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5-Outstanding: Exceeds Standards
Exhibits above average performance of nursing care for this level student. The student is
proactive, self-directed, and consistently engaged in learning; needs minimal guidance; is
knowledgeable; and appropriately incorporates knowledge with skills. Student is proactive and
self-directed in approach to learning.
3-Minimal
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.
2-Unsatisfactory
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.
1-Unsafe 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 I--Communication
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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
From week one of clinical, Rebecca has consistently demonstrated a high level of communication
skills. Regardless of what time during her shift she is seen by clinical faculty, she is prepared to give
a solid and detailed report about her patient. She is also capable of engaging in high-level
conversation regarding her patient's medical history and plan of care. She demonstrates great
interpersonal skills when communicating with her peers, nursing preceptors, other members of the
healthcare team, patients and clinical faculty.
Standard I-Knowledge
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.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice
Standard I-Attitude
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Standard II-Safety
1. Identifies data from the history and physical assessment to formulate appropriate
nursing diagnoses.
2. Identifies the patient's health education needs.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
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3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice
1. Synthesizes history and assessment data as well as diagnostic results into the
development of nursing diagnoses.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice
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 decision-making and priority setting.
5. Uses appropriate collaborative resources to personalize the nursing care the
patient receives.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice
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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.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice
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 co-
signature).
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.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice
1. Utilizes critical thinking skills to prioritize patient needs based on the patient
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assessment.
5 (Comment Required) Outstanding: Exceeds Standards
4 Satisfactory: Meets Standards
3 Minimal
2 (Comment Required) Unsatisfactory
1 (Comment Required) Unsafe to Practice
Rebecca has always demonstrated a high level of critical thinking abilities while in the clinical setting.
Comments:
It has been a true pleasure to teach Rebecca for her Med/Surg 1 clinical rotation, and she has
demonstrated excellent growth this semester. She has such a positive attitude, and a strong conscience.
She always asks appropriate questions and keeps the safety of her patients as a top priority. Rebecca
demonstrates characteristics of a strong team player and has excellent potential leadership abilities. I am
proud of her for the progress that she has made up to this point in her academic nursing career. Her
preceptors have made the following comments on her behalf:
Rebecca Netjes has reviewed the above evaluation on 12/8/2016 and has provided the
following comment:
Cancel
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