Carroll Community College
Dhvision of STEM, Nursing and Aled Health
Department of Nursing
NURS 133 - Nursing Concepis 1
'SUNMATIVE Student Cinial Performance Evaluation
Faculty fa
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Faure to progress in these areas may resin fave te cure.
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| Stunts wo mea ny of te folowing crea wi be given a remsdain plan and maybe placed on probation
| ‘Qneunsatsfecory grade ne crcl behavior Two needs improvements ina ctical behavior
Two unsaiston ‘anorecrcal behavior “Four nseds ingrovements
Outcome 1
Use the components ofthe nursing recess when creating a plan of care (CSLO1).
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Eval of
Stent
1_=Peiorzes palit care based on assessment wah coaching
‘2. Damonsales sccuale patent assessment sks wih coaching
'3.Gathers data from te patents medical record le Provide Caen care
4. Uses paen assessment data fo develo indvtuakzed an of care wih coaching
'S” Establshes appropriate nursing dlagnoses based on collected evidence and paler
'5_ Establishes messurble poten olcores based on nurting dlagnosl wih coaching
7. Estabishes appropriate nursing niervenitons based on assessment wih coaching
8. Evaluates patient resporso i care and revises pan a needed wih coaching
Outcome 2
Develop an awareness of that anal growth (CSLO2)
8,_Demonstaies professinal behave and appearance
107 Seeks nou om patient. nsvucor, and heateae eam in deWvary of palon
cored cre
{1 *Demensrles aczzuniably and accor respond (or own actions and alludes
12. “Adheras to attendance poe
"3, Pancigates seein a cnc] exparencas
“4. Engages in safuflecion and eonuricses eoring needs sior
15. Compoes assgnmens a5 eed and ext on tne
‘outcome 3
Provide palie-contred care with coaching (CSLO8)
va of
‘Shudent
16. “implements appropiate infection conto precautions
"7, Provides ctu sense care wih coaching
18, Documens patent care accuraely wih coaching
19. Uses beginning therapeu communication sis
20, Follows tough wih al patent care wih coaching
21. Verbaizes knowledge of medications fr sesivied paler
22, Demonstrates caring behavior.
23, Uses SBAR to communicate pani sale lo osutior wid coaching
24, Identifies tues neoding advocacy for aselgned patent
25. ‘Demonsvates physical and menial competence
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ovo YN, Ravan YO: YDSCarrol Community College
Division of STEM, Nursing and Allied Heath
Department of Nursing
NURS 133 Nursing Concepts 1
'SUMMATIVE Student iinical Performance Evaluation
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28. lentes paint and family health eucaton needs 3
28, “Updalesinsicior and hostticareleom regarding changes in hs patents condon 3S
30, “Provides nursing care based on the pots and procedures of he laiiy
31, “Provides nursing ear in accordance wih the Maryan Nurs Paces Act Cs
22. "Adhores lo HIPAA gigeines is
39, “Provides car according o ANA Scop and Sandards of Nursing Praies ete
Sele | ‘Evalol
‘Outcome 4 Eval | Stodont
Explore the scenic evionce that supports te palin’ plan of care (CSL.O4) sau | smu
ies evidence-based fens he supports th pln’ ian ol cave STS
‘Student Reflection (Thoroughly answer al quesions)
‘How has this clnial rotation helped to define your role as @ nurse? Please explain
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Which objective did you accomplish during this rotation? How did you doit?
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What aro your goals for your next clinical rotation?
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Facully Commenta/ Student Learning Goals (Goals must be eslablahed even i performance Salsfaclony
Han item was identified aN or U, narrative comments are necessary to clanly student performance along
with goals to improve performanes)
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Student Signature: || C204, ZZe [ Date: «77
Inatrutor Signature oa: 11/22/10
depron 12414, vant Wa0N: 92018