Carroll Community College

NURS 233 – Nursing Concepts 3

SUMMATIVE Student Clinical Performance Evaluation

Student Felicia Torres Date 11/18/19 Week # 2 Faculty

S = Satisfactory N = Needs Improvement U = Unsatisfactory NA = Not applicable (*) Critical behavior
Students who meet any of the following criteria will be given a remediation plan and may be placed on probation.
Failure to progress in these areas may result in failure of the course.
-One unsatisfactory grade in a critical behavior -Two needs improvements in a critical behavior
-Two unsatisfactory grades in a non-critical behavior -Four needs improvements
Student Instructor
Self- Eval of
Outcome 1 Eval Student
Analyze the effectiveness of the plan of care (CO1) S/N/U S/N/U
1. *Prioritizes patient care based on assessment with faculty as a resource S S
2. *Demonstrates accurate patient assessment skills S S
3. Analyzes and incorporates data from the patient’s medical record in the provision of care S S
4. Uses patient assessment data to implement individualized plan of care with faculty as a S
resource S
5. Establishes appropriate nursing priorities list based on collected evidence and patient S
assessment with faculty as a resource S
6. Establishes measurable patient outcomes based on nursing priorities with faculty as a S
resource S
7. Establishes appropriate nursing interventions based on assessment with faculty as a S
resource S
8. Evaluates patient response to care and revises plan as needed with faculty as a resource S S
Student Instructor
Self- Eval of
Outcome 2 Eval Student
Seek opportunities that promote professional growth (CO2) S/N/U S/N/U
9. Demonstrates professional behavior and appearance S S
10. Seeks input from patient, instructor, and healthcare team in the delivery of patient- S
centered care S
11. *Demonstrates accountability and accepts responsibility for own actions and attitudes S S
12. *Adheres to attendance policy S S
13. Participates actively in all clinical experiences S S
14. Engages in self-reflection and communicates learning needs to instructor S S
15. Completes assignments as required and submits on time S S
16. Demonstrates initiative in assisting peers and healthcare team members in the clinical setting S
Student Instructor
Self- Eval of
Outcome 3 Eval Student
Provide patient-centered care with faculty as a resource (CO3) S/N/U S/N/U
17. *Implements appropriate infection control precautions S S
18. Provides culturally sensitive care S S
19. Documents patient care accurately S S
20. Uses therapeutic communication skills S S
21. Follows through with all patient care S S
22. Demonstrates knowledge of medications for assigned patients S S
23. *Administers medication safely using six rights of medication administration N/A N/A
24. Demonstrates caring behaviors S S
25. Uses SBAR effectively S S
26. Acts as an advocate for patients and families S S
Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18
 Carroll Community College
NURS 233 – Nursing Concepts 3
SUMMATIVE Student Clinical Performance Evaluation

27. *Demonstrates physical and mental competence S S

28. *Identifies safety concerns and notifies instructor and appropriate healthcare team S
members S
29. Demonstrates time management techniques S S
30. Implements patient and family education and evaluates effectiveness of teaching S S
31. *Updates instructor and healthcare team regarding changes in the patient’s condition S S
32. *Provides nursing care based on the policies and procedures of the facility S S
33. *Provides nursing care in accordance with the Maryland Nurse Practice Act S S
34. *Adheres to HIPAA guidelines S S
35. *Provides care according to ANA Scope and Standards of Nursing Practice S S
Student Instructor
Self- Eval of
Outcome 4 Eval Student
Implement nursing care based on scientific evidence (CO4) S/N/U S/N/U
36. Incorporates evidence-based rationale that supports the patient’s plan of care S S
Student Reflection (Thoroughly answer all questions)

How has this clinical rotation helped to define your role as a nurse? Please explain.

This clinical rotation has helped me to define the nurse’s role as an educator. It is very important for
OB nurses to be competent because there is a lot of discharge teaching involved. This is especially
important for first time and young moms who have lots of questions.

Which objective did you accomplish during this rotation? How did you do it?

During this clinical rotation the objective that I accomplished was assessing a postpartum mom. I did
this by utilizing the BUBBLEHE assessment tool.

What are your goals for your next clinical rotation?

My goal for my next clinical rotation is to be in the NICU and obtain more experience with neonates.

Faculty Comments/ Student Learning Goals (Goals must be established even if performance is satisfactory.
If an item was identified as N or U, narrative comments are necessary to clarify student performance along
with goals to improve performance).

Felicia was an outstanding student in OB. She was motivated, competent,and jumped right in to hands on
learning. One of the nurses approached me and spoke very highly of her understanding of OB, her
competence with hands on, and her kindness and compassion to patients and their families. I also witnessed

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18

 Carroll Community College
NURS 233 – Nursing Concepts 3
SUMMATIVE Student Clinical Performance Evaluation

all these characteristics in my observations. Felicia also was a group leader and assisted her classmates
during clinical.

Student Signature: Felicia Torres Date:11/20/19

Instructor Signature: Jessica Dustin,RNC,BSN Date: 11/23/2019

Approved 12/4/14. Revised 12/10/2014; 01/2015; 3/16/18