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Nursing 111 Clinical Evaluation Tool Student Name: Dawn Neal

. Clinical Week
Competency
(C)
Course
Outcome
(CO)
1 2 3 4 5 6 7 8 9
Make-
up
Dates 1/16 1/23 1/30 2/6 2/13 2/27 3/6 3/13
Attendance: P=Present, A=Absent, T=Tardy P p P p p p p p
Facility/Unit BAH/3C psu 3/c 3d 3c psu psu Imcu/3c
C9
CO 1, 2
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 a chronic illness
s s s s s s s

2. Analyzes and interprets the data/assessment findings. s s s s s s s

3. Prioritizes health problems. s s s s s s s
4. Develops a plan of care that considers the individual,
family, age of client, developmental stage, psycho-
socio-cultural issues, and/or learning needs.
s s s s s s s


5. Evaluates and reflects on plan of care. s s s s s s s
C1, CO4
Applies ANA Code of Ethics in care of chronically ill s s s s s s s
C5, CO5 Identifies roles and functions of members of the health
care team involved in providing care for the chronically ill.
s s s s s s s

C8, CO6 Uses therapeutic communication with patients and agency
staff
s s s s s s s

C4, CO7 Recognizes potential legal and ethical issues related to
client autonomy across the lifespan in at risk populations.
s s s s s s s

C6, 7, 8
CO2

Recognizes cultural issues and interact with clients in
culturally sensitive ways
s s s s s s s

C10 Uses research and evidence to support clinical decision
making
s s s s s s s

C6
Utilizes resources as needed s s s s s s s

3


Competency
(C)
Course
Outcome
(CO)
1 2 3 4 5 6 7 8 9
Make-
up
C9, CO2 Demonstrates responsibility and accountability for
professional behavior:
1. Performs safely in clinical.
s s s s s s s
C3 2. Prepared for clinical (Appropriate attire, appropriate
tools such as stethoscope, skills list, evaluation tool,
assessment tools).
s s s s s s s
C4 3. Takes initiative in making decisions and assuming
responsibility for decisions.
s s s s s s s
C3 4. Looks for opportunities for continued learning and self-
development.
s s s s s s s
C4 5. Identifies behaviors and attitudes influencing
professional behavior.
s s s s s s s
C1 6. Demonstrates growth in coping with stressful situations
in a calm and dependable manner.
s s s s s s s
C1
7. Maintains patient confidentiality. s s s s s s s
C3
8. Completes and submits assignments on time. s s s s s s s
C2
9. Organizes and manages time effectively. s s s s s s s
C4
10. Attends and participates at post-conference. s s s s s s s
Instructor Initials mjs mjs mjs mjs mjs mjs mjs
Student Initials DN DN DN DN DN DN DN DN
4






Week Instructor Comments (Include Date/Signature)
1

Cares for patient with CP- does peri care, oral care and recognizes need for nutritional assessments. Finds stage 1
pressure ulcer and immediately notifies RN- nice job_________________ _________________MSperry RNcBSN

DN
2

Working on care planning and nursing dx- helps staff and classmates. Looks for opportunities for skill check offs------
---------------------------------------------------------------------------------------------------------------------------MSperry RNcBSN

DN
3

Cares for active GI bleed. Able to see blood transfusion process, identifies fluid balance needs. Nice assessment and
DAR. Very nice reflections on care plan. Be sure to consider all dxIneffective peripheral circulation would have
been very important for this patient- Nice job ________________________________________ MSperry RNcBSN

DN
4
Cares for patient with pneumonia and deconditioning- identifies nursing dx and reflects on care plan. Nice patient
interaction and helps staff and classmates.----------------------------------------------------------------------- MSperry RNcBSN


DN
5

Cares for patient that was having cardiac issues- does nice cardiac assessment and identifies irregularly irregular
rhythm. Patient indeed in and out of afib. Does medications and interacts with family very well MSperry RNcBSN

DN
6

Absent

DN
7
Cares for new surgical patient. Monitors CMS distal to surgical site and identifies need for O2 supplememtation
Nice job!----------------------------------------------------------------------------------------------------------------Msperry RNc BSN


DN
8
Czres for paraplegic patient with sepsis.Manages IV fluids and practices SBAR communication. Nicely done-------------
---Msperry RNc BSN


DN
9
Does first clinical on IMCU and cares for CHF patient. Identified Gas Exchange issues and appropriate interventions.
Also reflects on pain control and how important that is. Please read comments around Fluid Volume and Electrolyte
problems. Nicely done ----------------------------------------------------------------------------------------------- MSperry RNcBSN


DN
9/1/09sw: revised 20110102kw, revised 12/17/12sw 5