PA-1-PERFORMANCE-EVALUATION-TOOL.xlsx

	A	B	C	D	E	F	G	H	I	J	K	L	M	N	O	P	Q	R	S	T	U	V	W	X	Y	Z	AA	AB	AC	AD	AE	AF	AG	AH	AI	AJ	AK	AL	AM	AN	AO	AP	AQ	AR	AS	AT	AU	AV	AW	AX
1		RETURN DEMO:	ASSESSING APPEARANCE AND MENTAL STATUS
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3	#	NAME OF STUDENT
4	1	Explain procedure to the patient. (what you are going to do, why it is necessary, and how he can cooperate).	4	5	4	5	5	5	4	5	5	5	5	5	5	5	4	5	5	5	5	5	5	5
5	2	Do handwashing.	2	5	5	5	4	4	3	4	5	5	5	4	4	5	4	4	5	5	5	5	5	5
6	3	Provide privacy.	2	5	5	4	4	4	3	4	3	4	5	5	4	5	4	4	5	4	5	5	5	5
7	4	Observe body built, height and weight in relation to the client’s age, lifestyle and health.	5	4	3	4	4	5	4	5	4	5	5	5	4	4	5	5	3	5	4	4	3	3
8	5	Observe the client’s posture and gait, standing, sitting and walking	5	4	3	3	4	4	4	5	5	4	3	4	4	3	5	5	3	3	3	4	3	3
9	6	Observe the client’s overall hygiene and grooming. Relate these to the person’s activities prior to the assessment.	5	4	3	3	4	4	4	5	5	4	4	4	5	4	5	5	3	3	3	4	3	3
10	7	Note body and breath odor.	4	4	3	4	4	4	4	4	5	4	4	4	4	4	5	5	3	3	3	3	3	3
11	8	Observe for signs of distress in posture or facial expression.	4	4	3	4	4	5	4	5	5	4	4	4	4	4	4	4	3	3	3	3	3	3
12	9	Note obvious signs of health and illness	4	4	3	4	4	4	4	5	4	4	4	4	4	4	4	4	3	3	3	3	3	3
13	10	Assess the client’s attitude	5	4	3	4	5	4	4	5	5	4	4	4	4	4	4	4	3	3	3	3	3	3
14	11	Note the client’s affect/mood and the appropriateness of responses	5	4	3	4	5	4	4	5	5	4	4	4	4	4	4	4	3	3	3	3	3	3
15	12	Listen for quality, quantity and organization of speech.	5	4	3	5	5	4	4	4	5	5	4	4	4	4	4	4	3	3	3	3	3	3
16	13	Listen for relevance and organization of thoughts.	5	4	3	5	5	4	4	4	5	5	4	4	4	4	4	4	3	3	3	3	3	3
17	14	Document pertinent findings in the chart.	5	4	3	5	5	4	4	4	5	5	5	5	5	5	5	5	5	3	5	3	3	3
18		TOTAL	60	59	47	59	62	59	54	64	66	62	60	60	59	59	61	62	50	49	51	51	48	48	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
19		AVERAGE	4.3	4.2	3.4	4.2	4.4	4.2	3.9	4.6	4.7	4.4	4.3	4.3	4.2	4.2	4.4	4.4	3.6	3.5	3.6	3.6	3.4	3.4	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!
20		TRANSMUTATION	92.1	91	82	91	93.2	91	87.6	95.5	96.6	93.2	92.1	92.1	91	91	93.2	93.2	84.2	83	84.2	84.2	82	82	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!
21		40%	36.84	36.4	32.8	36.4	37.28	36.4	35.04	38.2	38.64	37.28	36.84	36.84	36.4	36.4	37.28	37.28	33.68	33.2	33.68	33.68	32.8	32.8	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!	#DIV/0!
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