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Carroll Community College

Department of Nursing
NURS 242- Nursing Concepts Four
SU MMATIVE Student Cl inical Perform ance Evalu ation

Student Lisa Slack Date 3122119 9 Week # 6 F Professor Rohrba

S = Satisfqlilgly I N = Needs lmprovement I U = Unsatisfactory I rue = fVotapptrcante ) Criticalbehavior
Students who meet any of the following criteria will be given a remediation plan and may be placed on probaiion.
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
Student Instructor
Self- Eval of
Outcome 1 Eval Student
Use the nursing process to optimize client health (CO1) SiN/U S/N/U
*Prioritizes patient care based on e
1 assessment S
2. *Demonstrates
accurate patient assessment skills S B
3- Analyzes and incorporates data from the patient's medical record in the provision of S
4. Uses patient assessment data to implement individualized plan of care S
5. Establishes appropriate nursing diagnoses based on collected evidence and patient
assessment S
6. Establishes measurable patient outcomes based on nursing diaqnosis S s
7. Establishes appropriate nursing interventions based on assessment S
B. Evaluates patient response to care and revises plan as needed S
Student lnstructor
Self- Eval of
Outeome 2 Eval Student
Assimilate into the profession of nursing (CO2) S/N/U S/N/U
L Demonstrates professional behavior and appearance S rJ
10. Seeks input from patient, instructor, and healthcare team in the delivery of patient- *
centered care S
11. *Demonstrates accountabilitv and acceots responsibilitv for own actions and attitudes
S s
12. *Adheres to attendance policv S

13. Participates actively in all clinical experiences S
14. Engages in self-reflection and communicates learninq needs to instructor S D
15. Completes assignments as required and submits on time S
16. Demonstrates initiative in assisting peers and healthcare team members in the clinical e
setting S
Student Instructor
Self- Eval of
Outcome 3 Eval Student
Provide patient-centered care (CO3) S/N/U S/N/U
17. *lmplements appropriate infection control precautions S
18. Provides culturally sensitive care S
19. Documents patient care accuratelv S e
20. Uses therapeutic communication skills S
21. Follows through with all patient care S
22. Demonstrates knowledqe of medications for assiqned patients S
23. "Administers medication safelv usinq six riqhts of medication administration S .-l,t

24. Demonstrates carinq behaviors S e

Approved 1214114. Revised 1211012014; O1 12015; 3116118; 1 113119

Carroll CommunitY College
Department of Nursing
NURS 242* Nursing ConcePts Four
SUMMATIVE Student Clinical Performance Evaluation

25. Uses SBAR effectively S

26. Acts as an advocate for patients and families S s

27. "Demonstrates phys ical and mental coll11: t!9!9e S
28. -ldentifies safeg concerns and notifies instructor and appropriate healthcare team
members S

29. Orqanizes time efficiently S

30. Evaluate effectiveness of patient and family teachlfrg and revises pla S s
31. "Updates instructor and healthcare team regarCing changes in the patient's condition S s
32. *Provides nursing care based on the policies and procedures of the facility S

33."ProvidesnursingcareinaccordancbwiththeMary|@ S

34. *Adheres to HIPAA guidelines S

35. *Provides care according toANA Scope and St@ S

Student lnstructor
Self- Eval of
Outcome 4 Eval Student
Enqaqe in evidence based care (CO4) S/N/U S/N1U
S .i:i
36. Critiques current practice based on evidence
Sfudent Reflection (Thoroughly answer all questlons)
How has this clinicat rotation helped to define your role as a nurse? Please explain.

This clinical rotation helped to define my role as a nurse by being able to see and do the different tasks a nurse needs to do. I was able to balance
having four patients at once, make decisions of what medications to give and why to not give a medication, see the duties of what the charge nurse
does,_and be able to critically think in the clinical setting. This has all helped me to see the whole picture of the nurse's role.

Which objective did you accomplish during this rotation? How did you do it?
patient. I
During this rotation, I accomplished prioritizing patient care based on assessment. I did this by assessing the systems of the body of the
what is going on with each patient. then was able to prioritize the most significant
compl-eted a head to toe assessment that helied me to understand I
probiem going on with the patient and come up with interventions. Lastly, I reassessed the patient to see if the intervention improved the patient's status

What are your goals for future work in the clinical setting?
is to continue working on time management. Another goal is to continue prioritizing patient care
one of my goals for future work in the clinical setting
with expeiience and use my clinical judgement. Lasfly, anoiher goal of mine is to continue to learn and continue to ask why something is happening and
why I am doing something.

lf an item was identified as N or U, narrative comments are necessary to clarify student performance along
with goals to improve performance).

you had a successful rotation. You were able to manage the care of multiple patients. You learned more about
prioritization and coordinating care. Medications were administered safely, and you learned a valuable lesson
about which meds to give first when a patient had an upset stomach. You were able to see patients from same
day admit to surgery tL discharge. Documentation in the computer was completed in a timely fashion. You are
well on your way to being a great nurse.

Student Signature:
lnstructor Signature: I o Bohr'baDg}" ".R't\l\ bs

Approved 1214114. Revised 1211012014; 01 12015; 3116118, 1 113119