Carroll Community College Divison of STEM, Nursing and Allied Heath Department of Nursing NURS 133 - Nursing Concepts 1 'SUMMATIVE Student Clinical Performance Evaluation seou)\ OIA, ilon$, 12157 Pme 4 oo Thing tLe ‘S = Salstocioy. feeds iproverent_| U= Unsatsfacory [ Students wo meet any of he folowing cra willbe given a remediation plan and may be placed on probaton. Faire to progress in these areas may resin falure of he course One unsatistaciory grade na ertcal behavior Two needs improvements in a cic! behavior | =Two unstisfeciotydrades ina non-rical Behavir _-Four needs imerovemenis ict applicable _ | () Cra behavior ‘Shader ‘Sele ‘Outcome 4 Eval rt 1) sm 1_Protizes patent care based on assessment wih coaching 2. Demonstrates accurate pain! assessment eile with coaching = 3. Gathers data from te palents medical record to provide patent care 4.Uses patent assessment dala to doveiopindvisualized plan of care with coaching 'Eslabishes appropriate ru'sing pro Ist Based on colecied evidence and pation assosement wih coaching 7. Establishes appropriate nursing interventions based on agsessrrent wih coaching 8. Evaluates patient response fo care and revises pla 35 needed with coaching s = s __Establishes measurable patient outcomes based on nursing priorities with coaching = 3 Ss ‘Suge fant ‘Sa Outcome 2 Eval Develop an awareness of opportunites that promote jrfessional youth (C2) sm '9._Demonstates profesional Behavior and appearance 167 Seeks input fom patent nsructor, and heathcare tear in the delivery of patent= centered care “1. *Demonsrates accountability and accepts responsibility fr ow: aclons and aitudes 12. “Adhere to attendance policy 13, Pariapates actualy inal sical experiences 14. Engages in se-efection and communicaleslearing need io intuior 18. Competes assignments as requres and submits on time ‘Outcome 3 Provide patient-centered care wth coaching (C03) 18. implements appropiate infection contol precausons 17, Provides cutualy senstive care with coaching 18. Documents patient care accurately wit coaching 18, Uses beginning therapeutic communication skis 20. Folows through wih all patient care wih cosching 2.1. Verbelizes knowledge of medication for assigned paionts 22. Demonsttes caring behaviors 23. Uses SBAR to communicate pation slaus fo netucor wih coeching ‘24. denies issues needing advocacy for assigned patents a COLL R RRS eee Php is 25, ‘Derronstrales physical and mental competence pewoves U4 Ravan YaaOV OV018, veCarrol Community College Division of STEM, Nursing and Aled Department af Nursing NURS 133 — Nursing Concepts 1 'SUMMATIVE Student Cincal Performance Evaluation 7E-"ariias saaty cancers and naiies Mattar and approprate Realicare eam members 27. dentines ways 6 spend cinicl tine mors efcienly 28. Mentiies patent and emily hesih education needs 28, “Updates instructor and healtcar toam regarding changes in the patients conction 30, “Provides nursing care based onthe policies and procedures ofthe faci 31, “Provides nursing care in asordance wah he Maryan Nurse Practice Ack 32. “Adheres to HIPAA guidelines 38, “Provides care according to ANA Scope and Siandards of Musing Procico s S = x = Trateior Eval of ‘uteome 4 Student Explore the scientific evidence that. the patient's plen of care (C04) 24. Kanes evidence‘ased rationale thal supers the paint lon of ere ‘Student Reflection (Thoroughly answer ail questions) ‘How has this clinical rotation helped to define your role as @ nurse? Plesse axplain. sai ren Be to bend hie ne percent Guoved a Bale, Klee Pics, pabeont een enh wahcch woe potvente, Dre also Which objective did you accomplish during this rotation? How did you oo it? + Haack tot assessments, Verdermng You assess werrhs wes o eV nidleesres enerie Dyes vey inktnmabie Hbte peserrna weal petrent her than clasunede What are four goals for your next cineal rotation? ~ . My yea) fo comaele muy Orica paper wa le Bt ireliendadh, Or with wovir \ip- Mees Faculty Comments/ Student Learning Goals (Goals must be established even i performance is eatsfocloy, ian item was loentiied as Nor U, narrate comments are necessary to clay student performance along ‘nla did a pcad job Ynis mesier incLiucac Sho wa Need ora blg “Alling ‘e donors aud read Ose wnt SILLS. Good Wwe rer ehuree - ‘Suident Signature: _[-7]— Date? 12] 4 Instructor Signature: Haga Al Date: | fo WY ered HV Rv ASHEN: DIRE, 8H