Carroll Community College

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

Brooke Edens

Faculty
Teresa Sparhawk
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
S
Establishes nursing diagnoses based on patient assessment.
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
*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.
S
S
*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
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
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
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
S
*Identifies safety concerns and notifies instructor and appropriate healthcare team members.
S
S
Demonstrates initiative in assisting peers and healthcare team members in the clinical setting.
S
S
Demonstrates communication skills using SBAR.
S
S
Acts as an advocate for patients and families.
S
S
Approved 12/41/4. Revised 12/9/2014

Date

3/20/16

Location HCGH

Carroll Community College

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

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.
Student Reflection Looking back on the rotation:

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

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

How have you grown as a nurse? Please explain and use specific examples.
I am more confident in myself when dealing with patients now. (Not all the way confident, but getting there!)
I feel like I have grown more independent in the clinical setting during my day.
I have a better idea of what is expected of me as a nurse.
I have the skills to deal with a variety of different types of patients.
I have learned that asking for help is not a failure.

Preceptor/Instructor comments/ Student Learning Goals: (**If an item was identified as N or U, narrative
comments are necessary to clarify student performance**)
I am very proud of Brookes performance in the clinical setting. She has been a delight to work with. She has
demonstrated confidence, poise, and a true passion for nursing. She was professional, attentive to her
patients, organized, and truly excited about her learning experiences. Brooke will be an asset to the nursing
profession. Best wishes Brooke!

Student Signature:

Brooke Edens

Date:

3/20/16

Date:

3/24/16

Teresa Sparhawk MSN, RN

Preceptor/Instructor Signature:

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