Nursing Assessment Template

Nursing assessment template is a layout which is being used to determine the nursing care provided to the patients. This kind of evaluation is one of the important appraisal documents as it helps to improve the healthcare status and make essential care plan for the benefits of the patients.

Sample Nursing Assessment Template

Healthcare organization ___________ [specify the name of the healthcare organization whose nursing services to the patients is to be assessed]

Patient’s name ____________ [mention the name of the patient who is being assessed to gain information about the nursing care of the particular healthcare organization]

Date of conducting the assessment: _________ [specify the date in dd/mm/yy format in order to keep a track of the record for future need]

Objective of the assessment: [In this section mention the intention behind conducting the assessment]

Tools: [specify the tools that is being used for conducting the assessment and finding out relevant results]

  • _______ [tool1]
  • _______ [tool 2]
  • _______ [tool 3]

Factors Considered: [In this section discuss about the factors that are being taken into consideration for fulfilling the purpose. Also mention about findings related to each determinate factor]

  • _______ [mention about factor 1]
  • ________________ [description of the findings related to factor 1]
  • _______ [mention about factor 2]
  • ________________ [description of the findings related to factor 2]
  • _______ [mention about factor 3]
  • ________________ [description of the findings related to factor 3]

Conclusion: [This lineation is done for outlining the conclusion based upon the factors and its relative findings.]

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