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Evaluations > Evaluation Review
Final Clinical Evaluation FormRevised 4/2016
Evaluations NUR 3215L.UD.LRH (3/30/2017)
Mcmahon, Morgan (mam7@health.usf.edu)
Evaluator: Sharp, Helen (helensharp@health.usf.edu)

5Outstanding: Exceeds Standards

Exhibits above average performance of nursing care for this level student. The student is proactive, selfdirected, and consistently
engaged in learning; needs minimal guidance; is knowledgeable; and appropriately incorporates knowledge with skills. Student is
proactive and selfdirected in approach to learning.

4Satisfactory: Meets Standards

Exhibits average performance of nursing care for this level student. Functions with minimum guidance. Demonstrates adequate
knowledge and requires minimum assistance in applying knowledge to skills. Recognizes learning opportunities but may require
assistance in utilizing them.

3Minimal

Exhibits minimal performance of nursing care for this level student. Functions safely with moderate guidance. Demonstrates minimal
knowledge and requires moderate assistance in applying knowledge to skills. Requires some direction in recognizing and utilizing
learning opportunities. Often focuses on the task or own behavior, not on the patient.

2Unsatisfactory

Requires intense guidance for the performance of activities at a safe level. Clinical performance reflects difficulty in the provision of
nursing care. Demonstrates gaps in necessary knowledge and requires frequent or almost constant assistance in applying knowledge
to skills. Requires frequent and detailed instructions regarding learning opportunities. Focuses primarily on the task or own behavior,
not on the patient.

1Unsafe to Practice

Is unsafe to practice without constant, intense guidance. Frequently lacks necessary knowledge and skills and unable to integrate
these into practice. Requires constant detailed instructions regarding learning opportunities and is often unable to utilize them.
Attempts activity or behavior, yet is unable to complete. Focuses entirely on the task or own behavior, not the patient.

Standard ICommunication

1. Communicates pertinent information regarding the patient's condition/concern to health team members.
2. Communicates effectively in written form (Nursing Process Worksheet is organized and complete)
3. Communicates effectively in verbal form.

4. Initiates, maintains, and terminates the nursepatient relationship using principles of therapeutic communication.
5. Functions as an advocate for the patient/family and communicates family needs to other members of the health care
team.

6. Examines the dynamic interactions between the patient, family, community, and society.
7. Initiates discussion to identify and resolve interpersonal problems that impact care.
8. Uses interpersonal skills to enhance patient/family coping abilities.

9. Discusses the ethical issues and approaches the ethical dilemmas that confront the patient/family and appropriately
discusses experience with faculty/preceptor.

10. Delegates appropriately to patient care technician, family, or other team members.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice

Standard IKnowledge

1. Applies knowledge of humanities, physical and social sciences, and nursing when providing patient care.
2. Applies knowledge of social, cultural, and genetic factors to the care of diverse populations.
3 Minimal

Standard IAttitude

1. Consistently demonstrates professional behavior as indicated by preparedness for rounds, contributing substantively
to post conferences, respecting staff, faculty and preceptors in communication and tone.
2. Provides clinical objectives to preceptor as determined in preconference.

3. Preparedness for the clinical day as indicated by timely arrival to clinical in the required dress code.
4. Focused attention during post conference to peers as well as faculty.
5. Is actively engaged in and seeks out opportunities for learning.
3 Minimal

Standard IISafety

1. Does not make judgmental, discriminatory, or prejudicial statements to the patient, staff, or faculty.

2. Applies principals of universal precautions, practices specific isolation techniques, and teaches the reasons for
universal precautions.

3. Assesses patients for fall risk and applies principles of safe patient handling.
4. Maintains the patient's physical safety by protecting the patient from harm.

5. Maintains medical and surgical asepsis when doing procedures requiring sterile technique.
6. Properly identifies techniques and teaches the reasons for universal precautions.

7. Validates the accuracy and appropriateness of orders for nursing/medical care prior to initiating care.
8. Implements orders accurately and efficiently.

9. Is able to identify potential signs and symptoms of an emergent medical condition and promptly reports changes in
the patient's health status to preceptor and/or clinical faculty member.
10. Adapts skill performance using principles of theory when necessary.
3 Minimal

Standard IIINursing Process: Assessment

1. Identifies data from the history and physical assessment to formulate appropriate nursing diagnoses.
2. Identifies the patient's health education needs.
3 Minimal

Standard IIINursing Process: Diagnosis

1. Synthesizes history and assessment data as well as diagnostic results into the development of nursing diagnoses.
3 Minimal

Standard IIINursing Process: Plan

1. Integrates psychosocial needs into care plan, identifies appropriate resources for the plan of care, and incorporates
health education into the care plan.

2. Identifies measurable, expected patient outcomes that are realistic and individualized to the patient.

3. Identifies the discharge planning process and needs of the patient upon admission and throughout the hospitalization.
4. Demonstrates judgment in decisionmaking and priority setting.

5. Uses appropriate collaborative resources to personalize the nursing care the patient receives.
3 Minimal

Standard IIINursing Process: Intervention/Implementation

1. Demonstrates understanding of the principles underlying nursing actions appropriate for the student at this point in
the curriculum.

2. Performs skills according to agency policy and procedure and clinical lab guidelines.

3. Implements the written action plan/protocol considering the priorities for each assigned patient.
4. Standard IIINursing Process: Intervention/Implementation

5. Implements a teaching plan based on scientific knowledge and utilizes resources appropriately.
6. Incorporates evidence based research into nursing practice.
7. Practices individualized and culturally competent care.
8. Initiates appropriate referrals as needed.
3 Minimal

Standard IIINursing Process: Evaluation

1. Evaluates the patient's response/outcome to the intervention.

2. Utilizes subjective and objective data to revise nursing actions (as appropriate for the student at that level of the
curriculum).
3 Minimal

Standard IIINursing Process: Organization

1. Provides organized, coordinated, and prioritized nursing care for the patients with a range of health problems.
2. Organizes time and resources effectively and efficiently.

3. Gathers and organizes equipment necessary for patient care/procedures.
4. Identifies and seeks appropriate resources during patient care provision.
5. Completes the daily clinical assignment in a timely manner.
3 Minimal

Standard IIINursing Process: Documentation

1. Appropriately develops long and short term patient oriented nursing care goals based on patient assessment and
scientific principles of nursing practice.

2. Documents problems and nursing care goals in the patient record (with cosignature).

3. Identifies and documents nursing actions/orders initiated in implementing the plan of care.
4. Correctly enters data into the patient record in a timely manner per agency protocol.
5. Assures privacy of the patient record at all times.
3 Minimal

Standard IIINursing Process: Critical Thinking

1. Utilizes critical thinking skills to prioritize patient needs based on the patient assessment.
3 Minimal
Comments:

Morgan Mcmahon has reviewed the above evaluation on 4/11/2017 and has provided the following comment:

172.31.7.190/projectnurse_usf_prod APP v4.60.6627.37408 DB v4_59 2/11/2018 APPUSER:MAM7

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