Student Name: Carlie Eaves Simulation/Clinical #____

3 Date: 2/16/18

✔ Clinical Lab ✔ Midterm Final

NURS 310C Clinical Evaluation Tool

1. Demonstrate beginning competence in nursing skills associated with identified physiological and psychological concepts.
2. Administer medications safely according to legal and practice guidelines and reason clinically to evaluate medication orders, assess client
response, and take remedial actions when appropriate.
3. Provide safe, evidence-based, patient-centered care for stable patients with common heath alterations.
4. Provide effective patient education and support for patients with simple needs and stable conditions.
5. Communicate effectively with patients, significant others, and members of the interdisciplinary team.
6. Document nursing care and basic clinical decisions using an Electronic Health Record (EHR) or other means of communication.
7. Assume responsibility for one’s own professional growth evidenced by preparation for simulation/clinical.

Check the box that matches the student performance in the rubric below for each objective.

Student assessment check green box. Peer assessment check blue box. Faculty assessment check yellow box.

Unsatisfactory/ Developing Proficient Distinguished

Beginning 2 3 4
1
Student failed to follow Student demonstrated basic Student demonstrated Student demonstrated
Nursing Skills
1.

recommended guidelines for knowledge of skill and knowledge of the skill and beginning competence in
beginning nursing skill(s) guidelines but requires was able to perform the skill nursing skill(s).
Missed critical steps or significant assistance from with minimal assistance from Procedural steps were
performed skill incorrectly faculty or peer. Unable to faculty or peer. Performed organized using correct
with potential to cause harm articulate rationale for each skill steps in order and techniques. No assistance
step in preforming skill. verbalized rationale for each was needed. Student
step. demonstrated depth and
✔ understanding of the skill.
✔
 Unsatisfactory/ Developing Proficient Distinguished
Beginning 2 3 4
1
Student missed one or more Student missed one or more Student demonstrated safe Student demonstrated
Medications
2. of the 6 rights of medication of the 6 rights of medication medication administration appropriate knowledge of
administration and/or had a administration. Able to using the 6 right. Unable to medication(s).
medication error. Unable to verbalize at least one of the articulate medication Student demonstrated safe
articulate indication, side following: indication of use indication of use, side effects, medication administration by
effects and contraindications for this patient, side effects and contraindications. Did using the 6 rights. Able to
of medication. Left or contraindications. Did not not leave the medication articulate indication of use,
medication unattended. leave the medication unattended. side effects and
unattended. contraindications of the
medication before
administration. Did not leave
the medication unattended

Student did not provide safe, Student provides patient Student provided safe, Student provided safe,
Care
Evidence Based
Provide Safe,
3.

evidence-based or patient- care that lacked the evidence-based, and patient- evidence-based, and patient-
centered care for stable understanding of patient centered care for a stable centered care for a stable
patient with common health safety, evidence-based patient. Student lacked the patient with common health
alterations. Student practice, and/or patient- ability to articulate rationale alterations.
performance had potential to centered cares. for evidence-based and/or Student demonstrated and
cause patient harm. patient centered care. verbalizes understanding of
✔ ✔ concepts used.

Student did not provide or Student provided partial or Student provided teaching to Student provided patient
Effective Patient Education
4.

provided incorrect patient incomplete patient patient, including basic education and support.
education or support for education. concepts and teaching Recognized and included
patients with simple needs Student demonstrated methods. Lacked depth and family when appropriate in
and stable conditions. insufficient knowledge about adequate knowledge base to teaching. Showed confidence
patient condition, lacked provide patient and family when teaching patient.
confidence and was unsure with all information needed Able to teach patient and
about what or how to teach related to current condition. family about conditions, self-
or instruct patient and/or ✔ ✔ care and utilized evidence
family. Did not use teach based teaching methods.
back method. Used teach back method to
assess knowledge of
information provided to the
patient/family.
 Unsatisfactory/ Developing Proficient Distinguished
Beginning 2 3 4
1
Communication was very Communication was Communication was Student used effective
Communicate Effectively
5.

limited, awkward, and lacked attempted, but lacked depth appropriate but lacked depth communication with the
flow, unable to effectively and direction. Student and detail. patient, family members, and
relay information to patient, appeared reluctant to Nurse appeared calm and interdisciplinary team.
family members, or communicate with the confident but had difficulty Student appeared calm and
interdisciplinary team. patient, family members, or with clear communication confident with clear
Student appears anxious interdisciplinary team. with the patient, family communication. Uses SBAR
and/or lacks organization members, and when communicating patient
interdisciplinary team. information to physician.
✔ ✔

Student failed to chart per Limited documentation Student completed Student demonstrated
Documentation
6.

instruction, charted on the completed. Student missed documentation. APIE was appropriate documentation
wrong patient, charted or omitted important correct. based upon the ability to
wrong information. Violated subjective or objective However, student lacked make basic clinical decisions.
HIPAA by leaving computer information. APIE was understanding of connection Student utilized APIE when
screen, charting, and or incorrect. between decisions made, documenting nurse notes.
medical records visible to Student failed to understand cares given, and what was
patient or visitors the connection between documented.
decisions made, cares given, ✔ ✔
and what needed to be
documented.

Student did not assume N/A N/A Student assumed

Growth
Professional
7.

responsibility for own responsibility for own

professional growth. professional growth.
Student was not prepared for Student was prepared for
simulation/clinical. simulation/clinical.
✔ ✔

Clinical Faculty Initial: Score: 19/24

 Peer comments* (2 compliments and 2 recommendations)
STUDENT MIDTERM COMMENTS:
I have enjoyed clinicals so far. Even though I had been a CNA in the past, the first week I did not feel very comfortable with
patient care. As I have continued to perform care, however, I have become more confident in my abilities. I now feel that I
have improved in this and am excited to continue applying teach-back methods with patients.

Student comments (2 strengths and 2 opportunities for improvement) ✔ Midterm Final

S: Confidence in basic care skills- I know I can safely care for patients.
S: Patient communication, I am good at explaining what I am doing and what the data means.
OFI: Gain a better understanding of medications and diseases.
OFI: Be more willing to help when the opportunity arises.
OFI: Teach-back, making connections from concept map data.

Faculty comments Midterm Final

*Peer comments not needed in clinical setting

Faculty Signature:

Student Signature: Carlie Eaves

Satisfactory Unsatisfactory Needs Remediation/Statement of Concern