Carroll CommunitY College

Division of STEM, Nursing and Allied Health

Department of Nursing
NURS 233 - Nursing ConcePts 3
SUMMATIVE Student Clinical Performance Evaluation

Faculty
Amy
Dinabur
Student han Talbot Date ot31t16 CSE #
S = Satlsfactory I N = Needs lmprovement I U Unsatisfactory I ') Criticalbehavior
Studentswhomeetaediationplanandmaybeplacedonprobation'=
Failure to progress in these areas may result in failure of the course.
-One unsatisflctory grade in a critical behavior -Two needs improvements in a critical behavior
-Two unsatisfactorv qrades in a non-critical behavior -Four needs improvements ,, ". , .-.,,. , , -, "

Outcome 1
analvze fhs-affecfiveness bf tfia olan of,car:e fe,S'LOI,]
*Prioritizes patient care based on assessment with faculty as a S
1. S

*Demonstrates accurate patient assessment skills S

2. S

3. Analvzes and incorporates data from the patient's mediqal record in the pr S S
individualized plan of care with faculty as a S
S
resource
es based on collected evidence and patient S
assessment with faculty as a resource S

A Es6bltsf'es mdsuEOj6Etient outcomes based on nursing diagnosis with faculty as a

S
S
resource
-
ventions based on assessment with faculty as a S
s
resource
response to care and revises plan as n9qdP4"Yv,ilh laqylty,=q9
S
8jrr"1,.,"t"" r"tb.t ?. [999!{l'99 S

S
9.DemonstratesprofessionalbehaviorandappeL S

healthcare team in the delivery of patient S

S
centered care
S S
11.*DemonstratesaccountabilityandacceptsreSpo
,lc *Ar{harac ln affanr{anea nnliev S S
S S
13. Participates actively in all clinical experiences
S S
14. Enqaqes in self-reflection and commqnicates learning n
S S
15. Completes assiqnments as required ald submits on time
s S
16. Demonstrates initiative in assisti
:*nstru:et0r

",Eval.o:f.,
S1ud6*,,,,,
r,,tr

..,:9611$il,

S
17. *lmplements appropriate infection control precautio
S

S S
18. Provides culturally sensitive care
accurately S S
19. Documents patient care . ,

S S
20. Uses theraoeutic communication skills
S S
21. Follows throuqh with all patient care
Approved'l2l 4l'l 4. Revised 121 1 01201 4; 01 1201 5