Carroll Community College

Department of Nursing
NURS 242 Nursing Concepts 4
Student Clinical Performance Evaluation SUMMATIVE
Student

Rhodes

Faculty
Taylor
N/A = Not
S = Satisfactory
N = Needs Improvement U = Unsatisfactory
(*) Critical behavior
applicable
Students who meet any of the following criteria will be given a remediation plan and may be placed on probation.
Failure to progress in these areas may result in failure of the course.
-One unsatisfactory grade in a critical behavior
-Two needs improvements in a critical behavior
-Two unsatisfactory grades in a non-critical behavior
-Four needs improvements
Student Instructor
Outcome 1
SelfEval of
Evaluate the effectiveness of a plan of care using the nursing process to achieve patient
Eval
Student
outcomes.
S/N/U
S/N/U
Collects evidence related to assigned patient(s) from appropriate resources.
S
S
*Demonstrates accurate patient assessment skills.
S
S
Establishes nursing diagnoses based on patient assessment.
S
S
*Prioritizes patient care based on assessment.
S
S
Identifies measurable patient outcome based on nursing diagnosis.
S
S
Implements care according to established plan and desired outcomes.
Uses therapeutic communication techniques during nurse/patient interactions to facilitate the
S
S
nursing process.
*Identifies appropriate interventions based on assessment.
S
S
S
S
*Demonstrates knowledge of medications for assigned patients.
S
S
*Administers medication safely using six rights of medication administration.
S
S
*Implements appropriate infection control precautions.
S
S
Follows through with all patient care.
*Evaluates patient response to care and revises plan as needed.
S
S
Student Instructor
Outcome 2
SelfEval of
Assimilate into the profession of nursing with a commitment to lifelong learning and personal and
Eval
Student
professional growth.
S/N/U
S/N/U
S
Participates actively in all aspects of the clinical experience.
S
S
Discusses patients plan of care with instructor.
S
S
Demonstrates professional behavior and appearance.
S
S
Engages in self-reflection and communicates learning needs to instructor/preceptor.
S
S
Completes assignments as required and submits on time.
S
S
Organizes time efficiently.
S
Student Instructor
Outcome 3
SelfEval of
Provide culturally competent, holistic care using respectful and caring behaviors.
Eval
Student
S/N/U
S/N/U
Demonstrates caring behaviors with the ability to develop and maintain therapeutic relationships
S
with people from diverse backgrounds.
S
Considers patient values, cultural characteristics and religious differences when planning care.
S
S
Student Instructor
Outcome 4
SelfEval of
Collaborate with healthcare teams to provide patient-centered care.
Eval
Student
S/N/U
S/N/U
S
Identifies patient/family health education needs.
S
S
Implements patient and family education.
S
S
Seeks input from patient, instructor, peers, and healthcare team in the delivery of patient care.
S
S
*Updates instructor and healthcare team regarding changes in the patients condition.
S
Approved 12/41/4. Revised 12/9/2014

Date

03/18/16

Location

CHC

Carroll Community College

Department of Nursing
NURS 242 Nursing Concepts 4
Student Clinical Performance Evaluation SUMMATIVE
*Identifies safety concerns and notifies instructor and appropriate healthcare team members.
Demonstrates initiative in assisting peers and healthcare team members in the clinical setting.
Demonstrates communication skills using SBAR.
Acts as an advocate for patients and families.
Outcome 5
Model a spirit of inquiry that supports evidenced-based practice.
Applies evidenced-based rationale that supports the patients plan of care.
Integrates knowledge from nursing and other disciplines to plan care.
Outcome 6
Practice within legal and ethical principles to deliver safe and competent care based on current
standards of practice.
Adheres to attendance policy.
*Demonstrates safe clinical practice.
*Provides nursing care based on the policies and procedures of the facility.
*Maintains legal accountability for nursing practice in accordance with the Maryland Nurse
Practice Act.
*Adheres to HIPAA guidelines regarding patient confidentiality.
*Provides care according to the ANA Nursing Scope and Standards of Practice.
*Demonstrates accountability and responsibility for own actions and attitudes.
Outcome 7
Research and communicate information through appropriate technology.
Gathers data from the electronic medical record to provide patient care.
Uses electronic medical record to document patient care accurately and in a timely manner.

S
S
S
S
Student
SelfEval
S/N/U
S
S
Student
SelfEval
S/N/U
S
S
S
S
S
S
S
Student
SelfEval
S/N/U
S
S

S
S
S
S
Instructor
Eval of
Student
S/N/U

S
S
Instructor
Eval of
Student
S/N/U

S
S
S
S
S
S
S
Instructor
Eval of
Student
S/N/U

S
S

Student Reflection Looking back on the rotation:

How have you grown as a nurse? Please explain and use specific examples. Looking back
on this rotation I feel I have gained confidence in my ability to provide excellent patient
centered care. I was able to use my skills and to build on them as well as use my critical
thinking skills. The learning atmosphere was excellent at this facility the nurses and
instructor were extremely open to questions and always willing to share their knowledge.
This rotation has also allowed me several opportunities to shadow other nursing careers
within the hospital such as wound care, critical care, and the cardiac cath lab. I especially
enjoyed our post conferences where Professor Taylor would have other areas of the hospital
come talk to us like palliative care and respiratory. I feel I have gained a wealth of
knowledge this rotation and it has better prepared me to take on my own nursing journey
here in a few short months. I also feel I demonstrated numerous times this semester how I
am a team player and am always willing to provide a helping hand to my fellow colleagues
whenever the need arises.
Preceptor/Instructor comments/ Student Learning Goals: (**If an item was identified as N or U, narrative
comments are necessary to clarify student performance**)

Tiffany has a gift of communication and caring with her patients, their families, her
peers and the nursing staff. In a ny given situation, Tiffany was able to learn and also
provide excellent care to here patients and their families. Tiffany is very quickly able to
identify acute situations and clinical changes in her patients. Tiffany is always looking
Approved 12/41/4. Revised 12/9/2014

Carroll Community College

Department of Nursing
NURS 242 Nursing Concepts 4
Student Clinical Performance Evaluation SUMMATIVE

for new experiences and makes the most of every opportunity she is provided. She is
very thorough at medication passes and her patient care is always complete.
Moving forward Tiffany will thrive in any environment she is placed in. It was a
pleasure watching her grow in knowledge and confidence over these 6 weeks.

Student Signature:

Tiffany Rhodes

Date:

03/18/2016

Preceptor/Instructor Signature:

Alyson Taylor, BSN

Date:

3/18/2016

Approved 12/41/4. Revised 12/9/2014