Multi Rater Competency Assessment

2015 - 2016 - NURS 253 Practical Nursing Pre-graduate Experience MRA Mid (201508)
NURS 253 Practical Nursing Pregraduate experience (PN, 18-Jan-2016 - 07-May-2016)
Student :
Clinical Teacher/Preceptor :
Advisor :
Program Coordinator :
Location :
Placement Setting :
Unit/Office/Clinic :
Description :

Period :
Student hours :
Required Hours :
Validated hours :

Sadiq Adisa Bello

Nadette Tanguilig
Mercelies McHugh
Judy Martin
The McCall Centre for Continuing Care
Agency
Complex Care
Organization consists of a mix of palliative, long term
care and complex care. Worked in close proximity with
a preceptor learning each floor routines, daily
organizational plans, documentation, report briefings
and giving care to patients. Care involved medication
administration, blood sugar reading, wound dressing,
patient safety management, managing catheters, Gfeeds, Ivs, subcutaneous injection administration and
fall prevention for patients. Also, worked interprofessional with physiotherapist, personal support
workers and occupational therapist .
18-Jan-2016 To 07-May-2016
200
200
200

I declare that this is my original work and the sources used are acknowledged.

Abilities and Outcomes / Learning Outcomes

Student Rating

Teacher Rating

1. Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies and procedures of the
practice setting.

1. 1 Comply with regulatory standards, relevant legislation and the practice settings policies and

Satisfactory

Satisfactory

procedures.
S.A.B. : I complied with organizational policy being on time to shift, listen to the reports and adhered to the medical directives as ordered by
physician.

1. 2 Act in a professional, responsible, ethical and accountable manner.

Satisfactory

Satisfactory

S.A.B. : I acted professionally by following good time management and adhering to institutional policies and procedure. I maintained accountability by
documentation clients changes and reporting client changes to my preceptor and charge nurse. I acted ethically by respecting clients choice and
maintaining commitment to client by being honest and keeping promises about time of procedures such as dressing and medication administration.

1. 3 Use the three factor and decision making frameworks to determine strengths and limitations and
when to collaborate and consult with other professionals.

Satisfactory

Satisfactory

S.A.B. : I make use of the three factor framework the client, nurse and environment.Taking into consideration when client complexity progresses,
responsibility switch from RPN to RN. I ask questions when in doubt about a procedure and consult with both intra professional and inter professional
team members

1. 4 Integrate evidence-informed practice and a theory based approach into nursing care.

Satisfactory

Satisfactory

S.A.B. : I maintained evidence-informed practice by maintaining good hand hygiene practice by regular hand washing between patient care.

1. 5 Assess practices and risk management principles and take action to ensure safety of clients,

Satisfactory

Satisfactory

self, and others.

S.A.B. : I maintained client safety by lowering of bed to prevent falls and positioning of patient in semi-fowlers position during administration of
medication to prevent aspiration or choking especially patient with G-feeds. Taking into consideration to leave client in semi-fowler position after
feeding.

1. 6 Question and clarify unclear orders or directions and when uncertain.

Satisfactory

Satisfactory

S.A.B. : I always clarify medication on the medication administration record with my preceptor when in doubt and seek assistance when needed.

1. 7 Question, clarify or challenge questionable orders, decisions or actions by others.

Satisfactory

Satisfactory

S.A.B. : I always follow the checks of medication so as reduce medication errors and clarify medication orders with my preceptor when in doubt.

1. 8 Respond in a professional manner to situations in which there is unsafe, unacceptable or

Satisfactory

Satisfactory

unprofessional behavior.
S.A.B. : I do maintain my ethical responsibilities by respecting client choice and maintaining commitment to client by practicing self reflection and not
try imposing my beliefs on client.

1. 9 Demonstrate understanding about the role of the nurse within health care.

Satisfactory

Satisfactory

S.A.B. : I understand the role of a nurse not just as a care giver but a leader, communicator and an advocate who strives for the betterment of client
and respecting family members while working judiciously both intra-professional and inter-professional team members.

Teacher comments for Model safe, competent, and ethical practice in compliance with legal and regulatory frameworks and the policies
and procedures of the practice setting. :
Sadiq practices safety in medication administrations, injections and procedures in accordance to company policies and from the knowledge learn from
school. He follows the guidance of transferring, positioning and lifting of patients by looking the instructions first before moving patients. He
demonstrated his competency in maintaining confidentiality, respecting patients' rights, and by practicing his role as an RPN student.

2. Communicate using strategies and technology to effect accurate and timely information sharing including data, research, and other
information.

2. 1 Contribute to team sharing and discussions.

Satisfactory

Satisfactory

Satisfactory

Satisfactory

S.A.B. : I do contribute to team discussion sometimes when my inputs are needed.

2. 2 Document clearly, accurately, concisely in a timely manner using written and electronic methods.

S.A.B. : I do document clearly in a concise manner and I ask my preceptor to evaluate what have written in the progress note of client and I take
corrections diligently

2. 3 Use effective communication techniques when reporting relevant information and providing

Satisfactory

Satisfactory

feedback to the appropriate members of the interprofessional heath care team.

S.A.B. : I do communicate effectively when reporting to my preceptor and give appropriate feedback to interprofessional team members.

2. 4 Evaluate and refine techniques used to communicate and share information with clients and the

Satisfactory

Satisfactory

interprofessional health care team.

S.A.B. : I always make sure my behavior matches my expression and try to smile more when attending to patient on the unit.

2. 5 Ensure privacy and confidentiality.

Satisfactory

Satisfactory

S.A.B. : I ensured privacy and confidentiality by getting rid of clients information and not talking about client when not on the unit. I also make sure I
maintain confidentiality by providing privacy when attending to client and all names on the medication strip properly disposed.

2. 6 Use technology to retrieve information including research and other date and to obtain and

Satisfactory

Satisfactory

forward information both within and outside the practice setting.

S.A.B. : I make use of available resource to research drugs, terms or diagnosis am not familiar with while taking note of institutional policy and
maintaining confidentiality during research.

Teacher comments for Communicate using strategies and technology to effect accurate and timely information sharing including data,
research, and other information. :
Sadiq demostrated proficiently in charting by jotting all the necessary informations.

3. Engage in relational practice that is caring, compassionate and respectful.

3. 1 Establish therapeutic caring, compassionate, and culturally safe relationships with clients and

Satisfactory

Satisfactory

health care team members.

S.A.B. : I try not to impose my belief on clients or co-workers by practicing self reflection and respecting others people view on what they believe. I try
to maintain my cultural boundary and am open to other peoples' culture. I am more culturally aware of the various client on the unit, taking account
that language barrier have a factor in determining the quality of care

3. 2 Establish a caring environment that supports clients in meeting their needs and outcomes,

Satisfactory

Satisfactory

managing their illness, or experiencing a peaceful death.

S.A.B. : I try as much as possible to provide patient with best therapeutic care so as to improve the quality of care experience. Some of the practice I
utilized are attending to call bells on time, maintaining confidentiality and dignity of client.

3. 3 Demonstrate therapeutic use of self to foster client well-being.

Satisfactory

Satisfactory

S.A.B. : I make sure client well-being is of utmost importance some of the technique I used in achieving this is by communicating with client and
spending time to explore their feeling and concerns.

3. 4 Utilize relational knowledge and skills, and ethical principles to support clients and to interact

Satisfactory

Satisfactory

with health care providers.

S.A.B. : I make sure my practice are of ethical standards which include maintaining commitment to client and team members both intra-professional
and inter professional members so as to have a good working relationship in which planned goal tend to be achieved. I make sure therapeutic
relationship is based on trust,compassion,equity, veracity and beneficence.

3. 5 Use self-awareness to identify the effects that beliefs, values, and personal experiences have on

Satisfactory

Satisfactory

relational practice.
S.A.B. : I am aware that beliefs and values can undermine therapeutic relationship so I try not to impose my beliefs on client and respect client
wishes.

3. 6 Collaborate with clients, members of the interprofessional and health care teams; and, consult

Satisfactory

Satisfactory

appropriately.
S.A.B. : I know my strength and weakness and seek assistance when I need one. Some of the ways I have demonstrated this goal is assisting team
members when moving client up in bed and transfers of client to bed that require two persons to do this task. Also, I ask questions when in doubt and
I put it out to my preceptor, charge nurse or other registered nurse on the unit who have more experience than I do.

3. 7 Uphold practices and systems that support the diversity of clients and of the interprofessional

Satisfactory

Satisfactory

health care team.

S.A.B. : I aware of diversity of clients. I try to support and embrace each client uniqueness to achieve the best therapeutic relationship making care a
wonderful experience for client. I also respect diversity of inter -professional and intra-professional team members by being culturally sensitive and
open to exploring people of different culture or belief that are different from mine.

3. 8 Provide effective client education.

Satisfactory

Needs
Development

S.A.B. : I always provide information on medication given to client such as the indication of the drug, adverse effects of medication and drug
interaction with other medications.

Teacher comments for Engage in relational practice that is caring, compassionate and respectful. :
Sadiq practiced caring, compassionate, and respect to all staffs, patients and patients' families by therapeutic communicating, and providing
necessary information to all concerns.

4. Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the profession.

4. 1 Evaluate and refine leadership skills to develop solutions, resolve conflict, create a positive work

Satisfactory

Satisfactory

environment and organizational culture, and to strengthen advocacy role.

S.A.B. : I have the knowledge and leadership skill sets to resolve conflict as conflict does not provide a good working environment to thrive.

4. 2 Provide feedback to peers and accept feedback from peers and members of the
interprofessional health care team.

Satisfactory

Satisfactory

S.A.B. : I always get feedback from my peers and I practice self reflection on my daily activities on the unit to figure out what I could have done better
to make my practice more efficient and effective. I also get feedback from my preceptor on what I did well and what I did wrongly so as for me not to
repeat such mistake or error again.

4. 3 Advocate for clients, self, others, and quality practice environment.

Satisfactory

Satisfactory

S.A.B. : I do advocate for client for example I do take note of changes in vital signs of client and report changes in client condition to my preceptor
and charge nurse to explore may be its a new finding or a known finding.

4. 4 Support clients rights for self-determination and choice.

Satisfactory

Satisfactory

S.A.B. : I do support client rights especially right to refuse to medication and other procedure. I try to explore client feelings and facilitate ways for
which choices will be implemented in the care plan of clients.

4. 5 Respond appropriately to unsafe, unacceptable, and unprofessional behaviors.

Satisfactory

Satisfactory

S.A.B. : I know how to respond to unsafe behavior by approaching the offender and documenting of the inappropriate behavior and reporting the
actions to the charged nurse.

4. 6 Demonstrate public protection and acting in the interests of the public through collaboration and

Satisfactory

Satisfactory

consultation with other members of the interprofessional health care teams.

S.A.B. : I know the nursing profession is all about protecting the public and since its self regulatory nurses are supposed to conduct themselves in
manners the curtail the security and protection upholds to the public. Some of the ways I achieved this indicator is by constant consultation and
collaboration with other team members to provide the best therapeutic care for client.

4. 7 Contribute to the creation of quality practice strategies and solutions.

Satisfactory

Satisfactory

S.A.B. : I contributed to quality practices by constant assessment and documentation of findings on client. I make use of the appropriate channel of
authority such as reporting any changes in client condition to my preceptor.

4. 8 Assign, supervise, teach as appropriate, and provide feedback to unregulated care providers

Satisfactory

Satisfactory

(UCPs) in collaboration with the interprofessional health care team.

S.A.B. : Well, I have not had the opportunity to carry out this indicator but I have the knowledge and skill sets in teaching and supervision of my
peers, provision of feedback and facilitating a good working environment.

Teacher comments for Act as a leader and an advocate to empower clients, self, the interprofessional health care team and to further the
profession. :
Sadiq hadn't had opportunity to act as a leader or to do patients teaching and directing staffs to do their tasks, but he demonstrated well in providing
explanations to the patients' regarding medications/procedures before giving them.

5. Integrate the nursing process into all aspects of nursing care and across diverse practice settings.

5. 1 Formulates clinical judgments that meet clients unique and changing health needs and priorities,
outcomes, and overall condition and incorporates these into evolving plans of care.

Satisfactory

Satisfactory

S.A.B. : I always make use of nursing process: assessment, diagnosis, planning, implementation and evaluation looking for way to provide the best
therapeutic care for client

5. 2 Devise evidence-informed plans of care that are holistic and client-centred.

Satisfactory

Satisfactory

S.A.B. : I understand care plan are designed holistically to fit the client proclaimed or perceived goals as non incorporation of client goals can
undermine therapeutic relationship which decreases the quality of care.

5. 3 Use clinical judgment to assess clients, prioritize needs, outcomes, and nursing interventions.

Satisfactory

Satisfactory

S.A.B. : Some of the clinical judgement I have made is prioritizing which client to first attend to when starting the shift by attending to unstable client
such as those on oxygen by nasal prongs and G-feeds

5. 4 Collaborate in the evaluation, refinement and modification of plans of care.

Satisfactory

Satisfactory

S.A.B. : I do collaborate with UCP, my preceptor, charged nurse and other nurses on the unit to determine goals that needs to evaluated on the care
plan of a client

5. 5 Safely and competently perform treatments and use techniques, and technology autonomously

Satisfactory

Satisfactory

and in collaboration with clients and members of the interprofessional health care team.
S.A.B. : I always use proper body mechanics because the facility maintain a Zero lifting policy to prevent injury. I do raise up the bed in semi fowlers
position when giving medication to client to prevent aspiration

5. 6 Collaborate with the clients across the lifespan and with members of the interprofessional health

Satisfactory

Satisfactory

care team to create a client centered plan of care that is articulated with competence both in writing
and orally.
S.A.B. : I always document in progress note of client for example how client ate, bowel movement characteristics and any changes noted in condition
of client with detailed assessment. I also consult with interprofessional health care team members to determine the level of activity of cleint and need
for changes in care plan of a client.

5. 7 Use awareness of own knowledge and skills, the three factors of nurse, client and environment

Satisfactory

Satisfactory

and the practice decision-making framework to guide practice.

S.A.B. : I am aware of the three factor framework as it specifies how to effectively manage a client without the risk of harm. With increase in
complexity nursing responsibility switch from RPN to RN. For example I had a client who was on G-feed and nasal prongs but upon assessing the
client the O2 sat was low and I called the attention of my preceptor for further assessment and reported the case to the charged nurse.

5. 8 Manage workload, time, and physical resources to provide effective, efficient and ethical care.

Satisfactory

Satisfactory

S.A.B. : I know how manage my time by planning ahead and attending to patient who are not being cleaned by the UCP and coming back to attend
to them when UCP have finished their morning care. Also, I manage my time wisely by taking vital signs of client especially blood pressure because
most of the medication are anti-hypertensive.

Teacher comments for Integrate the nursing process into all aspects of nursing care and across diverse practice settings. :
Sadiq attended clinical days functually and with 100% attendance and planned before the shifts start by getting information and by listening to the
report/s. He gathered all the necessary materials needed before med pass, and before doing procedures. He researches and ask questions to his
uncertainties.

6. Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and holistic health care in a
complex and changing environment.

6. 1 Collaborate with clients to determine needs, mutually agreed health outcomes, approaches to

Satisfactory

Satisfactory

care, and to evaluate care.

S.A.B. : I do collaborate client to determine their health care needs and choices so as to provide the best therapeutic care experience on the unit.

6. 2 Contribute as a member of the interprofessional and health care teams to respond to changing

Satisfactory

Satisfactory

client needs and outcomes.

S.A.B. : I work in close partnership with unregulated care provider, physiotherapist and occupational workers to determine the health care needs and
preference of client.

6. 3 Consult with and seek out assistance from members of the interprofessional health care team.

Satisfactory

Satisfactory

S.A.B. : I know my strength and weaknesses so I seek out assistance from my preceptor, charge nurse and other inter-professional team members.

6. 4 Use teamwork, consensus building, and conflict resolution and leadership skills to meet

Satisfactory

Satisfactory

expected client outcomes.

S.A.B. : I know what it takes to work in a team. This involves interacting, communicating and understanding another persons' point of view to reach a
unified set goals.

6. 5 Integrate effective, collaborative, and consultative strategies to meet clients needs within a

Satisfactory

Satisfactory

changing environment.
S.A.B. : I always make use of available resource to provide the best therapeutic care for clients which kicks off from assessment findings, using both
subjective and objective data to figure out appropriate personnel to consult and collaborate with within the unit.

6. 6 Respect the unique role and competencies of all members of the interprofessional health care

Satisfactory

Satisfactory

team.
S.A.B. : I do respect everyone ideas and opinion on the unit. I allow the UCP to execute their work on patient giving them the space they require and
I consult them appropriately when I need their help.

6. 7 Collaborate as a member of the interprofessional health care team to respond to changes in

Satisfactory

Satisfactory

nursing knowledge and practice and in the health care environment.

S.A.B. : I do collaborate with my team members to provide the best therapeutic care for clients.

Teacher comments for Collaborate and consult with clients and the interprofessional health care team to provide comprehensive and
holistic health care in a complex and changing environment. :
Sadiq work well with the team. He helped staffs to their tasks.

7. Engage in Quality Assurance consistent with the regulatory framework.

7. 1 Act in the best interests of clients and protect clients from harm through collaboration and

Satisfactory

Satisfactory

consultation with other members of the interprofessional and health care teams and by through
competent and safe practice.
S.A.B. : I always act in best interest of clients and protect them from harm through practice of regular good hand hygiene to reduce the spread of
nonsocomial infection. Lowering of bed to reduce fall risk and putting client in semi fowlers' position when giving medication to prevent aspiration.

7. 2 Commit to Quality Assurance practice to identify strengths and areas for professional growth and

Satisfactory

Satisfactory

in accordance with the regulatory framework (CNO).

S.A.B. : Quality is an on going process that needs to be reviewed all the time some of the ways I have contributed to quality service is attending to
patient on time and addressing their needs in good time.

7. 3 Create, implement, and evaluate a learning plan consistent with the Quality Assurance program

Satisfactory

Satisfactory

(CNO).
S.A.B. : I have a learning plan in place based on my weaknesses which I keep improving on. My learning goals was perfecting my parenteral
medication administration which I achieved through my learning plan.

7. 4 Assume responsibility to seek out feedback for colleagues and peers and learning opportunities

Satisfactory

Satisfactory

that foster professional development.

S.A.B. : I always get feedback from my colleagues some of the feedback I have gotten from my peers is to improve more on my communication skills

7. 5 Consistently review nursing research and information about health care to improve competence

Satisfactory

Satisfactory

and to support clients.

S.A.B. : I make use of available resource to perfect my research in nursing. The nursing research that am working on is the change in priority
assessment ABC which is now denoted to be C.A.B.

7. 6 Develop professional responses to health care system changes resulting from advances in

Satisfactory

Satisfactory

research, technology, and changes in societal and political forces.

S.A.B. : I have the skill sets to adjust to changes that present my way in the clinical settings. I am patient and willing to learn if given the opportunity.

Teacher comments for Engage in Quality Assurance consistent with the regulatory framework. :
Sadiq demonstrated well on medication administration in accordance to company policies and standard nursing practices.

8. Use critical thinking, problem solving and decision making skills to meet the health care needs and expected outcomes of clients.

8. 1 Use critical thinking to inform decision making in all aspects of nursing care.

Satisfactory

Satisfactory

S.A.B. : I use critical thinking in determining which patient deserves priority over another as this saves time and quick delivery of nursing care.

8. 2 Use clinical judgment to assess and refine assessments in collaboration with the
interprofessional health care team, formulate nursing diagnoses, plan nursing interventions, and
outline evaluative criteria.

Needs
Development

Needs
Development

S.A.B. : I make use of my knowledge base to make good clinical judgement about patients.

8. 3 Evaluate and refine critical thinking, problem solving, and decision-making skills.

Satisfactory

Satisfactory

S.A.B. : I make use of the decision making model used on the C.N.O documents to evaluate my problem solving skills.

8. 4 Integrate knowledge from variety of nursing, health, and other theory into nursing practice to

Satisfactory

Satisfactory

provide safe and competent care.

S.A.B. : I make sure I use knowledge gained from my theory class is integrated into my practice such as position of client, safe body mechanics to
avoid injury and prioritization of clients.

8. 5 Prioritize effectively.

Satisfactory

Satisfactory

S.A.B. : I know how prioritize effectively. Prioritizing on the unit involves attending to client that are unstable such as those on oxygen with frequent
monitoring of oxygen saturation level. Also, some

8. 6 Demonstrate professionalism, responsibility, and accountability.

Satisfactory

Satisfactory

S.A.B. : I demonstrate professionalism by coming into placement early, neat and ready to work. I get report from outgoing nurses. I document
findings and procedures done on clients. I respect everyone uniqueness on the unit and hold myself accountable for what I do or say to my team
members on the unit.

8. 7 Use critical thinking, the practice decision-making framework and the nurse-client-environment

Satisfactory

Satisfactory

framework to inform clinical judgments and practice.

S.A.B. : I use critical thinking to make good clinical judgement in the practice setting which is tied down to nursing process and making use of the 3
factor framework. I know that with increase in complexity and instability of client nursing care shift from RPN to RN.

Teacher comments for Use critical thinking, problem solving and decision making skills to meet the health care needs and expected
outcomes of clients. :
Sadiq reported important details and suggested solutions to the misbehaving patients.

Student Midway Summary with Strategies for Continued Growth

I will continue to improve on my skill sets since the nursing profession is self regulatory and the need for continuous improvement. I will keep
practicing my assessment skills, communication and procedural skills such as catetherization, wound dressing and parenteral medication.

Teacher Midway Summary with Strategies for Continued Growth

Sadiq can work well on various field environment such as rehab unit, chronic andpalliative , long term care and complex care unit. He is competent in
therapeutic communications, charting, and medication and injections. He knew how to managed himself into stressful surroundings. He continue
improving himself by practicing what was learned and trying to improve more in such a way that he will be ready to work in his own

Advisor Midway Summary with Strategies for Continued Growth

Sadiq is making satisfactory progress in his practice. He is able to function at an almost independent level. He is however, encouraged to continue to
further develop his knowledge, skills and judgement, through ongoing research and by seeking out new learning opportunities. Daily self assessment
and feedback are needed for safe and competent care delivery and for ensuring and maintaining quality assurance, thereby upholding the standards
of practice stipulated by CNO. Involving various members of the inter professional team,with a collaborative approach, he is encouraged to observe
the admission process of clients and become more familiar with how clients' care plans are created to meet a wide range of needs. In so doing,
nursing diagnoses, planning interventions and devising an evaluation system will be formulated and employed. This exposure will further advance his
skills and judgment.

Student's References
College of Nurses of Ontario. (CNO). (2011). Video: Abuse Prevention: One is One too Many.
Retrieved from www.cno.org
College of Nurses of Ontario. (2012). Entry to Practice Competencies for Ontario Registered
Practical Nurses (Updated 2011). Retrieved from www.cno.org
College of Nurses of Ontario. (CNO). (current edition). Practice Guidelines: Consent. Retrieved
from www.cno.org
College of Nurses of Ontario. (CNO). (2009). Practice Guidelines: Culturally sensitive care.
Retrieved from www.cno.org
College of Nurses of Ontario. (CNO). (2009). Confidentiality and Privacy Personal Health
Information. Retrieved from www.cno.org
College of Nurses of Ontario. (CNO). (2009). Practice Standard: Documentation, Revised 2008.
Retrieved from www.cno.org
College of Nurses of Ontario. (CNO). (2009). Practice Standard: Ethics. Retrieved from
www.cno.org
College of Nurses of Ontario. (CNO). (2009). Practice Standard: Infection prevention and control.
Retrieved from www.cno.org
College of Nurses of Ontar

Refer to Clinical Excellence Committee (CEC)

Grade

Satisfactory

Grade

Needs Development

Satisfactory

Program Coordinator Feedback

The Program Coordinator has reviewed the evaluation

Yes

No

Student Sign Off

I met with my Clinical Teacher/Preceptor and discussed my evaluation

Yes

No

In general this evaluation accurately reflects my performance

Yes

No

Student Comment
I will continue to improve on my nursing knowledge,skills and judgemnt.

Submitted Date: 22-Feb-2016 22:43

Unsatisfactory