Carroll Community College
NURS 233 — Nursing Concepts 3
SUMNATIVE Student Clinical Performance Evaluation
student SUsAg JACcBS date fo fal 1% Weekw 2 Faculty Prof Warthe 7
$= Satisfactory __ N= Needs improvement ‘Unsatisfactory | NA=Not applicable | (*) Critical behavior
Jents who mee! any of the following criteria will be given a remediation plan and may be placed on probation,
Faiivre to progress in these areas may result n failure of the course.
One unsatisteciory grade ina ctcal behavior Two needs improvements in @cticl behavior
Two unsatstector grades ina non-citica Cenavir _-Four needs imprevernents
] Student | instroctor
‘Seit. Eval of
Outcome 1 Eval | Stucent
_Analyze the effectiveness of ine plan of care (CO1) SMU siwu
¢ based on assessment with feculy as 3 resource s
“Demonstrates accurate patient assessment skis NA
Analyzes and incorporates data from the patient's medical record inthe provision of care _|
~ Uses patient assessment data to implement inevvidualized plan of care wih faculty 25 a
resource 7
5 Eetabsenes aparoprate nursing proviies Ist bated on collected evidence and G
assessment with faculty as a resource: ee 5
Estabishes measurable patent oulcomes based on nursing proves with Tacully as @ =
resource J Ss
7 Establenes Spproprate nursing interventions basad on assesemert with facuty as a 1 a
resource is
~ Evaluates patient response to care and revises plan as needed with faculy as aresowce | 5S
‘Student | Insiructor
Sel Evalof
Eval | Student
‘SINU
$0” Seake put Fon pauer atc, ad Neaeate Wir WS GORY ol POMBE
"centered care:
os
on
12 *Adheres to attendance policy
|__13, Paneipates actively in al cinscal expen
44 Engages in sett-eflection and communicates learning neads lo instructor i
18. Completes assignments as required ang submits on time
$6 Deroner:
17. ‘Implements appropriate infection control precautions
Provides culturally sensitive care aa
19 Documents patent care accurately.
20_ Uses therapeutic commu skis
24 Follows through with all patent care
22 Demonstrates knowledge of medications for assigned patienis
23 ‘Administers medication eafely using six nights of medication adminis
24 Demonstrates caring behaviors
25_Uses SBAR effectively
Asproved 124/14 Revaed 1202014 072015, 97678Carroll Community College
NURS 233 - Nursing Concepts 3
SUMMATIVE Student Ciinical Performance Evaluation
ns physi ard mare compen 2
TBarites Sieh onenia aid hodten Pav acer On SOpTSE SITS TERT 2
x
embers,
Ss
s
Demorstiaies lime menagementtechnguee S
Implements patert and family eduoaton and evaluates effectveness of teaching mor Tas
Ss
s.
s
$s
“Usdates instructor and healthcare team regarding changes in te patent's condtion
“Provices nursing care based on the poicies and procedures of the facility.
3. “Prowaes nursing care in eocerdance withthe Mariang Nurse Practice Act
HIPAA guidelines
ANA Scope and Standards of Nursing Pracice 8
instructor
Eval of
Student
based on scientifc evidence (CO4) SINU
rs the patent's plan of care Ss
‘Student Reflection (Thoroughly answer all questions)
How has this clinical rotation helped to define your role as a nurse? Please explain. Ths rotation
hak helped me. define My (21 Gia mute by app apes
Caraga. Cod Geant ThA Cinicet 4 (on $ ‘es eee identity
ween appCach F woud WM to iden hy nd meat patient Cole meds talleved
SD cack’ indivi click citer mbtance
Which objective dif you accomplish during this rotation? How did you doit? = manzgect te
ineeiyinte medication Compliada wih my paberts dating thor sel
femeons Zouabion A a erticak element in The Cate aXd trratnent.
2f patents Agnoice! With mental ined. 5 war able 10 apply edtuaton
on a enet of Undersiandiny thet the paladt coud compremind dnc
pele Tin (dae onal AM pabkaB fo toast gn achue TL in fel cond an cab
What arb your goals for your next clinical rotation? aasayinent of thaw iilvers
ges Fer nig Mat Chicad fotatirnase tm continue my therapentc Commuariahen
Teean guar wianney patiencs and ergoge ites ashley or he mth, Lemmon Qi cund
to menuuge The pitunk te futon someting Then ther ine,
Faculty Comments! Student Learning Goals (Goals must be established even f performance s salisfactory
f an item was identified as N or U, narrative comments are necessary to clarify student performance along
with goals to improve performance)
This student demonstrated ed ground the mileu and engaged wan many of ou
patients and ffered them appropriate nursing care. She was compassonate, open minded, and fuly accepting of an array of
complex patients and ther circumstances. This Student was vocal during our discussions ard added though anc insight
‘loas. Sho was a true asset to ourcinical group and mado 2 real diferenco to the patiorts cho touched
AAs an Adjunct instructor Ihave observed many students
interacting with and serving patients. This student has been a
__ shining example of “the art of nursing” -
Date: to/y [18
Date: 10/6/18
>
Student Signatur
Instructor Signature:
Stacey Warthi
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