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Evaluator: Wirth, Chris (cwirth@health.usf.edu)
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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
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
Stacy, you have a veru strong knowledge base already and you continue to build on this which is a
good thing. Also, throughout the semester you have continually looked for opportunities to learn and
to expand your knowledge. Never stop doing that.
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
You show very strong skills when assessing your patients and situations and then forming a oplan of
care for your patients.
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
Stacy, through out this semester you have used strong critical thinking skills each week, which were
noticed by your preceptors and they had nothing but good things to say about your work ethics and
skills.
Comments:
Stacy, you have done a great job this semester overcoming a lot of obsticals that have come your way
and you should be very proud of yourself. Continue on with this attitude through out your last semester.
You will go on to become a verys strong wonderful nurse!!
Stacy Dunham has reviewed the above evaluation on 7/6/2017 and has provided the
following comment:
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