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Evaluations - > Evaluation Review

Evaluations Clinical Evaluation Tool Revised June 2017
Evaluations NUR4467L LRH UD S18 (3/19/2018)
Experience Brashears, Taylor (tcbrashears@health.usf.edu)

Change password Evaluator: Harvey, Brolivia (broliviaharvey@health.usf.edu)

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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 (Consider Level 3 Violation)

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 (Consider Level 2 Violation)

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 (Consider Level 1 Violation)

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 1: Patient-Centered Care

1. Performs a comprehensive assessment including patient values, preferences, and
needs.
2. Develops an individualized plan of care with a focus on the nursing process.
3. Provides care with sensitivity and respect for the diversity of the human
experience.
4. Delivers care based on knowledge of pathophysiology and pharmacotherapy.
5. Identifies potential barriers to active involvement of patients in their own health
care process.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
 1 (Comment Required) Unsafe to Practice

Standard 2: Teamwork and Collaboration

1. Demonstrates awareness of own strengths and limitations as a team member.
2. Initiates requests for help from other team members as appropriate.
3. Communicates effectively with patients, family members, and other members of the
healthcare team.
4. Identifies potential complications related to handoffs or transitions of care.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice

Positive feedback received from clinical preceptors.

Standard 3: Evidence-Based Practice and Quality Improvement

1. Utilizes evidence-based literature to support clinical decision making as
demonstrated in written clinical assignments.
2. Differentiates clinical opinion from evidence-based practice to determine best
clinical practice.
3. Promotes and practices quality, cost-effective delivery of care.
4. Identifies potential areas for quality improvement in the clinical setting.
5. Participates in measures to improve patient outcomes as appropriate.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice

Standard 4: Safety
1. Identifies strategies to reduce the risk of harm or poor patient outcomes in the
delivery of care.
2. Delivers medication (as appropriate) in a timely and safe manner including
understanding the specific indications for the medication and potential side effects.
3. Communicates effectively between team members or to clinical faculty when giving
patient report.
4. Uses appropriate resources to improve organization and/or time management.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice

Standard 5: Informatics
1. Navigates the electronic health record where appropriate.
2. Documents clearly, concisely, and accurately in the electronic medical record
where appropriate.
3. Protects confidentiality of all protected health information.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice

Standard 6: Professionalism
1. Demonstrates core professional values (caring, altruism, autonomy, integrity,
human dignity, and social justice).
2. Maintains professional behavior and appearance.
3. Demonstrates expected behaviors and completes tasks in a timely manner.
4. Engages in self-evaluation and assumes responsibility for learning.
5. Arrives to clinical setting on time.
6. Demonstrates evidence of preparation for clinical learning experiences.
7. Maintains a positive attitude while interacting with patients, family members,
faculty, peers, or members of the healthcare team.
8. Accepts individual responsibility for actions.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice
 Levels of Practice Violations
Level 3 Violation
• Potential for unsafe practice
• Typically a single event or occurrence that presents minimal risk for patient harm
• Examples include but are not limited to being unprepared for clinical or a perceived
disrespectful attitude.
• Intervention: Interaction with clinical instructor. Complete student contact form.
Notify course coordinator.
Level 2 Violation
• Evidence of unsafe practice
• Pattern of behavior
• Examples include but are not limited to pattern of being unprepared for clinical,
unable to organize patient report, continued inability to describe indications for
medications or interventions
• Intervention: Meet with clinical instructor. Notify course coordinator and program
director. Academic Jeopardy Form with clear plan for resolution of concerning
behavior.
Level 1 Violation
• Unsafe practice with unacceptable risk for harm
• Examples include but are not limited to dishonesty, failure to change behaviors in
response to feedback, physical or mental impairment (intoxication or lack of sleep),
violent behavior, breach of confidentiality, extreme anxiety, angry or unprofessional
outburst.
• Intervention: Immediate removal from all clinical, lab, and simulation activities.
Notify course coordinator and program director.
No clinical practice violations

Comments:

Taylor Brashears has reviewed the above evaluation on 7/17/2018 and has provided the
following comment:

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