Final Clinical Evaluation

NUR 4467L BMC SBN Section 010 11/5/2014

Evaluation date: 11/6/2014
Evaluator: Kochman, Kristina (kkochma1@jhmi.edu)
Evaluatee: Valchine, Rachel (rvalchin@health.usf.edu)

5-Outstanding: Exceeds Standards Exhibits above average performance of nursing care for this level
student. The student is proactive, self-directed, and consistently engaged in learning; needs minimal
guidance; is knowledgeable; and appropriately incorporates knowledge with skills. Student is proactive and
self-directed in approach to learning.
4-Satisfactory: Meets Standards Exhibits average performance of nursing care for this level student.
Functions with minimum guidance. Demonstrates adequate knowledge and requires minimum assistance in
applying knowledge to skills. Recognizes learning opportunities but may require assistance in utilizing them.
3-Minimal Exhibits minimal performance of nursing care for this level student. Functions safely with
moderate guidance. Demonstrates minimal knowledge and requires moderate assistance in applying
knowledge to skills. Requires some direction in recognizing and utilizing learning opportunities. Often
focuses on the task or own behavior, not on the patient.
2-Unsatisfactory Requires intense guidance for the performance of activities at a safe level. Clinical
performance reflects difficulty in the provision of nursing care. Demonstrates gaps in necessary knowledge
and requires frequent or almost constant assistance in applying knowledge to skills. Requires frequent and
detailed instructions regarding learning opportunities. Focuses primarily on the task or own behavior, not on
the patient.
1-Unsafe to Practice Is unsafe to practice without constant, intense guidance. Frequently lacks necessary
knowledge and skills and unable to integrate these into practice. Requires constant detailed instructions
regarding learning opportunities and is often unable to utilize them. Attempts activity or behavior, yet is
unable to complete. Focuses entirely on the task or own behavior, not the patient.

Standard I--Communication The student communicates pertinent information regarding the patient's
condition/concern to health team members.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I--Communication The student communicates effectively in written form (Nursing Process
Worksheet is organized and complete)
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I--Communication The student communicates effectively in verbal form.

Answer: 4
Comment:

Satisfactory: Meets Standards

Standard I--Communication The student initiates, maintains, and terminates the nurse-patient relationship
using principles of therapeutic communication.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I--Communication The student functions as an advocate for the patient/family and communicates
family needs to other members of the health care team.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I--Communication The student examines the dynamic interactions between the patient, family,
community, and society.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I--Communication The student initiates discussion to identify and resolve interpersonal problems
that impact care.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I--Communication The student uses interpersonal skills to enhance patient/family coping abilities.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I--Communication The student discusses the ethical issues and approaches the ethical dilemmas
that confront the patient/family and appropriately discusses experience with faculty/preceptor.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I--Communication The student delegates appropriately to patient care technician, family, or other
team members.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I-Knowledge The student applies knowledge of humanities, physical and social sciences, and
nursing when providing patient care.

Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I-Knowledge The student applies knowledge of social, cultural, and genetic factors to the care of
diverse populations.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard I-Attitude The student does not in anyway demonstrate disrespect or inappropriate behavior to the
patient, staff, or faculty
Answer: 5

(Comment Required)

Outstanding: Exceeds Standards

Comment: Rachel has always maintained a professional attitude without any concerns regarding
disrespectful or inappropriate behavior.

Standard I-Attitude The student is actively engaged in and seeks out opportunities for learning.
Answer: 5

(Comment Required)

Outstanding: Exceeds Standards

Comment: Rachel has been consistently engaged and receptive to each clinical assignment, as well as
seeking opportunities for learning.

Standard II-Safety The student does not make judgmental, discriminatory, or prejudicial statements to the
patient, staff, or faculty.
Answer: 5

(Comment Required)

Outstanding: Exceeds Standards

Comment: Rachel has never made any judgmental, discriminatory, or prejudicial statements during any of
her clinical rotations.

Standard II-Safety The student applies principals of universal precautions, practices specific isolation
techniques, and teaches the reasons for universal precautions.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard II-Safety The student assesses patients for fall risk and applies principles of safe patient handling.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard II-Safety The student maintains the patient's physical safety by protecting the patient from harm.
Answer: 4
Comment:

Satisfactory: Meets Standards

Standard II-Safety The student maintains medical and surgical asepsis when doing procedures requiring
sterile technique.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard II-Safety The student properly identifies techniques and teaches the reasons for universal
precautions.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard II-Safety The student validates the accuracy and appropriateness of orders for nursing/medical
care prior to initiating care.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard II-Safety The student implements orders accurately and efficiently.

Answer: 4

Satisfactory: Meets Standards

Comment:

Standard II-Safety The student is able to identify potential signs and symptoms of an emergent medical
condition and promptly reports changes in the patient's health status to preceptor and/or clinical faculty
member.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard II-Safety The student adapts skill performance using principles of theory when necessary.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Assessment The student identifies data from the history and physical
assessment to formulate appropriate nursing diagnoses.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Assessment The student identifies the patient's health education needs.

Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Diagnosis The student synthesizes history and assessment data as well as
diagnostic results into the development of nursing diagnoses.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Plan The student integrates psychosocial needs into care plan, identifies
appropriate resources for the plan of care, and incorporates health education into the care plan.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Plan The student identifies measurable, expected patient outcomes that are
realistic and individualized to the patient.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Plan The student identifies the discharge planning process and needs of the
patient upon admission and throughout the hospitalization.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Plan The student demonstrates judgement in decision-making and priority
setting.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Plan The student uses appropriate collaborative resources to personalize the
nursing care the patient receives.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Intervention/Implementation The student demonstrates understanding of the

principles underlying nursing actions appropriate for the student at this point in the curriculum.
Answer: 4
Comment:

Satisfactory: Meets Standards

Standard III-Nursing Process:Intervention/Implementation The student performs skills according to agency

policy and procedure and clinical lab guidelines.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Intervention/Implementation The student implements the written action

plan/protocol considering the priorities for each assigned patient.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Intervention/Implementation The student implements a teaching plan based on

scientific knowledge and utilizes resources appropriately.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Intervention/Implementation The student incorporates evidence based research

into nursing practice.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Intervention/Implementation The student practices individualized and culturally

competent care.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Intervention/Implementation The student initiates appropriate referrals as

needed.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Evaluation The student evaluates the patient's response/outcome to the
intervention.
Answer: 4
Comment:

Satisfactory: Meets Standards

Standard III-Nursing Process:Evaluation The student utilizes subjective and objective data to revise nursing
actions (as appropriate for the student at that level of the curriculum).
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Organization The student provides organized, coordinated, and prioritized
nursing care for the patients with a range of health problems.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Organization The student organizes time and resources effectively and
efficiently.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Organization The student gathers and organizes equipment necessary for
patient care/procedures.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Organization The student identifies and seeks appropriate resources during
patient care provision.
Answer: 4

Satisfactory: Meets Standards

Comment:

Standard III-Nursing Process:Organization The student completes the daily clinical assignment in a timely
manner.
Answer: 5

(Comment Required)

Outstanding: Exceeds Standards

Comment: No issues or concerns regarding assignments.

Standard III-Nursing Process:Documentation The student appropriately develops long and short term patient
oriented nursing care goals based on patient assessment and scientific principles of nursing practice.
Answer: 4

Satisfactory: Meets Standards

Comment: Unable to observe, electronic documentation not permitted at this clinical site. Documentation
on NPW appropriate.

Standard III-Nursing Process:Documentation The student documents problems and nursing care goals in the
patient record (with co-signature).

Answer: 4

Satisfactory: Meets Standards

Comment: Unable to observe, electronic documentation not permitted at this clinical site. Documentation
on NPW appropriate.

Standard III-Nursing Process:Documentation The student identifies and documents nursing actions/orders
initiated in implementing the plan of care.
Answer: 4

Satisfactory: Meets Standards

Comment: Unable to observe, electronic documentation not permitted at this clinical site. Documentation
on NPW appropriate.

Standard III-Nursing Process:Documentation The student correctly enters data into the patient record in a
timely manner per agency protocol.
Answer: 4

Satisfactory: Meets Standards

Comment: Unable to observe, electronic documentation not permitted at this clinical site. Documentation
on NPW appropriate.

Standard III-Nursing Process:Documentation The student assures privacy of the patient record at all times.
Answer: 4

Satisfactory: Meets Standards

Comment: Unable to observe, electronic documentation not permitted at this clinical site. Documentation
on NPW appropriate.

Standard III-Nursing Process:Critical Thinking The student utilizes critical thinking skills to prioritize patient
needs based on the patient assessment.
Answer: 4

Satisfactory: Meets Standards

Comment:

Comments:
Rachel has been a great student this semester. She consistently sought out learning opportunities and never
hesitated with tackling the tough environment of pediatric nursing. There were no issues or concerns
regarding Rachel's clinical performance this semester. I wish her all the best in her nursing career.