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Student Name:

Dawn Kaneen

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.

Nursing 222 Clinical Evaluation Tool


.
Competency
(C)
Course
Outcomes
(CO)

C9
CO1,2, 5

Student Name:
1

Dates
Attendance: P=Present, A=Absent, T=Tardy
Facility/Unit

Applies concepts and theory to clinical practice in client care and


written assignments:
1. Conducts evidence-based assessment, using age, developmental
and culturally appropriate communication skills
2. Collects and monitors a variety of data
3. Analyzes and interprets the data/assessment findings in
increasing complex acute conditions.
4. Recognizes pathophysiological changes and symptoms
5. Regularly monitors clients level of comfort and ability to
manage symptoms and symptom distress
6. Prioritizes health problems.
7. Develops and uses evidence-based individualized interventions
8. Develops a plan of care that considers the individual, family, age
of client, developmental stage, psycho-socio-cultural issues,
and/or learning needs.
9. Evaluates and reflects on plan of care for clients with acute
conditions.
CO4
Develops discharge plans in collaboration with client, family, and
other members of the health care community.
C8
Uses therapeutic communication with patients and agency staff.
C 6,7,8
Recognize cultural issues and interact with clients in culturally
CO1
sensitive ways.
C5
Collaborates with other members of the health care team to provide
CO3
comfort and symptom management.
C10, CO2 Uses research and evidence to support clinical decision making.
C6, CO
Utilizes resources as needed.
C4
Able to identify/define leadership skills for nurse's role
C9
Exhibits critical thinking skills when prioritizing and delegating
CO1
patient care.

Dawn Kaneen
Clinical Week
5
6

10/7/1
4

10/14/
14

10/21/
14

10/28
/14

11/4/1
4

LDRP

OR

Make-up

No
clinical

11/18

11/25

11/20/
14

MCU

ICU

PSU

MCU

CCC

NA

NA

NA

S
S

S
S

S
S

S
S

S
S

S
S

S
S

NA

NA

S
S
S

S
S
S

S
S
S

S
S
NO

S
S
S

S
S
S

NA
NA

NA

S
3

1
C9, CO1

C3
C4
C3
C4
C1, 2
C1
C8
C3
C2
C4

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).
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. Documentation of client care is accurate and relevant and
consistent with agency policy
9. Completes and submits assignments on time.
10. Organizes and manages time effectively.
11. Attends and participates at post-conference.

Instructor Initials
Student Initials

Make-up

S
S
S

S
S
S

S
S
S

S
S
S

S
S
S

S
S
S

S
S
S

DH
DK

DH
DK

DH
DK

SW
DK

DH
DK

DH
DK

SW
DK

Key: C=Competency, CO=Course Outcome

Week

Instructor include comments that are positive, areas that need improvement or are unsatisfactory. Reference the course
outcomes listed in the syllabus and/or the OCNE Competencies from the Nursing Student Handbook (Date/Sign all entries)

Student Initials

1
2

NA (Absent)
Your care plan is right on. Keep up the good work.

DK
DK

Dustin Hawk, RN, BSN, PCCN


You had a good day in the OR. Work on APA, rem you never use first person.

DK

Dustin Hawk, RN, BSN, PCCN


Great job with a busy day. Keep working on your time management.

DK

Dustin Hawk, RN, BSN, PCCN


Nursing Instructor

11/4/2014 Assigned to ICU, provided care to one client. Met course outcomes 1a&d, 2, 3-5 and OCNE competencies #1, 2,
5.1, 7, 9. Your care prep was very well done and you did an excellent job in evaluating your plan of care. I am suggesting that
you work on your communication skills, specifically active listening. I did notice during your interactions with the nurses, and
one nurse did comment, that you interrupted before the nurse was finished speaking. You do accept constructive criticism
well and this is just for you to think about in order to make improvements. You also tend to be hesitant and take a
considerable amount of time to perform a skill. Accuracy is critical but we also need to do skills quickly at times for patient
safety, so think about how you can work on this, decrease your anxiety and nervousness. Perhaps practicing in the lab will
help build your confidence level. I would strongly recommend that you discuss this with your advisor as well for further
suggestions.
Susan Walker, RN 11/8/14

No clinical this week


PASSYou are meeting all the OCNE course outcomes for this term. If have really noticed your time management
improving this week. Second year nursing student looks good on you. Things are really coming together. Now that
you have gained some experience you can start adding some speed to your care.

DK

DK

8
Dustin Hawk, RN, BSN, PCCN
Nursing Instructor
9

PASSYou have done a great job on improving your time management and prioritizing. This will get easier with
time. Rem when you are doing your checks (double and triple) that you are listening to your pts. They notice when

DK

we are distracted with tasks and not paying attention to them. You have come a long way, and it will only get
better. Keep all the hard work.
Dustin Hawk, RN, BSN, PCCN
Nursing Instructor
Attended Crossroads Clinic, administered multiple flu vaccines. Excellent communication with clients and staff. D
Clinical well gathering data for a client in an outpatient setting. Provided health teaching as appropriate. Identifies own
Make-up learning needs and seeks out opportunities to improve. Psychomotor skill r/t administration of IM injections is
competent, less tremulous when administering injection.
Susan Walker, RN 11/21/2014
9/2/09: revised 5/06/11 sw

DK