge and keeping up-to-date on the technical or procedural aspects of the job. • Makes oneself available to others to help solve technical or procedural issues. • Thinks of ways to apply new developments to improve organizational performance and customer service. • Applies technical/procedural knowledge to correctly address a situation in a timely manner. • Recognizes trends in theory and practice. • Effectively prepares for anticipated changes. Influence and Impact: Influence and Impact Asserts ideas, persuades others and gains support and commitment by using creative approaches to motivate others to meet organizational goals. • Able to make persuasive argument to influence an audience. • Works to make others feel ownership in one's own solutions. • Identifies key decision-makers on issues of concern. • Develops and effectively uses networking both inside and outside the organization. • Seeks to build relationships with others who can provide information, intelligence, career support, or potential business opportunities. • Takes a personal interest in others to develop relationships. Insight into Others: Sensing others' feelings and perspectives and taking an active interest in their concerns. • Seeks to understand others perspectives and styles by valuing the uniqueness of the individual. • Attentive to emotional cues. • Listens well. • Shows sensitivity and understands others' perspectives. • Aware of others' feelings, needs and concerns. • Recognizes how feelings affect performance.

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Insight into Self/Self-Awareness: Knowing one's internal states, preferences, resources and intuitions. • Recognizes own emotions and how feelings affect one's own performance. • Has a guiding awareness of one's values and goals. • Ability to use one's values to guide decision making. • Open to candid feedback, new perspectives, continuous learning and self-development. • Knows one's strengths and limitations. • Able to show a sense of humor and perspective about themselves. • Aware of areas for self-improvement and development. • Reflective; able to learn from experience. • Self-confident; has strong sense of selfworth and capabilities. Knowledge Transfer: Seeks out opportunities to share knowledge and skills and readily answers team members' questions in an effort to increase organizational learning and performance. • Provides assistance, when necessary, to project team members in performing basic functions and tasks. • Clearly communicates the direction focus and goals of their discipline or functional area to the department managers and coworkers. • Actively seeks out opportunities to help team members understand the relevance their work has on other disciplines. • Educates others on specific technologies and/or procedures within their discipline.

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Patient Focus / Customer Service: Demonstrates concern for meeting the needs of those who depend on one's services, ensuring their full satisfaction. Includes patients, significant others, family members, co-workers, managers, students, internal and external professional staff, and community members. • Asks questions to identify the needs and expectation of others. • Considers the impact on external or internal customers when taking action or carrying out one's own job tasks. • Builds a relationship with the customer in order to anticipate and serve their needs. • Continually seeks efficient ways of providing services by minimizing procedural requirements. Looks for creative approaches to providing or improving services that may increase efficiency or decrease costs. • Takes personal responsibility for resolving service problems. • Effectively and professionally works with upset patients and/or customers to resolve issues. • Demonstrates a high level of compassion and sensitivity and follows through with actions for the patient and/or customer. Teamwork: Works well when partners with others to achieve organizational, team goals, and objectives. • Openly shares information, knowledge and expertise with team co-workers. • Cooperates with other members to achieve best outcomes for patient. • Works with team members to attain goals. • Puts accomplishing the interests of the organization ahead of accomplishing individual goals. • Actively works to remove barriers to team effectiveness. • Utilizes team members' skills to accomplish goals. • Demonstrates respect for the opinions of others. • Identifies and promotes solutions to benefit everyone involved. Keeps people informed and up-to-date. Shares information and own expertise with others to enable them to accomplish group goals.

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Change Management: Initiates and/or manages the change process and energizes it on an ongoing basis by taking steps to remove barriers or accelerate its pace. • Communicates a compelling vision and need for change within one's department/team/organization that generates excitement, enthusiasm, and commitment to the process. • Clearly communicates the direction, required performance, and challenges of change to all involved parties. • Helps employees quickly and effectively understand and adjust to new roles, challenges and changes in the organizational environment and in their jobs. • Obtains and provides resources to implement change initiatives and works to create ownership of the change in others. • Stays up-to-date on key trends and opportunities. • Initiates change instead of reacting to external pressures for change. • Identifies and enlists the support of key individuals and groups to move the change forward. • Makes sure technical/functional decisions are based on department priorities aligned with the organization. • Uses available resources (people, funds, time, material, support) and coordinates/manages these components including those outside the organization. • Serves as a personal model of the change that one expects of others by demonstrating commitment to innovation and continuous improvement in organizational performance.

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Innovation: Generates new and valuable ways to do one's job more effectively and efficiently by improving processes, methods, systems, or services. • Injects originality into daily work through research, personal knowledge, and networking relationships. • Brainstorms and fosters new ideas, approaches and solutions. • Takes appropriate risks. • Understands technical aspects of one's job and uses appropriate technology for the situation at hand. • Tries new approaches when problem solving and seeks ideas or suggestions from others as appropriate. • Reviews, selects and disseminates information regarding key technologies, best practices and tools to others in group. • Identifies novel approaches for completing work assignments more effectively or efficiently and works within the established system to promote a more effective way.

Summary Score Past Goals
Goals Goal:

Score:

/ 5.0

Accomplishments

Goal:

Goal:

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New Goals
Goals Goal: Weight

Goal:

Goal:

Manager Final Comments

Employee Final Comments

This sample form shows you just some of the layout possibilities available to you with Halogen eAppraisal Healthcare’s truly flexible forms. For more details, visit www.halogensoftware.com © 2008 Halogen Softwar All rights reserved. Software.

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