DE LA SALLE LIPA
COLLEGE OF NURSING
Nursing Care Management 103
Procedural Checklist in
ASSESSING VITAL SIGNS
Name: _______________________ Date: __________ Year/Sec: ____ Rating:
General Objective:
To measure and document patients’ temperature, pulse, respiration, blood pressure, and pain score accurately
and safely, recognizing deviations from the normal values.
Specific Objectives:
1. Assess patient readiness for the temperature, pulse, respiration, blood pressure, and pain score
checking procedure.
2. Determine appropriate patient outcomes of the TPR and BP process and the potential for adverse
outcomes.
3. Choose the appropriate equipment.
4. Position the patient appropriately for the procedure, maintaining principles of body mechanics.
5. Measure the TPR, BP, and NPS accurately.
6. Document the results in the patient record as required.
Item Descriptors Verbal Interpretation
Weight
1 Excellent Performed the procedure with great ease and confidence, observing work ethics
(prudent, accepts criticisms and suggestions), able to rationalize scientifically
and shows diligence in documenting observations at all times .
0.75 Very Performed the procedure with less confidence, observing work ethics (prudent,
Satisfactory accepts criticisms and suggestions), able to rationalize scientifically and shows
minimal diligence in documenting observations.
0.5 Satisfactory Performed the procedure but requires close supervision and shows potential for
improvement.
0.25 Needs Failed to perform the procedure, unable to function well and needs repeated
Improvement specific/ detailed guidance or direction.
CRITERIA:
I. Skills – 10% 1.0 0.75 0.5 0.25 Remarks
1. Checked patient's chart. Gathered all supplies/materials
needed then performed hand hygiene. Wear proper
protective equipment (PPE) Identified the patient and
explained the procedure. Provided patient privacy.
2. Raised bed to appropriate working height. Made sure that
lighting is adequate. Assisted patient to a comfortable
position (supine or sitting; arm should be fully supported
on a flat surface at heart level when processing BP).
3. Measured patient’s temperature using an axillary
electronic thermometer observing infection control
measures (placed patient in Fowler’s position, made sure
axilla is dry).
COLLEGE OF NURSING
Nursing Care Management 103
Procedural Checklist in
ASSESSING VITAL SIGNS
Name: _______________________ Date: __________ Year/Sec: ____ Rating:
General Objective:
To measure and document patients’ temperature, pulse, respiration, blood pressure, and pain score accurately
and safely, recognizing deviations from the normal values.
Specific Objectives:
1. Assess patient readiness for the temperature, pulse, respiration, blood pressure, and pain score
checking procedure.
2. Determine appropriate patient outcomes of the TPR and BP process and the potential for adverse
outcomes.
3. Choose the appropriate equipment.
4. Position the patient appropriately for the procedure, maintaining principles of body mechanics.
5. Measure the TPR, BP, and NPS accurately.
6. Document the results in the patient record as required.
Item Descriptors Verbal Interpretation
Weight
1 Excellent Performed the procedure with great ease and confidence, observing work ethics
(prudent, accepts criticisms and suggestions), able to rationalize scientifically
and shows diligence in documenting observations at all times .
0.75 Very Performed the procedure with less confidence, observing work ethics (prudent,
Satisfactory accepts criticisms and suggestions), able to rationalize scientifically and shows
minimal diligence in documenting observations.
0.5 Satisfactory Performed the procedure but requires close supervision and shows potential for
improvement.
0.25 Needs Failed to perform the procedure, unable to function well and needs repeated
Improvement specific/ detailed guidance or direction.
CRITERIA:
I. Skills – 10% 1.0 0.75 0.5 0.25 Remarks
1. Checked patient's chart. Gathered all supplies/materials
needed then performed hand hygiene. Wear proper
protective equipment (PPE) Identified the patient and
explained the procedure. Provided patient privacy.
2. Raised bed to appropriate working height. Made sure that
lighting is adequate. Assisted patient to a comfortable
position (supine or sitting; arm should be fully supported
on a flat surface at heart level when processing BP).
3. Measured patient’s temperature using an axillary
electronic thermometer observing infection control
measures (placed patient in Fowler’s position, made sure
axilla is dry).
