Professional Documents
Culture Documents
NUR4216L.005S15 4/22/2015
Evaluation date: 4/24/2015
Evaluator: Davis, Sandy (sdavis4@health.usf.e
Evaluatee: Mcgill, Liza (mol@health.usf.edu
3-Minimal
Exhibits minimal performance of nursing care for this level student. Functions safely with moderate guidance. Demonstrate
to skills. Requires some direction in recognizing and utilizing learning opportunities. Often focu
2-Unsatisfactory
Requires intense guidance for the performance of activities at a safe level. Clinical performance reflects difficulty in the
requires frequent or almost constant assistance in applying knowledge to skills. Requires frequent and detailed instruct
behavior, not on the patient.
1-Unsafe to Practice
Is unsafe to practice without constant, intense guidance. Frequently lacks necessary knowledge and skills and unable to i
learning opportunities and is often unable to utilize them. Attempts activity or behavior, yet is unable to compl
Standard I--Communication
The student communicates pertinent information regarding the patient's condition/concern to health team
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication
The student communicates effectively in written form (Nursing Process Worksheet is organized and comp
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication
The student communicates effectively in verbal form.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication
The student initiates, maintains, and terminates the nurse-patient relationship using principles of therape
Answer: 5
(Comment Required)
Outstanding: Exceeds Standards
Comment: Has impressed many preceptors and I have had numerous staff members tell me what a pleasure it
Standard I--Communication
The student functions as an advocate for the patient/family and communicates family needs to other mem
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication
The student examines the dynamic interactions between the patient, family, community, and society.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication
The student initiates discussion to identify and resolve interpersonal problems that impact care.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication
The student uses interpersonal skills to enhance patient/family coping abilities.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication
The student discusses the ethical issues and approaches the ethical dilemmas that confront the patient/fam
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I--Communication
The student delegates appropriately to patient care technician, family, or other team members.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I-Knowledge
The student applies knowledge of humanities, physical and social sciences, and nursing when providing pa
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I-Knowledge
The student applies knowledge of social, cultural, and genetic factors to the care of diverse populations.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard I-Attitude
The student does not in anyway demonstrate disrespect or inappropriate behavior to the patient, staff, or
Answer: 5
(Comment Required)
Outstanding: Exceeds Standards
Comment: Respects and gets to know every staff member from HUC to PCT and calls them by name. Very re
Standard I-Attitude
The student is actively engaged in and seeks out opportunities for learning.
Answer: 5
(Comment Required)
Outstanding: Exceeds Standards
Comment: Notifies staff of what she wants to see and experience and they seek her out for learning experience
Standard II-Safety
The student does not make judgmental, discriminatory, or prejudicial statements to the patient, staff, or f
Answer: 5
(Comment Required)
Outstanding: Exceeds Standards
Comment: Always uplifting and helpful to all staff.
Standard II-Safety
The student applies principals of universal precautions, practices specific isolation techniques, and teache
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety
The student assesses patients for fall risk and applies principles of safe patient handling.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety
The student maintains the patient's physical safety by protecting the patient from harm.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety
The student maintains medical and surgical asepsis when doing procedures requiring sterile technique.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety
The student properly identifies techniques and teaches the reasons for universal precautions.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety
The student validates the accuracy and appropriateness of orders for nursing/medical care prior to initiat
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety
The student implements orders accurately and efficiently.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety
The student is able to identify potential signs and symptoms of an emergent medical condition and promp
and/or clinical faculty member.
Answer: 4
Satisfactory: Meets Standards
Comment:
Standard II-Safety
The student adapts skill performance using principles of theory when necessary.
Answer: 4
Satisfactory: Meets Standards
Comment:
Comment:
Answer: 4
Comment: