Carroll Community College

NURS 233 – Nursing Concepts 3

SUMMATIVE Student Clinical Performance Evaluation

Student Sara Brewer Date 10/24/2019 Week # 6 Faculty McIntosh

S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not applicable (*) Critical behavior
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
Self- Eval of
Outcome 1 Eval Student
Analyze the effectiveness of the plan of care (CO1) S/N/U S/N/U
1. *Prioritizes patient care based on assessment with faculty as a resource S S
2. *Demonstrates accurate patient assessment skills S S
3. Analyzes and incorporates data from the patient’s medical record in the provision of care S S
4. Uses patient assessment data to implement individualized plan of care with faculty as a S
resource S
5. Establishes appropriate nursing priorities list based on collected evidence and patient S
assessment with faculty as a resource S
6. Establishes measurable patient outcomes based on nursing priorities with faculty as a S
resource S
7. Establishes appropriate nursing interventions based on assessment with faculty as a S
resource S
8. Evaluates patient response to care and revises plan as needed with faculty as a resource S S
Student Instructor
Self- Eval of
Outcome 2 Eval Student
Seek opportunities that promote professional growth (CO2) S/N/U S/N/U
9. Demonstrates professional behavior and appearance S S
10. Seeks input from patient, instructor, and healthcare team in the delivery of patient- S
centered care S
11. *Demonstrates accountability and accepts responsibility for own actions and attitudes S S
12. *Adheres to attendance policy S S
13. Participates actively in all clinical experiences S S
14. Engages in self-reflection and communicates learning needs to instructor S S
15. Completes assignments as required and submits on time S S
16. Demonstrates initiative in assisting peers and healthcare team members in the clinical setting S S
Student Instructor
Self- Eval of
Outcome 3 Eval Student
Provide patient-centered care with faculty as a resource (CO3) S/N/U S/N/U
17. *Implements appropriate infection control precautions S S
18. Provides culturally sensitive care S S
19. Documents patient care accurately S S
20. Uses therapeutic communication skills S S
21. Follows through with all patient care S S
22. Demonstrates knowledge of medications for assigned patients S S
23. *Administers medication safely using six rights of medication administration S S
24. Demonstrates caring behaviors S S
25. Uses SBAR effectively S S
26. Acts as an advocate for patients and families S S
Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18
 Carroll Community College
NURS 233 – Nursing Concepts 3
SUMMATIVE Student Clinical Performance Evaluation

27. *Demonstrates physical and mental competence S S

28. *Identifies safety concerns and notifies instructor and appropriate healthcare team S
members S
29. Demonstrates time management techniques S S
30. Implements patient and family education and evaluates effectiveness of teaching S S
31. *Updates instructor and healthcare team regarding changes in the patient’s condition S S
32. *Provides nursing care based on the policies and procedures of the facility S S
33. *Provides nursing care in accordance with the Maryland Nurse Practice Act S S
34. *Adheres to HIPAA guidelines S S
35. *Provides care according to ANA Scope and Standards of Nursing Practice S S
Student Instructor
Self- Eval of
Outcome 4 Eval Student
Implement nursing care based on scientific evidence (CO4) S/N/U S/N/U
36. Incorporates evidence-based rationale that supports the patient’s plan of care S S
Student Reflection (Thoroughly answer all questions)
How has this clinical rotation helped to define your role as a nurse? Please explain.
This clinical rotation helped define my role as a nurse by bringing forth critical thinking skills. I have learned to
work backwards from the diagnosis which helps me break down all the parts that contribute to their
hospitalization. I have also learned a lot about the cardiovascular system that I can bring forth into any
specialty that I decide to pursue.

Which objective did you accomplish during this rotation? How did you do it?
The objective I accomplished during this rotation would be critical thinking. Every patient was different, even if
they may have had the same procedure done. For example, one could be on a medication for PVC’s post-
surgery and another may not need it. For the patient who needs the medication you would need to check their
electrolytes to see if they are low on Mg or K. If you fix the electrolyte imbalance it may resolve the PVC’s.
Same goes for the rate of healing. You need to ask yourself why one patients healing is faster than another.
The answer could be as simple as one patient has diabetes and the other doesn’t.

What are your goals for your next clinical rotation?

My goals for my next clinical rotation are to keep working on a routine that ensures things are done on time as
far as meds, assessments, charting, etc. without compromising time with my patients to establish trust. In
addition, I would like to be more familiar with different medications that are typically used.

Faculty Comments/ Student Learning Goals (Goals must be established even if performance is satisfactory.
If an item was identified as N or U, narrative comments are necessary to clarify student performance along
with goals to improve performance).

Sara is a motivated student who strives to “put the pieces together” regarding all aspects of her patient’s care.
She is readily able to link basic concepts in relation to her patients’ histories, diagnoses, and plans. She treats
her patients holistically; has a keen awareness of and consistently addresses their emotional needs (she is
one of the most proficient at this in her clinical group.) She interacts personably and professionally with
hospital staff. She administered medications in a safe and timely fashion on one clinical day – these included a
subcut injection and IV piggyback. She gained experience with chest tubes, wound vacs and IV gtts like
dobutamine.
She had 1 clinical absence during this rotation.
Moving forward, Sara can continue to hone her time management and organization skills.

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18

 Carroll Community College
NURS 233 – Nursing Concepts 3
SUMMATIVE Student Clinical Performance Evaluation

Student Signature: Sara A. Brewer Date:10/24/19

Instructor Signature: Date: 10/27/19

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18