Carroll Community College

Division of STEM, Nursing and Allied Health

Department of Nursing
NURS 140 – Nursing Concepts 2
SUMMATIVE Student Clinical Performance Evaluation

Student Katelyn Patterson Date 04/02/2020 Week # Faculty Prof. Steinhice

Criteria: S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not (*) Critical
(Meets) (Requires assistance) (Unable) applicable behavior
Students who meet any of the following criteria will be given a remediation plan and may be placed on probation.
Failure to progress in these areas may result in failure of the course.
-One unsatisfactory grade in a critical behavior -Two needs improvements in a critical behavior
-Two unsatisfactory grades in a non-critical behavior -Four needs improvements
Instructor
Student Eval of
Course Goal 1 Self-Eval Student
Apply the nursing process when implementing a plan of care (PG1) S/N/U S/N/U
With assistance:
1. Prioritizes and completes daily nursing tasks S S
2. Completes assessments accurately S S
3. Uses EMR/MAR, patient charts, handoff report to provide care S S
4. *Establishes appropriate nursing priority list S S
5. Creates measurable patient outcomes S S
6. Establishes appropriate nursing interventions S S
7. Evaluates patient response to care and revises plan as needed S S
Instructor
Student Eval of
Course Goal 2 Self-Eval Student
Participate in opportunities that promote professional growth (PG2) S/N/U S/N/U
With assistance:
8. Adheres to dress code S S
9. Seeks input from patient, instructor, and healthcare team when providing care S S
10. *Demonstrates accountability and accepts responsibility for own actions and attitudes S S
11. Actively participates in all clinical experiences S S
12. Communicates learning needs to instructor S S
13. Completes assignments/evaluations as required S S
Instructor
Student Eval of
Course Goal 3 Self-Eval Student
Provide patient-centered care with assistance (PG3) S/N/U S/N/U
With assistance:
14. *Implements appropriate infection control precautions S S
15. Identifies client’s cultural needs S S
16. Accurately documents patient care N n
17. Communicates appropriately with patient, family, healthcare team, and instructor S S
18. Explains the actions, side effects, and nursing implications of medications S S
19. *Administers medication using the six rights S S
20. Demonstrates concern, compassion and empathy with patients S S
21. *Demonstrates physical and mental competence S S
22. *Notifies instructor and appropriate healthcare team members with safety concerns and changes S
in the patient’s condition S
23. Identifies patient and family health education needs S S
24. Provides nursing care in accordance with the Maryland Nurse Practice Act and the ANA Scope & S
Standards of Nursing Practice S
25. *Adheres to HIPAA guidelines S S
Criteria: S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not (*) Critical
(Meets) (Requires assistance) (Unable) applicable behavior

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18, 1/2020

 Carroll Community College
Division of STEM, Nursing and Allied Health
Department of Nursing
NURS 140 – Nursing Concepts 2
SUMMATIVE Student Clinical Performance Evaluation

Instructor
Student Eval of
Course Goal 4 Self-Eval Student
Plan nursing care based on scientific evidence (PG4) S/N/U S/N/U
With assistance:
26. Justifies patient’s plan of care using appropriate resources S
S
Student Reflection (Thoroughly answer all questions)
How has this clinical rotation helped to define your role as a nurse? Please explain.
Through this rotation I have learned a lot when it comes to advocating for your patient, having proper knowledge of the patient
and past medical history, having to do proper med passes and learning to slow down and take your time when completing these
tasks. Being patient with the systems and learning how to deal with a new system.

Which objective did you accomplish during this rotation? How did you do it?
II would say med passes were a big accomplishment through this rotation- I learned a lot when it came to be looking up meds and
being able to do them correctly and patiently.

What are your goals for your next clinical rotation?

For my next clinical I would hope to have more confidence in having more information about meds.
I need to have better documenting skills and ask more questions if I am confused on what I am responsible for.

Faculty Comments/ Student Learning Goals (Goals must be established even if performance is satisfactory. If an item was
identified as N or U, narrative comments are necessary to clarify student performance along with goals to improve performance).

Katelyn was very much a patient advocate for her patients. She learned that when a patient is not happy with their care,
administration gets involved. This was a great learning opportunity for her. The patient was happy to have a student and Katelyn
was able to give her more time to listen to her concerns. She was able to build a therapeutic relationship with her patient, who
loved spending time with her. Katelyn was able to pick up on an abnormal heartbeat and lung sounds. Great job!! She completed
her concept map for which she received 36/40 points. She was a good team player with both her peers and the staff on the unit.
Katelyn received a n for number 16 due to her last clinical day on the unit. I talked with her about the importance of
documentation and explained that it is not okay just to not document anything if you don’t know what to do. She assured me that
she would not do this again. We did not go to the last clinical day on the unit, so I was unable to reassess this with her.
Katelyn was showing great progress and was building on her knowledge base. I think she also learned that she needs to learn how
to slow down and not rush through tasks just to get them done.
Keep up the good work.

**Student Signature: Katelyn Patterson Date: 04/20/2020

**Instructor Signature: Dorothy Steinhice BSN, RN Date: 04/02/2020

** Typing your name and date here will verify as an electronic signature.

Definitions:
Coaching – Faculty guides student to define objectives, set goals, and develop action plans through collaboration in the decision-making process
Assistance – Student unable to perform task independently; needs some aid or minimal direction from faculty to complete tasks. Not autonomous but does not
require coaching.
Resource - Faculty serves as a facilitator but student is capable of completing self-directed tasks.
Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18, 1/2020