College Division of STEM, Nursing and Allied Health Department of Nursing NURS 242 — Nursing Concepts 4 ‘SUMMATIVE Student Clinical Performance Evaluation st Student __Shalansi Streaker Date_si14/17__CSE# Agnes _ Faculty D Rohrbaugh, RN, BS 'S = Satisfactory __[ N= Needs Improvement _| U= Unsatisfactory | NA lot applicable [() Gniical behavior Failure to progress in these areas may result in failure of the course. ‘Students who meet any ofthe following oriteria willbe given a remediation plan and may be placed on probation. One unsatisfactory grade in a critical behavior “Two needs improvements ina critical behavior =Two unsatisfactory grades in a non-critical behavior __-Four needs improvements Student] Tistuctor Sei | Evalof ‘Outcome 1 Eval | Student Use the nursing process fo optimize clent health (CSLO‘) siNu_| “SINU 1._*Priotizes patient care based on assessment Ss s 2,_*Detmonstrates accurate patient assessment sills s Ss ‘3. Analyzes and incorporates data from the patient's medical record inthe provision of s Ss care 4. Uses patient assessment data to implement individualized pian of care s 5 %. Establishes appropriate nursing diagnoses based on colected evidence and palient s assessment s 6._Establshes measurable patient outcomes based on nursing diagnosis s s 7._ Establishes appropriate nursing interventions based on assessment s s ‘8. Evaluates patient response to care and revises plan as needed s Ss ‘Studsen | Tnstructor tSet | Evalof Outcome 2 Eval | Student | Assimilate into the profession of nursing (CSLO2) ES snu_| SIU ‘9._Demonstrates professional behavior and appearance s Ss 10. Seeks input from patient, instructor, and healthcare team in the delvery of patient= S centered care 8 11, “Demonstrates accountability and accepts responsibilly for own actions and atitudes |S s 12. “Adheres to attendance policy e Ss s 18, Participates actively inal cinical eweriences s Ss “14. Engages in sef-reflection and communicates learing needs ta instructor s s 15, Completes assignments as required and eubmits on time Ss s “16. Demonsirates intative in assistng peers and healineare team members in the cinical S setting 8 Student | Tastructor Self. | Eval of ‘Outcome 3 Eval | Student Provide patient-centered care (CSLO3) siNU_| “SINIU ‘17. “Implements appropriate infection control precautions s s 418. Provides culturally sensitive care s 3 19. Documents patient care accurately s s | 20. Uses therapeutic communication skis s s 21. Follows through with all patient care s s 22. Demonstrates knowledge of medications for assigned patents Ss Ss 23, “Administers medication safely using six rights of medication administration Ss Ss Approved 1214/14, Revieed 12110204 O20