Student Name:

Molly Plowman

Southwestern Oregon Community College Nursing Program

Nursing 112
Foundations of Nursing in Acute Care I

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 weekly 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 weekly grade of U, the faculty will review the students
performance and determine whether or not the student will be dismissed from the program.

Nursing 112 Clinical Evaluation Tool

Student Name:

.
Compete
ncy
(C)
Course
Outcomes
(O)
C9/O1,
O2

C1/O3
C5/O3

C8/O5
C4/O4

C6, C7,
C8/
O1
C10/O2

Molly Plowman

Clinical Week
Dates
Attendance: P=Present, A=Absent, T=Tardy
Facility/Unit
Applies concepts and theory to clinical
practice in client care and written
assignments:
1. Collects data and conducts a health
assessment on a client with an acute
condition.
2. Analyzes and interprets the
data/assessment findings.
3. Prioritizes health problems.
4. Develops a plan of care that considers
the individual, family, age of client,
developmental stage, psycho-socio-cultural
issues, and/or learning needs.
5. Evaluates and reflects on plan of care.
Apply ANA Code of Ethics to care of
patients with acute conditions/processes.
Identifies roles and functions of members of
the health care team involved in providing
care for acute conditions/processes.
Uses therapeutic communication with
patients and agency staf
Recognizes potential legal and ethical
issues related to client autonomy across the
lifespan in at risk populations.

4/7
p
BA
HPSU

4/14
p

4/21
P
BAH
MCU

4/28
p

5/5
P
BAH
MCU

5/12

5/19
p
BAH
MCU

BAH
-REU

BAH
-REU

ni

ni

Recognizes cultural issues and interact with

clients in culturally sensitive ways

ni

Uses research and evidence to support

clinical decision making

Make
-up

C6/O2
C9/O2

C3/O

Competen
cy
(C)
Course
Outcomes
(O)
C4

C3

C4
C1, C2

C1/O3
C3
C2
C4

Utilizes resources as needed

Demonstrate responsibility and
accountability for professional behavior:
1. Performs safely in clinical.
2. Prepared for clinical (Appropriate attire,
appropriate tools such as stethoscope, skills
list, evaluation tool, assessment tools).

ni

Make
-up

3. Takes initiative in making decisions

and assuming responsibility for
decisions.
4. Looks for opportunities for
continued learning and selfdevelopment.
5.Identifies behaviors and attitudes
influencing professional behavior.
6. Demonstrates growth in coping
with stressful situations in a calm and
dependable manner.
7. Maintains patient confidentiality.
8. Completes and submits
assignments on time.
9. Organizes and manages time
efectively.
10. Attends and participates at postconference.
Instructor Initials
Student Initials

ni

ni

ni

N/O

mjs
MP

mjs
MP

mjs
MP

mjs
MP

mjs
MP

mjs
MP

mjs
MP

Clinical
Week

Instructor Comments (Include Signature)

First clinical this term. Cares for pt laking 90% of bowel. Identifies top 3 priority diagnosis
and interventions. Reflects thoroughly on each and identifies changes she would make.
Assessments are thorough and patient care is safe and efective. Reflect on what would be a
better approach to appetite and nutrition Welcome Back--------------MSperry MSN RNc
Molly, I noticed a BIG change in your care prep from last term. The information is vague,
incorrect, and sparse. The areas of concern on the preclinical were not addressed. I also have
noticed you are not fully listening or responding to information or feedback. You are not
meeting the benchmarks of OCNE competencies specifically: 1,2,3,4, 6, 7, 8, 9, 10. As a third
term student you should be making better connections between your data and presenting
patient. Work on DAR chartingthis is a Focused form of charting and should focus on issues
that are out of range of your baseline assessment. Look up your medications, critically think
about what would be specific to your patient or if the adverse efect is appropriate. 2-3 mL of
NACL for IV flush will not cause a PE; C-Dif is not caused by H2 blockers or proton pump
inhibitors. If you are not understanding the information or application please ask me in
clinical or stop by the office. Your advisor is also available to help you. Try to slow down and
focus on the present..then look to what you will do about it.
You have a great approach to patient care and you communication is very patient centered
bring this into your care
planning---------------------------------------------------------------------------------------------------MSperry
MSN, RNC
Much improved care plan and assessment documentation. Beginning to prioritize dx and
interventions in a patient centered way. Review all data to be sure you are seeing the highest
priority dx and then bring goals and interventions to patient center. Improving on DAR note
and pathoI would suggest you have the writing center review your work and give you ideas
on how to improve sentence structuring and grammar.. Excellent patient focused care today!
-----------------------------------------------------------------------------------------------MSperry MSN RNc
You are still struggling bringing all your data together to support and strengthen you care
plans. Your reflections and evaluations are showing critical thinking and process more this
is greatOnce again I must ask you to seek help through the writing center or have a friend
review your writingyou patho paper has many grammatical, spelling and structural deficits.
This is seen throughout your paper and decreases the strength of your work.
Bring all of your supporting data to the patient information box at the top of your care plan

Student
Initials

MP

MP

MP

MP

agetis wat all of your data is together in one place and you can see it
clearly---------------------------------------------- MSperry MSN RNc

Cares for quadriplegic teen with C-dif infection. Identifies priority dx and care planning after
am assessment, Continue working on being specific and measurable with goals and
interventions. I am delighted you have sought help through the writing centerthis remains
a weakness in your care planning but I do see you are becoming more objective and concise
in many areas-nice improvement---------------------------------------- MSperry MSN RNc

MP

MP
6

No Clinical

Cares for patient in respiratory failure. You care plan and patho are based on a pneumonia
dx yet I did not see this in primary dx or co-morbidities. Nice improvement in patho paper
and assessment documentation. Continue working on prioritizing dx and
interventions.----------------------------------------------------------- MSperry MSN RNc

9
12/08/12: sw, reviewed 3/30/15sw
5

MP