Abstract Nurse performance evaluation is a formal system structure in evaluating nurses' performance in the past and present periods.However, its implementation in health service facilities still has many shortcomings. The problem of nurse performance appraisal is the existence of unstructured supervision, and the results remain subjective.This study aims to provide recommendations on the nurse performance appraisal system, which can be applied as a basis for career development, promotion, and reward.This study employed a descriptive quantitative approachby comparing secondary data and interview resultswith the head of the hospital room. The data included 160 documents that were selected using a simple random samplingfrom medical record data in the NganjukGeneral Hospital in East Java and analyzed based on the literature.Data from the general unit suggested that there were 25% of documents for nurse promotion in October 2017 and an increase of 40% in April 2018. There was no correlation between employee performance goalsand the proposed list of proposed credit scores. There weresome recommendations based on contextual problems, appraisal structure problems, appraisal process problems, and appraisal result problems. Nurse performance evaluation requires job descriptions, performance appraisal indicators, assessment according to the guidelines.