Practical Nursing Diploma Program

Final Clinical Evaluation Form

Student:

Bindu

Sharma

Student Number:

Course: NUR 261

Dates:

Section

May 6, 2014

S: Satisfactory

800-720-708

to

August 10, 2014

ND: Needs Development

Summary of Areas of
Practice

COMPETENT AND SAFE

PRACTICE IN A
PROFESSIONAL, LEGAL
AND ETHICAL
FRAMEWORK
ii. Act in a responsible,
ethical and accountable
manner.

iv.Use evidence informed

practice and a theory-based
approach to care.

v. Ensure client safety and a

safe environment.

COMMUNICATION
ii.Document clearly,
accurately, concisely in a
timely manner using written
and electronic methods.

54

U: Unsatisfactory

Student Comments:
Summary of clinical
experience

S:

ND:

U:

Faculty Comments:
Summary of clinical
Experience

S:

ND:

U:

I saw at 7:45am the drawer of

medication cart left open by nurse
on floor. Nurses are at nursing
station It is very unsafe any
patient can take the medication
out of the drawer. It is important
nurse should lock the kardex after
taking medication, so patient or
visitor has no access to kardex.

Bindu, you have demonstrated

understanding of this objective by
acting responsibly, you showed
accountability by acting as a team
member when you closed the
drawer for a fellow nurse and
acted ethically by recognizing the
value to keeping medications
under lock

I practiced medication
administration in lab by using
evidence informed practice. In
clinical placement I administer
medication. Three checks to be
done for safety. Three checks are
to prevent medication error.

You have demonstrated how

evidence-informed practice and
theoretical approach requires
several checks to prevent
medication error and thus,
keeping the patient safe.

I went to see my previous patient.

The patient beside her bed was
sitting on the chair. She asked me
to lower her bed she wants to go
to the bed and the nurse /psw left
the bed in a high position.
Leaving bed high is very unsafe
Patient doesnt know how to lower
it. Patient can fall while sitting/
lying on the bed. The bed should
always be kept low to prevent fall.

S:

ND:

U:

Documentation to be completed
in Meditech in each shift. Staff
working other shift can check
when client had BM and if client
didnt had BM in last three days

This example demonstrates your

understanding and evidencebased practice that ensures client
safety and a safe environment
through placing the bed in a low
position

S:

ND:

U:

You have indicated the need to

document into Meditech within
each shift (timely) as a accurate
means for other staff to provide
care based on the data placed

v.Maintain privacy and

confidentiality according to
the Personal Health
Information Protection Act
(PHIPA).

VI. Use technology to

retrieve information
including research, data and
other information

CARING RELATIONAL
PRACTICE

the nurse can give fleet enema to

the patient to relief constipation.

into Meditech accuracy is

required as it impacts the actions
of another shift providing patient
care.

My patient cannot communicate

verbally. One lady came stating
she is friend and wants to know
personal information about
patient. I am not sure she is friend
and to maintain confidentiality I
shared no information with her. I
informed primary nurse patients
friend need information. I need to
maintain privacy and
confidentiality of patient.

A good example that

demonstrates understanding of
the use of privacy and
confidentiality although it was a
friend with good intentions,
patient information cannot be
shared without permission from
the patient or the Power of
Attorney.

Meditech is a source to get

patients information. Information
is needed to provide care to the
client. Nurses notes and
documentation in Meditech about
patient is very important.

S:

ND:

U:

Meditech is an electronic source

of technology that allows the
nurse access to patient data you
have utilized it to document
patient data with minimal
assistance from your instructor

S:

ND:

U:

I Utilize effective
communication techniques

Communicating with patient.

Therapeutic relationship with
patient is very important. I tell
patient when I am doing nursing
care tasks Example: Morning
care, pericare, repositioning,
suctioning administering
medication Patient have right to
know what nurse is doing.

Effective communication provides

the patient with the information
that the nurse will be doing but it
also assists in building trusting
and therapeutic relationships.
Communication may be verbal or
non-verbal (touch, empathy)

iv.Use self-awareness to
identify the effects that
beliefs, values, and personal
experiences have on
relational practice.

I would like to be treated with

respect. I should be given
opportunity to have my choices,
autonomy and self-determination.
Patients should be treated with
respect. Nurse should respect
patient choices, self
-determination and autonomy.

Good example that demonstrates

the underlying foundation of
respect (self-determination,
autonomy and choice your selfawareness of the meaning of this
concept allows you to transfer this
value onto your patient and treat
him similarly

I asked primary nurse if any

family member visits patient. The
nurse informed me her mother
visits every Sunday. I told patient
in the morning today is Sunday
and your mother will visit today.
Patient
has aphasia. In the evening, the

Good understanding for the need

to interact with client and staff in
this case, gathering information
from staff allowed you to share
this with your patient

v.Interact with clients and

members of the interprofessional health care
team; and, consult
appropriately.

mother visited and updated the

patient about the family and
friends .When mother was saying
good bye, the patient had tears
rolling on her cheeks. Nurse
should always be caring and
understanding of patients
feelings.

LEADERSHIP AND
ADVOCACY
Ii .Demonstrate leadership
skills that foster group work
and a positive learning
environment:

I. Recognize conflicts and

strategies for resolution:

Vii. Consult and collaborate

when carrying out health
care and nursing practices
that are in the best interests
of the public and protect the
public through collaboration
and consultation:

PLANS OF CARE:
MEETING CLIENTS
NEEDS AND MUTUALLY
AGREED OUTCOMES
i. Incorporate the unique
needs and expected
outcomes into individual
clients plan of care:
iv.Provide information that

S:

ND:

U:

S:

ND:

U:

A patients g- tube needed to be

flushed due to error in flow.
Primary nurse asked me to flush
it. I told her as per my instructor, I
cannot flush it, so primary nurse
did it. I observed the procedure.
After observing procedure, I am
able to flush with assistance of
my instructor at another time

Leadership was demonstrated

when action was taken to advise
primary care nurse of nursing
problem but also that
inexperience with G/J tube
prevented flushing after
observing within a positive
learning environment created by
the primary care nurse and the
instructor, you were able to flush
at another time.

In this clinical rotation, students

were asked not allowed to wear
gowns while doing suctioning. As
per Potter and Perry (2010)
nurses may wear gown when
doing suctioning if they consider it
necessary to protect their uniform.
As we are guests in this hospital,
the strategy taken was to accept
resource nurses instruction.

In this example, students were

asked not to wear gowns due to
budgetary constraints however
staff were still wearing gowns
when given the same patients
as guests of the organization, the
strategy for resolution was to
comply and not argue for our
evidence-based cause.

I should ask visitors /family

members to wash their hands or
ask them to use PPE if client has
contagious disease. Infection
control is very important, so that
family members do not get sick or
carry the germs.

Good example that protects the

interests of the public at large but
also the family or friends of
patients.

S:

S:

ND:

U:

ND:

U:

Patient has tracheostomy tube.

Trach care and suction as needed
(at a minimum of q4h and
maximum of q2h). I will do the
trach care and suction as needed
and I will monitor patients oxygen
sat.

Good understanding of this

objective this example
demonstrates the need to suction
based on individual patient need.

Vital signs were taken and if the

Due to a change in a patients

contributes to the
evaluation and refinement of
plans of care.

v.Safely and competently

carry out nursing
assessments and nursing
interventions that are
theory-based and within
skill abilities.

COLLABORATIVE
PRACTICE
i.Work with clients and
members of the interprofessional health care
team to assess clients,
determine health needs, and
to achieve mutually agreed
expected outcomes.
ii. Contribute as a member
of the inter-professional
health care team to respond
to the changing needs and
expected outcomes of
clients.

iv. Use teamwork,

consensus building, and
conflict resolution skills.

QUALITY ASSURANCE

blood pressure is low, I will

hold antihypertensive medication
(Metoprolol) as guided by my
clinical instructor and inform the
primary nurse and document.

vital signs, a medication was held

thereby modifying the plan of
care.

For safety, I perform interventions

that are theory based. I have
learned in clinical placement it is
important to take vital signs
before giving medication, doing
assessments, safely
administering medication,
repositioning, changing diaper for
incontinent patient applying the
barrier cream in peri area to
prevent rash and skin breakdown
according to nursing text (Perry &
Porter, 2010)

This objective recognizes the

need to perform nursing tasks
that are based on theoretical
foundations, explained in nursing
texts such as Potter and Perry
(2010) tasks described can be
found within the RPN student
nurse scope of practice you
have demonstrated your
understanding of this objective
and provided an example that
reflects your understanding

S:

S:

ND:

U:

ND:

U:

My patients suctioning container

was full. I reported to the primary
nurse. She changed it. I observed
and learned how to do it and
where it should be disposed.
When it is full, it should be
changed.

Good concrete example that

demonstrates observation of a
nursing task that needed to be
done, asking for assistance from
the nursing staff, observing how it
is to be completed and being able
to do it when needed in the future.

I help all my peers with their

patients if needed. It is very
important to work in team in
nursing profession. The nurses
goal is patient care and comfort.
When my peer is taking break, I
monitor her patient.

Good example of teamwork and

when you carry out tasks for your
team peers.

We work in team and share the

nursing duties. I and my peer do
my peers patient first because her
patients husband visits her in the
afternoon, so before he visits we
have completed Q4h positioning
and pericare for the patient. We
are able to take our breaks on
time.

Bindu, you have demonstrated

how you used consensus to
determine which patients care is
prioritized and prevent potential
conflict with your peer but also
with family members

S:

S:

ND:

U:

ND:

U:

i.Act in the best interests of

clients and protect clients
from harm through
collaboration and
consultation with members
of the inter-professional
heath care team and
through competent and safe
practice:
Iii Create, implement, and
evaluate a learning plan
consistent with the Quality
Assurance Program (CNO)

Vi use a theory based

approach and evidenceinformed practice:

I learned while administering

medication in the g- tube. The
feed should be on hold. G- tube
should be flushed before and
after administering medication to
prevent error in g- tube feeding.
Patient with trach tube should be
in semi fowlers position to prevent
aspiration.

Good example that recognizes

the need to protect the patient
from harm you practiced
evidence-based theory to know
when to flush and how to positon
the patient to decrease the risk of
aspiration.

I created learning plan. I will

implement it .My first goal is to be
proficient with physical
assessment specifically taking
dorsal Pedalis pulse and second
goal is to organize my clinical day
and organizational skills. So, I can
complete the documentation on
time and effectively organize my
patient care. It will be completed
in next semester.

Good example that recognizes

Humbers assignment of a
learning plan as a means to
establish goals that can be met in
the next clinical rotation. You have
demonstrated your understanding
of this objective by creating,
implementing and evaluating
goals to be met in a future
rotation.

When medication is given through

G tube. G tube should be flushed
before and after giving
medication. It is important to flush
so that the G tube do not get
clogged and feed run smoothly.

Good example for the necessary

to flush and why it is necessary