Pass fail clinical performance evaluation tool

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Pass fail clinical performance evaluation tool

  1. 1. 1 Clinical Performance Review Evaluation Tool NURSING Second SemesterStudent Clinical Agency(ies)Purpose of Clinical Performance ReviewThe purpose of the Clinical Performance Review is to evaluate student’s progress towards meeting each clinical objective. The student isexpected to demonstrate competencies in each course by meeting the clinical objective specified in the course outline and syllabus. Studentsare expected to progress in performance as they advance through each course and the program.The following criteria, based on the nursing process, will form the guidelines for the student’s performance in all client-care situations: 1. Utilize learned scientific and behavioral principles to identify needs of adult patients experiencing common health stressors with progressive ability. 2. Utilize the nursing process in meeting the priority needs of the patient with progressive ability. Emphasis is to be placed on priority nursing diagnoses, including physiological needs, ego integrity and teaching/learning. 3. Perform all learned nursing skills (including medication administration) safely and therapeutically under supervision of an instructor with progressive ability. 4. Function as an accountable member of the health care team. Dates Absences/Tardies (A) (T) Medication Error (Type) Faculty Initials Student Initials NURSING
  2. 2. 2 Second SemesterExplanation of Rating Scale (S) Satisfactory = Clinical performance is safe and student adequately demonstrates application of the nursing process, required skills, and expected synthesis of learning appropriate to level in the program. (U) Unsatisfactory = Clinical performance is unsafe and inadequately demonstrates application of the nursing process, required skills, and expected synthesis of learning appropriate to level in the program.Clinical instructors will provide weekly written feedback for clinical objective(s).Accomplishment of the clinical objectives will be evaluated at midterm and final conferences. When the student successfully meets theclinical objectives of the course, a satisfactory (S) grade will be given. When a student is unsatisfactory at meeting the clinical objectives, aconference will be scheduled with the faculty. The student and faculty will develop a clinical contract that outlines activities to assist thestudent to correct the identified deficiencies.
  3. 3. 3 Clinical Objectives NURSING Second SemesterClinical Objectives for NURSING Second Semester are derived from the following course-specific objectives: 1. Utilize Maslow’s hierarchy of needs to assess clients with emphasis on health promotion throughout the life span. 2. Involve the client in participating in his or her own health care. 3. Apply the components of the nursing process as related to the care of clients at various stages of the life span. 4. Perform essential nursing skills according to critical requirements. 5. Utilize therapeutic communication techniques. 6. Exhibit caring behaviors. 7. Identify legal and ethical parameters of nursing practice. 8. Identify situations beyond one’s knowledge and experience and seek appropriate assistance; 9. Provide safe nursing care to clients.10. Recognize socio-cultural differences in assigned clients.11. Accept responsibility for personal and professional behaviors.12. Exhibit preparation for planned learning experience using required resources.
  4. 4. 5Clinical ObjectivesAssessment 1. Gathers relevant subjective/ objective data pertaining to selected client from all available sources across the lifespan. 2. Assesses all bio-psycho-social needs.Instructor Midterm Evaluation: S UInstructor Comments:Instructor Final Evaluation Comments and Ratings: S U
  5. 5. 7Clinical ObjectivesPlanning1. Sets realistic goals in collaboration with clients. These goals are derived from prioritized nursing diagnoses, inclusiveof client learning needs. These goals are client-centered and have target-specific expected outcomes and specific timeframes for achievement.2. Identifies specific nursing actions to meet goals.3. Includes appropriate rationale for planned nursing care.4. Individualizes plan of care.5. Uses available resources to plan holistic care.6. Establishes priorities for client care according to Maslows Hierarchy.Instructor Midterm Evaluation: S UInstructor Comments:Instructor Final Evaluation Comments and Ratings: S UClinical ObjectivesImplementation1. Interventions are formulated to achieve specific outcomes (goals), are individualized, theoretically sound, andproviding safe, competent client care.2. Demonstrates organization in the performance of nursing actions.3. Includes client responses to care provided.4. Serves as client advocate.5. Adapts environment for the welfare and safety of clients.6. Uses verbal and nonverbal communication skills appropriately.7. Documents accurately and appropriately.8. Demonstrates psychomotor skills by performing currently learned skills and previously learned skills in a competentmanner.Instructor Midterm Evaluation: S UInstructor Comments:
  6. 6. 8Instructor Final Evaluation Comments and Ratings: S UClinical ObjectivesEvaluation1. Collaborates with client and other health care professional to evaluate the expected outcomes in relation to goalsestablished.2. Implements appropriate modifications/ revisions of specific nursing actions, with scientific rationales.Instructor Midterm Evaluation: S UInstructor Final Evaluation Comments and Ratings: S U
  7. 7. Clinical ObjectivesProfessional Development1. Verbalizes his or her own thoughts, feelings, strengths, and limitations.2. Demonstrates the use of basic critical thinking concepts and the development of independent judgment in clinicaldecision-making.3. Assumes responsibility for own learning (showing initiative by seeking out learning experiences in the clinical setting,participating appropriately in clinical activities and in clinical conferences).4. Works effectively with other professional, peers, and instructor within the clinical setting, and seeks and providesfeedback.5. Reflects respect for self and others through professional attire, deportment, identification of self and role, and throughthe notification of tardiness/ absences prior to clinical experience.6. Reflects cultural sensitivity to others in the clinical setting.7. Provides nursing care within the legal/ ethical guidelines and within the scope of registered nursing practice.Instructor Midterm Evaluation: S UInstructor Comments:Instructor Final Evaluation Comments and Ratings: S U
  8. 8. Weekly Anecdotal Notes Clinical Objectives Faculty Comments Faculty Comments Faculty Comments Faculty CommentsAssessment Date Date Date Date1. Gathers relevant subjective/objective datafrom selected client from all availablesources across the lifespan.2. Assesses all bio-psycho-social needs.Planning1. Sets realistic goals in collaboration withclients. These goals are derived fromprioritized nursing diagnoses, inclusive ofclient learning needs. These goals are client-centered and have target-specific expectedoutcomes and specific time frames forachievement.2.Identifies specific nursing actions to meetgoals.3.Includes appropriate rationale for plannednursing care.4.Individualizes plan of care.5.Uses available resources to plan holisticcare.6.Establishes priorities for client careaccording to Maslow’s Hierarchy.Implementation1.Interventions are formulated to achievespecific outcomes (goals), individualized,theoretically sound, and providing safe,competent care.2. Demonstrates organization in theperformance of nursing actions.3. Includes clients’ responses to careprovided.4. Serves as client advocate.5.Adapts environment for the welfare andsafety of clients.6.Uses verbal and nonverbal communicationskills appropriately.7. Documents accurately and appropriately.8. Demonstrates psychomotor skills byperforming currently learned skills andpreviously learned skills in a competentmanner.Weekly Anecdotal Notes
  9. 9. Clinical Objectives Faculty Comments Faculty Comments Faculty Comments Faculty CommentsEvaluation1. Collaborates with client and other healthcare professionals to evaluate the expected outcomes in relation to goals established.2. Implements appropriatemodifications/ revisions of specificnursing actions, with scientificrationales.Professional Development Date Date Date Date1. Verbalizes his or her own thoughts,feelings, strengths, and limitations.2. Demonstrates the use of basic criticalthinking concepts and developingindependent judgment in clinicaldecision-making.3. Assumes responsibility for ownlearning (showing initiative by seekingout learning experiences in the clinicalsetting, participating appropriately inclinical activities and clinicalconferences).4. Works effectively with otherprofessional, peers, and instructor withinthe clinical setting, seeking andproviding feedback.5. Reflects respect for self and othersthrough dress, deportment, identificationof self and role, and through thenotification of tardiness/ absencesprior to clinical experience.6.Reflects cultural sensitivity to others inthe clinical setting.7.Provides nursing care withinlegal/ethical guidelines and the scope ofregistered nursing practiceWeekly Anecdotal Notes
  10. 10. Medications Given SkillsWeek 1 Week 1Week 2 Week 2Week 3 Week 3Week 4 Week 4Week 5 Week 5Week 6 Week 6Week 7 Week 7Student Signature: DateStudent Signature: DateStudent Signature: DateStudent Signature: DateStudent Signature: DateStudent Signature: DateStudent Signature: Date

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