Clinical Evaluation Process for the ... - My Nursing Portfolio



Clinical Evaluation Process Nursing 3020Instructions The Mid-Term Evaluation will be completed by students at the mid-point of the clinical placement to assist students to take inventory of their current development and assist them to make plans for future clinical practice. The student will use a reflective process to help assess progress in meeting established program, year, and course objectives. The student will submit an electronic copy of the Mid-Term Evaluation document to the clinical instructor prior to the formal mid-term student evaluation. Because the document is to be completed electronically, the student and instructor can take as much space as they need to provide appropriate evidence and feedback.After receiving the student’s Mid-Term Evaluation, the clinical instructor will complete the comment section providing feedback and evaluation of the student’s progress. The clinical instructor will provide suggestions for improvement. The instructor will place a check in the “S” column if progress is satisfactory, and in the “U” column if progress is unsatisfactory. If a student demonstrates unsatisfactory progress at mid-term, the student and instructor will develop a Learning Plan outlining strategies in which the student will engage, along with clear expectations that must be met for the successful completion of the course. The course professor may be involved in developing the learning plan. The student and instructor should save and print a copy of the mid-term evaluation. Printed copies must be submitted to the course professor within a week of completion. At the end of the rotation, students will complete a Final Evaluation. Students will use a new copy of the evaluation template to archive their achievements and areas for future development. The student will submit an electronic copy of their final evaluation to the instructor; this will help the instructor complete an assessment of the student. In order to complete the final evaluation, the clinical instructor will provide additional evidence by completing the comment section, providing feedback and evaluating the student’s progress. The clinical instructor will collect evidence in the form of the student self-assessment, comments of the health care team members, patient input, student submissions (including portfolios) and observations. A summary of achievement as well as implications for future learning should be included in this document. The attendance section and record of completed hours is to be filled in completely. The completed document is to be printed, shared with the student and signed. The signed copy must be returned to the TFSON within 10 days. The Year Lead, lab instructor, and/or course professor will assess the completion of the Learning Center Component, if applicable.Students and instructors will complete both the mid-term and final clinical evaluation documents electronically. An electronic copy of the completed (student and instructor) final evaluation should be submitted to the course professor within 48 hours of the final evaluation delivery. A printed and signed copy should follow within 10 days of the evaluation meeting.yNURS 3020HClinical Evaluation (Check one) Midterm __________ Final ____________Student Name: __________________________________Clinical Instructor: ____________________________Missed Clinical Hours: ______ Missed Lab Hours: ______Program GoalsGraduates are generalists entering a self-regulating profession in situations of health and illness.Graduates are prepared to work with people of all ages and genders (individuals, families, groups, communities and populations) in a variety of settings. Graduates continuously use critical and scientific inquiry and other ways of knowing to develop and apply nursing knowledge in their practice.Graduates will demonstrate leadership in professional nursing practice in diverse health care contexts.Graduates will contribute to a culture of safety by demonstrating safety in their own practice, and by identifying, and mitigating risk for patients and other health care providersGraduates will establish and maintain therapeutic, caring and culturally safe relationships with clients and health care team members based upon relational boundaries and respect.Graduates will be able to enact advocacy in their work based on the philosophy of social justice.Graduates will effectively utilize communications and informational technologies to improve client outcomes.Graduates will be prepared to provide nursing care that includes comprehensive, collaborative assessment, evidence-informed interventions and outcome measures.ObjectivesProgressIndicators/EvidenceSU1Explain the experience of acute illness in individuals receiving care in acute settingA patient was very upset because she had broken her femur and she would no longer be able to stay at her retirement home because they do not have the means to care for her. We explained to her that it was better for her to move somewhere that had the capacity to care for her. When we discussed that she may like the new home that she was going to she seemed to have much less anxiety and stress about moving.A patient was experiencing more pain than she had expected post op and was feeling very discouraged because she was unable to perform the exercises physio gave her because of the pain. It was clear that it was hard for her to need help with ADL’s like washing herself going to the washroom because she was a very active senior and was used to being fully independent.2Interpret critical aspects of the person’s experience of acute illness in relation to common signs and symptoms, responses to treatment, patterns of coping, and impact on individual and family relationshipsA patient was experiencing symptoms indirectly due to their acute illness because a medication they were on was causing undesired side effects (itching). This was difficult for the patient because she was unprepared for this kind of discomfort and it negatively effected her experience One patient felt a lot of anxiety about being in the hospital. IT was important for them to make their room feel as “homey” as possible. One of her coping strategies was having as much control over her day as possible. She liked to schedule her days (ex. knowing when her family was going to come visit, when meals were going to come, when I would come do her vitals). It was important for her to feel the control that she felt when she was at home 3Identify common medical treatments and potential consequences/complications of selected acute illnesses After a patient has had their catheter removed it is important to monitor their ins and outs to ensure that they are not retaining urine in their bladder. If their ins do not match their outs after the first few hours a bladder scan is performed and if the urine volume is greater than 400mL post void (or post attempted void) a catheter is inserted in the patient to prevent infection and rupture of the bladderWhen a peripheral IV has a distal occlusion that cannot be explained by a kink in the tubing it is important to flush the IV with 5mL of normal saline to make sure it is still functional and the occlusion is not beneath the skin. While flushing the IV ask the patient if there is pain as well as look and feel to make sure the saline goes into the vein. If the solution drips out of the site it is an indication that the IV is no longer functional and must be dc’d or replaced with a new, functional IV4Demonstrate selected nursing and collaborative interventions related to clinical pathways, peri-operative care, IV medication administration, cardiac assessment and rhythm strips, neurological assessment, wound care, blood component therapy, TPN and central lines, pulmonary care including chest tubes and tracheotomy, initiating IVs, rapidly changing conditions, and resuscitationI have demonstrated my ability to care for post-operative patients by:Monitoring IV sites (flushing and removing)Completing dressing changesPerforming subcutaneous enoxaparin injectionsMorning and HS careFeedingCompleting ead to toe assessments 5Under the supervision of a Registered Nurse, demonstrate safe, competent, evidence-based, holistic nursing practice with clients with acute illness Apply relevant nursing models, philosophical frameworks, theories and evidence Demonstrate therapeutic use of selfEngage with patients in an ethical and culturally safe mannerUnderstand and anticipate emerging bio-psycho-social needs of persons with acute illness and apply this knowledge to care:Plan appropriate nursing carePredict outcomes of nursing care Evaluate client response to nursing care Demonstrate health promotion and illness prevention practicesEngage with patients and families to identify health-related situational challenges Work with patients and families to create reasonable and effective solutionsDemonstrate patient advocacyDemonstrate accountabilityDemonstrate reliabilityI apply Orem’s self care theory by ensuring that patients have all the tools and education they need to care for themselves when they leabe the hospital. I also apply King’s theory of goal attainment by helping patients set attainable goals in order for their pathway to become more clear and achievable.I demonstrate therapeutic use of self by encouraging conversation by asking open ended questions and allowing patients to fill silences when they feel comfortableBy keeping cultural and ethical differences in mind I am able to remain unbiased when providing care By following the pathway given to the patients I am abl to plan appropriate nursing care by deciding if patients should be using a bed pan or getting out of bed, going for walks and when they should move from bed to chair. By doing this I can predict whether the patients mobility will increase or decrease and evaluate when they are more willing and able to move around. Most families have worked through barriers that will arise when the patients go home but through conversations with families and patients I have suggested home care nurse visits for people who may need more care then their families can offer themI advocate for my patients when they describe their pain as greater than 2/10 vas by looking to see when they are able to have PRN pain medication and either administering it or asking their nurse to do soI demonstrate accountability by charting assessments and decisions I make in patient careI demonstrate reliability by doing for patients what I tell them I will do6Critically appraise own practice in relation to nurse-client/family interactions and as a member of the health care teamWhen interacting with the patient’s family I remained respectful of their wishes as well as maintaining patient comfort. I did this by including the family in patient care but asking them to leave the room for things like bed baths and toileting7Participate in professional development based on reflective practice and critical inquiry In post clinical I was able to reflect on each clinical day. I also reflect after performing new skills, which enables me to identify what I did well and what could use improvement in future practice.Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)Signature of Instructor___________________________________________________Date _____________________________Signature of Student_____________________________________________________Date ______________________________ (Final Evaluation Only)Student Areas of Strength1.2.3.Student Areas for Future Development1.2.3.Clinical Instructor Comments (All areas marked as unsatisfactory must have a comment)AttendanceThursFriThursFriWeek 1Week 6Week 2Week 7Week 3Week 8Week 4Week 9Week 5Week 10Total number of clinical hours completed_____________Clinical ComponentSatisfactory Unsatisfactory (Please circle the appropriate outcome)Clinical Learning Center CompletedNot completedSignature of Instructor____________________________________Date_______________________________Signature of Student______________________________________Date________________________________ ................
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