NorthWest Arkansas Community College
Clinical Evaluation Tool
Psychiatric Mental Health NURS 9231
Student Name: Alexis Jorgensen
Instructor: Crystal Perry RN, MSN-ed.
Clinical Site: NorthWest Springdale BH
Semester: Spring/2nd
1. Apply ethical and legal guidelines in the nursing care of the diverse patients experiencing common mental
health conditions/disorders. (PO 1)
Day 1
M/NM/NI
Day 2
M/NM/NI
FINAL
M/NM/NI
Comments:
2. Demonstrate the ability to collaborate with health care team members to meet the patient’s health care
goal and needs of the diverse patients experiencing common mental health conditions/disorders. (PO2)
Day 1
Day 2
FINAL
M/NM/NI
M/NM/NI
M/NM/NI
Comments:
3. Administer safe, high quality, evidence based nursing care of diverse patients experiencing common
mental health conditions/disorders. (PO3)
Day 1
Day 2
FINAL
M/NM/NI
M/NM/NI
M/NM/NI
Comments:
NorthWest Arkansas Community College
Clinical Evaluation Tool
Psychiatric Mental Health NURS 9231
Student Name: Alexis Jorgensen
Instructor: Crystal Perry RN, MSN-ed.
Clinical Site: NorthWest Springdale BH
Semester: Spring/2nd
4. Apply clinical reasoning and judgement into each nursing care decision involving the diverse patients
experiencing common mental health conditions/disorders. (PO4)
Day 1
Day 2
FINAL
M/NM/NI
M/NM/NI
M/NM/NI
Comments:
5. Implement compassionate and holistic care of the patient experiencing mental health
conditions/disorders that incorporates their cultural and spiritual beliefs and practices. (PO 5)
Day 1
Day 2
FINAL
M/NM/NI
M/NM/NI
M/NM/NI
Comments:
NorthWest Arkansas Community College
Clinical Evaluation Tool
Psychiatric Mental Health NURS 9231
Student Name: Alexis Jorgensen
Clinical Site: NorthWest Springdale BH
Instructor: Crystal Perry RN, MSN-ed.
Semester: Spring/2nd
Student Midterm Evaluation Summary:
(to be completed by student prior to evaluation at
the end of clinical rotation)
Faculty Midterm Evaluation Summary:
 Care experiences:
Identify your strengths and weaknesses
 Student Strengths:
Strengths: I was able to successfully obtain the
information I needed to fill out an SBAR form on
a patient. I was also able to remain calm while
Areas for Improvement:
communicating with patients, which helped the
patients to remain calm as well.
Weaknesses: I need to work on how I perform
mental status exams with patients; I should
perform them while sitting down with patients
instead of standing. I also need to build confidence
while communicating with patients.
Student Final Evaluation Summary:
Faculty Final Evaluation Summary:
(to be completed by student prior to evaluation at
 Care experiences:
the end of the semester)
Identify your strengths and weaknesses

Student Strengths:

Areas for Improvement:
Mid-Term Clinical Evaluation:
Meets Criteria: ________
___________
Clinical Faculty Signature: __________________________________
Student Signature: Alexis Jorgensen________________________
Final Clinical Evaluation:
Meets Criteria: ________
_______
Clinical Faculty Signature: _________________________________
Student Signature: _______________________________________
At Risk:
Date: _____________
Date: 3/31/2021____
Does Not Meet Criteria:
Date: _____________
Date: _____________
DATES OF CLINICAL ABSENCE(S): __________________________________________________________________
Clinical Portfolio Points
Clinical Paperwork (200 pts)
Simulation Paperwork (200 pts)
AA/NA or Alanon Paper (50 pts)
vSIM Lab (100 pts)
Case Study (50 pts)
Score
NorthWest Arkansas Community College
Clinical Evaluation Tool
Psychiatric Mental Health NURS 9231
Student Name: Alexis Jorgensen
Instructor: Crystal Perry RN, MSN-ed.
Clinical Site: NorthWest Springdale BH
Semester: Spring/2nd
Average of above (468/600 points possible)
Note: 78% average of above must be achieved in order to pass clinical
DEFINITION AND CRITERIA OF CLINICAL LEARNING OUTCOMES
SLO#1 Apply ethical and legal guidelines in the nursing care of the diverse patients experiencing common mental health
conditions/disorders. (PO 1)
 Organizes nursing care and completes care on time
 Demonstrates respect for patients and patient care units
 Reports off to the faculty and/or appropriate personnel when leaving the unit at any time
 Maintains confidentiality of all patient information
 Follows the ANA code of ethics
 Follows the chain of command when reporting any variance or concern
SLO # 2 Demonstrate the ability to collaborate with health care team members to meet the patient’s health care goal and needs of the
diverse patients experiencing common mental health conditions/disorders. (PO2)
 Establishes priorities of care for patient with psychiatric or mental health conditions.
 Continuously assesses patient for changes in condition.
 Adapts plan of care to meet the changing needs of the patient.
 Offers assistance to health care team members when not providing care for assigned patient
 Collaborates with primary nurse and health care team members to meet patient care goals
 Communicates and consults with other health care team members to provide holistic patient care
 Incorporates interventions to involve family/support persons who need to be involved with the patient’s care
SLO #3 Administer safe, high quality, evidence based nursing care of diverse patients experiencing common mental health
conditions/disorders. (PO3)
 Identify gaps between local and best practice and provide recommendations for closing the gaps.
 Implement patient safety initiatives and performance improvement measures, including nursing-sensitive indicators in the delivery
of nursing care.
 Completes a basic bio-psycho-social assessment and prioritizes patient’s needs based on Maslow’s Hierarchy
 Follows all safety protocols and guidelines per institutional policies to maintain a safe environment (for example: CIWA, Aggressive
patient)
SLO # 4 Apply clinical reasoning and judgement into each nursing care decision involving the diverse patients experiencing common
mental health conditions/disorders. (PO4)
 Establishes and maintains therapeutic relationships with patient, family, and staff.
 Participates in group therapies and other milieu activities.
 Functions as a resource person to patient regarding their care.
 Establishes nursing diagnoses based on identified needs, developmental stage, and other assessment data.
 Formulates short-term patient goals.
 Plans and implements individualized nursing interventions, including those appropriate for pharmacotherapy.
 Helps patient to explore feelings and problem-solve
 Promotes patient participation in therapeutic and social activities.
 Identifies, implements and evaluates psychosocial health teaching.
 Evaluates nurse-patient relationship, and achievement of short-term outcomes
SLO # 5 Implement compassionate and holistic care of the patient experiencing mental health conditions/disorders that incorporates
their cultural and spiritual beliefs and practices. (PO 5)
 Utilizes appropriate resources to collect assessment data, including patient record, patient, family, and staff
 Reports pertinent observations promptly and accurately
NorthWest Arkansas Community College
Clinical Evaluation Tool
Psychiatric Mental Health NURS 9231
Student Name: Alexis Jorgensen
Instructor: Crystal Perry RN, MSN-ed.
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Clinical Site: NorthWest Springdale BH
Semester: Spring/2nd
Documents pertinent patient data clearly and concisely
Promotes the development of trust between the nurse and patient.
Utilizes self therapeutically both verbally and non-verbally in responding to the individual needs of the patient.
Incorporates patient’s cultural and religious practices and preferences in patient’s care
Respects and advocates for all patients regardless of religious or cultural practices
Provides psychosocial and cultural support for the patient and family