Carroll Community College

Department of Nursing
NURS 242 Nursing Concepts 4
Student Clinical Performance Evaluation SUMMATIVE
Faculty:
Professor:
Shilling
S=
N/A = Not
N = Needs Improvement
U = Unsatisfactory
(*) Critical behavior
Satisfactory
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
*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
with people from diverse backgrounds.
s
S
Considers patient values, cultural characteristics and religious differences when planning care.
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
Student

Claris Tafie

Date:10/16/16

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

Location:
CVPCU

Carroll Community College

Department of Nursing
NURS 242 Nursing Concepts 4
Student Clinical Performance Evaluation SUMMATIVE
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.
Student Reflection Looking back on the rotation:

s
s
Student
SelfEval
S/N/U
s
s
Student
SelfEval
S/N/U
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
Student
SelfEval
S/N/U
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.
It has been an interesting and exciting clinical experience for me at CVPCU. Each week comes with new challenges
and my experiences keeps getting better and better, and I fill more confidence in myself. Looking at my previous
performances, I can say that I have acquired a lot from this clinical rotation. I work with patient with different level of
acuity. I took care of patients with Mitral Valve Prolapse, CABGX 2,3and4, LVAD, Wound VAC, Chest Tube, External
Space maker, End Stage Renal Disease, Pts. On heparin drip, fluid overload, NG Tube, Trach as well as pts. with CVA.
I was able to make connections between their medications, their disease process and their labs. I also had the
opportunity to observe in the Cath lab and Dialysis center. I attended Pts. rounds and meet with the different
interdisciplinary team. Had a great lecture on LVAD. Apart from doing a full head to toe assessment on my pts., I collect
and document VS and assessment electronically using EPIC, preform ADL, update instructor and the nurse about
patients condition. Also I perform bladder scan, take pulses using a Doppler, did a 12 lead EKG and perform wound
care. Each week, I had the opportunity to administer medication to at least one pt. (PO, IV, SUB Q, Rectal and
Transdermal), which greatly improved on my medication administration skills. I also did a lot of Pts. teaching,
encouraging Pts. to used their incentive spirometer, cough and deep breath follow sternal precautions and help them
ambulate in the hall way. I have greatly improved in my critical thinking, prioritization and time management skills as
well as pts. Care, but above all following the nursing process in meeting pts. Goal.

Preceptor/Instructor comments/ Student Learning Goals: (**If an item was identified as N or U, narrative
comments are necessary to clarify student performance**)
Claris,
I want to applaud you for your caring and compassion with your patients! I think the patients loved the care that you
Approved 12/41/4. Revised 12/9/2014

Carroll Community College

Department of Nursing
NURS 242 Nursing Concepts 4
Student Clinical Performance Evaluation SUMMATIVE
offered and appreciated all of the caring support. I was thrilled to hear not one, but three nurses compliment you on
your abilities and assistance in the excellent care for the patients in the CVPCU! I felt your knowledge base grew
significantly over the six weeks and it was exciting to see you put all of the pieces together with the pathophysiology and
what you were assessing.
Continue to seek out your weaknesses and continue to challenge your knowledge base to expand your level of
understanding. Continue to apply all of the steps in the nursing process to evaluate for effectiveness. I was excited for
you and all of the opportunities you had to travel with your patient to Hemodialysis and cardiac cath lab. I hope these
observations increased your level of understanding. It was nice to hear you share how the Saunders audio had helped
you with NCLEX prep! Keep seeking out these types of resources!

Good luck to you and continue to practice your NCLEX questions daily to refresh yourself about
things you did not see during this clinical rotation! Continue to look toward evidence based practice
to make your role as a nurse more efficient! I feel you are more than ready for your practicum
rotation!

Student Signature:
Preceptor/Instructor
Signature:

Claris Tafie

Date:10/16/16

Stacy Shilling RN, BSN

Date:
10/17/16

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