ࡱ > [ bjbj 4 ΐ ΐ G G G G G [ [ [ 8 \ L [ J ; ; ( c c c J J J J J J J M KP | J G O | J G G c c J X G c G c J J @ ZC c {; [ W p A " J J 0 J @A P $ P D ZC ZC J P G C > , 5 $ Y J J * J P
: UGANDA CHRISTIAN UNIVERSITY
Annual Evaluation and Development Review Form- (Nurses)
Review Period: to
SECTION A: TO BE COMPLETED BY JOBHOLDER
1. PERSONAL INFORMATION Employee NameEmployee IDJob TitleCampus Department/FacultyDivision Supervisor/Head of Department DivisionMarital Status Date of BirthHighest Qualification Held Contract expiry 2. LIST SIGNIFICANT ACHIEVEMENTS/PROBLEMS DURING THE PAST YEAR3. REVIEW OF TRAINING AND DEVELOPMENT List the training and development undertaken and qualifications gained during this review period.Training/Learning/Development undertaken Benefit gained and application made
4. REVIEW OF PERFORMANCE BY JOBHOLDER Key Competencies Marking (A-E)Justification / Evidence Maintains patients confidentiality Examines the patient following an ethical approachAccurately and completely fills in documents Evidence based decision makingHandles all patients appropriatelyPatients confidentiality maintainedTeamworkPromotes continuity of care in UCU community.Patients counsellingKnowledge seeking and sharingIntegrating of faith into serviceI have read, understood the staff code of conduct and continue to affirm to the universitys instrument of identitySignature of Jobholder
Date
Keys used for ranking performanceAConsistently outstanding level of competence/performance BExcellent level of competence/performanceCRequired level of competence/performance with some strength DA level of competence/performance which requires development/review EA level of competence/performance which is unsatisfactory
SECTION B TO BE COMPLETED BY THE SUPERVISOR/HEAD OF DEPARTMENT
1. WHO ELSE HAS BEEN CONSULTED WHEN COMPLETING THE REVIEW2. DO YOU AGREE WITH THE JOBHOLDERS REVIEW ON THEIR PERFORMANCE IN PART 1 4 (YES), NO AND JUSTIFY BELOW.comments Yes No3. LIST STRENGTHS / ACHIEVEMENTS OF THE JOB HOLDER DURING THE CURRENT YEAR4. TRAINING AND DEVELOPMENT UNDERTAKEN Please comment on the benefits gained / application of development during the review period 5. REVIEW PERFORMANCE BY SUPERVISOR OR HEAD OF DEPARTMENT (against the job descriptions). Key Competencies Marking
(A-E)Justification/ Evidence Maintains patients confidentiality Examines the patient following an ethical approachAccurately and completely fills in documents Evidence based decision makingHandles all patients appropriatelyPatients confidentiality maintainedTeamworkPromotes continuity of care in UCU community.Patients counsellingKnowledge seeking and sharing
Integrating of faith into service
Keys used for ranking performanceAConsistently outstanding level of competence/performance BExcellent level of competence/performanceCRequired level of competence/performance with some strength DA level of competence/performance which requires development/review EA level of competence/performance which is unsatisfactory
SECTION C: THE FOLLOWING SECTION MUST BE COMPLETED JOINTLY BY THE REVIEWER AND JOBHOLDER
1. BELOW ARE YOUR KEY RESULT AREAS, PLEASE RATE THE JOB HOLDER
KEY RESULT AREAS SCORE ACHIEVEMENT LEVELCOMMENTS 1. Effectively attends to patients.30%2.Prepares for sterile procedures and assists
Doctors during the procedures.20%3. Adheres to standard operation procedures.10%4. Accompanies the referred patients until they
reach the referred place.20%5. Adheres to professional code of conduct.20%Key (Achievement Level)
A.90-100% consistently outstanding level of performance
B+ 80-89% Excellent level of Performance
B 70- 79% Required level of Performance with some strength
C-60- 69% Level of performance which requires development or review
D-50- 59% Level of performance which is unsatisfactory
E-0-49% level of Performance not accepted 2. LIST ANY TRAINING AND DEVELOPMENT THAT IS NEEDED TO IMPROVE ON THE PERFORMANCE OF THE JOB HOLDER.3. WHAT ARE THE WEAKNESSES EXHIBITED IN THE CURRENT YEAR THAT NEED IMPROVEMENT?4. SIGNATURES 1. Job HolderSignatureDate2. Co Reviewer Signature Date 3. Supervisor / Head of DepartmentSignatureDate4. Head of Department / Faculty SignatureDate(a) . I note and agree to the assessment done, objectives set & personal development plan.(b). I do not agree with the assessment done, objectives set & personal development plan (you must justify below).
5. VC, Line DVC , Principal or Campus DirectorSignatureDate(a). I note and agree to the assessment done. (b). I do not agree with the assessment done. (You must justify below).
DIRECTORATE OF HUMAN RESOURCE & ADMINISTRATION
Date received by DHRAForm completed Date filed by DHRAUrgent action is needed
Page PAGE 6 of NUMPAGES 7
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