Student Name: Jessica McElravey

Southwestern Oregon Community College Nursing Program Nursing

222 Foundations of Nursing: Acute Care II

Clinical Evaluation Tool

The purpose of the weekly clinical performance evaluation tool is to provide feedback about achievement of the course outcomes and
competencies and to assist the student to meet the standards of care for nurses in Oregon as outlined in the Nurse Practice Act.

Explanation of Rating Scale:

(S) Satisfactory = Clinical performance is safe and student adequately demonstrates application of the nursing process/clinical judgment,
required skills, and expected synthesis of learning appropriate to level in the program. Verified by direct instructor observation.

(NI) Needs Improvement = Indicates that additional learning and attention to detail is required for a particular item or that the overall
performance for the week is at a minimum level. The instructor will write an explanation of the rating on the comments page.

(U) Unsatisfactory = Clinical performance is unsafe and inadequately demonstrates application of the nursing process/clinical judgment model,
required skills, and expected synthesis of learning appropriate to level in the program. The instructor will write an explanation of the rating on
the comments page.

(NA) Not applicable = Particular item does not apply to the clinical performance.

(NO) Not observed = Instructor did not observe or has no knowledge of the students performance of the activity.

Students with a grade of NI or U will be required to meet with their advisor and clinical instructor and discuss a plan for change in their behavior
before their next clinical experience.

Safety and legal/ethical concepts are considered critical to the profession and will be graded as NI or U if any violation occurs.

If a student is assigned a U or NI for two weeks, the faculty will review the students clinical performance and consider the options of either
placing the student on probation or dismissing from the program.

In cases of potential failure, notification of the student by the instructor that she/he has been assigned a grade of U or NI for one week
constitutes proper warning of the grade status.

If a student is placed on probation and then receives a grade of U, the faculty will review the students performance and determine whether or
not the student will be dismissed from the program.

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 Nursing 222 Clinical Evaluation Tool Student Name:
. Clinical Week
Mid- Final
2 3 4 5 6 Term 7 8 9 10 Eval
Eval
Competen
QSEN cy (C) 10/ 10/ 10/ 10/ 11/1 11/ 11/ 12/
Competen Course
Dates 10/3 11/7 N/A
cies: 10 17 24 31 14 28 1
Outcomes
(KSA) P
(CO) Attendance: P=Present, A=Absent, T=Tardy P P P P - P P P
BAH BAH - BAH BAH BAH
Facility/Unit PSU BAH BAH BAH
REU ER FBC OPI
C9 Applies concepts and theory to clinical practice in client care and S
CO1,2, written assignments:
5 1. Conducts evidence-based assessment, using age, S S S S S S S S
developmental and culturally appropriate communication
skills
2. Collects and monitors a variety of data S S S S S S S S S
3. Analyzes and interprets the data/assessment findings in S
S S S S S S S S
increasing complex acute conditions.
4. Recognizes pathophysiological changes and symptoms N/O S S S S S S S S
5. Regularly monitors clients level of comfort and ability to S
S S S S S S S S
manage symptoms and symptom distress
6. Prioritizes health problems. S S S S S S S S S
7. Develops and uses evidence-based individualized interventions S
S S S S S S S S
8. Develops a plan of care that considers the individual, family, S
age of client, developmental stage, psycho-socio-cultural S S S S S S S N/A
issues, and/or learning needs.
9. Evaluates and reflects on plan of care for clients with acute S
conditions.
S S S S S S S N/A

CO4 Develops discharge plans in collaboration with client, family, and S

other members of the health care community. N/O S S S S S S S

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C8 Uses therapeutic communication with patients and agency staff. S S S S S S S S S

C 6,7,8 Recognize cultural issues and interact with clients in culturally S

CO1 sensitive ways. N/O S S S S S S S

C5 Collaborates with other members of the health care team to S

CO3 S S S S S S S S
provide comfort and symptom management.

C10, S
CO2
Uses research and evidence to support clinical decision making. S S S S S S S S

C6, CO S
Utilizes resources as needed. S S S S S S S S
C4 S
Able to identify/define leadership skills for nurse's role N/O N/O S S S S S S
C9 Exhibits critical thinking skills when prioritizing and delegating S
patient care. N/O N/0 S S S S S S
CO1
C9, CO1 Demonstrate responsibility and accountability for professional S
behavior: S S S S S S S S
1. Performs safely in clinical.
C3 2. Prepared for clinical (Appropriate attire, appropriate tools such S
as stethoscope, skills list, evaluation tool, assessment tools). S S S S S S S S

C4 3. Takes initiative in making decisions and assuming responsibility S

S S S S S S S S
for decisions.
C3 4. Looks for opportunities for continued learning and S
S S S S S S S S
selfdevelopment.
C4 5. Identifies behaviors and attitudes influencing professional S
S S S S S S S S
behavior.
C1, 2 6. Demonstrates growth in coping with stressful situations in a S
S S S S S S S S
calm and dependable manner.
C1 7. Maintains patient confidentiality. S S S S S S S S S
C8 8. Documentation of client care is accurate and relevant and S
S S S S S S S S
consistent with agency policy
C3 9. Completes and submits assignments on time. S S S S S S S S S

pg. 4
 C2 10. Organizes and manages time effectively. S S S S S S S S S
C4 11. Attends and participates at post-conference. S S S S S S S S S

Instructor Initials JT JT CD CD CD CD JT JT JT JT
Student Initials JM JM JM JM JM JM JM JM JM
Key: C=Competency, CO=Course Outcome, QSEN=Quality and Safety Education for Nurses, KSA=Knowledge, Skills & Attitudes (QSEN Competencies)

Instructor include comments that are positive, areas that need improvement or are unsatisfactory. Reference the course outcomes listed in Student
Week Initials
the syllabus, the OCNE Competencies from the Nursing Student Handbook and/or the QSEN competencies (Date/Sign all entries)
Jessica, this week you cared for a pre surgical patient on PSU. Your care plan is complete and pertinent to your patient. I would like to see your JM
patho paper look like more like a college research paper. It should flow and read easily and pull the pieces of your patient together. You did well
2 interacting with your patient in verbal and nonverbal ways, I feel that you easily developed a rapport with her and met her needs effectively.
Overall, this was a good clinical week for you, keep up the good work and continue to look for ways to improve yourself as in the clinical setting.
Jenny Tausch RN MSN PCCN 10/8/2017
Jessica, this week you started having to switch patients in the REU, then you ended up spending most of your clinical day observing in the cardiac JM
cath lab. This was a wonderful experience for you, just seeing how other parts of the interdisciplinary teams work together. I feel that you were
3 actively engaged in intentional learning in the cath lab and that you were eager to practice new skills. This was a productive week for you,
continue to look for ways to manage your time effectively and become more confidence in the clinical setting. Jenny Tausch RN MSN PCCN
10/15/17
Good job this week. You are learning critical thinking skills. You are doing wonderful in seeking out new experiences. Keep up the good work. JM
Celia Dolan, RN MSN 10/17/17
4

Marvelous job. You are establishing critical thinking skills and are eager to learn new skills. Nice job. Keep up the good work. JM
Celia Dolan RN MSN 11/1/17
5

pg. 5
 Good job this week. You are being able to connect with the RNs that you work with. You seek new experiences appropriately. Good job, again. JM
Celia Dolan RN MSN 11/1/17
6

Fabulous job with seeking out new experiences these past few weeks. You are beginning to develop and expand on critical thinking skills. These JM
skills will help as you continue further into the nursing world. You are developing good patient-nurse relationships. You are also gaining confidence
Midterm you need to prepare yourself for nurse to nurse relationships. Keep up the good work and keep seeking opportunities for expanding skills sets.
Celia Dolan RN MSN 11/1/17

Jessica, this week you rotated through the Emergency Department. Your reflection paper was complete and well done. I did not have any JM
comment on it for you. I feel that you are becoming more confident in the clinical setting and more confident in your skills, this demonstrates
7
growth in your leadership abilities. This was a successful week for you, continue to look for ways to improve yourself as a student.
Jenny Tausch RN MSN PCCN 11/8/17
Jessica, this week you were able to spend time in the Family birth center and see the start of an induction. It is too bad that you were unable to see JM
a birth, but we cannot rush these things. Your care plan was complete and well done. I did not have any comments on it for you. You were very
aware of your patient's discomfort and her privacy and did spend time educating her on how some of the exposures and exams are necessary. You
8
were actively engaging in supporting your patient with therapeutic communication. I am glad that you enjoyed this week and that you were able to
see and do so much on the unit.
Jenny Tausch RN MSN PCCN 11/16/2017
JM
9 MAKE UP

Jessica, this week you were able to spend the day in Outpatient Infusion. I feel that you were able to see and practice a variety of different skills. I JM
feel that you communicated effectively with the staff and the patients during the day and you were able to accept feedback from the staff. This was
10
a wonderful learning opportunity for you, I am glad that you enjoyed it.
Jenny Tausch RN MSN PCCN 12/1/2017
Jessica does well in the clinical setting, she is eager to learn she does look for learning opportunities and I feel that she does practice safely in the JM
clinical setting. There are times I feel that she does get a bit nervous, but I feel that will improve with time and with more experience.
Final
Jenny Tausch RN MSN PCCN 12/1/2017

9/2/09: revised 5/06/11, rev 8/2/16 sw

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