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Skills Assessment Report
Date:
Skill Assessment - Post-Intervention Management Steps
Student Name:
Credentials:
Date:
Location:
Laboratory Simulation
Clinical Environment
Step
Pass
Unsatisfactory
Post-Procedure Assessment
Reassess patient condition; provide additional instructions as needed.
Verify patient comfort and ensure safety measures are in place.
Ensure call light is within reach and easily accessible.
Perform
hand hygiene
Equipment Maintenance
Maintain and process used equipment; perform troubleshooting if necessary.
Dispose of infectious waste properly; wash hands or apply disinfectant.
Data Documentation
Record pertinent patient data in the chart and update departmental records.
Personnel Notification
Notify appropriate personnel and make recommendations if necessary.
References
Summary Performance Evaluation
PASS: Satisfactory performance
Student has demonstrated skill proficiency and may perform under supervision of clinical instructor or preceptor.
Student has demonstrated skill proficiency and may perform in clinical environment.
FAIL: Unsatisfactory performance
Remediation Required
Evaluator
Student Signature
Evaluator Signature
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