Clinical nurse appraisal form

Clinical nurse appraisal form

Clinical nurse appraisal form

This free sample/template/form of job performance appraisal include information as follows:

1. Employee Details

• Employee Name
• Review Period
• Position
• Date of joining
• Department
• Review Date
• Line Manager

2. Key duties/responsibilities of Clinical nurse

State your understanding of your main duties and responsibilities of Clinical nurse, for examples:

• Collaborate with other health care professionals and service providers to ensure optimal patient care.
• Read current literature, talk with colleagues, or participate in professional organizations or conferences to keep abreast of developments in nursing.
• Make clinical recommendations to physicians, other health care providers, insurance companies, patients, or health care organizations.
• Identify training needs or conduct training sessions for nursing students or medical staff.
• Develop or assist others in development of care and treatment plans.

You should design a table for this area that include columns: No, duties, weight, core, comments.

3. Key result areas (KRAs) of Clinical nurse

Using the 4-point scale below, please assess your employee performance in the following areas:

• 4 – Performance was always successful, consistent and respectable and at times clearly superior and exceeding standards.
• 3.5 – Performance was at most times clearly superior and exceeding standards.
• 3 – Performance was successful, consistent, and respectable in every regard with few exceptions.
• 2.5 – Performance at times was inconsistent and did not meet standards.
• 2 – Performance at most times was inconsistent and did not always meet standards.
• 1 – Performance was overall unsuccessful and unacceptable with regard to expectations and the requirements of the position.

Then, you can create a table with columns: No, KRAs, weight, performance score, descriptions.

4. Job objectives of Clinical nurse

List the objectives you set out for your staff (Clinical nurse) to achieve in the past 12 months (or the period covered by this appraisal) with the measures or standards agreed – against each comment on achievement or otherwise, with reasons where appropriate.

Score the performance against each objective (1-3 = poor, 4-6 = satisfactory, 7-9 = good, 10 = excellent):

Then you create a table with columns: No – Objectives – Measure/standard – Score – Comment

5. Job competencies

Discuss and agree the skills, capabilities and experience required for competence in current role, and if appropriate, for readiness to progress to the next role or roles.

Using the 4 point scale below, fill up the following table:

• 4 – Exceeds expectations
• 3.5 – Somewhat Exceeds Expectations
• 3 – Meets expectations
• 2.5 – Somewhat meets expectations
• 2 – Less than expectations
• 1.5 – Somewhat less than expectations
• 1 – Inadequately short of expectations 4

Core Values And Leadership Skills

• Results Orientation [e.g. quality of delivery].
• Customer Focus – internal as well as external.
• Leadership Qualities (e.g.initiative , integrity, enthusiasm and zeal, instilling trust, stretching the goals, caring and sharing , interested in people development).
• Organizational alignment [e.g. corporate initiative, acceptance of change].
• Communication (e.g. Written and verbal communication, presentation skills, facilitation skills).
• Problem Solving.
• Team work.
• Self-confidence (e.g. .taking on new responsibility, confronting and dealing with issues and problems with confidence, risk taking ability).
• Professional Demeanor and Appearance.
• Openness to Feedback and Suggestions.
• Time management.
• Reliability.

6. Career development of Clinical nurse

Discuss and agree (as far as is possible, given budgetary, availability and authorisation considerations) the training and development support to be given to help the appraisee meet the agreed objectives above.

7. Overall rating of Clinical nurse:

• Exceptional
• Strong
• Fully Competent
• Continued Development
• Poor
• New to Position

Other comments:

8. Signatures

Name of Manager
Designation
Signature
Date

Appraisal acceptable to Employee: Yes / No Date
Signature

Clinical nurse’s Signature
Comments, if any
New Title (if applicable)
Date

Distribution: (1) Copy to HR departmental Personnel File (2) Copy to line manager. (3) Copy to Manager / Supervisor.

Related docs to nurse appraisal:

• All Nurse job descriptions
Nurse KPIs
Self appraisal form
Performance appraisal methods
Appraisal examples
360 degree appraisal
Performance appraisal handbook
Performance appraisal form
Performance appraisal tools
Performance appraisal process
360 degree performance appraisal
Nurse career ebooks (you can download free and ref all ebooks related nurse career).

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