Assessment Hair
Assessment Hair
COLLEGE OF NURSING
PERFORMANCE EVALUATION CHECKLIST
NAME: _____________________________________ DATE PERFORMED: _________________
YEAR & SECTION: ______________
PREPARATION 1 2 3 4 5
1. Assemble equipment:
• Clean gloves
PROCEDURE
1. Introduce yourself and verify the client’s identity.
Explain to the client what you are going to do, why
it is necessary, and how the client can cooperate.
2. Perform hand hygiene and observe other
appropriate infection control procedures.
3. Provide for client privacy.
4. Inquire if client has any history of the following:
• Recent use of hair dyes, rinses, or curling or
straightening preparations
• Recent chemotherapy
• Presence of disease
Assessment
TOTAL
________________________
Clinical Instructor
(sign over printed name)