Home Health Nurse Performance Evaluation

Location *

Employee First Name *

Employee Last Name *

Evaluation Period Start *

Evaluation Period End *

Evaluator First Name *

Evaluator Last Name *

Provides high-quality clinical care (1-7, 1=lowest, 7=highest) *

Demonstrates up-to-date nursing knowledge (1-7, 1=lowest, 7=highest) *

Follows all healthcare protocols and procedures (1-7, 1=lowest, 7=highest) *

Conducts thorough and accurate patient assessments (1-7, 1=lowest, 7=highest) *

Creates and updates care plans effectively (1-7, 1=lowest, 7=highest) *

Monitors patient status and adjusts care as needed (1-7, 1=lowest, 7=highest) *

Communicates effectively with patients, families, and the healthcare team (1-7, 1=lowest, 7=highest) *

Documents patient care accurately and in a timely manner (1-7, 1=lowest, 7=highest) *

Ensures clear handover and continuity of care (1-7, 1=lowest, 7=highest) *

Maintains required certifications and licensure (1-7, 1=lowest, 7=highest) *

Participates in educational opportunities to enhance nursing practice (1-7, 1=lowest, 7=highest) *

Shares knowledge with colleagues to improve team competence (1-7, 1=lowest, 7=highest) *

Adheres to legal, ethical, and regulatory standards (1-7, 1=lowest, 7=highest) *

Maintains patient confidentiality and privacy (1-7, 1=lowest, 7=highest) *

Demonstrates honesty and integrity in all aspects of work (1-7, 1=lowest, 7=highest) *

Evaluator Comments

Overall Performance Rating (total possible score = 105) *

Date

Duration of Review

Date-Time

Signature — type your full legal name to sign *