I. Provider of Care
A. Assessment
1. Completes health history,
including culture, as outlined on assessment form. |
S U |
| 2. Performs a physical assessment
as outlined on the assessment form. |
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B. Nursing Diagnosis
1. Uses assessment data
to identify potential alterations in client's ability to meet basic needs
(oxygenation, food & fluid, elimination, activity/rest, safety, love
& belonging, self esteem, self actualization) |
S U |
| 2. With guidance, lists
pertinent nursing diagnoses (learning needs) to promote health of assigned
client. |
S U |
C. Planning
1. With guidance,
lists a goal and outcome criteria for each nursing diagnosis. |
S U |
| 2. Selects basic,
age appropriate teaching interventions to promote health and prevent illness. |
S U |
D. Implementation
1. Maintains client
safety. |
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| 2. Follows universal
precautions and body substance isolation. |
S U |
| 3. Implements teaching
plan to promote client's health |
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| 4. Treats client/family
in a caring manner being sensitive to cultural diversity and individual
needs. |
S U |
E. Evaluation
1. Identifies the
extent to which outcome criteria of teaching plan was met. |
S U |
II. Manager of Care
1. Respectfully communicates
with peers and agency staff. |
S U |
| 2. Participates in
conferences. |
S U |
| 3. Utilizes goal-oriented
communication techniques to promote client's health. |
S U |
III. Member within the Discipline of Nursing
1. Maintains confidentiality
concerning client. |
S U |
| 2. Receives and follows
directions appropriately. |
S U |
|
3. Seeks appropriate supervision |
S U |
| 4. Reports to clinical
on time and turns in written work on time. |
S U |
| 5. Follows course
policies re: uniform, absences, assignments. |
S U |
Student's Comments:
Student Signature:________________________
Instructor's Comments:
Instructor Signature:_______________________ |
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