DURHAM COLLEGE – PRACTICAL NURSING
NURS 2517 - SEMESTER II
EVALUATION
STUDENT:
____________________________________
Clinical Supervisor:
____________________________________
STUDENT NUMBER:
AGENCY:
LTC FINAL EVALUATION
MET
Over-riding Principles
Weekly Evaluations
Cue Cards
Reflection
Professional Practice Alert:
# initiated
Safety
Communication
Confidentiality
Professionalism/Accountability/Respect
Consistency
Ethical Practice
Personal/social use of technology – computers, phones, etc.
Attendance
Potential Harm
Significant Harm
Critical Harm
Student Success Contract:
#initiated
Learning Plan
Reflection
Rubrics
Attendance:
# Late
# Absent
1
____________________________________
____________________________________
NOT MET
Student Comments
LTC Final
Student
Comments
Areas of Strengths
Areas of Development
2
Caring &
Competency
Practice Concepts / Learning
Outcomes
Psychomotor Skills
1.1 nursing interventions
(actions, treatments,
techniques) independently
that:

promote health

prevent disease and
injury

maintain and restore
health

promote rehabilitation

provide palliation (if
applicable)
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Critical Indicators of Performance
1.1.1
Verifies and clarifies policies, procedures and
orders before commencing care
1.1.2
Obtains client consent before initiating nursing
care and respects privacy and dignity when
carrying out any interventions
1.1.3
Manages physical resources to provide safe,
ethical care
1.1.4
Washes hands using appropriate technique,
before and after all client care - uses non-sterile
gloves as needed (spot check by instructor)
According to agency policies and best practice,
following the DC Skills Policies (Program Guide)
and the rubric, the student must be directly or
indirectly supervised by the practicum teacher
1.1.5
Demonstrates safe donning and doffing of PPE selects appropriate PPE according to type of
Transmission based precautions
ordered and indicated
1.1.6
Measures oral or tympanic temperatures, oxygen
saturation, radial & apical pulses, respirations
and pulse oximetry (if available) accurately
1.1.7
Measures blood pressure accurately
1.1.8
Conducts basic head to toe assessment at
beginning of shift
1.1.9
Demonstrates medical and/or surgical asepsis
when changing wound dressings (if applicable
and available)
1.1.10
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Evidence of Learning
1.1.11
Baths client while adhering to principles of
safety, privacy, dignity, and comfort - bed bath,
tub bath, shower, shampoo, skin care, and
shaving.
Makes unoccupied, occupied bed, handling linen
according to appropriate infection control policies
1.1.12
1.1.13
1.1.14
1.1.15
1.1.16
1.1.17
Dresses clients as appropriate for setting,
comfort respecting client's ability to help
self/need for assistance
Keeps bedside area free of clutter, clean and
orderly (spot checks by instructor)
Assists clients with bladder and bowel elimination
using appropriate aids (bedpan, urinal, catheter
care and maintenance, colostomy appliance,
etc.) - disposes of wastes in appropriate
receptacles
Measures intake and output according to agency
policy
Assists clients with feeding as clinically indicated
(i.e. Feeding dysphasic clients, tube feedings,
etc.)
Ambulates clients safely - 1 person and 2 person
transfers from bed to chair, chair to bed, using
appropriate body mechanics and patient
ambulation aids (rubric)

demonstrates safe use of mechanical lift
(according to agency policy)

observes safety precautions when using
wheelchairs for transport of clients

demonstrates safe support of clients
using ambulation aids such as walkers,
canes, crutches as appropriate

demonstrates appropriate client turning
and positioning for comfort, skin
integrity, while showing awareness of
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1.1.18
Documentation
1.2 Documentation presents an
accurate, clear and
comprehensive picture of
client needs, interventions
and client outcomes.
according to standards of
CNO and policies of the
agency
Technology
1.3 Uses appropriate technology
to perform safe and efficient
nursing interventions.
Maintains confidentiality of
the client health record by
ensuring passwords and other
information required to
access the client’s health
record remain secure.
Requires minimal assistance
1.2.1
clinical restrictions (limited ROM
allowed, etc.)
Recognizes and reports situations within the
practice environment that are potentially unsafe
Documents care in a timely fashion, with less
than 3 errors, using appropriate technology
(paper, tick sheets, electronic documentation)
according to standards of CNO (rubric)
1.2.2
Uses appropriate terminology to describe client
assessments, condition and interventions in
documentation (Note ** if unable to document
electronically because of agency access policies,
must write out narrative documentation and
submit to co-assigned nurse and instructor)
1.2.3
All documentation and assigned work reflects
fluency in the use of the English language and
English comprehension
1.3.1
Independently gathers electronic data regarding
the client history and condition from clinical
records as indicated
1.3.2
Uses computer to find agency policies and
procedures and refrains from personal use of
computer
1.3.3
Uses college email professionally to
communicate with clinical instructor and clinical
peers. Checks DC course page and emails daily
1.3.4
Use electronic sources for research purposes
(peer-reviewed sites)
1.3.5
Uses all equipment safely, following agency
policies. Ensures equipment is accurate and
functional
1.3.6
Only accesses information required to provide
care and ensures secure and confidential
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destruction of temporary documents that are no
longer in use
Reporting
1.4 Communicates with
healthcare team and
promptly recognizes and
reports situations within the
practice environment that are
potentially unsafe.
1.4.1
Receives thorough report from co-assigned nurse
prior to commencing care
1.4.2
Reports significant facts to co-assigned staff in
an accurate and timely manner and includes the
situation, background, assessment and student’s
recommendation (SBAR) This includes
communicating with co assigned staff about
client progress at beginning/end of shift and
during the shift
1.4.3
Gives and receives report to another student
covering client during assigned breaks
1.4.4
Uses accurate terminology to describe client
assessments, condition and interventions when
reporting
1.4.5
Conducts complete, relevant end of shift report
according to agency policy using verbal, written
or electronic means
Caring &
Connectedness
Practice Concepts / Learning
Outcomes
Therapeutic Relationship:
Therapeutic Communication
2.1 Communicates effectively
and professionally with
clients, health team
members and others to
ensure that all professional
behaviours and actions
meet the therapeutic needs
of the client.
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Critical Indicators of Performance
2.1.1
Introduces self to client by name/category and
discusses with the client the student’s and the
client’s role in the therapeutic relationship.
Addresses the client by the name/title client
prefers
2.1.2
Gives client time, opportunity and ability to
explain self. Listens to client with the intent to
understand and without diminishing the client’s
feelings or immediately giving advice
2.1.3
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Evidence of Learning
Establishes appropriate professional boundaries
with clients including the distinction between
social and therapeutic relationships
2.1.4
2.1.5
2.1.6
Informs client information will be shared with coassigned nurse
Demonstrates awareness of her/his verbal and
non-verbal communication style and how clients
might perceive it
Modifies communication style, as necessary, to
meet the needs of the client
2.1.7
2.1.8
2.1.9
Demonstrates principles of active listening
(attentive body language, no interruptions,
summarizes client’s thoughts)
Uses effective strategies to enhance
communication with clients where this is
impaired due to hearing, vision or cognitive or
aphasic difficulties or language barrier (e.g.
Diagrams, use of communication board,
Interpreter, etc.) demonstrate respectful, caring
communication through tone of voice, nonverbal
communication (body language) and eye contact
(rubric)
Communicates effectively demonstrating English
language fluency and understanding
2.1.10
Client confidentiality
2.2 Based on ethical and legal
considerations, maintains
client confidentiality in all
forms of communication.
2.2.1
Evaluates and refines therapeutic\communication
techniques as needed
Refrains from discussing client information with
colleagues or the client in public places
(elevators, cafeterias and hallways)
2.2.2
Collects only information that is needed to
provide care
2.2.3
Adheres to CNO Standards for Confidentiality
and Privacy — Personal Health Information
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( 2009) and the agency policies
Caring relationships
2.3 Forms caring partnerships
with clients and their
families, which support the
client achieving mutually
agreed upon health
outcomes.
Cultural Diversity
2.4 Use knowledge of culture,
diversity and age
differences to communicate
effectively
Collaboration/ Team Building
2.5 Participates effectively as a
team member to support
clients’ achievement of their
expected health outcomes.
2.3.1
Respects the client’s rights to self determination
2.3.2
Considers the client’s lived experience and how
the current health challenge might be impacting
the client and family
2.3.3
Uses a variety of approaches that demonstrate
individualized, client specific caring behaviours
2.3.4
Uses basic conflict resolution skills
2.4.1
Identifies values and biases that underscore
her/his approach and interventions, and their
impact on client care
2.4.2
Respects the dignity and worth of individuals of
all cultures, values and belief systems without
judging or labeling
2.4.3
Identifies how one’s values, beliefs and
assumptions affect interactions among members
of the inter-professional health care team
Recognizes limitations of personal experiences /
knowledge and seeks guidance appropriately.
2.5.1
2.5.2
Identifies the unique role and competencies of
each member of the inter-professional health
care team
2.5.3
Uses appropriate title, respect, terminology and
communication skills when consulting with
clinical teacher, co-assigned nurse, and interprofessional team
2.5.4
Addresses peers in a respectful manner
2.5.5
Uses basic conflict resolution skills when
interacting with staff/peers
2.5.6
Gives constructive peer feedback
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2.5.7
Accepts feedback from peers, staff and clinical
teacher in a positive manner
2.5.8
Participates in team conferences
Caring & Healing &
Health Promotion
Practice Concepts / Learning
Outcomes
Teaching and Learning
3.1 In collaboration with the
client, identifies and
evaluates appropriate health
teaching strategies that will
enhances the client’s
learning.
L Critical Indicators of Performance
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3.1.1 Identifies client's learning:

style

barriers

developmental needs

level of literacy

preferences
Evidence of Learning
3.1.2 Collaborates with client to identify priority learning
needs and readiness to change
3.1.3 Uses evidence-based theory to deliver simple health
teaching to clients i.e. regarding condition, ADL's, promoting
independence, nutrition, elimination, prevention of
constipation, mobility and falls prevention, breast feeding,
care of newborn, baby bath, care of circumcision
3.1.4 Encourages and supports healthy lifestyle choices
3.1.5 Utilizes a variety of materials/resources for teaching
(verbal, printed instructions, pictures, etc.)
3.1.6 Evaluates client’s learning and refines health teaching
strategies as needed
Advocacy
3.2 Advocates for clients or their
representatives, especially
when they are unable to
advocate for themselves.
3.2.1 Recognizes client's unique preferences, situation, needs
and advocates as appropriate
3.2.2 Demonstrates beginning knowledge of
resources/professionals/departments that client may be
referred to for various needs
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3.2.3 Recognizes client's need for spiritual intervention and
advocate for appropriate spiritual support
Encourages clients to draw upon their strengths
Client Autonomy
3.3 Recognizes client as expert
on his/her life and utilize the
client’s unique preferences,
situation and needs as the
basis of the plan of care
3.3.1 Fosters client independence to the level of the client’s
ability
3.3.2 Explores clients’ wishes
3.3.3 Provides education and support to promote client
choice
3.3.4 Enables the client to make informed decisions
Caring & Practice
Judgement
Practice Concepts / Learning
Outcomes
Preparation
4.1 Recognizes and demonstrates
accountability for independent
research and preparation to
ensure care is evidence informed.
This is done the Wed. before the
practicum experiences on
Thurs./Fri. and as needed during
the practicum shifts (i.e. change
in client assignment)
L Critical Indicators of Performance
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Evidence of Learning
4.1.1. Completes comprehensive research related to client
care needs using appropriate sources (electronic, MAR etc.)
following the expectations in the course outline
4.1.2 Based on the client assignment, looks up any policies,
skills or other information to prepare self for the assignment
the next day
4.1.3 Develops and brings to the start of each practicum shift
a completed worksheet with the data and proposed plan of
care outlined ensuring the care decisions are evidence based
with a rationale for all decisions. This work must be in the
student’s own words and the student must be prepared to
share his/her understanding with the
teacher/interprofessional health team members
4.1.4 Recognizes and takes measures to address own
limitations in knowledge
4.1.5 Recognizes own limitations in scope of practice and
collaborates and consults with inter-professional health care
team members to provide safe care
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Client care planning
(Assessment, Planning,
Intervening and Evaluating).
4.2 Collaborates with client to
develop a plan of care that
incorporates critical thinking
and problem-solving skills into all
aspects of care.
4.2.1 Utilizes a systematic approach to complete initial and
on-going holistic assessments of adults
4.2.2 Uses a variety of assessment data to identify, abnormal
or unexpected client responses, and potential health
problems or issues and their consequences to clients
4.2.3 Refines and expands client assessment information in
collaboration with the inter-professional health care team, by
using initial assessment findings to focus on additional and
more detailed assessments
4.2.4 Collaborates with the client and interprofessional health
care team to develop an original plan of care that is
individualized, evidence informed and uses best-practice
guidelines and current research to address client needs,
preferences by:

questioning and offering suggestions regarding
approaches to care

seeking information from relevant nursing research,
experts and literature

incorporating the determinants of health into all
aspects of care

identifying a minimum of 3 actual/potential areas of
focus in the written plan of care and including
rationale and expected outcomes

developing a range of possible alternatives and
approaches to care

providing rationale for decisions made and care
given
4.2.5 Discusses and justifies decisions and planning
approaches to providing care/service with the client
4.2.6 In collaboration with the interprofessional health care
team, and client modifies and evaluates the plan of care as
needed
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Critical thinking
4.3 Applies, evaluates and refines
critical thinking and problemsolving skills in all aspects of
nursing care. Engages in critical
thinking to inform clinical
decision-making, which includes
both systematic and analytical
processes, along
with reflective and critical
processes.
4.3.1 Reviews literature and consults with colleagues and
other resources in selecting assessment tools or techniques
4.3.2 Analyzes and interprets data from client assessments;
distinguishing between relevant and irrelevant data, knowing
when assessment findings are abnormal and by
understanding cause and effect relationships
4.3.3 Makes valid judgements/conclusions from the data
collected and takes appropriate action.
4.3.4 Questions and suggests some modifications of plan of
care if unexpected outcomes occur
4.3.5 Demonstrates knowledge of the distinction between
ethical responsibilities and legal rights and their relevance
when providing nursing care
Writes reflective notes as per guidelines and demonstrates
use of evidence (See rubric )
4.3.6 Consults with professor about any unclear or
questionable orders, decisions, or actions made by other
inter-professional health team members
4.3.7 Demonstrates knowledge of the distinction between
ethical responsibilities and legal rights and their relevance
when providing nursing care
4.3.8 Uses an ethical reasoning and an ethical framework to
address situations of ethical distress and dilemmas
4.3.9 Evaluates and refines critical thinking and problemsolving skills
Prioritizing
4.4 Formulates clinical judgments
that are consistent with clients’
needs and priorities by responding
to changing situations that affect
clients’ health and safety.
4.4.1 Demonstrates that the nurses primary duty is to the
client to ensure consistently safe, competent and ethical care
4.4.2 Compares ongoing assessments to initial shift
assessments and reports and distinguishes between
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immediate priorities and secondary problems and responds
appropriately
4.4.3 Establishes priorities for care and ensures client care
needs are met and completed
4.4.4 Manages multiple nursing interventions simultaneously
4.4.5 Responds appropriately to rapidly changing situations
4.4.6 Responds to changes in the health care environment
through consultations and collaboration with the
interprofessional health care team
Evaluation and consultation
4.5 Evaluates and refines
approaches to care and
provides feedback to the interprofessional health care team.
4.5.1 Evaluates client care and determines whether or not the
desired outcomes of the care were achieved
4.5.2 Actively identifies and asks questions of self, colleagues
(including members of the
interprofessional health care team) and clients in a
knowledgeable and professional manner
4.5.3 Recognizes limits of practice and consults appropriately
Time Management
4.6 Organizes workload and
develops time management
skills to meet responsibilities.
Is able to complete client care
and to finish all work, and
report off within established
time frame (barring emergencies)
4.5.4 Evaluates changes in the health care setting that affect
one’s nursing practice
4.6.1 Organizes workload and demonstrates timemanagement skills to meet responsibilities by:






preparing for client care before the practicum shift
begins – collects data and receives report
organizing and modifying the schedule/worksheet
and plan of care around client needs, availability of
peer/staff/teacher assistance, and client’s
schedules.
completing an initial head to toe assessment as
soon as report is received
completing initial documentation within the first 2
hours of beginning of shift
going to and returns promptly from breaks
ensuring all required care is provided and completed
in the allotted time frame
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

organizing multiple demands into manageable
interventions
independently, competently and safely cares for two
clients meeting all outcomes by the end of week 8
Caring &
Professionalism
Practice Concepts / Learning
Outcomes
Professional Responsibility/
Legislation and Standards
5.1 Demonstrates professional
accountability to public and
ensures practice meets
requirements for semester two
of the Durham College
Practical Nursing Program in a
manner that is consistent with
the College of Nurses of
Ontario Standards of Practice.
Professional accountability
means being responsible for
decision-making, competency
and integrity, and it is reflected
through a student’s actions,
attitude, communication and
through accurate
documentation.
Critical Indicators of Performance
Evidence of Learning
5.1.1 Demonstrates through actions, attitude and
communication that the primary role of the Practical Nurse is to
serve the public.
5.1.2 Adheres to the CNO Standards of Practice, Durham College
guidelines, policies of Durham College and the hosting clinical
agency.
5.1.3 Demonstrates leadership within the health care team by:


applying the most appropriate leadership skill and style
that is appropriate to the situation
evaluating and refining leadership skills and style as
needed.
5.1.4 Accountable for one’s decisions and actions by practising
within one’s role and responsibilities
5.1.5 Demonstrates honesty and integrity for own decisions,
actions and communication. All written work is one’s own work.
Owns up to mistakes and treats as learning opportunities.
5.1.6 Demonstrates professional conduct by:


responding professionally to unacceptable behavior
identifying, responding to and documenting incidents of
unsafe practice or professional misconduct
5.1.7 Promotes the continuing development of the profession of
nursing(e.g. joining or participating in professional associations
or committees, or engaging in scholarly activities)
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Self- Assessment/ Role
Socialization/ Comportment /
Attendance/ Assignments
5.2 Uses self and all ways of
knowing as part of the caring
process; to engage caringhealing practices
5.2.1 Demonstrates a professional presence (comportment) and
models professional behaviour/attitude and communication at all
times and with learners and the interprofessional health care
team
5.2.2 Demonstrates responsibility through excellent attendance
and adherence to Durham College policies regarding attendance
5.2.3 Hands in all assigned work in the required format, within
the allotted time frame, observing all policies related to
plagiarism and academic integrity/honesty
5.2.4 Works within role and responsibilities, independently and
collaboratively
5.2.5 Responds to changes in the health care system that affect
one’s nursing practice
5.2.6 Demonstrates an attitude of inquiry as a way to improve
own knowledge and practice
5.2.7 Values questioning and feedback by making constructive
efforts to improve own knowledge and practice
5.2.8 Engages in reflective practice in dialogue and by writing
reflections which are honest, detailed, clear and meet
expectations
5.2.9 Self-evaluates awareness that the primary aims of the
nurse are to practice in the best interest of the public and to
protect the public from harm by reflecting on own
practice/behaviour/attitudes/communication
5.2.10 Uses the CNO standards of practice to assess
competence, identifying gaps in knowledge, skill, judgment and
attitude taking action to seek assistance when necessary
5.2.11 Seeks and is open to feedback and pursues professional
growth
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5.2.12 Completes self-evaluation following Durham College
expectations and the CNO Standards of Practice
5.2.13 Identifies and addresses learning needs and completes
success plans if indicated
5.2.14 Modifies practice according to self-assessed needs and
feedback given
5.2.15 Submits weekly feedback, with evidence, to DC connect
by Sunday by 2300 hours
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