CH 1

Clinical Evaluation Tool
Evaluator: Davis, Valery (valery20@usf.edu) Completed Date:03/11/2023

Evaluatee: Mott, Paige(pmott@usf.edu) Rotation:NUR322L.450S23_Spring23_BayfrontGold_Davi
s_Final
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.
4-Satisfactory: Meets Standards

Exhibits average performance of nursing care for this level student. Functions with minimum guidance. Demonstrates adequate knowledge and
requires minimum assistance in applying knowledge to skills. Recognizes learning opportunities but may require assistance in utilizing them.
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.
Course
Answer: NUR 3225L COMPLEX HEALTH NURSING I CLINICAL
Semester
Answer: Spring
Year
2023
Select Evaluation Type
Answer: Formative
Standard 1: Patient-Centered Care

1. Performs a comprehensive assessment including patient values, preferences, and needs.
2. Develops an individualized plan of care with a focus on the nursing process.
3. Provides care with sensitivity and respect for the diversity of the human experience.
4. Delivers care based on knowledge of pathophysiology and pharmacotherapy.
5. Identifies potential barriers to active involvement of patients in their own health care process.
Answer: 3 Minimal
Standard 2: Teamwork and Collaboration

1. Demonstrates awareness of own strengths and limitations as a team member.
2. Initiates requests for help from other team members as appropriate.
3. Communicates effectively with patients, family members, and other members of the healthcare team.
4. Identifies potential complications related to handoffs or transitions of care.
Answer: 3 Minimal
Page 1 of 2
Clinical Evaluation Tool
Standard 3: Evidence-Based Practice and Quality Improvement
1. Utilizes evidence-based literature to support clinical decision making as demonstrated in written clinical assignments.
2. Differentiates clinical opinion from evidence-based practice to determine best clinical practice.
3. Promotes and practices quality, cost-effective delivery of care.
4. Identifies potential areas for quality improvement in the clinical setting.
5. Participates in measures to improve patient outcomes as appropriate.
Answer: 3 Minimal
Standard 4: Safety
1. Identifies strategies to reduce the risk of harm or poor patient outcomes in the delivery of care.
2. Delivers medication (as appropriate) in a timely and safe manner including understanding the specific indications for the medication
and potential side effects.
3. Communicates effectively between team members or to clinical faculty when giving patient report.
4. Uses appropriate resources to improve organization and/or time management.
Answer: 3 Minimal
Standard 5: Informatics
1. Navigates the electronic health record where appropriate.
2. Documents clearly, concisely, and accurately in the electronic medical record where appropriate.
3. Protects confidentiality of all protected health information.
Answer: 3 Minimal
Standard 6: Professionalism
1. Demonstrates core professional values (caring, altruism, autonomy, integrity, human dignity, and social justice).
2. Maintains professional behavior and appearance.
3. Demonstrates expected behaviors and completes tasks in a timely manner.
4. Engages in self-evaluation and assumes responsibility for learning.
5. Arrives to clinical setting on time.
6. Demonstrates evidence of preparation for clinical learning experiences.
7. Maintains a positive attitude while interacting with patients, family members, faculty, peers, or members of the healthcare team.
8. Accepts individual responsibility for actions.
Answer: 3 Minimal
Comments: Paige has made great improvement during this clinical rotation. Her confidence in her nursing skills has increased due to her
willingness to be hands-on during patient care. Paige demonstrates critical thinkings skills by identifying patients risks and
creating the nursing interventions to keep patients safe.
Page 2 of 2

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Clinical Evaluation Tool

Evaluator: Davis, Valery (valery20@usf.edu) Completed Date:03/11/2023

5-Outstanding: Exceeds Standards

4-Satisfactory: Meets Standards

Answer: NUR 3225L COMPLEX HEALTH NURSING I CLINICAL

Select Evaluation Type

Standard 1: Patient-Centered Care

Standard 2: Teamwork and Collaboration

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