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HR/PACU Manager Tool
MANAGER / ASSISTANT MANAGER / CHARGE NURSE FEEDBACK TOOL: Operative Services- HR/PACU Nurses
Subject’s Name: ___________________________________ Evaluator’s Name: _____________________________________
Requires Evaluation Descriptors (Quality & Effect on Team) for reference
PLANNING & MANAGING CARE
1. Practice adheres to all hospital and
perioperative policies and procedures.
2. Addresses patient safety needs (ex:
identification of correct pt, procedure,
site and side, radiation safety, care of
anesthetized or emerging pt, positioning,
skin care, fluid & electrolyte balance,
alarms are set). May be evidenced by
absence of safety problems.
3. Applies age-specific / cultural
considerations to care of patient.
4. Prioritizes patient care (ex: knows case
specific needs based on knowledge of
procedure being performed,
pathophysiology re pt/procedure,
intervenes to change level of care from
the expected or ordered one; anticipates
high risk for malignant hyperthermia,
troubleshoots missing
documentation/medical records, Xrays,
labs, permits).
5. Organizes work and manages patient
flow for maximum efficiency and notifies
internal resources of changes/delays
(ex: facilitates timely completion of prep
for OR including consents,
documentation, site marking, labs, pre &
post op orders, translators, anticipate
and manage pt turnover by expediting pt
recovery and discharge).
6. Recognizes and communicates changes
in patient condition that may require
adjustment in assignment.
Job
Description
Quality/
Expertise
Effect on
Team
Specific /Example(s) recommended for above level
criteria; especially in support of advancement
RN 1-4
RN 1-4
RN 1-4
RN 1-4
RN 2-4
RN 1-4
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006
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HR/PACU Manager Tool
7. Takes on additional clinical
responsibilities and/or assists others (ex:
flexes to HR/PACU/Radiology).
8. Delegates to staff appropriately, with
consideration for other team members’
workload (Ex: ask RN to
transport/discharge while you admit new
patient).
9. Patients and families are satisfied with
the care this nurse has given.
10. Manages complex clinical situations.
RN 2-4
RN 2-4
RN 1-4
RN 2-4
It is required to describe specific example(s) for each Key Function. Please enter specific example(s) below:
CONTINUUM OF CARE PLANNING
Planning for discharge or transfer to next level of
care.
1. Plans for next level of care (ex: aware of
bed availability, notifies receiving area of
special equipment needs, precautions,
family considerations, valuables).
2. Uses internal & external referrals &
resources that support pt/families through
continuum of care.
RN 1-4
3. Initiates change in plan for next level of
care in unexpected, changing and complex
situations (ex: when pt condition changes
and requires a change in transfer area).
RN 3-4
Job
Description
Quality/
Expertise
Effect on
Team
Specific /Example(s) recommended for above level
criteria; especially in support of advancement
RN 1-4
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006
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4. Acts to resolve systems breakdowns,
knowledge, and behavioral issues that
impact continuum of care (ex: facilitates
sharing limited equipment & resources,
RN 3-4
addresses physician/staff-related delays,
uses inservice or other method to share
knowledge re COC, teaching receiving staff
re use of equip).
It is required to describe specific example(s) for each Key Function. Please enter specific example(s) below:
PATIENT / FAMILY EDUCATION
Job
Description
Quality/
Expertise
Effect
on
Team
Specific /Example(s) recommended for above level
criteria; especially in support of advancement
1. Incorporates a variety of resources to teach
and support patient and family learning (ex:
RN 1-4
EZTV, pt ed materials, web sources,
drawings, etc).
2. Individualizes patient/family education for
complex patients/families (Ex: resistant, non- RN 3-4
compliant, significant barriers to learning).
3. Led in the development/revision/use of
RN 4
teaching tools/aids for specific population
within the last year.
It is required to describe specific example(s) for each Key Function. Please enter specific example(s) below:
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006
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HR/PACU Manager Tool
PROBLEM SOLVING
1. Identifies and takes action to resolve pt
safety related problems and other clinical
issues.
2. Identifies and takes action to resolve
systems (operational/workarounds)
problems.
3. Follows appropriate chain of command
when problem solving.
4. Actively participates in team/group problem
solving.
5. Uses interdisciplinary approach to lead
others in problem solving projects and
evaluates outcomes using data.
6. Positively supports change.
Job
Description
Quality/
Expertise
Effect
on
Team
Specific /Example(s) recommended for above level
criteria; especially in support of advancement
RN 1-4
RN 1-4
RN 1-4
RN 1-4
RN 4
RN 1-4
7. Is a consultant to manager (Ex: clinical,
RN 3-4
proposed changes, dept enhancements).
It is required to describe specific example(s) for each Key Function. Please enter specific example(s) below:
COMMUNICATION & COLLABORATION
1. Personal behavior positively influences
environment and others (may include
attendance, tardiness, team support).
2. Accesses HCT to form plan of care/meet
patient’s needs.
3. Effectively communicates and collaborates
with patients and families.
Job
Description
Quality/
Expertise
Effect
on
Team
Specific /Example(s) recommended for above level
criteria; especially in support of advancement
RN 1-4
RN 1-4
RN 1-4
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006
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4. Effectively communicates and collaborates
with staff and other HCT members.
5. Communicates positively and constructively
in stressful situations.
6. Provides accurate and objective feedback in
a respectful and professional manner while
maintaining confidentiality.
7. Completes assigned evaluation tools within
designated timeframe (ex: peer feedback,
self report, end of orientation).
8. Receives peer feedback in a respectful and
professional manner.
RN 1-4
RN 2-4
RN 1-4
RN 2-4
RN 1-4
RN 2-4
9. Participates directly in and/or supports
orientation of new staff.
It is required to describe specific example(s) for each Key Function. Please enter specific example(s) below:
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006
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Evaluation Scoring Descriptors Effective May 2006
For each criterion, evaluator considers 2 dimensions and chooses only 1 descriptor for each:
ƒ How well the subject performs this behavior, the quality or degree of expertise
ƒ The subject’s effect of the team when performing this behavior
Quality / Expertise
Effect on team
a
Does not perform
a
Unaware or ignores standards and/or direction
b
Performs inconsistently or not to standard
b
Requires much direction
c
Consistently competent = performing to standard
c
Requires some support = what would be expected of a new nurse within their first year
d
Performs independently
consistently
d
Consistently proficient = model performance
exceeding standard with big picture view
Consistently an expert = exceptional, masterful
e
performance, specialist
e
Role model & resource to others (beyond precepting) = a positive example for others to try to meet;
demonstrates knowledge & expertise that others recognize and go to (outside the preceptor
relationship), personal behavior demonstrates interest in sharing knowledge/expertise with others
Initiates informal coaching 1:1 with others (beyond precepting) = Takes opportunities to share
f
Benner’s definitions for above descriptors:
•
Competent = uses experience-based practical
knowledge to apply this criteria appropriately
and efficiently while mindful of goals
•
Proficient = has achieved a global “big
picture” perspective, attends to total situation,
proactive
•
Expert = highly skilled performance intuitively
knowing what to do and expected results
g
expertise with the intention of facilitating other’s professional development
ƒ
Isn’t waiting until asked (resource), sees a situation and spontaneously coaches
ƒ
Not telling how, but uses questions, etc. to prompt critical thinking
ƒ
Random, and persons and topics vary
Facilitates improved group practice = beyond 1:1 individual coaching, does something to improve
the practice group’s performance:
ƒ
In-service
ƒ
Poster, posting, group email
ƒ
Develop or update a standard, protocol, etc.
ƒ
Debrief a critical incident for the benefit of the group present
Formally mentors individuals &/or groups by mutual agreement =
h
Individual
ƒ
Active, personal relationship by mutual agreement focused on specific personal &/or
professional goals
Group
ƒ
Commits to perform an operational or clinical activity or service for a group or practice area,
e.g. chart rounds, competency training, review of policies, pathways, area super-user, etc.
Instructions continued on next/back page
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006
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As the evaluator
¾ read each criteria- even above level criteria
¾ choose the 1 descriptor for each of the 2 dimensions that fits best with the subject’s performance of that specific criteria
¾ If above level criteria is not applicable, skip it, do not select any descriptors
The selected descriptors eventually are tallied from all evaluation tools into overall key function scores related to the subject’s RN level
One specific example is required for each key function: Planning & Managing Care, Patient/Family Ed, etc.
For advancement evaluations only: One specific example is required for each RN 3-4 level criteria in addition to key function examples
If one example will cover > 1 criteria or key function, you can refer to it rather than add another
©Nursing Research Office – Vanderbilt Univ. Medical Center
Revised 05/2006