Vital Signs
Criteria
1.) Performed hand hygiene.*
2.) Ensured privacy (closed door or
curtain).
3.) Introduced self to patient &
checked two identifiers.*
4.) Explained what is to be done.
5.) Helped patient to a comfortable
position.
6.) Assessed patient pain level on
scale of 0-10.*
7.) Obtained oral temperature.*
8.) Palpated brachial pulse.
Ensured arm was at level of heart,
palm up, legs uncrossed & feet flat
on floor. *
9.) Obtained electronic BP.*
10.) Obtained manual BP.*
11.) Selected appropriate site for
pulse ox.
*Checked patient’s capillary
refill and digit temperature.*
12.) Applied pulse oximeter with
light over nail bed.
13.) Obtained electronic heart
rate.*
14.) Obtained oxygen saturation
using pulse oximeter.*
S
U
Comments
Vital Signs
15.) Obtained respiratory rate.*
16.) Obtained manual radial
pulse.*
17.) Told patient obtained values.
18.) Educated patient about values.
19.) Recorded values.
20.) Ensured patient comfort.
21.) Performed proper hygiene
when leaving room.*
22.) Documented patient’s vital
signs. (verbalize).
Student’s Name: _____________________________________
Final Grade: _______________________ (17 or above = >77%)
Evaluator:_____________________________________ Signature: __________________________________
Date____/________/__________
*If a student receives a “U” on three steps containing asterisks (*), or if they
fail to perform any vital sign check as outlined on the rubric, they will fail the
check off. *