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Clinical Week
Compete
ncy (C)
Course
Outcomes
(CO)
C9
CO 1, 2
Dates
C4
C3
C4
C1,2
C1,
CO3
C3,
CO8
C2
4
10/2
7
AVA
AVA
AVA
AVA
CFD
N/A
S
S
S
S
S
S
S
S
N/A
N/A
10/6
5
11/3
N/A
N/A
5.
C3
3
10/2
0
6
11/1
0
3.
4.
C 8, CO
5
C 6,7,8
CO 1,4
C10,
CO2
C6,
CO2
C9,
CO2
2
10/1
3
8.
9.
CC
7
11/17
8
11/2
4
9
12/1
Makeup
C4,
CO8
Instructor Initials
Student Initials
PW
AJ
PW
AJ
PW
AJ
PW
AJ
PW
AJ
The purpose of the weekly clinical performance evaluation tool is to provide feedback about achievement of the course outcomes
and competencies and to assist the student to meet the standards of care for nurses in Oregon as outlined in the Nurse Practice
Act.
Explanation of Rating Scale:
(S) Satisfactory = Clinical performance is safe and student adequately demonstrates application of the nursing process/clinical
judgment, required skills, and expected synthesis of learning appropriate to level in the program. Verified by direct instructor
observation.
(NI) Needs Improvement = Indicates that additional learning and attention to detail is required for a particular item or that the
overall performance for the week is at a minimum level. The instructor will write an explanation of the rating on the comments
page.
(U) Unsatisfactory = Clinical performance is unsafe and inadequately demonstrates application of the nursing process/clinical
judgment model, required skills, and expected synthesis of learning appropriate to level in the program. The instructor will write
an explanation of the rating on the comments page.
(NA) Not applicable = Particular item does not apply to the clinical performance.
(NO) Not observed = Instructor did not observe or has no knowledge of the students performance of the activity.
Students with a grade of NI or U will be required to meet with their advisor and clinical instructor and discuss a plan for change in
their behavior before their next clinical experience.
Safety and legal/ethical concepts are considered critical to the profession and will be graded as NI or U if any violation occurs.
If a student is assigned a U or NI for two weeks, the faculty will review the students clinical performance and consider the
options of either placing the student on probation or dismissing from the program.
In cases of potential failure, notification of the student by the instructor that she/he has been assigned a grade of U or NI for one
week constitutes proper warning of the grade status.
If a student is placed on probation and then receives a grade of U, the faculty will review the students performance and
determine whether or not the student will be dismissed from the program.
Week
Instructor include comments that are positive, areas that need improvement or are
unsatisfactory. Reference the course outcomes listed in the syllabus and/or the OCNE
Competencies from the Nursing Student Handbook (Date/Sign all entries)
Avamere; Day one; No passwords to find info on patients but oriented to facility and patients.
Basic care today with blood glucose checks done, some physical therapy observation.
Pamela Wick RNCMSN
Avamere; Blood glucose checks done, bed making and baths done. Still minimal information
regarding patient information but beginning to talk about assessments and performing skin
assessments.
Student
Initials
AJ
AJ
Avamere; Beginning to obtain patient information, basic ADLs attended to. Good
communication with your patient and with the staf.
Pamela Wick RNCMSN
Avamere; Collected information on your patient to begin building a care plan, see noted on care
plan for more insight. Good communication with your peers and with staf. Good day.
Pamela Wick RNCMSN
Charleston Fire Department; Great day; You did an excellent job working with the patients that
came in, thank you for the hypoglycemic poster and for the attentiveness to the patrons
Pamela Wick RNCMSN
AJ
AJ
9
Clinic
al
Makeup
9/1/09: rev 05062011: reviewed 9/2014 sw