| Student Name: | Faculty: | ||
| Course: | Semester: | Year: | Clinical Site: |
| DEMONSTRATES PROFESSIONAL BEHAVIOR | |
| · Student is on time and appropriately dressed
· All pre-clinical assignments and readings are completed · Adheres to all legal and ethical guidelines according to the Standards of Professional Performance · Demonstrates cultural sensitivity · Protects patients’ rights |
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| FACULTY COMMENTS | STUDENTS COMMENTS |
| Midterm
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| Final
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| COMMUNICATES EFFECTIVELY | |
| · Asks for help when needed
· Therapeutically communicates with patient and family, demonstrates empathy appropriately · Effectively communicates with staff and all members of patient care team · Acts as patient advocate · Provides handoff to staff in SBAR form |
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| FACULTY COMMENTS | STUDENT COMMENTS |
| Midterm
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| Final
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| MEDICATION MANAGEMENT | |
| · Assesses patient prior to medication administration
· Knows appropriate information regarding medication; drug class, side effects, medication contraindications · Required labs are obtained prior to administration · Evaluation of medication completed |
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| FACULTY COMMENTS | STUDENT COMMENTS |
| Midterm | |
| Final | |
| CLINCAL SKILLS | |
| · Student nurse will follow all policies and procedures when performing clinical skills
· Looks for opportunities to observe or perform clinical skills · All skills performed are documented appropriately · Accepts constructive feedback of clinical skills performed and uses it to improve practice · Refers to evidenced-based practice |
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| FACULTY COMMENTS | STUDENT COMMENTS |
| Midterm | |
| Final | |
| CRITICAL THINKING & PATIENT CENTERED CARE | |
| · Participates in pre and post clinical conferences
· Creates detailed Patient Care Plan · Provides safe environment for patients · Adheres to HIPAA and patient safety guidelines · Implements appropriate nursing interventions and evaluates · Utilizes problem solving skills
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| FACULTY COMMENTS | STUDENT COMMENTS |
| Midterm | |
| Final | |
| PATIENT EDUCATION | |
| · Assesses learner’s ability to learn and preferred method of learning
· Identifies when learning will need teaching reinforcement · Determines content that needs to be taught · Provides handouts or demonstrations when necessary · Evaluate teaching and implementation strategies |
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| FACULTY COMMENTS | STUDENT COMMENTS |
| Midterm | |
| Final | |
Daily Clinical Feedback: