Clinical Self-Evaluation Tool

Evaluator: Moravecky, Gracie (gmoravecky@usf.edu) Completed Date:04/06/2023

Evaluatee: Neavins, Cynthia(cneavins@usf.edu) Rotation:CH1 3/18/2023-4/8/2023

5-Outstanding: Exceeds Standards

Exhibits above average performance of nursing care for this level student. The student is proactive, self-directed, and consistently engaged in
learning; needs minimal guidance; is knowledgeable; and appropriately incorporates knowledge with skills. Student is proactive and
self-directed in approach to learning.

4-Satisfactory: Meets Standards

Exhibits average performance of nursing care for this level student. Functions with minimum guidance. Demonstrates adequate knowledge and
requires minimum assistance in applying knowledge to skills. Recognizes learning opportunities but may require assistance in utilizing them.

3-Minimal
Exhibits minimal performance of nursing care for this level student. Functions safely with moderate guidance. Demonstrates minimal knowledge
and requires moderate assistance in applying knowledge to skills. Requires some direction in recognizing and utilizing learning opportunities.
Often focuses on the task or own behavior, not on the patient.

2-Unsatisfactory
Requires intense guidance for the performance of activities at a safe level. Clinical performance reflects difficulty in the provision of nursing
care. Demonstrates gaps in necessary knowledge and requires frequent or almost constant assistance in applying knowledge to skills. Requires
frequent and detailed instructions regarding learning opportunities. Focuses primarily on the task or own behavior, not on the patient.

1-Unsafe to Practice
Is unsafe to practice without constant, intense guidance. Frequently lacks necessary knowledge and skills and unable to integrate these into
practice. Requires constant detailed instructions regarding learning opportunities and is often unable to utilize them. Attempts activity or
behavior, yet is unable to complete. Focuses entirely on the task or own behavior, not the patient.
Course

Answer: NUR 3225L COMPLEX HEALTH NURSING I CLINICAL

Semester

Answer: Spring

Year

2023

Select Evaluation Type

Answer: Summative

Standard 1: Patient-Centered Care

1. Performs a comprehensive assessment including patient values, preferences, and needs.
2. Develops an individualized plan of care with a focus on the nursing process.
3. Provides care with sensitivity and respect for the diversity of the human experience.
4. Delivers care based on knowledge of pathophysiology and pharmacotherapy.
5. Identifies potential barriers to active involvement of patients in their own health care process.

Answer: 4 Satisfactory: Meets Standards

I complete a head to toe assessment of both of my assigned patients at the beginning of each shift. I also assess for any psychosocial
issues that I feel should be addressed. I also possess a foundational knowledge of pathophysiology and pharmacology that helps guide
my assessments. I could improve on assessing a client's cultural and spiritual needs.

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Standard 2: Teamwork and Collaboration
1. Demonstrates awareness of own strengths and limitations as a team member.
2. Initiates requests for help from other team members as appropriate.
3. Communicates effectively with patients, family members, and other members of the healthcare team.
4. Identifies potential complications related to handoffs or transitions of care.

Answer: 4 Satisfactory: Meets Standards

I work well in a team setting and have a solid dynamic with my team. I am proactive about asking my peers if they need any help, I answer
any questions that are asked of me, and I also ask for help when necessary. I also deliver report to the nurses at the end of the shift and
involve them with any pertinent assessment findings.
Standard 3: Evidence-Based Practice and Quality Improvement
1. Utilizes evidence-based literature to support clinical decision making as demonstrated in written clinical assignments.
2. Differentiates clinical opinion from evidence-based practice to determine best clinical practice.
3. Promotes and practices quality, cost-effective delivery of care.
4. Identifies potential areas for quality improvement in the clinical setting.
5. Participates in measures to improve patient outcomes as appropriate.

Answer: 4 Satisfactory: Meets Standards

When providing care for patients, I implement evidenced based practice in order to improve patient outcomes. I only implement
techniques taught to me by my clinical instructor and didactic instructors. I also recognize areas that could be improved in my clinical
setting.
Standard 4: Safety
1. Identifies strategies to reduce the risk of harm or poor patient outcomes in the delivery of care.
2. Delivers medication (as appropriate) in a timely and safe manner including understanding the specific indications for the medication
and potential side effects.
3. Communicates effectively between team members or to clinical faculty when giving patient report.
4. Uses appropriate resources to improve organization and/or time management.

Answer: 4 Satisfactory: Meets Standards

Patient safety is at the forefront of my clinical practice. Practicing hand washing, identifying my patients correctly, checking for allergies,
monitoring VS and the chart, etc. helps to provide a safe environment for patients and improve patient outcomes.
Standard 5: Informatics
1. Navigates the electronic health record where appropriate.
2. Documents clearly, concisely, and accurately in the electronic medical record where appropriate.
3. Protects confidentiality of all protected health information.

Answer: 4 Satisfactory: Meets Standards

I am able to navigate the EHR in order to chart skills I have completed when necessary and find pertinent medical information. I am also
aware of protecting patients' PHI when I am utilizing the charting system.
Standard 6: Professionalism
1. Demonstrates core professional values (caring, altruism, autonomy, integrity, human dignity, and social justice).
2. Maintains professional behavior and appearance.
3. Demonstrates expected behaviors and completes tasks in a timely manner.
4. Engages in self-evaluation and assumes responsibility for learning.
5. Arrives to clinical setting on time.
6. Demonstrates evidence of preparation for clinical learning experiences.
7. Maintains a positive attitude while interacting with patients, family members, faculty, peers, or members of the healthcare team.
8. Accepts individual responsibility for actions.

Answer: 4 Satisfactory: Meets Standards

I believe I effectively demonstrate professionalism in the clinical setting because I arrive early to every shift in my appropriate uniform and
submit all paperwork in a timely manner. I also maintain a positive attitude when interacting with patient, family members, faculty, and
peers.

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Comments: Overall, I believe I have grown significantly throughout the semester. I am a more confident and competent student nurse and my
skills have improved as well.

Neavins, Cynthia reviewed the above evaluation on 4/15/2023 9:34:00AM and has provided the following comment:

Gracie, you have grown! You communicate very well with all staff students and instructor. You use evidence-based practice in care and
providing information to and about your patients. You're a team player, very professional and practice safely and confidently. You are
performing fully satisfactorily! I wish you the best.

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