Carroll Community Colege
Dhvsion of STEM, Nursing and Allied Health
Department of Nursing
NURS 140 ~ Nursing Concepts 2
'SUMMATIVE Student Cinical Performance Evaluation
al Wott Date cse# Faculty
‘Us Unsaiafactory [WA Not spotcatie | (Ciel behavior
‘Suds whe meal any ofthe (clowng erers wil Be given a remediaion plan and may be paved on probabwr
Fealure to progres in these areas may rsultn fale ofthe course
| Ono uneaisactry grade in ctl behav Two needs improvements in a cial behavior
{Two unsatisfactory grades ina nancial behavior Four needs Imrovements
‘Siadent | Taatustor
‘Salt | Evatot
‘outcome + Eval | Student
ody the nursing process when implementing a plan of care (CSLO1) e SIwU_| SIND
1_“Prortizes patent care basod on assessment wih sistance Ss Ss
2 S s
'3._ncorporates data fom the palent's medical recor inthe provision of care s s
“4. Uses patient assessment data to devel individualized pan of care with acsciance Ss
'5. Establishes appropri nursing dagnosos based on colected evidence and patient s
aassesamentmih assistance ~ N
1._Establahos measurable patent oulcomes based on nursing diagnosis wth assistance s s
shes approprate nursing interventions based on assessment wih assistance | _S s
'8._ Evaluates pation responce fo care and revises pian as needed wih asisiance s s
‘Sudent | inseucior
| Sate | ‘Evalot
‘Outcome 2 Eval_| Sucent
Paricisate in opportunites that promote professionel arouth (CSLO2) si
'9._Demonsates professional behavier and appearance Ss.
1107 Seeks input fem patent, instructor, and heallware team into dalivery of patent
‘erorod care
41, "Demonstrates accountability nd aczedts responsibly or own actions and ates
“12. "Acheres to stendance pole
13, Paripates actively na cial experiences
"14. Engages in eo-efcton and communicates fearing neds to racer
715. Completes assignments 8 reauied ond subatson tine
lolol alle
‘Siodent | Fatructor
‘sat | Evalof
Outcome 3 Eval | Stadent
Provide pation. centered care wih assistance (CSL03) smuy_| “sn
16, simplements appropriate infecton contro! precautions 8 SI
17. Provides culuraly sensitive care wth assistance - - s s
18, Documents patent care accurtely wih assistance s s_|
18. Uses therapeute communication skis s s
20. Folows trough wit all patent care wih assistance s s
21, Demonstrates knowedge of medications for assigned patents s s.
22 “Agminsters medication safely using sh righis of medication administration NA | na
23, Demonstrates caring behaviors Ss s
24, Uses SBAR to communicate paler Salus to nevustor and healinare eam with ss s
aastance
| 25. Aots as an advocate for patients and amiios wih assistance
Aewoves 244 Revs 120201; 012015.Carroll Community College
Division of STEM, Nursing and Alied Health
Department of Nursing
NURS 140 — Nursing Concepts 2
'SUMMATIVE Student Clinical Performance Evaluation
[26 “Demonstrates physic! and mental competence 3
| 27, Ideniles safety conceme and roles instructor and appropiate Raalhcare team
members i. s
728. Demonstrates tine management techniques —_ s -
29, Implements tient and family eduction
20. “Updates instructor and healthcare team recardng changes inthe patients eondtion
31, Provides nursing care based on the pices and procedures ofthe fect
22, “Provides nursing caren acsordance withthe Mayland Nurse Pracice Act
| 33, Acheres to HIPAA guidelines
| 34. Promdes eae according io ANA Scope and Standards of Nursing Proce
ln oa|e0|co|en|cnlen| n\n
stor | rma
et oon
oe me | Sect
ee escanmmnnienlcne ss arena ae
Lee ues eet er |
Fr ee
Haaeererecpee Taio helped to din your role ata nurse? Peso oxpl fake fam Like
oe ee aoe tis cecmnine my ples docning om on ay
sain ar secceno ana iarentens noon ed testing te hospice cons ey
a etrsatrprare sa responce hypeenshcasseuatonepscce, Wel done
Which objective did you accomplish during this rotation? How did you de i? was able to talk fo the
‘nursing staff to advocate for patient and talk to the family to find out what the patient truly wanted out
life at the point of being dx. With ailiness. Yes and you continued to advocate until the issue was
‘addressed, which is offen necessary innursing and you used basic chain of command to cock help for
hhor physical needs.
What are your goals for your next clinical rotation? I feel like I struggle with writing my nursing Dx. As
far as the patho. So | would like to get better with this for next rotation. | want to advance my
understanding of medication and knowledge.
Yes, lagree with your selfassessmont on the nursing diagnoses and the pathophysiology because |
did notice some trouble there in your paperwork. You have the ability to see the problem and sce
where itis going, soit doesn't worry me in a clinical or critical thinking capacity, but working through
those nursing diagnoses and understanding how thy ft with the pathophysiology will help with
‘exams and assignments.
Faculty Commental Student Loarning Goals (Goals must be established even If performanca Is saistactory
fan tem was dented as N or U, narrative comments are necessary to claify student performance slong
with goals to improve performance).
‘As mentioned above, | think thal continuing to work on those nursing diagnoses is @ reasonable goal. Itisnt
ikaly that you wil use them in day lo day nursing practice, but | do think they help wih seeing how cause and
‘effect and antepation of certain Outcomes works witha patient. Think it through In terms of wnat you are
‘ooking at because | ean see that you putthe pioces together. Then make it work with the nursing diagnoses,
[think simpleris better. Work with cne body system at atime in terms ofthe diagnoses (even though they are
alinter-elated in the patient's picture.)
Aoproves 1104 Rates Yron044 07085Carroll Community College
Divsion of STEM, Nursing and Aled Health
Department of Nursing
NURS 140 ~ Nursing Concepts 2
'SUMMATIVE Student Cinical Performance Evaluation
‘Student Signature:
Crystal Wolf Date:4/29/18
Instructor Signature:
Henrietta Taylor MS RN | Date: 4/20/18
Aeroved BAIA Rand 12004; 012018