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Glendale Career College- San Diego Campus

Clinical Performance Evaluation Record


NU119 Medical Surgical Nursing I- Lab Skills
Student Name: Faculty:

S= Satisfactory NI= Needs Improvement, U= Unsatisfactory- student has failed to demonstrate competence with the skill.
*Complete Remediation Plan
Skill S NI* U Date(S) Faculty Initials Comments
27.1 Skill Insertion of a Short-Peripheral
Intravenous Device
7.3 Skill Assessing the Thorax and Lungs

8.4 Skill Collecting a Sputum Specimen

29.1 Skill Inserting an Oropharyngeal Airway

14.2 Skill Airway Management: Noninvasive


Intervention
14.3 Skill Chest Physiotherapy

14.4 Skill Airway Management: Suctioning-


Oropharyngeal
14.6 Skill Managing Closed Chest Drainage
Systems
7.4 Skill Cardiovascular Assessment

16.2 Skill Applying Elastic Stockings and


Sequential Compression Devices
Simulation

12.1 PG Site Care of Enteral Feeding Tubes

12.3 Skill Insertion and Removal of a Small-


Bore Feeding Tube
12.4 Skill Verifying Placement and Irrigating a
Feeding Tube
12.5 Skill Administering Enteral Nutrition:
Nasogastric, Gastrostomy, or
Jejunostomy Tubes
7.6 Skill Assessment Assessing the
Genitalia and Rectum
18.2 Skill Insertion of a Straight or Indwelling
Catheter
18.4 Skill Suprapubic Catheter Care

18.5 PG Performing Catheter Irrigation

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