Student Name: Amanda Lindstrom

Southwestern Oregon Community College Nursing Program

Nursing 110
Foundations of Nursing: Health Promotion

Clinical Evaluation Tool

Nursing 110 Clinical Evaluation Tool

Student Name:

Clinical Week
1

Compete
ncy (C)
Course
Outcome
s
(CO)

C9
CO 1, 2

C4
C3
C4
C1,2

3
10/2
2

4
10/2
9

7
11/1
9

11/26

12/2

10/8

Attendance: P=Present, A=Absent, T=Tardy

Holid
ay

Facility/Unit

BCV

BCV

CC

Flu
clnic

BCV

BCV

BCV

NA

BCV

na

Prioritizes health problems.

Develops a plan of care that considers the individual,
family, age of client, developmental stage, psychosocio-cultural issues, and/or learning needs.
Evaluates and reflects on plan of care.

na

na

na
na
na
na
na

11/5

6
11/1
2

na
na
na

na
na
na

s
s

s
s

s
s

s
s

na
na
na

s
s

na
na

na
na

Uses therapeutic communication with patients and

agency staf

n/o

na
n/o

Recognizes cultural issues and interact with clients in

culturally sensitive ways

na

n/o

na

na

na

na

5.

C3

2
10/1
5

Dates

Applies concepts and theory to clinical practice in client

care and written assignments:
1. Collects data and conducts a health assessment on a
client.
2. Analyzes and interprets the data/assessment findings.
3.
4.

C 8, CO
5
C 6,7,8
CO 1,4
C10,
CO2
C6,
CO2
C9,
CO2

Amanda Lindstrom

Uses research and evidence to support clinical decision

making

na

Utilizes resources as needed

na

na

na

Demonstrate responsibility and accountability for

professional behavior:
1. Performs safely in clinical.
2. Prepared for clinical (Appropriate attire, appropriate
tools such as stethoscope, skills list, evaluation tool,
assessment tools).
3. Takes initiative in making decisions and assuming
responsibility for decisions.
4. Looks for opportunities for continued learning and
self-development.
5. Identifies behaviors and attitudes influencing
professional behavior.
6. Demonstrates growth in coping with stressful
situations in a calm and dependable manner.

na

ni

na

na

na

na

na

na

na

na

na

s
s

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C1,
CO3
C3,
CO8
C2
C4,
CO8

7.

Maintains patient confidentiality.

na

na

8.

Completes and submits assignments on time.

na

na

9.

Organizes and manages time efectively.

na
na

na
na

10. Attends and participates at post-conference.

s
s

Instructor Initials
Student Initials

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Key: C=Competency, CO=Course Outcome

2

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

4
5

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)

Student
Initials

First clinical experience. Introduces self to patient- spends quality time listening to patient. Does
skin assessment and documents well for initial
attempt-------------------------------------------------------------------------------MSperry MSN RNc
Does skin assessment, ears and partial neuro. Voices concerns about communication between
staf and patients. This can be an area we can all work onhow we communicate definitely
influences how others view us. If you see patient abuse you must report it, if it is a
communication style or concern with tone, it is always best to speak with the person directly
let me know if this continues to occur-------------------------------------------------------------MSperry MSN
RNc
Spent clinical experience at Community Caf- Submits required paperwork. Be cautious of using
assumptive and subjective statements. Use objective data to chart and document withsubjective data can be used with quotation marks if it is what a client
said.-----------------------------------------------------------------------------------MSperry MSN RNc
Participates in flu clinic at CB Fie Dept. Identifies elevated BP. Remember when you find an
abnormal VS b sure to notify your instructor and/or nurse in acute care. With the patrons BP
that elevated he was at risk. Nice reflection on care plan and
clinic----------------------------------------------------------------------------------------------------MSperry MSN RNc
Cares for patient post CVA. Identifies 2 nursing dx and creates nursing statements for both.
Practice being more specific and measurable with goals and interventions and include more

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specific data to support you dx. Works with classmates and

staf-------------------------------------------------------------------------------------------------MSperry MSN RNc
Demonstrates beginning understanding of nurse care planning. Identifies 2 nursing dx and
appropriate interventions. Practice making these measurable and specific. Work on your goals
these are very generalized and need to be realistic, patient centered and
measurable.---------------------------------------------------------------------MSperry MSN RNc
Working on basic care planning skills and beginning prioritization. Able to perform skills
adequately in clinical setting and continues to work on communication. Excellent listening this
week and problem solving when finding watch that was missing by a
patient.-------------------------------------------------------------------------------------------MSperry MSN RNc
Thanksgiving Holiday

AKL

AKL

AKL

Final clinical week- able to complete a beginning care plan that is patient centered. We will work
on goal setting and measurable, specific interventions next term.
----------------------------------------------------------------MSperry MSN RNc

Clinic
al
Makeup
9/1/09: rev 05062011: reviewed 9/2014 sw

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