SAINT LOUIS UNIVERSITY

BACHELOR OF SCIENCE IN NURSING (BSN)

NCM 121: INTENSIVE NURSING PRACTICUM

ICU RD

RUBRIC FOR ICU SKILLS SIMULATION (DAY 3)

EXPECTED ACTIVITIES Criteria Score
ICU
5 4 3 2 1 0

Performed ALL relevant

relevant assessment

relevant assessment
a. Checks patient’s chart for updates

Missed 4 or MORE

Missed 5 or MORE
Missed 2 relevant
Missed 1 relevant

Missed 3 relevant
assessment

assessment

assessment

assessment
ASSESSMENT

b. Performs initial assessment on the patient

c. Performs further assessment on the patient

to investigate a change in the patient’s status
as reflected in a medical device

a. Uses appropriate PPE as per infection

Missed 4 or MORE relevant

Missed 5 or MORE relevant

Performed ALL relevant

control policies

Missed 2 relevant
Missed 1 relevant

Missed 3 relevant
b. Troubleshoots mechanical ventilator
INTERVENTION

intervention

intervention

intervention

intervention

intervention

intervention
effectively
c. Prepares and administers appropriate
medication effectively, considering the 10Rs
of drug administration
d. Observes proper after-care of materials,
equipment, supplies as per infection control
policies
responses (ALL) to treatment/ intervention given

patient’ s response to treatment/ intervention

patient’ s response to treatment/ intervention

patient’ s response to treatment/ intervention

Failed to evaluate 4 or more relevant indicators

Failed to evaluate 2 relevant indicators of the

Failed to evaluate 3 relevant indicators of the

Did not evaluate the patient’ s response to

Failed to evaluate 1 relevant indicator of the
Comprehensively evaluates the patient’ s

of the patient’ s response to treatment/

a. evaluates patient’s response to treatment or intervention given

interventions
intervention
EVALUATION

b. Documents the patient’s response

appropriately

c. Refers to the physician pertinent patient’s

response to interventions

TOTAL SCORE:

Evaluated by: ____________________________________ Conforme: ___________________________________

Date: ______________________________________