Bryant & Stratton College Nursing Clinical Evaluation Form

Student: Caitlyn Wegner NURS 211: Med/Surg Nursing I

Instructor: ___V. Moore SEMESTER: _Winter 2020

The student must receive a minimum of a 2.5 average for an overall evaluation of Satisfactory in the
clinical rotation. This means out of the 10 objectives with 48 items, the student must earn 120 points out
of a possible 192 points.

Starred items “*” indicate that the student must receive a minimum of Satisfactory 3.0 by final faculty
evaluation in order to pass clinical and progress to the next course.

Any item receiving a 1 in the faculty final evaluation is an automatic clinical failure.
Any item that is Not Applicable will be scored as “n/a”

CLINICAL OBJECTIVES (Course Outcomes):

1 Demonstrate competence in the performance of nursing skills to provide safe and

effective care in order to adjust learning processes for continual improvement.
2 Employ the nursing process and QSEN competencies to manage the nursing care of
acutely and chronically ill patients.
3 Assimilate appropriate pharmacologic and nutritional principles into the care of acutely
and chronically ill patients.
4 Integrate diagnostic testing into the care of acutely and chronically ill patients.
5 Apply standards of practice into the care of acute and chronically ill patients.
6 Describe assessment and evaluation findings to appropriate members of the health care
team.
7 Examine the principles of teaching and learning techniques and demonstrate leadership
skills in the care of acutely and chronically ill patients.
8 Demonstrate legal and ethical accountability in the care of patients with health care needs.
9 Employ a framework of personal accountability for lifelong learning through utilization of
culturally relevant evidence-based practice to provide safe, effective nursing care for
acutely and chronically ill patients.
10 Apply information literacy skills to provide nursing care for acutely and chronically ill
patients.

The six roles of the Associate Degree nurse (Advocate, Member of Discipline, Provider of Care,
Researcher, Manager of Care, and Teacher)

Nursing Program Student Learning Outcomes:

1. Employ critical thinking and reasoning to utilize the nursing process as a framework to
deliver comprehensive, safe, and culturally sensitive care across the lifespan.
2. Demonstrate clinical competence in the performance of nursing skills utilizing quality
measures to provide safe effective nursing care. 
3. Apply best current evidence and appropriate nursing judgment in collaboration with the
patient to guide clinical decision making in the delivery of nursing care.
4. Collaborate and communicate effectively with patients, families and their social support
system, and the members of the health care team to achieve mutually agreed upon patient
outcomes.
 5. Practice within the ethical, legal and regulatory frameworks of professional standards for
nursing, including employing agencies’ standards of care, assuming students had no past
conduct or convictions, which prevent such practice.
6. Construct a framework of personal accountability for lifelong learning with an entry-level
set of knowledge, skills, and behaviors to provide safe, effective nursing care.
7. Employ information literacy skills through the effective use of informatics to
communicate, manage knowledge, mitigate errors, and support decision-making.

Guide for Interpretation of Evaluation Scale

4.0 = Student consistently functions at expected level independent
Proficient, coordinated, confident, with minimal or no direction
3.0 = Student consistently functions at expected level with minimal guidance.
Safe, accurate, efficient, coordinated, confident, with occasional direction
2.0 = Student requires reminders and guidance to function at adequate level.
Safe and accurate, inefficient or inconsistently efficient
1.0 = Student performs unsatisfactorily, is unable to meet clinical objectives without needing
constant guidance, or the student is unsafe in the clinical setting. Unable to demonstrate
procedures. Needs continuous verbal and/or physical direction.

Student and Faculty will indicate their individual scoring using their initials:

Student/Faculty Mid-Term Eval Faculty Final Eval

1 2 3 4 1. Demonstrate competence in the performance of nursing skills to 1 2 3 4
provide safe and effective care in order to adjust learning
processes for continual improvement.
(provider of care, member of discipline; SLO 1, 2)
√ 1. Safely performs skills in the clinical setting that have been demonstrated in √
the lab. *
√ 2. Maintains a safe environment based on age-appropriate individual patient √
assessment and interventions. *
√ 3. Conducts appropriate risk assessments on a routine basis to ensure safe -
and effective care (ex – Morse and Braden scoring) *
√ 4. Recognizes need for help and requests assistance when needed from either -
instructor or RN*
√ 5. Prioritizes nursing care effectively. √

4/12/20 Clinical was not in session for last ½ of semester so areas are not able to be assessed.

1 2 3 4 2. Employ the nursing process and QSEN competencies to manage 1 2 3 4

the nursing care of acutely and chronically ill patients.
(provider of care, member of discipline, advocate; SLO 1, 3, 4)
√ 6. Collects subjective and objective data through appropriate patient √
assessment and pertinent medical record information.*
√ 7. Interprets and analyzes data to identify patient problems and needs.* √
√ 8. States appropriate outcomes based on patient needs and assessment data. √
√ 9. Identifies and provides nursing interventions and rationale to meet √
outcomes.*
√ 10. Revises the nursing plan of care based on changes in patient condition √
and/or patient response to interventions
Faculty Final Eval
 4/12/20 Assessment based on clinical paperwork. Student needs to work on setting measurable
interventions.
1 2 3 4 3. Assimilate appropriate pharmacologic and nutritional principles 1 2 3 4
in the care of acutely and chronically ill patients.
(provider of care, manager of care, member of discipline; SLO 1, 3,
5)
11. Consistently comes prepared to clinical with medication cards and the ability to √
√ personalize the information to the patient*
√ 12. Applies pharmacologic knowledge to patient care in the clinical setting √
√ 13. Verbalizes important information about prescribed medications.* √
√ 14. Administers medications correctly.* √
√ 15. Incorporates nutritional principles in clinical practice. -
√ 16. Evaluates nutritional assessment data to create a plan of care -
Student/Faculty Mid-Term Eval Faculty Final Eval
4/12/20 Assessment based on V Sim math assignments.

Faculty Final Eval

1 2 3 4 4. Integrate diagnostic testing into the care of acutely and 1 2 3 4
chronically ill patients.
(manager of care, member of discipline; SLO 1, 3)
N
A
17. Incorporates appropriate diagnostic testing results into nursing assessment.* √
N
A
18. Collaborates with the RN regarding diagnostic findings and changes in the -
patient plan of care.
N
A
19. Communicates clinical results with the patient as appropriate. -
N
A 20. Anticipates diagnostic tests to be performed √
N
A 21. Prepares the patient appropriately for diagnostic tests -

4/12/20 Assess not graded unable to assess due to limited clinical experience.
Faculty Final Eval
1 2 3 4 5. Apply standards of practice into the care of acute and chronically 1 2 3 4
ill patients.
(advocate, member of discipline, provider of care; SLO 1, 2, 3, 4, 5,
7)
√ 22. Uses knowledge from theory courses in patient care. √
√ 23. Asks instructor or RN for assistance for standards of practice.* √
√ 24. Refers to and follows agency policies and procedures at all times.* -
√ 25. Provides care which minimizes risk to the patient, family, self, and other -
providers
√ 26. Follows agency guidelines and ANA professional standards for √
practice.*

4/12/20 Unable to adequately assess due to limited clinical site experience

Faculty Final Eval
1 2 3 4 6. Describe assessment and evaluation findings to appropriate 1 2 3 4
members of the health care team.
 (member of discipline, advocate; SLO 1, 3, 4, 5, 7)
√ 27. Communicates effectively, using appropriate medical terminology to √
other health care team members
√ 28. Documents accurately and completely the assessments completed, √
nursing care provided, and other pertinent information on patient’s
record as appropriate to the clinical setting per instructor’s direction.*
√ 29. Protects confidential affairs of facility and patient information.* -

4/12/20 Clinical experience limited due to pandemic.

Faculty Final Eval
1 2 3 4 7. Examine the principles of teaching and learning techniques 1 2 3 4
and demonstrate leadership skills in the care of acutely and
chronically ill patients.
(teacher, researcher, manager of care; SLO 1, 4, 5)
√ 30. Provides teaching as appropriate to patient and family circumstances.* -
√ 31. Conducts a patient learning assessment and correctly identifies -
learning barriers and optimal teaching strategies individualized for the
patient
√ 32. Arrives for clinical well-rested and prepared to give safe patient care √
√ 33. Arrives on time and stays for full duration of clinical. √
√ 34. Adheres to dress code as specified in the Nursing Student Handbook √
and/or by the facility *
√ 35. Demonstrates ability to act on written and verbal directions from √
faculty and members of the healthcare team. *
√ 36. Demonstrates professionalism (flexible, tolerant) in ability to work √
effectively and cooperatively with patients, faculty, and members of the
healthcare team.

4/12/20 Limited due to shorten clinical experience.

Faculty Final Eval
1 2 3 4 8. Demonstrate legal and ethical accountability in the care of 1 2 3 4
patients with health care needs.
(member of discipline, advocate; SLO 1, 2, 3, 4, 5, 6, 7)
√ 37. Identifies ethical issues. √
√ 38. Provides compassionate care.* √
√ 39. Offers nursing care options in identified ethical issues and -
differentiates options which support the individual patient and family
√ 40. Demonstrates accountability for care given by self and/or delegated to 20. -
others.*
√ 41. Practices standards of professionalism and student conduct.* √

4/12/20 Limited clinical experience due to pandemic.

Faculty Final Eval
1 2 3 4 9. Employ a framework of personal accountability for lifelong 1 2 3 4
learning through utilization of culturally relevant evidence-
based practice to provide safe, effective nursing care for
acutely and chronically ill patients.
(researcher, member of discipline, manager of care; SLO 6)
√ 42. Displays a non-judgmental attitude when providing care for patients -
and families of different cultures.*
 √ 43. Applies knowledge from completion of cultural competence self – -
assessment
√ 44. Describes the impact of social, cultural, global, ethnic differences -
when providing nursing care. *
√ 45. Adjusts nursing care to accommodate and respect patient’s cultural -
differences
√ 46. Identifies and takes responsibility to access appropriate resources for √
learning. *

4/12/20 Limited due to shorten clinical experience secondary to the pandemic.

Faculty Final Eval
1 2 3 4 10. Apply information literacy skills to provide nursing care for 1 2 3 4
acutely and chronically ill patients.
(manager of care, provider of care, member of discipline; SLO 7)
√ 47. Utilizes agency electronic health care system in adherence to required -
standards of operating procedures including HIPAA regulations, per
clinical site.*
√ 48. Utilizes bar coding for medication administration per hospital -
standards. *

4/12/20 No EHR, electronic medical equipment, or bar coding used per V Sim
Overall Student/Faculty Mid-Term Evaluation (number score) _______/________
AVERAGE ________/________See comments (attached).

Overall Final Faculty Evaluation (number score) __________________ AVERAGE_________See

comments (attached).
 Bryant & Stratton College

Mid-Term Evaluation Summary

Name: ___Caitlyn Weigner Semester: ___Winter 2020

Course: ____NU 211 Clinical Site: ___CSM

Student completes these 3 areas and submits to clinical instructor for faculty comments:

Identification of Strengths

I think my background in healthcare really attributes to my strengths here at clinical. I took two medical
terminology classes at my previous college, so I am very knowledgeable when it comes to interpreting
and using medical terms. I have been around many different patients, so I am very good with working with
all different patients because no two are the same. I feel that I am adjusting well to the assessments and
charting system.

Areas for Development

I think an area that I need to work on would be working on the Braden and Morse scales to help me better
understand the ratings. A big think I need to work on is jumping at more learning opportunities when they
arise instead of being timid. I also want to work on doing my assessments earlier in the shift if possible.

Plan for Improvement

I have been doing the Morse and Braden scales at the same time I am charting my assessment which
helps me remember to do it, I plan on sticking with this. I plan to try to get my patient’s assessment done
right away after getting report and looking them up if I am able. I am also working on doing things on my
own without asking for help and taking more charge of my patient. I have been reminding my nurses so I
can try and stay on top of things. I have also been offering help with my nurses for further learning
opportunities, which I am going to try doing every week. I look forward to taking on two patients and
seeing how well I handle it.

Faculty Comments:
Caitlyn continues to adjust working on 7 East. Caitlyn is motivated and open to learning. Caitlyn ask for help
appropriately and works well with staff and peers. I encourage Caitlyn to utilize client resources for learning at
Ascension such as Lexicomp and NRC. Also, with these resources, I recommend Caitlyn implement with client
teaching. The goal is at the end of 211 Caitlyn will deliver care to 2 clients.

Student Signature_______________________________/Initials_______

Faculty Signature Veronica Moore MSN RN RRT 3/10/2020

Bryant & Stratton College

Final Evaluation Summary

Name: __ Caitlyn Weigner Semester: _Winter 2020

Course: __NU 211. Clinical Site: __CSM

Faculty Comments:

Caitlyn was unable to obtain second part of clinical experience due to the pandemic experience. Some of
the areas are not graded due to difficulty of proper assessment using V SIM. I have planned to have
Caitlyn complete NU 211 caring for 2 clients. I recommend for Caitlyn to work in a client care area to keep
growing in the area of client care to become competent and confident. Also, I recommend Caitlyn work on
care plan development and lab interpretation with client disease process.

Faculty Signature__ Veronica Moore RN MSN RRT 4/12/20