Carroll Community College
Division of STEM, Nursing and Allied Health
Department of Nursing
NURS 233 - Nursing Concepts 3
‘Student Ciinical Performance Evaluation ~ SUMMATIVE
Student: Rachel Panok Date: 127/15 Location: Ummc _ Faculty:
Kelerman
S= Satisfactory | N= Needs Improvement | U= Unsatisfactory | NA=Not applicable | (*) Critical behavior
Failure to progress in these areas may result in failure of the course.
‘Students who meet any of the following criteria will be given a remediation plan and may be placed on probation.
One unsalisfactory grade in a citcal behavior Two needs improvements ina critical behavior
Two unsatisfactory grades in @ non-critical behavior __-Four needs improvements
Sludent | trstructor
Outcome 4 set. | Evalof
Analyze the effectiveness of the plan of care using the nursing process (SLO 1, GE 3) Eval | Student
smu _| SIU
‘Collec evidence related to cintcal pracice Wom appropriate resources. s s
“Demonstrates accurale patient assessment skils, s s
Establishes appropriate nursing diagnoses based on palient assessment. s Ss
“Prioiizes patient care based on assessment. s Ss
Identifies measurable patient outcome based of nursing diagnosis. S Ss
“Implements care according to estabished pian and desired outcomes. Ss S
‘Uses therapeutic communication techniques during nurse/patient interactions to facitate Bi ie
the nursing process.
Identity appropriate inferventions based on assessment = s
‘Demonstrates knowledge of medications for assigned patients. s Ss
“administers medication safely using six righis of medication administration S Ss
“Implements appropriate infection control precautions. s Ss
Folows through wih al patient care s s
Evaluates patient response to care and revises plan as needed. s s
Ome 2 Sade stir
Incorporate learning opportunities that promote personal and professional growth and a eames
‘commitment o lifelong learning, (SLO 2, GE 5) eae
Participates actively in al aspects of the cinieal experience s Ss
Discusses patient's pian of care with instructor. s Ss
Demonstrates professional behavior and appearance. s s
[Engages in self-reflection and communicates learning needs to struclorpreceplor s s
‘Completes assignments as required and submits on time. s s
[ Organizes time efficient s s
Implement nursing care that considers the uniqueness of various cultures, backgrounds, and | Self
belief systems (SLO 3, GE 6) prt ee
Demonstrates caring behaviors with the abiity to develop and maintain therapeutic
relationships with people from diverse backgrounds. s s
Considers patient values, cultural characteristics and religious diferences when planning care_|_—S Ss
‘Student | Instructor
Outcome 4 sett. | Evalof
Contribute to healthcare teams to provide patient-centered care (SLO 4, GE 1) Eval | Student
siy_| SIN
Identifies patient and family health education needs, s s
Implements patient and family education Ss $
‘Seeks input from patient instructor, peers_and heahcare team in the delivery of patient care| Ss s
“Updates instructor and healthcare team regarding changes in the patients condition. s Ss
“Identifies safely concems and notes instructor end appropriate healthcare team members. s S
Demonstrates initiative in assisting peers and healthcare team members in the cinical seting |S s
Demonstrates communication skils using SBAR. s s
‘Acts as an advocaie for patients and families Ss s
‘Approved 12/4/14, Revised 120972014Carroll Community College
Division of STEM, Nursing and Allied Health
Department of Nursing
NURS 233 - Nursing Concepts 3
Student Clinical Performance Evaluation - SUMMATIVE
Student | Instructor
Outcome & Self | Evalof
Provide nursing care based on scientific evidence, (SLO 5, GE 2) Eval | Student
SINIU_|_SINIU,
Identifies evidenced-based rationale that supports the patient plan of care. Ss Ss
Integrates knowledge from nursing and other disciplines to plan care. Ss Ss
Student | instructor
Outcome 6 eau esclce
Implement nursing care based on legal and ethical principles that reflect current standards of | fo, |