Carroll Communtty College Division of STEM, Nursing and Allied Health Department of Nursing NURS 233 — Nursing Concepts 3 ‘SUMMATIVE Student Clinical Performance Evaluation stutent Susan Sécob pate F/ 13/18 cse# 0) Faculty CHC ae) 'S = Satistacto N= Needs Improvement _| U = Unsatisfactory | NA= Not applicable ny pt €) Critical behavior ‘Students who mest any of the following criteria will De given a remediation plan and may De plaec Faiure-to progress in these areas may result in failure of the course. Two unsatisfactory grades in a non-citical behavior -Four needs improvements, -One unsatisfactory grade in a critical behavior =Two needs improvements in a critical behavior ‘on probation. Outcorie 4 Analyze the effectiveness of the pian of care (CSLO1) 1._“Prioritizes patient care based on assessment with faculty as a resource 2._*Demonsirates accurate patient assessment skills 3._ Analyzes and incorporates data from the patient's medical record In the provision of care 4. Uses patient assessment data to implement individualized plan of care with faculty as a resource 5 Establishes appropriate nursing diagnoses based on collected evidence and patient assessment with faculty as a resource 6 Establishes measurable patient outcomes based on nursing diagnosis with faculty as uroe blishes appropriate nursing interventions based on assessment with faculty as a resource 8__Eveluates patient response to care and revises plan as needed with faculty as a resource Quicome2 ‘Seek opportunities that promote professional growth (CSLO2) 9. Demonstrates professional behavior and appearance 10. Seeks input from patient, instructor, and healthcare team in the dalivery of patient- centered care 11. "Demonstrates accountability and accepts responsibilty for own actions and attitudes 12. *Adheres to attendance policy 13. Participates actively in all cinical experiences |___14. Engages in self-reflection and communicates leaming needs to instructor 15. Completes assignments as required and submits on time 16. Demonstrates initstive in assisting peers and healthcare taam members in the clinical satiing utcome 3- aS ines aie “ * ent Provide patient-centered care with fealty as @ resource (CSLO3) Sealeme SNU 47. “Implerments appropriate infection control precautions s 18. Provides cultwally sensitive care s Ss 19. Documents patient care accurately. a y S 20. Uses therapeutic communication skis al s 21, Follows through with all patient care s 22. Demonstrates knowiedge of medications for assignéd patients: Ss. 23. *Administers medication safely using six righis of medication administration N/E Approved 12/4/14, Revised 12/10/2014; 01/2015Carroll Commurity College Division of STEM, Nursing and Allied Health Department of Nursing NURS 233 - Nursing Concepts 3 SUMMATIVE Student Clinical Performance Evaluation 24, Demonstrates caring behaviors 5 S$ 25. i SBAR effectwvely $ SN] 26. Acts 2s an edvosete for patients and families Ss 27. *Demonstrates physical and mental competence $ s 28. “Identifies safety concems and notfies instructor and appropriate healthcare team S Ss members 29. Demonstrates time management techniques. 3: Ss '30_Implements patient and family education and evaluates effectiveness of teaching [s s 31. “Updates instructor and healthcare team regarding changes in the patient's condition 5 Ss 32. *Provides nursing care based on the policies and procedures of the facility 3 S 33. "Provides nursing care in accordance with the Maryland Nurse Practice Act 5 S 34, *Adneres to HIPAA guidelines Ss Sead 35. *Provides care according to ANA Scope and Standards of Nursing Practice s ‘Student | Insirustor . Self. | Eval of ‘Outcome 4 Eval | Student Implement nursing care based on scientific evidence (CSLO4) sINU_|_SINU 36. incorporates evidence-based Tationale that supports the patient's plan of care S ‘Student Reflection (Thoroughly answer all questions) How has this clinical rotation helped to define your role as a nurse? Please explain. Unndeettancliong the labor prouM ard bow imporlat i) fp be urderitanding, anc Gig puterda gow patient ond family member, Which objective did you accomplish during this rotation? How did you do it? Eiwah able te Complete Anamersrart on A Baloy £ Bhei.cld LD wh abltte complet an abet om a Aatpacte mom ard Prk AA A forret aicmetuh a PE Mmm hack - What are your goals for your next clinical rotation? Be aware of how mom may feeling drt arune tty pre aduiteg happy. ity Comments/ Student Learning Goals (Goals must be established even if performance is satisfactory fan item was identified as N or U, narrative comments are necessary to clarify student performance along with goals to improve performance), ‘ did & £ sat yoo wath thie i pied ak Ain. non 0b clnleals x lense prac: SBAR zar pubure paberds! : ‘Approved 12/4/14, Revised 12/10/2014; 01/2015Carroll Community College Division of STEM, Nursing and Allied Health Department of Nursing NURS 233 — Nursing Concepts 3 SUMMATIVE Student Clinical Performance Evaluation Student Signature: Instructor Signature: Approved 12/414, Reviend 12/10/2014; 01/2015