Carroll Community College

Division of STEM, Nursing and Allied Health

Department of Nursing
NURS 233 Nursing Concepts 3
Student Psychiatric Clinical Performance Evaluation WEEKLY
Student:

Kristen Renda

S = Satisfactory

Date:

N = Needs Improvement

09/30/15

Location:

U = Unsatisfactory

HCGH

Faculty:

NA = Not applicable

Minnema
(*) 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
Outcome 1
SelfEval of
Analyze the effectiveness of the plan of care using the nursing process (SLO 1, GE 3)
Eval
Student
S/N/U
S/N/U
Collects evidence related to clinical practice from appropriate resources.
S
S
*Demonstrates accurate patient assessment skills.
S
pending
Establishes appropriate nursing diagnoses based on patient assessment.
S
pending
*Prioritizes patient care based on assessment.
S
pending
Identifies measurable patient outcome based on nursing diagnosis.
pending
*Implements care according to established plan and desired outcomes.
S
pending
Uses therapeutic communication techniques during nurse/patient interactions to facilitate
S
S
the nursing process.
Identify appropriate interventions based on assessment.
S
pending
Demonstrates knowledge of medications for assigned patients.
S
S
*Administers medication safely using six rights of medication administration.
n/a
N/A
*Implements appropriate infection control precautions
S
S
Follows through with all patient care
S
pending
*Evaluates patient response to care and revises plan as needed.
S
pending
Student Instructor
Outcome 2
SelfEval of
Incorporate learning opportunities that promote personal and professional growth and a
Eval
Student
commitment to lifelong learning. (SLO 2, GE 5)
S/N/U
S/N/U
Participates actively in all aspects of the clinical experience.
S
S
Discusses patients plan of care with instructor.
S
S
Demonstrates professional behavior and appearance.
S
S
Engages in self-reflection and communicates learning needs to instructor/preceptor.
S
S
Completes assignments as required and submits on time.
S
S
Organizes time efficiently.
S
S
Student Instructor
Outcome 3
SelfEval of
Implement nursing care that considers the uniqueness of various cultures, backgrounds, and
Eval
Student
belief systems (SLO 3, GE 6)
S/N/U
S/N/U
Demonstrates caring behaviors with the ability to develop and maintain therapeutic
s
relationships with people from diverse backgrounds.
S
Considers patient values, cultural characteristics and religious differences when planning care.
s
S
Student Instructor
Outcome 4
SelfEval of
Contribute to healthcare teams to provide patient-centered care (SLO 4, GE 1)
Eval
Student
S/N/U
S/N/U
Identifies patient and family health education needs.
S
S
Implements patient and family education.
S
pending
Seeks input from patient, instructor, peers, and healthcare team in the delivery of patient care.
S
S
*Updates instructor and healthcare team regarding changes in the patients condition.
S
S
*Identifies safety concerns and notifies instructor and appropriate healthcare team members.
S
S
Demonstrates initiative in assisting peers and healthcare team members in the clinical setting.
S
S
Demonstrates communication skills using SBAR.
S
pending
Acts as an advocate for patients and families
S
S
Approved 12/4/14. Revised 12/9/2014

Carroll Community College

Division of STEM, Nursing and Allied Health
Department of Nursing
NURS 233 Nursing Concepts 3
Student Psychiatric Clinical Performance Evaluation WEEKLY
Outcome 5
Provide nursing care based
on scientific evidence.
Student Self-Eval
(SLO 5, GE 2)
S/N/U
Identifies evidenced-based rationale that supports the patient plan of care.
Integrates knowledge from nursing and other disciplines to plan care.

Instructor Eval of Student

S/N/U
S
S
Student
Outcome 6
SelfImplement nursing care based on legal and ethical principles that reflect current standards of
Eval
practice. (SLO 6, GE 7)
S/N/U
Adheres to attendance policy
S
*Demonstrates safe clinical practice.
S
Provides nursing care based on the policies and procedures of the facility.
S
*Maintains legal accountability for nursing practice in accordance with the Maryland Nurse
Practice Act.
S
*Adheres to HIPAA guidelines regarding patient confidentiality.
S
*Provides care according to the ANA Nursing Scope and Standards of Practice.
S
*Demonstrates accountability and responsibility for own actions and attitudes.
S
Outcome 7
Student
Incorporate informatics skills using technology and electronic sources of health care
Selfinformation to support clinical decisions, promote communication, and monitor care outcomes.
Eval
(SLO 7, GE 4)
S/N/U
Gathers data from the electronic medical record to provide patient care.
S
Uses electronic medical record to document patient care accurately and in a timely manner.
N

S
S
Instructor
Eval of
Student
S/N/U
S
S
S
S
S
S
S
Instructor
Eval of
Student
S/N/U
S
N/A

Student Learning Goals (List desired learning goals, and your plans to meet them, for the next weeks clinical
experience. Goals should be based on identified performance issues and the desire for new knowledge and
experiences.)
I forgot to write down the specific dosages and times given for the patient on my paperwork
Goals:
Assertiveness in setting limits to inappropriate behavior
SBAR communication
Recognition of medication side effects and teaching to reduce side effects
Faculty Comments/ Student Learning Goals (**If an item was identified as N or U, narrative comments are
necessary to clarify student performance**)
Student had a challenging patient this first week, but was able to spend much time with him so as to practice
therapeutic communication skills. It was good that you came to me periodically to clarify these skills from
time-to-time. This demonstrates motivation to learn, and good reflective practice.
Excellent documentation of the complicated disease process schizoaffective disorder - demonstrated very
good understanding. Excellent discussion/description of patients presentation compared to researched
pathophysiology of his disease process. Also excellent discussion of his prognosis. Thorough discussion of
patients discharge planning needs. Documented research on patients medications is exemplary. Student is
able to identify nursing considerations related to patients prescribed drugs. Discussion of patient teaching,
lab findings related to medications is also exemplary. Thought processes are similar to seasoned RN. Student
listens carefully to what has been taught.

Student Signature:

Kristen Renda

Date:

09/30/15

Preceptor/Instructor Signature:

Jo Lynn Minnema, MS, RN

Date:

9/5/15

Approved 12/4/14. Revised 12/9/2014