STUDENT HEALTH & PROFESSIONAL GOAL SETTING

Specialist NURSE
School(s) / Specialty Area
Administrator

Student Health Goal Statement By February 20th, 2013 I will have completed all reporting requirements for
SMART goal criteria is used to formulate the the 50 students at OMS and the 20 students at VP who have not met the
goal. immunization for the state reporting requirements.

Professional Growth Goal: I will Learn how to use the new Synergy reporting system to track
 What professional development will immunization for state required reporting. Trainings were provided by
help me accomplish my SHG? (D:4) TECH to the nurse team, December 2012 and follow up TECH support has
 How will achieving my professional
growth goal improve my services to
been provided throughout the reporting period to ensure that I
students? (D:3) appropriately report exclusions of students and am able to follow up with
 How has my self-reflection and students who have not yet received their immunization.
assessment on Domains 1-4 informed
this goal? (D:4)
 How might I team with colleagues to
successfully achieve my goal? (D:4)
Content Domain 4b: Professional Responsibilities: Maintaining health records in
Goal-Setting Conference

 The goal is being written around which
domain/component from my area of
specialty?
Context
 What are the characteristics or special
circumstances of my area of specialty?
 What are the demographics of my
caseload?
Baseline Data
 What are the needs of my students?
 What are the assessments or evidence
sources I will use?
 Attach supporting data.
Strategies for Improvement
 What strategies will I incorporate into
my methodology/professional practice?
accordance with policy and submitting reports in a timely fashion.
Domain 1d: Planning and Preparation: Demonstrating knowledge of
government, community and district regulations and resources
As a school nurse I provide nursing services for 1045 students in two
school settings.
Currently there are 72 students who do not have required immunizations.
I will use the state exclusion report to determine the number of students
that will require my attention to meet the immunization deadline.
Communication to parents in writing, and phone calls. Communication
with district personnel regarding exclusions and awareness of which
students might need to be excluded.

Communication with county health department, assist with synergy/TECH

Resources and Support: related issues to print out accurate information
 What resources and support do I need
to meet my Professional Growth Goal?

Specialist Signature: Date: Administrator Signature: Date:

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Collaborative Mid-Year Goal Review
Mid-Year Review

 What progress has been made?

 Attach supporting data

Strategy Modification
 What adjustments need to be made to
my strategies?
Specialist Signature: Date: Administrator Signature: Date:

End-of-Year Data
 What does the end of the year data
Summative Conference

show?
 Attach data
Reflection on Results
 Overall, what worked or what should be
refined?
Professional Growth Plan
Implications
 How can I use these results to support
my professional growth?
Specialist Signature: Date: Administrator Signature: Date: