You are on page 1of 3

Canall Community College

Division of STEM, Nurslng and Allied l-"lealth


Departmsnt of Nursing
NURS 233 * Nursing Concepts 3
$tudent Clinical Performance Evaluation - $ummative

$tudent: Tcdd Stewart

Oate:

lllt;-

Location:

l-lcGll

Facutty:

Minnema

5=Satisfactory lN=Needslmprovement lU=Unsatisfactory lHl=Notapplicable l(')Critical behavior


$tudenls who do not mael any oi the following criteria will bs given a ramediation plan and will be placed on prohation.
-One unsatisfactory grade in a critlcsl behevior
-Two needs improvements ln a crilicat behavior
-Two unsatisfactory grades in a non-critieal behavior -Four needs improvements
Student
lnstruclor
Sutcorne {
SelfEval of
Analyze the effeetiveness of the pl*n r:f car* using the nursing pr&ce$s {SLO 1, GE 3)
Student
Eval
Collects evidence related to ciinical practiee from appronriate resources.
"Demonstrates accur&t patierrt assessment skills.
Establishes appropriale nursing diagnases basad on patient assessrnent.
"Friori{izes patient eare b*sed un as$essmant.
ldentifies measurable patient outcoma based on nursinq diaanosis.
'lmplaments care ancording ta established plan and desired oulcomas.
Uses therapeutic communication techniques during nursalpatient interaclion$ ts facilitate
the nursinq pr*cess.
ldentifu appropriste interventions based cn assessment.
Demonstrates knowledse of medications for assiqned patierts"
"Administers medication aafelrl using six riqhis of medication administration.
"lmplemenls appropriala infection control precautions
Follows through with all patient care
"Evaluales patieill response to care and revises plan as needed.

(}uteorne

lncorpara{o learning *pporluniti*s that promate personaland prrfeesional growth and a


con:mitrnent to lifelong learning. {SLO 2, Ge 5}
Pcdicipates actively in all aspects af ths clinical experience.
Discusses patient's plan 6f care wilh instuctor.
Demonstratas professional behavior and asoearance.
Engages in seltrefleciion and communicates learning needs lo instructor/preceplor.
Completes assignments a* requirod and subrrnils on time.
Orsaniaes lime elTicientlv.

0utcrrne

lrnplernent nursing care lhat considers th* uniqueness of variour cullures, backgraunds, and
belief systeffis (SLO 3, GE 6)

Semonstrates caring behaviors with the ability to develcp and maintain therapeutic
relationships with p*oBls from diverse baekgrounds.
Considers patient values. cultural characterlstics and reliqious differences when planninq care.

0utcsme 4
eontribule to healthcare tearns lo provide patient-centered care {SLO 4, GC

1)

ldentifies patient and family heallh edr.lcation needs"


lmplernents paiient and family educalicn.
$eeks lnput from patient, instructor, peers, and healthcare team in the delivery of patient care,
'Updales instructor and healthcare tearn regarding chanoes in the patient's condition.
'ldentifies safety concsrns and notifies instructor and appropriate healthcare team mernbers.
Oemonslrates initiative in assistinq peers and healthcere tearn members in the clinical setiino"
Oemonstrales conrmunicaiion skills usins SBAR.
Acis as an advocate fnr patients and families

Approved

A 4/ 1 4. R*viseC 12lg/t01 4

S/N/U

S/N/U

s
s
5
q

c
Q

c
q

c.

n/a

N/A

s
s

i)

Studenl

lnslructor
Eval of
$tudent

Selt
Eval
S/NIU
q
S

5
e

c
e

S/N/U
S
S

Student

lnstructor

$elt
Eval
SIN/U

Eval of
Student
S/N/U

$tudent

$elt

lnstructor
Eval of

Eval
S/N/U

Student
S/NIU

S
S
S

s
s

s
s

NIA

Carroll Community Collag*


Divisisr"r of STEL'{, l{ursing and Allied Health

OePartment of l{ursing
NURS 233 * lilursing Concepts 3

$tudent Clinical Performance Evaluatisn

Summativo

Outcams 5
Provide nursing care based on scientific evidance. (SLCI 5' GE 2)

ldentiGffintdenced-based ratisnale that suppqrt! the satient plan of care.


lnteerates kn*wled*e from nursincl and other disciplines to plan care'

Student
Self-

lnslructor
Eval of

Eval
SIN/U

Student

siNtu
s
$

OutcomE 6
lmplement nursing care based on legal and ethical principlas that reflect curreni standards of
practice" {SLO 6, GE 7}
Adheres to attendance policy
"Demonstrales safe clinical $ractice.
proyides nuiiinq care based on the policies and procedures of lhe facillty,
;[ia'rnt3insGge ai-iountaUitity for nursing praelice in accordance wilh the Maryland t''lurse
Practice Act.
"Adheres to HIPAA quidelines regarding patient confidentiallty,
Trovidee care accordinfi to the ANA Nursing Scope and $teq{6$gg[-[gg!ga
-Oemonsirates accountability and responsibility fot own actions 88d q
Outcome 7
lncorporate informatics skills using technology and electronic sourees of health eare
inforrnation to support clinical decisions, promote communication, and monitor care oulccmes.
{sLo 7, GE 4}
Gathers data from the electrcnic rnedical record to provide patient care'
midioal ieiord to docurnent palient care accurately and in a timely manner.
Uses

Student

lnstrueterr

SelfEval
SIN/U

Eval of
Student
bIN/U

s
S

J
e
5

cg

$tudent
e -t,
I \)qil

Eval
SIN/U

lnstructor
Eval of
Student

SIN/U
S

q
ehctffi
ffi6{t-lsidgslredlearninggoals,andyeurplanstarnectthem,fcnthe*extweek'sclln[cal
and
daslro for new knowledge and

N/A

the
exporionc*. Goais shol,ld be based on identiflsd podormancs lssues
expariences.)
I was enlightened as to the importance of leaming how tc connect a patient urith sclcial senrices"
Mental health patients must confront challenges f,ar peater than just economies. I was atrle t* giean the
importance of discharge planning and education in this particular set of patients. The educational needs fcr
these patients are great and communications can be difficult. Finding a good tresoures helps soliclify the plan,
gcal, and outcome. I recognize the importance of using therapeutic communicati*ns, tltaugh having a goal, a
plan, an{ expectcd autcome(s) make tire process easier on everyone c$ncerned, eommunication is the key to
accomplishing those goals" I believe I rvas able t* help my patients. I am thankful for the experience. lt
soundi as though you have achievcei some very !;:l;:*rtant g*als. Yor* d*monstrated pati*n** ;tnd r*e p*et
when delivering care to your patients isith m*ntal i!in*ss. T!:ese wlll h* su irnportant as y*e"l pra*ti*e nr*nxlng
in the future
facuity%mmantst SiuUinf Learning Goals {**lf an itern was identifiad as $I or U, narrative c*mrnents are
necassary to clarify studsnt performance*)
$econd week clinical assignments: Sccd psyr:h n:axia! l"**al{}: nurs.inE assessrnent for 1'1 ett*rn$}t" fi*nsidei'
working on clocumenting rnore detaiJs *f pati*nt fincli*gs vx. g*nerallee* t*rminology {e.g', $:*ti**t haej,
,,irnpaiied percsption of reality," or u,*reJs that r:r*y ha i*l*rpr*ted as j*eigmental (e.g", "n:;.lt'lip*lxtlve") ** ilrat
reader obtains a clearer pereepticn *{ patient iss*s*. &*fir*fi:hsr, a$s8$*ment data must !:* *l***r::*tltecl l*
reinforce nursing diagnoses. Focus*d !*teractisn A*xignrn*rli: Final r*bric sc*re = 33/36;:*inis. Y*x
demanstrated the use of the nursing prsces$; and veny g**el use of tlrerapeutie ccmrnunlcati**s. fiei*ci
asse$sm6nt of patient's syolptorn$ during th* te**$rir"lg pr***$s.

T*dd $lewart has satislactorily eompleted learnir:g {.:iL{t*sm*$ {or psy*ir rx*ntal h*alth clln!*xl at F"l*wars}
Ccunty General Hospital" lt was a pl*a*ure to have h;rC h*r s* a studeni
Todd, I am available to discuss thie evaluatio* and *lir:ic*l *xpcrienc* fxrther if you'e{ lik*" Fl*ase f*ql {r** t*
make *n as$:ointrnent.
-',i,'r-o'-,/ ' t.''', '

Approved 1A4l14. Revised 121S12014

t-l*';-'-'-' '."','.'.'

t'ut-('

Bate:

3-0-1S

Carrall Cornmunity Coltege


Division of STEM, Nursing and Allied Healih
Depertment oi Nursing
NUR$ 233 - Nursing Concepts 3
$tudent Clinical Performance Evaluation * Summative

Preceptor/lnstrustor Sign*ture:
Revised ?Y1l16. 3d lefin learniNP

Approved

214114. Revised 1?f*J?S14

ff, Sy'" $X",",^q W6, &gt

Oale: __41112016-_

._-