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APPENDIX FF

.-..

l..Arl.U·,t'C-; .... : j;; n Student Name _1 __ ~_\,,_V'-_.,_~I'J

OEP!\RTMENT OF NURSING

NSG 315A CLINICALEV AL UA TION TOOL

Midterm : M = Meeting expectation; P = Progressing; NI = Needs Improvement Final: S = Satisfactory' U = Unsatisfactory

.~ .-

.'. "'.--' -

s:> . u "

Provide nursing care to the pediatric patient and the family effectively:

- Perform basic nursing skills safely and e ffectively.

- Administer nursing care based on the patient's present developmental phase and bie-psycho-social-cultural-spiritual situation.

- Determine the patient's priority of needs and plan care accordingly.

- Complete nursing care for at least two pediatric patients on time using an organized and efficient approach.

- Administers IV medications safely with guidance of'instructor

Utilize the nursing process to administer cafe to the' pediatric with clearly defined, commonly occurring health care needs and problems.

v

Iv

- Collect data on the patient'S healthstatus in a systematic and objective manner using the system's review.

- Assess the data considering the normal physiologic and psychologic parameters of the pediatric experience and identi fy theassets and

, deficits 0 fthat experience.

- State a nursing diagnosis for each actual or poternlal problem which

has been identified from the patient's health assessment. ,

- Devise a nursing care plan which provides nursing interventionsto the patient as needed and reflects awareness of rhe priority problems . in the care of the patient.

- Implement the plan of care and state the rationale for the nursing intervent ions.

Provide basic health information to the patient and the family du ring the patient's hospitalization.

• Evaluate the effectiveness ufIhe care based on the stated expected outcomes or goals of care.

- Assess the patiern/farni Iy to ii'ssess the patient/ram ily's as to their learning needs.

· Implement a standard teaching plan to meet the patient's learning needs at a developmentally appropriate level

· Eva luare the effect i ve ness 0 f the leach i ng/l earn ing experi e nee.

National University

Page 50

February - March 2009

- Utilize therapeutic comm u nication skills guidance and support
in interacting with pediatric patient and the family. Record
observa tions in proper seq uence and format.
- Stat" own feelings in response to the pediatric patient's and/or ,./ I~
family's verbal and/or non-verbal expression of feelings.
- Identify 'own values which may enhance or hinder effective v- I .>
communications with other.
- Recognize own behavioral responses which may be conditioned by V" .>
own culture and experiential backzround.
- Provide developmentally appropriate therapeutic and supportive r/ I /
communication to the pediatric patient and the family.
- Communicate and report pertinent observations and inferences ro V V'
appropriate personnel i.e. instructor, team leader. etc. promptly.
- Record medications, treatments and subjective/objective V l/'
observations properly in the patient's record.
Assume responsibility [or personal and professional growth in I
the pediatric setting.
- Accept responsibility for one's own actions/behaviors, v .>
- Report promptly to clinical laboratory and pre/post conferences. V if
- Constructively use instructor's feedback by initiating appropriate v' V
actions in subsequent written work or clinical behavior.
- Implement learning goals and objectives and seek appropriate v' Iv
resources to achieve them,
- Identify specific experiences in clinical practice which V ./
are needed to accomplish learning objectives,
- List [hose experiences in clinical practice where assistance is 0/ V
needed,
- Contribute EO the growth of self and classmates by sharing learn ing v'" I .>
experiences on the clinical units during pre and post conferences.
- Evaluate own clinical and academic performance based on these ~ Iv
course objectives by completing andtuming in the monthly student
clinical self-evaluation forms.
_L C{(j'l 'I \, ',,'1.( t LU1"hi r '-ITt cLr')'1,'e i,U tll,f rrH, ca Or ,:'I ttl National University

Page 51

February - March 2009

DEPARTMENT OF NURSING

NSG 325A CLINICAL EVALUATION TOOL

* Mid = ~1I2 way through course * U = Unsatisfactory

* Final = at the end oftbe course ~ * S = Satisfactory

NT = Needs Im t; IP = InProgress; P = ~~~MI!

Student N arne . ~D Student ID # . - _~-r>

~~~~

Complete nursing care for assigned patients on time using an organized and efficient approach.! participates in planning, and intervention

or potential problem ealth assessment.

a nursing care plan provides nursing interventions to

the patient as needed and reflects awareness of the priority problems in the care of the

Implement the plan of care and state the rationale for the nursing interventions.

Evaluate the effectiveness of'the care based on the stated expected Is of care.

Identify hospital and community resources ava their families; make referrals following consultation with healthcare I P team or instructor.

26

p

f

p

Mid -Term Student Comments:

r tlf!V1. tf1Jvvt'tVj 'tJ1.Pr;(. V() rCL.[..' ftr't c 'r I ru: ~

Mid-Term Faculty Comments:

Course End Faculty Comments;

Faculty SignaturelD.t~~,.b

Revised Aug. 2007 '~

I

/

I

,/

"

,!~~: "it trliJ.ifL, Student SignaturefDate--"TL-''''''''- _ ____':;____:::;''__:~'f--_ :::0"./ /'

.1h,iLoi 7 jl c,l

27