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5-Outstanding: Exceeds Standards Exhibits above average performance of nursing care for this
level student. The student is proactive, self-directed, and consistently engaged in learning; needs
minimal guidance; is knowledgeable; and appropriately incorporates knowledge with skills.
Student is proactive and self-directed in approach to learning. 4-Satisfactory: Meets Standards
Exhibits average performance of nursing care for this level student. Functions with minimum
guidance. Demonstrates adequate knowledge and requires minimum assistance in applying
knowledge to skills. Recognizes learning opportunities but may require assistance in utilizing
them. 3-Minimal Exhibits minimal performance of nursing care for this level student. Functions
safely with moderate guidance. Demonstrates minimal knowledge and requires moderate
assistance in applying knowledge to skills. Requires some direction in recognizing and utilizing
learning opportunities. Often focuses on the task or own behavior, not on the patient. 2Unsatisfactory Requires intense guidance for the performance of activities at a safe level.
Clinical performance reflects difficulty in the provision of nursing care. Demonstrates gaps in
necessary knowledge and requires frequent or almost constant assistance in applying knowledge
to skills. Requires frequent and detailed instructions regarding learning opportunities. Focuses
primarily on the task or own behavior, not on the patient. 1-Unsafe to Practice Is unsafe to
practice without constant, intense guidance. Frequently lacks necessary knowledge and skills and
unable to integrate these into practice. Requires constant detailed instructions regarding learning
opportunities and is often unable to utilize them. Attempts activity or behavior, yet is unable to
complete. Focuses entirely on the task or own behavior, not the patient.
Standard I--Communication The student communicates pertinent information regarding
the patient's condition/concern to health team members.
Answer: 3
Minimal
Comment:
Standard I--Communication The student communicates effectively in written form
(Nursing Process Worksheet is organized and complete)
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication The student communicates effectively in verbal form.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication The student initiates, maintains, and terminates the nursepatient relationship using principles of therapeutic communication.
Answer: 3
Minimal
Comment:
Standard I--Communication The student functions as an advocate for the patient/family
and communicates family needs to other members of the health care team.
Answer: 3
Minimal
Comment:
Standard I--Communication The student examines the dynamic interactions between the
patient, family, community, and society.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication The student initiates discussion to identify and resolve
interpersonal problems that impact care.
Answer: 3
Minimal
Comment:
Standard I--Communication The student uses interpersonal skills to enhance
patient/family coping abilities.
Answer: 3
Minimal
Comment:
Standard I--Communication The student discusses the ethical issues and approaches the
ethical dilemmas that confront the patient/family and appropriately discusses experience
with faculty/preceptor.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication The student delegates appropriately to patient care
technician, family, or other team members.
Answer: 3
Minimal
Comment:
Standard I-Knowledge The student applies knowledge of humanities, physical and social
sciences, and nursing when providing patient care.
Answer: 3
Minimal
Comment:
Standard I-Knowledge The student applies knowledge of social, cultural, and genetic
factors to the care of diverse populations.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I-Attitude The student does not in anyway demonstrate disrespect or
inappropriate behavior to the patient, staff, or faculty
(Comment
Answer: 5
Outstanding: Exceeds Standards
Required)
Comment: Always very respectful - where some may show frustration this has never been
seen in Ms. Dean's actions.
Standard I-Attitude The student is actively engaged in and seeks out opportunities for
learning.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety The student does not make judgmental, discriminatory, or prejudicial
statements to the patient, staff, or faculty.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety The student applies principals of universal precautions, practices
specific isolation techniques, and teaches the reasons for universal precautions.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety The student assesses patients for fall risk and applies principles of safe
patient handling.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety The student maintains the patient's physical safety by protecting the
patient from harm.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety The student maintains medical and surgical asepsis when doing
Comment:
Standard III-Nursing Process:Intervention/Implementation The student implements the
written action plan/protocol considering the priorities for each assigned patient.
Answer: 3
Minimal
Comment:
Standard III-Nursing Process:Intervention/Implementation The student implements a
teaching plan based on scientific knowledge and utilizes resources appropriately.
Answer: 3
Minimal
Comment:
Standard III-Nursing Process:Intervention/Implementation The student incorporates
evidence based research into nursing practice.
Answer: 3
Minimal
Comment:
Standard III-Nursing Process:Intervention/Implementation The student practices
individualized and culturally competent care.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard III-Nursing Process:Intervention/Implementation The student initiates
appropriate referrals as needed.
Answer: 3
Minimal
Comment:
Standard III-Nursing Process:Evaluation The student evaluates the patient's
response/outcome to the intervention.
Answer: 3
Minimal
Comment:
Standard III-Nursing Process:Evaluation The student utilizes subjective and objective
data to revise nursing actions (as appropriate for the student at that level of the
curriculum).
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard III-Nursing Process:Organization The student provides organized, coordinated,
and prioritized nursing care for the patients with a range of health problems.
Answer: 3
Comment:
Minimal
Standard III-Nursing Process:Documentation The student correctly enters data into the
patient record in a timely manner per agency protocol.
Answer: 3
Minimal
Comment:
Standard III-Nursing Process:Documentation The student assures privacy of the patient
record at all times.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard III-Nursing Process:Critical Thinking The student utilizes critical thinking skills
to prioritize patient needs based on the patient assessment.
Answer: 3
Minimal
Comment:
Comments:
Ms. Dean I have seen growth in you this semester. You are always professional and are eager to
learn. You apply what you have learned in didactic to your clinical experience. You have wellwritten papers that shows you take pride in work. I can tell your comfort level improved greatly
the last time I saw you on the floor. You have very successfully passed your fundamental
clinical.