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CRITERIA
RATING STUDENT’S GRADE
BREAKDOWN TOTAL BREAKDOWN TOTAL
I. ASSESSMENT 30%
A.
Subjective & objective data to
support nursing diagnosis including
client history, physical assessment
findings, lab findings & any other
pertinent subjective and/or
objective data.
[30]
II. ANALYZING/NURSING
DIAGNOSIS 10%
A.
Prioritized nursing diagnosis
supported by clearly stated
subjective & objective data.
[5]
B.
Contains statement regarding client
problem & etiology of problems.
May also contain signs &
symptoms.
[5]
III. PLANNING (2 goals) 20%
A. Goals are derived from problem
statement of nursing diagnosis.
[4]
B. Client goals supported by data and
nursing diagnosis.
[4]
C.
Goal statements contain subject,
verb, criteria & time frame (Must be
measurable).
[8]
D. Goal is realistic for client. [4]
IV. IMPLEMENTATION (4
interventions for each goal) 28%
A.
Interventions are derived from the
etiology of the nursing diagnosis, &
will help the client achieve goal.
[8]
B.
Intervention statements contain
who, what, when, where, & how
often (frequency including times
when applicable)
[8]
C
Interventions are culturally safe and
must be within the scope of practice
of an LPN
[4]
D.
Rationale for each intervention &
uses evidence to support
[8]
CRITERIA
RATING STUDENT’S GRADE
BREAKDOWN TOTAL BREAKDOWN TOTAL
intervention.
V. EVALUATION 12%
A.
Evaluation statements include
whether goals were met, partially
met, or not met, compared to
outcome criteria listed in goal
statements. Lists evidence to
support evaluation statement.
[8]
B.
Identifies factors which prevent
goals from being accomplished.
Includes recommendations to
facilitate the accomplishment of the
goal.
[4]
Grade = ___________
(A minimum of 65% is required to consider this care plan as satisfactory.)
No late care plans will be accepted
Date: _______________________________________________________________
Student Signature: ____________________________________________________
Clinical Supervisor Signature: ___________________
 
 
 
 

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