28

Clinical Evaluation Summary

Student's Name:

Absences:

Course:

Clinical Sites: H &**

3^1- l-

Final Evaluation Date:

Midterm Evaluation Date:

*-r I '

MIDTERM EVALUATION
I.
Student comments:
A. Areas of strength

B. Areas for improvement

II.

Faculty Comments:

Student Signature:

Faculty Signature:

FINAL CLINICAL EVALUATION

Clinical Rating (circle one):
III.

Unsatisfactory

iSludeifccobiments:
A. Areas of strength
B. Areas for improveme

IV.

Outstanding

Faculty Comments:

,I
-V.

,4,
Ck

U '

'

v
.

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Faculty Signature

Student Signature

Faculty Signature

28

FINAL CLINICAL EVALUATION

Clinical Rating (circle one):
III.

Unsatisfactory

Satisfactory

Outstanding

Student comments:
A. Areas of strength
I feel that I communicate well with the patients and am able to develop a rapport with them and their
families easily.
I have gained more confidence in providing care, and when I am not sure about something, I seek
guidance first to be sure that I am proceeding properly.
I am comfortable with doing assessments, and I have learned to refer back to the patient's baseline to
see what "their normal" is. Also, when I have a finding that is different and still have a question, I
discuss it with the nurse (or faculty) to understand what may be causing the difference and what the
significance is.
I am comfortable with the documentation process, and make notes when I don't feel that the standard
click menu gives an adequate picture of what I am seeing. I also like to look back through the day's
documentation to see how the patient has progressed and what may have happened during the day (or
previous day or two).
I feel that I am effective in working with patient's families to meet their needs, answer their questions
and provide teaching when necessary.
I believe that I contribute a lot as a "team player" when I am on the floor. I am always happy to assist
my nurse with other patients when my patient is asleep or assist a CNA who needs help getting a patient
to the bathroom, or repositioning, etc.
I am very comfortable with administering meds - and have administered by almost all methods. I also
make sure that 1 verify the drugs as 1 pull them from the drawers, and then check them again just before
giving them to the patient.
1 am very effective at researching and learning about the condition/s of my patient so that I can
understand their symptoms and what is going on with them, as well as how their condition makes them
feel.

B. Areas for improvement

Wound care is an area that I have not had a lot experience with this semester. I have had several
patients who had wounds, but most of them were open air and required only monitoring - with no
dressing changes, irrigation or topicals applied.
I would like to gain more experience working with invasive devices such as ostomies, trach tubes and
such. I have worked with ostomies, and drains, but only on a few occasions, and feel that I would
benefit a lot from more of these experiences.
As indicated above, 1 am comfortable with the documentation process, but I would like to improve
3

from an efficiency standpoint and be able to complete it in a more timely fashion - which 1 realize
comes with practice.
I enjoy learning about the patients' conditions and learning by reading the doctors' notes and analyses,
and studies, but this takes up time that would be better spent working directly with the patients.

IV.

Faculty Comments:

Faculty Signature

Faculty Signature

Student Signature

LYNCHBURG COLLEGE
DEPARTMENT OF NURSING
BSN PROGRAM
Clinical Performance Evaluation Tool
Junior/Senior level
Student Name

Faculty_

Self Evaluation
Faculty Evaluation
Clinical Hours Completed
Simulation Hours Completed
Total Hours Completed
VLJCO/U

Course:

6JL

Semester/Year

Fill in appropriate fields to the right & below:

Student must obtain a Satisfactory "S" grade in all competencies at the Final Evaluation to pass the Course.

Core Competencies

Midterm

S D

Nl

Final

Nl

Focusing on wellness, health promotion, illness and disease management across

the life span in a variety of settings while recognizing the diverse uniqueness of
individuals, providing directed care to individuals with well-defined health
alterations, the student at the end of NRSG
, should be able to:

Patient-Centered Care
Demonstrates respect and sensitivity for patient and family preferences, values
and needs in the provision of holistic care.
Demonstrates caring behaviors
Implements comprehensive, holistic care including patient values, preferences
and needs
Provides patient-centered, culturally sensitive care to individuals and or families
with chronic or acute illnesses within complex health care systems
Assesses the presence and extent of pain and suffering

/
S

Demonstrates beginning competency in skills

Recognizes the boundaries of therapeutic relationships

i/

Teamwork and Collaboration

Communicates effectively with nursing and interdisciplinary team members to
meet patient and family needs, adapting own style to meet needs of patients,
teams and situations.
Follows communication and documentation practices that minimize risk
associated with handoffs among providers and across transitions in care utilizing
SBAR or agency guidelines
Identifies relevant data for communication with inter-professional team members

Identifies intra and inter-professional team member roles and scopes of practice

u-

Establishes professional relationships with team members

i/

Identifies need for help when appropriate to situation

Coordinates and delegates as appropriate the delivery of care for multiple

patients

Evidence-Based Practice
Utilizes appropriate evidence-based practice resources within the context of
patient/family care

"Content based upon QSEN Competencies and KSA's.

S = Satisfactory
D= Developing
Nl = Needs Improvement
U = Unsatisfactory

Core Competencies
References clinical related activities with evidence-based literature

Midterm
D Nl U

Understands the concept of evidence-based practice in determining best clinical

practice
Integrates legal-ethical and policy issues in the delivery of optimal health care

Final
Nl U

Quality Improvement
Delivers care in a timely and cost effective manner

Seeks information about processes/projects to improve care (Ql Quality

Improvement)
Identifies and questions inconsistencies in practice at the unit, department,
and/or agency levels

J
~J

Safety
Incorporates scientific principles, theoretical, and developmental knowledge in
the performance of safe and effective care and performance of skills
Identifies and implements strategies to prevent and analyze errors, increase
safety, reduce risk, and support quality patient and family care
Demonstrates appropriate clinical decision making

t/
i/
I/

Organizes multiple responsibilities and provide care in a timely manner

Demonstrates proficiency in performing comprehensive assessments of the
health status of diverse patients and families
Demonstrates knowledge and skill in the administration of medications using
standardized practice guidelines

v/

s
*/

Informatics
Navigates the (electronic) health record for patient information where appropriate
for clinical setting
Documents clear and concise responses to care in the (electronic) health record,
where appropriate for clinical setting
Identifies information and clinical technology using critical thinking to collect,
process, and communicate data
Manages data, information, and knowledge of technology in an ethical manner
Protects confidentiality of (electronic) health records

v/

*S
\y
^
~/

Professionalism
Demonstrates core professional values (caring, altruism, autonomy, integrity,
human dignity, and social justice)
Maintains professional behavior and appearance
Complies with the American Nurses Association Code of Ethics, Standards of
Practice, and policies and procedures of Lynchburg College, Department of
Nursing, and clinical agencies
Accepts constructive criticism and develops plan of action for improvement
Maintains a positive attitude and interact with inter-professional team members,
faculty, and fellow students in a positive, professional manner
Provides evidence of preparation for clinical learning experiences
Arrives to clinical experiences at assigned times
Accepts individual responsibility and accountability for one's own actions and
attitudes
Engages in self evaluation

V'
**/
>^

i/
^

^'
^''

"Content based upon QSEN Competencies and KSA's.

S = Satisfactory
D= Developing
Nl = Needs Improvement
U = Unsatisfactory

NRSG

Midterm Comments (Address Strengths and weaknesses)

Faculty

Student

Student Signature

Date

Faculty Signature

Date

Mid-clinical Evaluation: faculty and student must complete documentation for remediation of unsatisfactory
areas. CPR Tool must be initiated for any unsatisfactory areas.
Unsatisfactory
Area

Remediation Strategy

Student Signature

Date

Faculty Signature

Date

* Content based upon QSEN Competencies and KSA's.

S = Satisfactory
D= Developing
NI = Needs Improvement
U = Unsatisfactory

NRSG

Final Comments (Address Strengths and weaknesses)

Faculty

Student

Student Signature

Date

Faculty Signature

Date

S = Satisfactory

D= Developing

NI = Needs Improvement

U= Unsatisfactory

RATING SCALE
Satisfactory
Almost Always Exhibits (>90% of the time)
A focus on the client or system
Accuracy, safety & skillfulness
Assertiveness and initiative
Efficiency and organization
An eagerness to learn
Developing
Occasionally requires (25% of the time)
Very often exhibits (75% of the time)

Direction
A focus on the client or system
Accuracy, safety & skillfulness

Guidance

Monitoring
Assertiveness and initiative

Support
Efficiency and organization
An eagerness to learn
Needs Im provement
Often requires (50% of the time)
Often Exhibits (50% of the time)

Direction

A focus on the client or system

Guidance

Accuracy, safety & skillfulness

Monitoring

Assertiveness and initiative

Support

Efficiency and organization

An eagerness to learn
Unsatisfactory
Very often requires (75% of the time)
Occasionally Exhibits (25% of the time)

Direction

A focus on the client or system

Guidance

Accuracy, safety & skillfulness

Monitoring

Assertiveness and initiative

Support

Efficiency and organization

An eagerness to learn
Note: ALL Criteria need to be MET at the Developing or Satisfactory Level by the end of the clinical experience (Any student performing at
the NI or Unsatisfactory level at the end of the assigned clinical hours will Not Pass the clinical component of the course and will receive a
Unsatisfactory in Clinical
Almost Never Requires (<10% of the time)

Direction

Guidance

Monitoring

Support

* Content based upon QSEN Competencies and KSA's.

S = Satisfactory
D= Developing
NI = Needs Improvement
U = Unsatisfactory