Clinical Evaluation

BETHLEHEM UNIVERSITY
FACULTY OF NURSING & HEALTH SCIENCES

Advanced Medical Surgical Nursing
NURS 337 /Fall 2020
Coronary Care Unit (CCU) Evaluation

Student Name:
The student's practice in the CCU will be evaluated according to the following criteria
4. Performed independently 3. Performed under supervision
2. Assisted in performance 1. never performed
No. Roles & Responsibilities 4 3 2 1

1. Assesses the patient’s thoroughly
2. Observes closely the cardiac monitor & responds well to alarms
3. Obtains ECG
4. Identifies various dysrhythmias
5. Administers medication as ordered
6. Checks the emergency bell
7. Checks the emergency trolley and reports and missing
8. Operates the D.C shock
9. Provides nursing care appropriately
10. Communicates effectively and appropriately with the health team
through verbal or written patterns
11. Provides emotional support and teaching for patients and families
12. Acts professionally in the CCU
COMMENTS:________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________
EVALUATOR SIGNATURE: ___________________________
1
NURS 337 /Fall 2020
Intensive Care Unit (ICU) Evaluation

Student Name:
The student's practice in the ICU will be evaluated according to the following criteria:
2. Assisted in performance 1. Never performed

1. Provides basic nursing care for the patient (bed making, bed bath, oral
Hygiene, positioning....etc.).
2. Monitors the patient's closely (hemodynamic monitoring, i.e. CVP.
Arterial line, BP...Etc.).
3. Detects and explains any deviation in the pt's vital signs or
hemodynamic readings.
4. Reports appropriately any of the above deviations through verbal
Communication or/ and proper documentation.
5. Uses sterile techniques when suctioning or doing dressing, or any
Other nursing procedures.
6. Monitors and maintains the ventilator's setting, according to the pt's
Condition or Dr.'s order.
7. Administers medications as ordered
8. Responds well to monitor's ventilator's alarms
9. Communicates effectively with the health team through proper verbal
communication and documentation
10. Provides family and patient's teaching
11. Provides emotional & psychological support for the patient and family
12. Acts professionally in the ICU. with nurses, doctors, families, patient's
And other students.
COMMENTS:________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________
2
NURS 337 /Fall 2020
Emergency Room Evaluation

Student Name:
The student's practice in the E.K. will be evaluated according to the following criteria:

1. Provides comprehensive direct care to the patient and family
2. Provides required information for patient and family according to their
needs.
3. Uses triage to determine priorities based on assessment and anticipations
of the patient's needs
4. Helps in provides & resuscitation when necessary
5. Provides preliminary care to the patient before he/she is transferred to
the ward.
6. Checks the emergency trolley, Oxygen, suction, emergency bell. . .etc.
(Proper documentations)
8. Acts professionally with the health team.
COMMENTS:________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________
3
NURS 337 /Fall 2020
Operating Room Evaluation
Recovery Room Nurse Practice

Student Name:
The student's practice in the O.R. will be evaluated according to the following criteria:

1. Receives the patient and obtain sufficient information pertaining to the
operation (name of surgery, type of an anesthesia, …etc.). Check the
pt's checklist.
2. Gives medications as ordered
3. Monitors the patient's condition (Vital signs, IV fluids, monitor, etc.) as
needed.
4. Communicates effectively and professionally with the surgical team.
5. Follow the infection control protocols in the OR.
6. Scrubs her/his hands properly as required.
7. Documents appropriately for actions that have been taken as required.
COMMENTS:________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________
4
NURS 337 /Fall 2020
Circulating Nurse Practice
Student Name:
The student's practice in the O.R. will be evaluated according to the following criteria
3. V Good 2 Good 1 Satisfactory 0 Poor

1. checks O.R lights, suction, O machines ….etc.
2. Adjust light, stands, stool
3. Communicates properly with the scrub nurse, surgical team and
other personnel or departments
4. Receives patients appropriately at the reception area "pt's
checklist"
5. Checks pt's chart, X-rays and certain blood tests.
6. Prepares the room for surgery
7. Prepares all required equipments before surgery
8. Helps in transferring pt to the operating table & position
Appropriately
9. Be ready all the time for surgical team requests
10. Helps to gown surgical members
11. Supervises and share in needles, sponge …etc. count
12. Cleans, tables and other equipments after the surgery
COMMENTS:________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________
5
NURS 337 /Fall 2020

Scrub Nurse Practice
Student Name:
The student's practice in the O. R. will be evaluated according to the following criteria
3. V Good 2 Good 1 Satisfactory 0 Poor

1. Checks instruments & equipments needed for surgery and handle them properly
2. Be alert all the time to the surgeon and assistant surgeon needs and respond
appropriately
3. Applies sterile techniques through the surgery & observes for break of sterile
field
4. Communicates effectively with the surgical team
5. Anticipates each step and the need for special instruments
6. Helps in sponge, needles & instrument count
7. Holds retractor when necessary
8. Wash hands (scrubs) appropriately
9. Helps in dressing placement after surgery
10. Helps in draping the patient
COMMENTS:________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________________________________
6
NURS 337 /Fall 2020
Operating Room Report
“ OR Report “
Each student has to submit a report describing his/her experience in the theater.
This report should include the following information
1. Structure of the O.R.: Describe the structure of the O.R you did your
practice in and compare it to the ideal one. Draw a map for its
structure. (20%)
2. Present your patient case (age, sex, type of surgery, elective/ urgent),
name of surgery, duration and other important information) (10%)
3. Describe the role of the circulating / Scrub nurse you worked with (15%)
4. Identify safety precaution that were carried out when the patient was
admitted to surgery (15%)
5. List potential hazards of the intraoperative experience for this patient (15%)
6. Identify nursing care aimed at preventing the above hazards (20%)
7. Summary (5%)
* Due: At the end of your practice in the O.R. within one week after this practice
7
FACULTY OF NURSING
Advanced Medical Surgical
NURS 337 /Fall 2020
Emergency Room Report

“ ER Report “
Each student has to submit a report describing his/her experience in the E.R.
This report should include the following information:
1. Describe the structure of the E R Where you did your practice in and
compare it to the ideal one. Draw a map. (20%)
2. Describe one day experience in the E R . This description should include
what cases where admitted to E R that day and a general description
for the medical and nursing care for each case. Do you think was it
appropriate for each case??(25%)
3. Suppose all of these cases come at once. Classify them according to
priority (triage). (20%)
4. Choose one patient who was admitted to E R and describe the following:
*Medical Diagnosis * Emergency care (nursing and medical)
* Chief complaints * Medications & rationale
* Discharge (Where?) * Teaching
*What do you think about the management (appropriate or not).(30%)
5. Summary (5%)
* Due: At the end of your practice in the E.R. within one week after this practice
8
NURS 337 /Fall 2020
Case Study
Each student has to submit a case study. The student should choose a patient who is going to
be followed at least for two days in the ICU, OH, CCU.
This paper should include the following information:
1. Demographic Data: pt's initials, age, sex, diagnosis, marital status, date of admission... etc. (2%).
2. Present illness and past medical history. (3% past)
3. Physical assessment data: Include only systems with abnormal findings and the
rationale for these findings. (10%)
4. Hemodynamic monitoring- Rationale, readings and interpretation.(10%)
5. Pathophysiology of the main disorder and relate it to your physical assessment (10%)
6. Nursing Care: Identify nursing diagnoses your patient has.(30%)
* Goals - short & long term goals
* Nursing interventions
* Rationales for each nursing action
* Evaluation of the outcome
7. Medications: Trade & generic name, dose, route, action, side effects & contraindication (10%)
8. Lab Values: Normal findings, interpretation and rationale for abnormal findings.(10%)
9. X-rays - ECG, Echocardiography ...etc. Include the result. (5%)
10. Discharge planning & Teaching (5%)
11. Stressors you faced during practice and how did you manage? (5%)
12. Summary (3%)
13. References (APA format) (2%)
9
NURS 337 /Fall 2020
Coronary Care Unit (CCU)
Clinical Objectives
1. Roles & Responsibilities
2. Assesses the patient’s thoroughly
3. Observes closely the cardiac monitor & responds well to alarms
4. Obtains ECG
5. Identifies various dysrhythmias
6. Administers medication as ordered
7. Checks the emergency bell
8. Checks the emergency trolley and reports and missing
9. Operates the D.C shock
10. Provides nursing care appropriately
through verbal or written patterns
12. Provides emotional support and teaching for patients and families
13. Acts professionally in the CCU
10
NURS 337 /Fall 2020
Intensive Care Unit (ICU)
Clinical Objectives
Roles & Responsibilities
1. Provides basic nursing care for the patient (bed making, bed bath, oral
hygiene, positioning....etc.).
2. Monitors the patient's closely (hemodynamic monitoring, i.e. CVP.
arterial line, BP...Etc.).
3. Detects and explains any deviation in the pt's vital signs or hemodynamic
readings.
4. Reports appropriately any of the above deviations through verbal
communication or/ and proper documentation.
5. Uses sterile techniques when suctioning or doing dressing, or any other
nursing procedures.
6. Monitors and maintains the ventilator's setting, according to the pt's
condition or Dr.'s order.
7. Administers medications as ordered
8. Responds well to monitor's ventilator's alarms
9. Communicates effectively with the health team through proper verbal
communication and documentation
10. Provides family and patient's teaching
11. Provides emotional & psychological support for the patient and family
12. Acts professionally in the ICU. With nurses, doctors, families, patients
and other students.
11
NURS 337 /Fall 2020
Emergency Room
Clinical Objectives

1. Provides comprehensive direct care to the patient and family
2. Provides required information for patient and family according to their needs.
3. Uses triage to determine priorities based on assessment and anticipations of the
patient's needs
4. Helps in provides & resuscitation when necessary
5. Provides preliminary care to the patient before he/she is transferred to the ward.
6. Checks the emergency trolley, Oxygen, suction, emergency bell. . .etc.
7. Communicates effectively and appropriately with the health team (Proper
documentations)
8. Acts professionally with the health team.
12
NURS 337 /Fall 2020
Operating Room Clinical Objectives

Scrub Nurse Practice
1. Checks instruments & equipments needed for surgery and handle them properly
2. Be alert all the time to the surgeon and assistant surgeon needs and respond appropriately
3. Applies sterile techniques through the surgery & observes for break of sterile field
4. Communicates effectively with the surgical team
5. Anticipates each step and the need for special instruments
6. Helps in sponge, needles & instrument count
7. Holds retractor when necessary
8. Wash hands (scrubs) appropriately
9. Helps in dressing placement after surgery
10. Helps in draping the patient
Circulating Nurse Practice

1. Checks O.R lights, suction, O2 machines. …etc.
2. Adjust light, stands, stool
3. Communicates properly with the scrub nurse, surgical team and other personnel or
departments
4. Receives patients appropriately at the reception area "pt's checklist"
5. Checks pt's chart, X-rays and certain blood tests.
6. Prepares the room for surgery
7. Prepares all required equipments before surgery
8. Helps in transferring pt to the operating feeble & position appropriately
9. Be ready all the time for surgical team requests
10. Helps to gown surgical members
11. Supervises and share in needles, sponge …etc. count
12. Cleans, tables and other equipments after the surgery
Recovery Room Nurse Practice

1. Receives the patient and obtain suff1cient information pertaining to the operation (type of
an anesthesia, needs for 0, IV…etc.)
2. Gives medications as required analgesic
3. Monitor the patient's condition (Vital signs, IV fluids, monitor,… etc.)
4. Communicates effectively with the surgical team particularly the anesthetist.
5. Assesses the patients level of consciousness & gag reflex
6. Notify the ward when the patient is ready to be returned
7. Charts appropriately for actions that have been taken.
13

Clinical Evaluation

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BETHLEHEM UNIVERSITY

FACULTY OF NURSING & HEALTH SCIENCES

Coronary Care Unit (CCU) Evaluation

No. Roles & Responsibilities 4 3 2 1

EVALUATOR SIGNATURE: ___________________________

Intensive Care Unit (ICU) Evaluation

No. Roles & Responsibilities 4 3 2 1

Emergency Room Evaluation

No. Roles & Responsibilities 4 3 2 1

EVALUATOR SIGNATURE: ___________________________

Recovery Room Nurse Practice

No. Roles & Responsibilities 4 3 2 1

No. Roles & Responsibilities 3 2 1 0

Operating Room Evaluation

No. Roles & Responsibilities 3 2 1 0

Emergency Room Report

Roles & Responsibilities

Operating Room Clinical Objectives

Circulating Nurse Practice

Recovery Room Nurse Practice

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