Bryant & Stratton College Nursing Clinical Evaluation Form

Student: _Vanessa Benning__________ NURS 211: Med/Surg Nursing I

Instructor: _Simons_________________ SEMESTER: _Fall 2018__________

The student must receive a minimum of a 2.5 average for an overall evaluation of Satisfactory in the clinical
rotation. This means out of the 10 objectives with 49 items, the student must earn 122.5 points out of a
possible 196 points.

Starred items “*” indicate that the student must receive a minimum of Satisfactory 3.0 by final faculty evaluation
in order to pass clinical and progress to the next course.

Any item receiving a 1 in the faculty final evaluation is an automatic clinical failure.
Any item that is Not Applicable will be scored as “n/a”

CLINICAL OBJECTIVES (Course Outcomes):

1 Demonstrate competence in the performance of nursing skills to provide safe and effective care
in order to adjust learning processes for continual improvement.
2 Employ the nursing process and QSEN competencies to manage the nursing care of acutely
and chronically ill patients.
3 Assimilate appropriate pharmacologic and nutritional principles into the care of acutely and
chronically ill patients.
4 Integrate diagnostic testing into the care of acutely and chronically ill patients.
5 Apply standards of practice into the care of acute and chronically ill patients.
6 Describe assessment and evaluation findings to appropriate members of the health care team.
7 Examine the principles of teaching and learning techniques and demonstrate leadership skills
in the care of acutely and chronically ill patients.
8 Demonstrate legal and ethical accountability in the care of patients with health care needs.
9 Employ a framework of personal accountability for lifelong learning through utilization of
culturally relevant evidence-based practice to provide safe, effective nursing care for acutely
and chronically ill patients.
10 Apply information literacy skills to provide nursing care for acutely and chronically ill patients.

The six roles of the Associate Degree nurse (Advocate, Member of Discipline, Provider of Care,
Researcher, Manager of Care, and Teacher)

Nursing Program Student Learning Outcomes:

1. Employ critical thinking and reasoning to utilize the nursing process as a framework to deliver
comprehensive, safe, and culturally sensitive care across the lifespan.
2. Demonstrate clinical competence in the performance of nursing skills utilizing quality measures
to provide safe effective nursing care.
3. Apply best current evidence and appropriate nursing judgment in collaboration with the patient
to guide clinical decision making in the delivery of nursing care.
4. Collaborate and communicate effectively with patients, families and their social support system,
and the members of the health care team to achieve mutually agreed upon patient outcomes.
5. Practice within the ethical, legal and regulatory frameworks of professional standards for
nursing, including employing agencies’ standards of care, assuming students had no past
conduct or convictions, which prevent such practice.
6. Construct a framework of personal accountability for lifelong learning with an entry-level set of
knowledge, skills, and behaviors to provide safe, effective nursing care.
 7. Employ information literacy skills through the effective use of informatics to communicate,
manage knowledge, mitigate errors, and support decision-making.

Guide for Interpretation of Evaluation Scale

4.0 = Student consistently functions at expected level independent
Proficient, coordinated, confident, with minimal or no direction
3.0 = Student consistently functions at expected level with minimal guidance.
Safe, accurate, efficient, coordinated, confident, with occasional direction
2.0 = Student requires reminders and guidance to function at adequate level.
Safe and accurate, inefficient or inconsistently efficient
1.0 = Student performs unsatisfactorily, is unable to meet clinical objectives without needing
constant guidance, or the student is unsafe in the clinical setting. Unable to demonstrate
procedures. Needs continuous verbal and/or physical direction.

Student and Faculty will indicate their individual scoring using their initials:

Student/Faculty Mid-Term Eval Faculty Final Eval

1 2 3 4 1. Demonstrate competence in the performance of nursing 1 2 3 4
skills to
provide safe and effective care in order to adjust learning
processes for continual improvement.
(provider of care, member of discipline; SLO 1, 2)
4 1. Safely performs skills in the clinical setting that have been
demonstrated in the lab. *
4 2. Maintains a safe environment based on age-appropriate individual
patient assessment and interventions. *
4 3. Conducts appropriate risk assessments on a routine basis to ensure
safe and effective care (ex – Morse and Braden scoring) *
4 4. Recognizes need for help and requests assistance when needed
from either instructor or RN*
4 5. Prioritizes nursing care effectively.

Student/Faculty Mid-Term Eval Faculty Final Eval

1 2 3 4 2. Employ the nursing process and QSEN competencies to 1 2 3 4
manage
the nursing care of acutely and chronically ill patients.
(provider of care, member of discipline, advocate; SLO 1, 3, 4)
3 6. Collects subjective and objective data through appropriate patient
assessment and pertinent medical record information.*
3 7. Interprets and analyzes data to identify patient problems and needs.*
3 8. States appropriate outcomes based on patient needs and
assessment data.
4 9. Identifies and provides nursing interventions and rationale to meet
outcomes.*
4 10. Revises the nursing plan of care based on changes in patient
condition and/or patient response to interventions
 Student/Faculty Mid-Term Eval Faculty Final Eval
1 2 3 4 3. Assimilate appropriate pharmacologic and nutritional 1 2 3 4
principles
in the care of acutely and chronically ill patients.
(provider of care, manager of care, member of discipline;
SLO 1, 3,
5)
4 11. Consistently comes prepared to clinical with medication cards and the
ability to personalize the information to the patient*
3 12. Applies pharmacologic knowledge to patient care in the clinical setting
4 13. Verbalizes important information about prescribed medications.*
4 14. Administers medications correctly.*
4 15. Incorporates nutritional principles in clinical practice.
4 16. Evaluates nutritional assessment data to create a plan of care

Student/Faculty Mid-Term Eval Faculty Final Eval

1 2 3 4 4. Integrate diagnostic testing into the care of acutely and 1 2 3 4
chronically ill patients.
(manager of care, member of discipline; SLO 1, 3)
3 17. Incorporates appropriate diagnostic testing results into nursing
assessment.*
4 18. Collaborates with the RN regarding diagnostic findings and changes in
the patient plan of care.
4 19. Communicates clinical results with the patient as appropriate.
4 20. Anticipates diagnostic tests to be performed
4 21. Prepares the patient appropriately for diagnostic tests

Student/Faculty Mid-Term Eval Faculty Final Eval

1 2 3 4 5. Apply standards of practice into the care of acute and 1 2 3 4

chronically
ill patients.
(advocate, member of discipline, provider of care; SLO 1, 2, 3,
4, 5,
7)
3 22. Uses knowledge from theory courses in patient care.
4 23. Asks instructor or RN for assistance for standards of practice.*
4 24. Refers to and follows agency policies and procedures at all
times.*
4 25. Provides care which minimizes risk to the patient, family, self,
and other
providers
4 26. Follows agency guidelines and ANA professional standards for
practice.*

Student/Faculty Mid-Term Eval Faculty Final Eval

1 2 3 4 6. Describe assessment and evaluation findings to appropriate 1 2 3 4
members of the health care team.
 (member of discipline, advocate; SLO 1, 3, 4, 5, 7)
4 27. Communicates effectively, using appropriate medical terminology to
other health care team members
4 28. Documents accurately and completely the assessments completed,
nursing care provided, and other pertinent information on patient’s
record as appropriate to the clinical setting per instructor’s direction.*
4 29. Protects confidential affairs of facility and patient information.*

Student/Faculty Mid-Term Eval Faculty Final Eval

1 2 3 4 7. Examine the principles of teaching and learning techniques 1 2 3 4
and demonstrate leadership skills in the care of acutely and
chronically ill patients.
(teacher, researcher, manager of care; SLO 1, 4, 5)
4 30. Provides teaching as appropriate to patient and family
circumstances.*
4 31. Conducts a patient learning assessment and correctly identifies
learning barriers and optimal teaching strategies individualized
for the
patient
3 32. Arrives for clinical well-rested and prepared to give safe patient
care
4 33. Arrives on time and stays for full duration of clinical.
4 34. Adheres to dress code as specified in the Nursing Student
Handbook
and/or by the facility *
4 35. Demonstrates ability to act on written and verbal directions from
faculty and members of the healthcare team. *
4 36. Demonstrates professionalism (flexible, tolerant) in ability to
work
effectively and cooperatively with patients, faculty, and members
of the
healthcare team.

Student/Faculty Mid-Term Eval Faculty Final Eval

1 2 3 4 8. Demonstrate legal and ethical accountability in the care of 1 2 3 4
patients with health care needs.
(member of discipline, advocate; SLO 1, 2, 3, 4, 5, 6, 7)
4 37. Identifies ethical issues.
4 38. Provides compassionate care.*
4 39. Offers nursing care options in identified ethical issues and
differentiates options which support the individual patient and family
4 40. Demonstrates accountability for care given by self and/or 20.
delegated to
others.*
4 41. Practices standards of professionalism and student conduct.*

Student/Faculty Mid-Term Eval Faculty Final Eval

1 2 3 4 9. Employ a framework of personal accountability for lifelong 1 2 3 4
 learning through utilization of culturally relevant evidence-
based practice to provide safe, effective nursing care for
acutely and chronically ill patients.
(researcher, member of discipline, manager of care; SLO 6)
4 42. Displays a non-judgmental attitude when providing care for patients
and families of different cultures.*
4 43. Applies knowledge from completion of cultural competence self –
assessment
4 44. Describes the impact of social, cultural, global, ethnic differences
when providing nursing care. *
4 45. Adjusts nursing care to accommodate and respect patient’s cultural
differences
4 46. Identifies and takes responsibility to access appropriate resources for
learning. *

Student/Faculty Mid-Term Eval Faculty Final Eval

1 2 3 4 10. Apply information literacy skills to provide nursing care for 1 2 3 4
acutely and chronically ill patients.
(manager of care, provider of care, member of discipline;
SLO 7)
4 47. Utilizes agency electronic health care system in adherence to required
standards of operating procedures including HIPAA regulations, per
clinical site.*
4 48. Utilizes bar coding for medication administration per hospital
standards. *

Overall Student/Faculty Mid-Term Evaluation (number score) _185/196___/________

AVERAGE __94.4______/________See comments (attached).

Overall Final Faculty Evaluation (number score) __________________ AVERAGE_________See

comments (attached).
 Bryant & Stratton College

Mid-Term Evaluation Summary

Name: _Vanessa Benning____________________ Semester: Fall 2018_____________________

Course: _Med Surg__________________________ Clinical Site: St. Lukes 3EF________________

Student completes these 3 areas and submits to clinical instructor for faculty comments:

Identification of Strengths
- Bedside manner and patient interaction
- Ability to self-direct and also delegate
- Powerful organization skills
- Willingness to ask questions or ask for help if needed
- Leadership mentality
- Able to think critically and problem solve
- Passion for nursing and patient care
- Empathy and compassion for others
- Able to communicate and speak clearly so that both collaborators and patients know the message
- Ability to handle difficult situations calmly and logically when they arise
- Able to multitask
- Quick learner when presented with instruction
- Flexibility (I am able to switch from one patient or task to another without strain)
- Appropriate with time management
- Attention to detail
- Understanding of the importance in policy and procedure
- Willingness to learn
- Professionalism

Areas for Development

- Managing my fatigue : This is more personal that has been somewhat effecting me this semester. I have a
serious health problem that is leaving me fatigued and at times sick. Figuring out what is ailing me, and getting it
under control is something I need to continue working on. Also knowing my limits and taking a break if needed.
- Introducing more teaching into my daily plan with the patients
- Continuing my education and devoting more time to it
- Teamwork and communication with my other fellow students

Plan for Improvement

- Taking breaks as needed, and working with my physicians outside of school in order to find a plan that suits my
health best. I tend to “go-go-go” and not take pauses. Taking some little moments off my feet or just meditating for 5
minutes could really help with the fatigue and get me re-centered
- Coming up with a list at the beginning while getting report of items I want to teach to the patient. Then taking
some time after morning meds to get those education items in order.
- Finding a way to balance my homelife and studying to really be able to understand the topics being discussed in
lecture. Taking time when my illness is not as bad to really go over some of the book pages and topics.
- Finding patience and being a more active listener to my teammates
Faculty Comments:

Student Signature__Vanessa Benning_____________________________/Initials_VB______

Faculty Signature_______________________________/Initials_______

Date__10/26/18_____________

Bryant & Stratton College

Final Evaluation Summary

Name: ___________________________________ Semester: ___________________________

Course: _________________________________ Clinical Site: __________________________

Student completes these 3 areas and submits to clinical instructor for faculty comments:

Identification of Strengths
- Determination
- Provide patient centered care
- Always willing to go a step above the minimum requirement
- Always lend a helping hand to my peers when needed
- Provide thoughtful reflection
- Give respect to my patients and peers
- Allow the patient to be in charge of their treatment and be their advocate
- Always finding ways to educate the patient
- I follow policies and procedures set forth by the college and institution
- I exert creativity and critical thinking
- I follow all safety precautions and keep a clean working environment
- I am always willing to learn, and welcome constructive criticism
- I keep a positive attitude
- I am an active listener to both my peers, and the patients
- I show patience when dealing with the patient population
- I give lots of one on one attention to my patients, and also am able to read situations where they may want more
privacy
- I work well in fast paced and stressful environments
- I am able to persevere with any obstacles ( still completing my work and communicating with school and my
professors about the illness I had this semester)
- I am able to multi-task
- I show leadership abilities and qualities

Areas for Development

- I need to practice my skills more in the working environment
- Finding better ways of time management, and delegating more if overwhelmed (I tend to want to tackle every task
right away, and rarely ask for help unless absolutely needed)
- More balance with home and school
- To become more aware of laboratory result findings, and diagnosis rationale
 Plan for Improvement
- To watch more videos and practice with more case studies in my spare time
- To continue with clinicals being open with the nurses and practice asking for them to show me more skills
- To take more time delegating some tasks at busy times to the assistive personnel
- To make a timeline of study time at home as to get all my study time complete and not overwhelming

Faculty Comments:

Student Signature_________________________________

Faculty Signature_________________________________ /Initials_______

Date_______________