Carsll Community Oollege

ilivision of $TEM, Nursing and Allied Health

Departm*nt of Nursing
NUR$ 133 - Nursing Concepts 1
SUMMATIVE $tudent Clirrical Performance Evalu*tian

$t*sdent tiea Slack 11/10/1f C$E # Faculty Prsf*ssar

$i$atisf*ctory I N=Needs lmprovement I U*LJnsatisfaetory | NA=Nptapplicahlg- Critical bahavior
gtuO*nts who meei any cf th* falluwing criterie wlll be giv*n a remediation pl*n and may be pla*ed on prabation.
Failure tr progrese in thsse areas BIay r*sult in failure af the courue.
-*ns unsetisfectory grade in a critica! behavior *Ttvo needs improvements in a critical behavior
-Twa uncetisfactory srades in a nsn-criticalbehavisr -F*tLlregg!$ improy€!"asnl$
$tudent lnstructor
Belf- Eval of
Ouieome I hval Student
Us* tha ccmponents *f the tGq{qlng-ple*ess when creatingg plan of care tCSLOl S/NIU S/NJU
1. "flri*ritiees patient care based on a$sessment with eaachi*g c
2. Eemonstrate$ acsurrte patisnt assassment skills with coA{i$g S s
3. SatFa*rs data frcm th* patient's m*dical reeard to proyide pqltgn|gelg b c
4. Uses patient assessment data ta develop i&lividuelized plan *f care with ctaching N -r,!
5. E*tabliehes appropriate nursing diagnases based on colleeied evid*nce and patient
ssss$srlen{ with coachinc f\i t)
fi. Establishes me*sur*bls patienl nutcomes based on nursing diagnosis with qpaching N hI $ET*I
7. Est*blishes appropriate nur$lng inl*rventlefiL bgggg-qn qggqgg8g$-wllh csechirg :
7*
._u S r-fl
S. Evaluaten peti*nt r&spon$e to care and rqviqes plan as-needs{ with coaching N s ft
Studsnt lnstructor
$elf- Eval of
flutearsla e Evsl Stud*nt
Eevelar &n awarefi€gs of cpportunities that promot* prrfessional gr*ncth {C$LQel SINIU siNlu
(=
$. Dern cr*trates Fr*f*ssi*n*! behsvtqgn{__Spp3areqqe s
1CI. $eeks input from patient- instructor, and healthcare tearn in the delivery of patient-
centered care $
s
11. *D*monstrat*s accountab!!itv and accepts respcnsibility fur own actions and attittides b s
12. *AChares
tc attendafisa prlicy s s
'l$. Pariieirates actively in all clinical experiences e t3
14" Ensaqes in self-reflection and eemm S s
15. Ccmcle{es assiqnments as required and submits on lirne b s
$tudeni lnstruetur
Self- Eval of
Outcome 3 Eval Student
Frnvide patient-centqred care wlth llachiqglCgLggl S/N/U $/NIU

1 " "[mplements apprapriate infection control preeautlqnq

fr s .s
1?. Frovides culturellv sensitive care with coachlnfi
c s
18. D*cuments pati*nt care accuratsb, wil[-qqqqhi_qq s s
19. Uses beqinninq therapeulic communieation skills 5 5
?0. Follrws throuch with atl patient cere with coaehi*g S s
21. Verbalixes knowledge af medicatisns&fegsigned patients di
,rq lnFarwrlr
r€N s
l?. Demonslrates caring behavicrs D 5
?S. Uses $8AR t* communicate patieni statur to instrqctgrwith qqqqIhg-. Clerand(Sry- , ieN ?rl

?4. ldentifies issues needing advocacy for assigqe{pat!en!$--- s s

l tS, *Dsmnnstraiex physical and mental competenc* s s
Approved 134/14. Revised 1W$l€fi1 4: 01i2015
 Carroll Community Ccllege
Division of $TEM, Nuraing and Allied Health
Department of hlursing
NURS 133 - Nursing ConcePts 1
SUMMATIVE Student Clinical Performance Evaluation

@rngandnotifiesinstructorandappropriatehealthcareteam S
g
members
27. ldentifies ways to spend clinical time more eJfigigi-ltiy l! s
28. ldEntifies patient and family health education needs NA s
?9. "Updates instructor and healthcare teatl re*ardino chanses in the patieryli 9p!lI[]ilig! D c
30, *Frovldss nursing care based on the policies and procedqles of the facilitu .,,
s s
31. *Provides nursinq care in accordance with the Marvland Nurse Fractigg Ag! s S
32. *Adheres to HIPAA auidelines S
Q

ilt'Uttpgfreqtlry. c s'
33. 'Provldes care accordins to ANA Scope and Stg!$qrd!
Student lnstruclor
Self- Eval of
Outccms 4 Eval Student
Exolore the scientific evidence that suprorts the patient's plan uf care {CSLO4} $/N/U S/NIU
34. ldentifies evidence'based rationale that supports the p{ient's plarclqglq N s
Sfndenf Eeflectisn {Tharaughly aflsLver all questions}
Horry fras ttris cfirica I retatian helped to define yaur role Es a n.rfse? Please *xplain.
This clinical rota1on helped me to define my role as a nurse through basic hands on care for the patient. I truly
enjoy*d meeting the paiient's needs even if it wae something like puHing lotion on their back. Learning about
baiii patient-centereb care defined my rale as a nLtrse. You want to be able to rneet their needs even through
the littiest things" I feel that I developed assertlveness through getting assessments finished and
communication with the patient. This clinical rotation helped qre divqin. I learnpd !o be pleasant while being
Rrm as a nurse. ttrot uim 1.1r€,qgot sF this rutif,fion !
lssw tTerner$otE qrD$Jttt tn . }gul
-,rlmm{,.#ur"gi[ffi1i,*?#iH'Jrly#ffi:pi;tu{o-oP}ariilrnecilrer
Iaccomplished the goh of prisritizing care foithe patient. I did this by taking my a.s$es$ment findings and
laoking at what could rea6y herm the patient first. I am able to look at the bigger pitture fsr the patient than
ever f,efore. I still need prictice and increase my skill in this- area. I do think that I showed impr.o-vernent.-
'nrat Ossr*lrrunt done eodS tn-lh€ dag ts €t) PU
is rrrnoortoilt, ond Wthilq \our FlPortont
What areydur goali far yo*r neit itinicat ratatian? tr*BbOSrltfu tOComftrele.
My goal fc,? tne iext clinicil rotation is to tak* what I have learned from this clinical rotatiqn such as prioritizing
ortre-, communication skills, and time management ta the next clinical rolation. I have a goal in mind to really
work en diagnoses and ouicomes for the pitient. Like I said last week, I plan on prauticing ccncept maps each
week to increase my knowledge about different nursing diagnoses and to look at the big picture. My goal is to
l
provide the best care i can to pafient. I want to continue tg uqe my 9*ri1g pers*nality-t9 leing a-nurse and
utitize it everywhere tgo. Thc oia*rnscs,0tltfsrEs,sndtntenefih0fi$ ttlltt ger v 6,8ter o! Y0u f?q[e*s
rn itu ?*$''am-t,iu ollltliliH{T'r? b ;'griatsto'+t
iF Performance is satisfactory'
clarify student performance along
i: lf an item was identified as N or U, narfitive comments are necessary to
with gaals tu improve pedormance).
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