LINCOLN MEMORIAL UNIVERSITY

School of Nursing
CLINICAL OUTCOMES TOOL GUIDE
This tool is used to evaluate student performance in the clinical setting in conjunction with the Associate Degree in
Nursing courses. This evaluation tool follows objectives and guidelines which are included in the CLINICAL
OTCO!"# TOOL $ID". In addition% the guide gives e&amples of behaviors that would be demonstrated b' the
student in order to receive a satisfactor' for the items in this evaluation tool. This tool is based on the ANA(s Clinical
#tandards for Nursing )ractice* as designated in the CLINICAL OTCO!"# TOOL $ID". The identified
behaviors are consistent with the Adaptation nursing theor' of #ister Callista +o'.*
EVALUATION CRITERIA
5 = EXCELLENT ,The clinical objective has been met with a high level of competenc'% be'ond e&pectation.-
= A!OVE AVERAGE ,The clinical objective has been met at a level e&ceeding e&pectation-
" = AVERAGE #The clinical objective has been met b' the student.-
$ = !ELO% AVERAGE ,The clinical objective has been minimall' met b' the student.-
& = UNSATIS'ACTORY ,The clinical objective has not been met b' the student.-
,An unsatisfactor' rating on an' clinical objective that has been identified as
critical for that particular semester will result in unsatisfactor' clinical grade.-
N(A . NOT A))LICA!LE ( NOT O!SERVED #This indicates that the clinical objective was either not
observed or not applicable in that clinical setting.-
#E*ch UNSATIS'ACTORY or NEEDS IM)ROVEMENT r*+ing ,us+ inclu-. *n ins+ruc+or/s co,,.n+ *n- -*+.01
CLINICAL O!2ECTIVES
/I+#T #"!"#T"+ 0 clinical objective met with assistance for instructor.
#"COND #"!"#T"+ 0 clinical objective met with minimal assistance from instructor.
T1I+D #"!"#T"+ 0 clinical objective met with supervision from instructor.
/O+T1 #"!"#T"+ 0 clinical objective met with minimal supervision from instructor.
Listed below are the evaluation categories with the corresponding ANA S+*n-*r-s of Nursing )r*c+ic..
2
"ach behavioral item from the CLINICAL OTCO!"# TOOL is listed. These items are followed b'
criteria for satisfactor' behaviors which indicate student progression. The semester in which these items
are critical behaviors is designated b'3
,2- 0 /irst #emester 4 ,5- 0 #econd #emester 4 ,6- 0 Third #emester 4 ,7- 0 /ourth #emester.
/rom that semester until the program is completed% that objective must be attained.
American Nurses Association. ,2889-. #tandards of Nursing )ractice. :ansas Cit'% !O3 American Nurses )ublishing.
+o'% C.% ; Andrews% A. A. ,2888-. The +o' adaptation model ,5nd ed.-. Norwal<% CT3 Appleton and Lange.
SECTION I 3 STANDARDS O' CARE #SO)1 #Nursing )roc.ss1
ASSESSMENT #SOC I1
&0 #&1 Coll.c+s *44ro4ri*+. 4*+i.n+ infor,*+ion +o for, * +horough *n- org*ni5.- -*+* 6*s. for 4*+i.n+ c*r.0
,2- 0 +eviews the patient(s chart% :arde&% and medication records.
,2- 0 Obtains appropriate histor' information from the patient and famil'.
,2- 0 $ets report from members of the health care team to clarif' information
and provide for continuit' of care.
,5- 0 Organi=es and records data as directed.
,5- 0 Identifies individual and famil' learning and discharge needs.
,6- 0 )rioriti=es data collection based on patient(s condition.
$0 #$1 ).rfor,s +horough *n- *ccur*+. 4h7sic*l *ss.ss,.n+s0
,2- 0 Obtains and records vital signs% inta<e 4 output% height 4 weight accuratel'.
,5- 0 Documents assessment findings accuratel' in appropriate records.
,5- 0 Identifies changes in patient(s health status and ta<es action when necessar'.
DIAGNOSIS #SOC II1
"0 #$1 An*l75.s -*+* +o i-.n+if7 *44ro4ri*+. nursing -i*gnos.s0
,2- 0 #elects and documents appropriate nursing diagnoses.
,5- 0 Identifies actual or potential problems that threaten or promote adaptation.
OUTCOME IDENTI'ICATION #SOC III1
0 #&1 I-.n+ifi.s *44ro4ri*+. 4*+i.n+ ou+co,.s0
,2- 0 Derives outcomes from written nursing diagnoses.
,2- 0 "stablishes desired patient outcomes as realistic and obtainable goals.
,5- 0 Documents outcomes appropriatel'.
,6- 0 )articipates with patient% famil' and health care team to establish patient0centered
outcomes which promote health% prevent illness% and provide for rehabilitation.
)LANNING #SOC IV1
50 #"1 Cr.*+.s *n- -ocu,.n+s * 8.ll9-.:.lo4.- 4l*n of c*r.0
,5- 0 Develops a plan of care with input from the patient% famil'% other members of the health care team.
,5- 0 Includes appropriate patient and famil' learning and discharge needs.
,5- 0 Creates a plan that provides for continuit' of care.
,6- 0 Incorporates patient(s cultural and spiritual beliefs in plan of care.
,6- 0 Incorporates patient(s ph'siologic% ps'chosocial% developmental needs%
and patient strengths in plan of care.
;0 #$1 Es+*6lish.s 4riori+i.s for nursing c*r.0
5
IM)LEMENTATION #SOC V1
<0 #$1 )ro:i-.s *44ro4ri*+. in+.r:.n+ions 6*s.- on +h. 4*+i.n+/s 4l*n of c*r.0
,5- 0 Implements plan of care according to the patient(s needs and established priorites.
,5- 0 /ollows prescribed medical regimen for the patient undergoing diagnostic tests%
therapeutic procedures% and 4 or surger'.
,5- 0 Implements appropriate teaching plans specific to patient(s learning and discharge needs.
,6- 0 tili=es communit' resources when appropriate.
,7- 0 )romotes the patient(s optimum level of functioning and adaptation to changes in health status.
=0 #&1 )ro:i-.s for 4h7siologic h.*l+h *n- s*f.+7 of +h. 4*+i.n+ *n- o+h.rs0
,2- 0 /ollows universal precautions when providing care.
,2- 0 /ollows isolation policies when applicable.
,2- 0 )rovides for patient(s h'giene needs.
,5- 0 Implements necessar' care for the bed0ridden% immobili=ed% or unconscious patient.
>0 #&1 D.,ons+r*+.s s*f. 4.rfor,*nc. of nursing s?ills0
,2- 0 Administers medications safel' and correctl' and documents appropriatel'.
,2- 0 /ollows established hospital policies% procedures% protocols% and routines.
,2- 0 Demonstrates understanding of aseptic techni>ue when providing patient care.
,5- 0 Administers parenteral fluids safel' and documents appropriatel'.
&@0 #&1 U+ili5.s +h.r*4.u+ic co,,unic*+ion s?ills in in+.r*c+ions 8i+h +h. 4*+i.n+ *n- 4*+i.n+/s f*,il70
&&0 #&1 D.,ons+r*+.s *ccur*+. *n- *44ro4ri*+. ch*r+ing *n- 8ri++.n co,,unic*+ion0
&$0 #"1 Incor4or*+. .ff.c+i:. +.*ching 9 l.*rning s+r*+.gi.s +o 4ro,o+. 4*+i.n+ *n- f*,il7 *-*4+*+ion
+o h.*l+h c*r. n..-s0
&"0 #$1 )ro,o+.s 4s7chologic*l s*f.+7 of 4*+i.n+s0
&0 #&1 M*?.s -.cisions 6*s.- on ?no8l.-g. of f*c+s *n- soun- Au-g,.n+0
&50 #1 )ro:i-.s for con+inui+7 of c*r. in +h. ,*n*g.,.n+ of h.*l+h c*r. n..-s0
EVALUATION #SOC VI1
&;0 #$1 D.+.r,in.s +h. .ff.c+s of nursing in+.r:.n+ions on +h. 4*+i.n+0
,7- 0 )articipates with the patient% famil'% and health care team to evaluate the
patient(s progress towards written outcomes.
&<0 #"1 R.:is.s 4l*n of c*r. 6*s.- on ongoing *ss.ss,.n+s0
SECTION II 3 STANDARDS O' )RO'ESSIONAL )ER'ORMANCE #SO))1
BUALITY O' CARE #SO)) I1
&=0 #&1 Is * r.li*6l. *n- consci.n+ious c*r.gi:.r0
,2- 0 #pends time with patients.
,2- 0 Is conscientious? follows through with responsibilities.
,6- 0 #erves as an advocate for patients.
&>0 #"1 Is s.lf9-ir.c+ingC *ssu,.s ini+i*+i:. 8h.n *44ro4ri*+.0
$@0 #1 )ro:i-.s c*r. for * grou4 of 4*+i.n+s 6*s.- on 4riori+7 of n..-s0
6
)ER'ORMANCE A))RAISAL #SO)) II1
$&0 #&1 Assu,.s r.s4onsi6ili+7 for his ( h.r o8n *c+ions0
$$0 #&1 Acc.4+s cons+ruc+i:. cri+icis, 8.ll *n- u+ili5.s sugg.s+ions for i,4ro:.,.n+0
$"0 #&1 R.4or+s +o clinic*l 4r*c+ic. *n- conf.r.nc.s on +i,.0
,2- 0 Notifies instructor if he 4 she is going to be late or absent.
$0 #&1 Dr.ss.s *44ro4ri*+.l7 in +h. clinic*l s.++ing0
,2- 0 /ollows the L! niform polic'.
,2- 0 @ears nametag at all times.
$50 #1 Org*ni5.s +i,. *n- is .ffici.n+ in 4.rfor,ing nursing c*r.0
EDUCATION #SO)) III1
$;0 #&1 )*r+ici4*+.s in 4r. ( 4os+ conf.r.nc.s0
$<0 #&1 Turns in co,4l.+.- 8ri++.n *ssign,.n+s on +i,.0
0
COLLEGIALITY #SO)) IV1
$=0 #"1 Coo4.r*+.s 8i+h *n- su44or+s o+h.r ,.,6.rs of +h. h.*l+h c*r. +.*,0
ETDICS #SO)) V1
$>0 #&1 Con-uc+s s.lf in *n .+hic*l ,*nn.r0
,2- Is truthful in dealings with patients% families% health care team members and instructors.
"@0 #&1 A44li.s l.g*l i,4lic*+ions of nursing 4r*c+ic.0
"&0 #&1 M*in+*ins confi-.n+i*li+7 r.g*r-ing 4*+i.n+ infor,*+ion0
"$0 #&1 M*in+*ins * non9Au-g,.n+*l *++i+u-.0
COLLA!ORATION #SO)) VI1
""0 #$1 R.cogni5.s his ( h.r o8n s+r.ng+hs *n- 8.*?n.ss.s *n- s..?s *ssis+*nc. 8h.n n.c.ss*r70
"0 #&1 Co,,unic*+.s *44ro4ri*+.l7 *n- r.s4.c+full7 8i+h o+h.r ,.,6.rs of +h. h.*l+h c*r. +.*,0
,2- 0 Aerball' communicates patient information to other members of the health care team when needed.
,5- 0 )rovides for continuit' of care through receiving and giving reports about patient status and plan of care.
RESEARCD #SO)) VII1
.
"50 #1 Incor4or*+.s *44ro4ri*+. r.s.*rch fin-ings0
,7- 0 tili=es a variet' of resources to incorporate evidence0based practice into plan of care
and 4 or other assignments.
RESOURCE UTILIEATION #SO)) VIII1
";0 #1 )ro:i-.s 4*+i.n+ c*r. u+ili5ing o+h.r 4.rsonn.l in r.g*r-s +o +h.ir .-uc*+ion*l 4r.4*r*+ion *n-
.F4.ri.nc.0
7