PL-BSN Clinical Evaluation Competency Criteria

Domain 1

a. Adheres to university, College of Nursing, and agency policies regarding professional appearance, behavior, attitude, and attendance.

• Turn in assignments on time,
• Arrives to all scheduled clinical events on time (pre-con, post-con, simulation/skills, orientation, etc.)
• Follows clinical policies and procedures as communicated by preceptor/instructor.
• Communicates with instructor when late or absent ASAP.
• Wears appropriate WSU scrubs.
• Arrives with all necessary supplies/equipment (stethoscope, badge, etc.)
• Attends 100% of clinical experiences or approved make-up opportunities.
• Demonstrates positive and respectful attitude.
• No phones or electronic devices in clinical spaces
• Does not gossip or speak negatively about a patient EVER (at the nurses’ desk, at home, anywhere)

b. Adheres to registered nurse scope and standards of practice, including bioethical and legal principles.

• Complete Scope and Standards of Practice ATI Module assignment and discuss in clinical conference.
• Participate in discussions of multiple ethical dilemmas and principles in post-conference and discuss implication to care.

c. Assumes accountability for own behaviors and practices, and acts, including seeking assistance and feedback, as appropriate.

• Demonstrate awareness of patient safety by arriving at clinical site prepared for all anticipated aspects of care including assigned Clinical Prep Guides.
• Ready to answer questions from clinical instructor including procedures, cares, or medication questions.
• Asks questions of nurse preceptor or instructor if unsure of the correct way to do something.
• Seeks assistance for skills that require more than one person – do not do it alone!
• Communicate with instructor immediately if an error occurs.
• Know where your code or staff assist call buttons and emergency equipment are in your patient’s room.
• Seek help immediately if patient deterioration or emergency identified.

d. Conducts oneself in a professional manner in all interactions with members of the interprofessional team.

• Introduces self to person receiving care and any significant others, staff members and peers.
• Asks and answers questions politely.
• Respectful and courteous to all members of the healthcare team and ancillary staff (housekeeper, etc.)
• If you have down time, ask your team if you can help them with tasks.
• Show your appreciation for their help, knowledge, precepting – say thank you often!

e. Incorporates diverse, equitable, and inclusive practices in all professional settings.

• Explores and considers diverse values and cultures.
• Recognizes personal bias and how that may influence the care they are providing.
• Asks person for preferred name.
• Avoids stereotypes in speech or writing.
• Students will seek opportunities to ensure all members of their clinical group can participate in clinically related group activities.

f. Advocates, promotes, and protects the client’s rights to privacy, autonomy, and confidentiality.

• Does not take any identifying information out of clinical site.
• Does not use any patient identifiers in course work.
• Listen to person’s requests for care and respects those.
• Does not discuss person’s information in public setting or with those who do not need to know.
• Maintain and obey HIPAA laws.
• ALWAYS ask permission when performing an assessment or skills with patient, especially if you must expose any skin.
• Pull the curtain in the room and make sure the patient has privacy.
• No posting on social media about hospital, patient, or clinical experience

g. Analyzes own limitations in nursing skills and technologies and demonstrates initiative in seeking learning opportunities and resources to further professional growth.

• Reviews skills with instructor or staff prior to performing with person.
• Seeks out experiences that are within scope to participate in during clinical day.
• Asks for help if does not know how to use a piece of equipment.
• Take ownership of your learning – ask questions or find appropriate resources (not Wikipedia) when you do not know the answer or identify a gap in knowledge.
• Share with your peers if you learn about something new (clinical conference is a great opportunity for this)

h. Employ leadership strategies and skills in the delivery of nursing care to individuals and groups in a variety of health care settings.

• Complete clinical evals in depth—looking at strengths and weakness objectively for self.
• Participates in post clinical reflection of shift.
• Completes peer feedback activities i.e., SimCapture peer review for skills.
• Willingness to give/receive feedback and then adjust their strategies based on the feedback.

i. Practices the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

• Practice self-care and self-compassion, be able to describe these and how they help.
• Get enough sleep, especially before clinicals.
• Take care of yourself to minimize stress – exercise, meditation, etc.
• Prepare by reading assigned material before clinicals or simulation

Domain 2

a. Conveys clear, relevant, organized, and thorough behaviors in all forms of written and non-written communication.

Written communication:

• Correct spelling, grammar, and sentence structure in documentation in health record and in school assignments.
• Completes written clinical prep guides with minimal guidance.
• Inputs accurate assessments and other patient care data into EHR Tutor or EHR at site.

Non-written communication:

• Use active listening.
• AIDET method
• Communication and hand off information are accurate, clear, and organized.

b. Effectively utilizes ISBAR (or other acceptable communication tools) to communicate patient condition, changes, and recommendations to interprofessional team.  

• Effectively utilize ISBAR (or other acceptable communication tools) to communicate patient condition, changes, and recommendations to health care team and/or instructors or peers in at least five shift reports throughout the course.

c. Utilizes culturally and linguistically responsive communication strategies.

• Determine what interpretation services are available a clinical site.
• Recognize when need to use an interpretation service.
• Recognize cultural practices that may influence how care is delivered for populations encountered most frequently at clinical site.
• Recognize that culture may not be the same as race.
• Examines own culture and how it affects communicate with clients.
• Provides culturally safe communication by allowing patient to direct how culture is meaningful to them in context of healthcare.

d. Exhibits timely, legally accurate, and appropriate documentation.

• Document patient care and pertinent findings in a timely, legally accurate and appropriate manner in the clinical/simulation electronic health record or facility system according to agency policies and guidelines at least five times throughout the course.

e. Communicates in a therapeutic and developmentally appropriate manner using utilizing verbal and nonverbal skills.

• Utilizes therapeutic communication techniques appropriate for clients and families (i.e., active listening, sharing empathy, providing information, etc.)
• Using therapeutic touch and reassurance (ask permission first!)
• Incorporates patient/family cultural and religious beliefs and desires related to therapeutic communication.

f. Applies principles of team dynamics to improve quality and assure safety in a variety of healthcare settings.

• Interact positively with peers in clinical group and instructor.
• Identify team dynamics and how good teams’ function.
• Can work easily and effectively in groups/pairs with other students, health care workers/staff, patients, and families to address problems, questions, issues.
• Displays a team mentality (offering help, jumping in to assist in a procedure, offering to get supplies, etc.)
• Demonstrate teamwork in an urgent/emergent situation.
• Demonstrate role delegation in simulation.

g. Communicates priorities and rationale for decisions to instructor.

• Using clinical judgment model, discusses priorities for patient care (prioritize cues) depending on assessment data (recognize and analyze cues) and condition.
• Prioritizes care based on the best evidence.
• Demonstrate rationale for the plan of care

h. Acknowledges implicit biases and how they may affect communication and the delivery of care.  

• Able to have discussions or express in writing about learning situations that challenge personal bias and bring about self-awareness (interacting with possible child abuse perpetrators, etc.)
• Acknowledges own implicit biases that may affect team dynamics, communication, or collaboration (E.g., working with a nurse from a different culture or background who is difficult to understand)
• Identify biases and consider what challenges they pose to the delivery of quality care.

i. Develops and maintains effective partnerships with the interprofessional team and key stakeholders.

• Demonstrate effective and respectful collaboration with all members of the healthcare team.
• Be accountable to the client/family and healthcare team.
• Utilize clinical instructor as mediator/resource for clinical site.
• Brings staff issues to clinical instructor to mediate with clinical site leadership if needed.
• Attempt to create a working relationship with nurse they are assigned to on a clinical day.

Domain 3

a. Establish relationships of mutual respect with clients and family built on empathy and compassion.  

• Shows empathy towards patient so that the patient feels cared for.
• Maintain eye contact, slow down cares, and answer questions (even if feeling rushed or hurried).
• Be aware of negative body language, sit down at level of patient and ask questions.

b. Utilizes clinical judgment to identify, prioritize, and organize the care of actual or potential health problems and needs.  

• Review NGN Clinical Judgement model and practice the parts while at clinical.
• Practice synthesizing pathophysiology of patient’s disease process with interventions.
• Recognize and analyze cues for common chronic conditions and prioritize care (prioritize hypotheses and generate solutions) for the patient.
• Identify how student makes decisions, and how that skill becomes part of clinical judgement.

c. Perform appropriate assessment skills given patient presentation and situation.

• Perform an age-appropriate assessment with special consideration to patient status.
• Recognize need to perform focused assessments as indicated.
• Can identify when more information or an alternative method or sequence of assessing a patient may be needed.

d. Synthesize the needs and preferences of the client with assessment data when developing a plan of care with realistic goals and expected outcomes.

• Identifies person(s) preferences when addressing unmet need and considers when providing potential interventions.
• Identify expected outcome from intervention and determine how it will be measured.
• Work with the patient to develop a plan of care consistent with patient needs and assessment findings.
• Articulate patients need to faculty.

e. Plans and implements evidence-based interventions that are congruent with assessment data.  

• Explain the role of evidence in determining best clinical practice.
• Implement standardized, evidence-based processes for providing care.
• Seeks out appropriate resources available in a clinical setting (i.e., uses embedded EHR tools, look up procedures in online facility library, seek clarification from the pharmacists about an off label med)

f. Performs nursing skills and therapeutic procedures safely and competently.

• Utilize CON skills lab and simulations to learn and practice skills.
• Follow correct procedures when performing skills (if you have not been checked off, ask for help).
• Know where to find current facility procedures, policies or who to ask.
• Shows ability to prepare and deliver nursing skills while recognizing potential issues related to developmental age or condition.
• Integrate didactic learning to enhance skill delivery, ex. Considers effects of dehydration when placing an IV catheter.

g. Contributes to a culture of safety for all in clinical settings.   

• Identifies types of workplace violence —nurse to nurse, patient to nurse-and methods to avoid or mitigate.
• Patient safety—Applies skills for patient mobility, medication administration, patient procedure prep.
• Follows protocols and policies of agency or facility.
• Assess, identify, and act upon safety issues in the clinical setting.
• Speak up (report) when you see or hear something that is harmful or unsafe.
• Asking for help or assistance when performing a skill/intervention student has not performed.

h. Reports abnormal data and changes in client condition to instructor or appropriate health team member.

• Student reports any abnormal vital signs, labs, assessment findings to person RN and instructor.
• Identify and communicate abnormal findings (cues): VS changes, respiratory distress, etc.

i. Evaluates sources of data for appropriateness, usefulness, and accuracy.

• Know what sources are considered reliable for health care information i.e., Up-To-Date site, WSU or facility libraries, nursing/medical journals.

Domain 4

a. Demonstrates accountability for the delivery of care.  

• Comes to clinical site prepared by having gathered information on person as possible.
• Actively listens in bedside or shift report.
• Gives shift report at end of clinical day to peer or staff member. Documents cares as completes them.
• Practices what they are legally able to with proper supervision and considers other domains in their client/nurse interaction, i.e., if a mistake is made student notifies appropriate personnel immediately. Open to feedback and asks how can improve.
• Considers environmental and other factors that affect client well-being.
• Takes every advantage to take part on the care of the pt. and extra (checks on patient with our RN telling them to, asks appropriate questions when unclear).

b. Accurately determines priorities for care.

• Can list priorities for care, interventions and rationale depending on pt status.
• Uses standards of care and empirical frameworks for priority setting.
• Can respond to questions about the care for the patient the at any time during the entire shift.
• Can explain new orders, interventions and rationale regarding new situations occurring during the shift.

c. Modifies plan of care as needed based on continued evaluation of health outcomes.

• Relates assessment data to underlying physiology /pathophysiology.
• Identifies when a patient’s assessment is changing (vitals changing, mental status change).
• Utilizes multiple assessment techniques to determine patient condition change– listening, asking questions, observation, etc.
• Re-prioritizes nursing actions as the client’s condition changes.
• Organizes client assessment information according to changes, patterns, and trends.
• Understands and plans for the potential impact of selected interventions i.e., Giving a medication and planning for the expected side effects.

d. Advocate for and include the client and family as the center of the caregiving team when setting and modifying care goals.

• Practice shared decision making.
• Continuously provides information about goals of care and includes the patient/significant other in determining if the goals are appropriate or need to be updated.
• Incorporate client preferences and needs when performing nursing actions.

e. Recognizes barriers to care such as socioeconomic factors, environmental factors, and support systems.

• Discuss person’s plan for discharge—where would they go and what help might they have?
• Ask person what they may see as needs for care.
• Assess client for barriers to care (sometimes SDOH information is documented in the chart or ask them)
• Do not assume someone has everything they need at home to take care of themselves.

f. Integrates family and client input to effectively and proactively coordinate resources to provide safe, quality, equitable care to diverse population.

• Involve client/family and utilize informed consent and shared decision making when assessing for additional needs (I.e., social work consult, PT/OT, etc.)
• Provide resources to clients with special situations.
• Seek opportunities to observe and participate in client care teaching and to include family members in teaching if possible.

g. Demonstrate organizational skills in collaboration with members of the healthcare team when providing care in a variety of healthcare settings.   

• Recognize flow of clinical unit working on, when are meals, when are patient cares done (showers, baths, therapies).
• Documentation completed to learn where and how to put data in EHR Tutor.
• Ability to delegate to members of the team when applicable to coordinate care.
• Use teamwork to accomplish goals of patient care.

h. Educate individuals and families using evidence-based strategies to ensure health promotion, illness prevention, and illness management.   

• Assess levels of understanding prior to providing education to client/family.
• Find areas of knowledge gap in talking with patient regarding their health status and history.
• Individualize care and evaluate for understanding (teach-back, etc.).
• Use any opportunity to teach – while giving meds, performing assessments, etc.
• Explain to patients the “why” behind the skills you perform.
• Determine patient teaching areas by looking at chart information and patient diagnosis.

i. Uses time management when providing care in a variety of health care settings.

• Establishes a clear plan for the day with preceptor/instructor at beginning of the shift in all settings.
• Complete assessments within first 2 hours of clinical day, document cares as they are completed.
• Finish work in a timely manner, hand off completed with precepting RN, etc. by the end of the clinical shift.
• Provides appropriate care/education/service within a reasonable amount of time independently.

j. Integrates and applies didactic nursing knowledge into care.

• Bring concepts learned in Fundamentals and Pathopharm didactic courses into the clinical setting.
• Use components of the Clinical Judgment model when caring for clients.
• Relate pathophysiology and epidemiology of disease(s) to clients’ assessment findings, medications, laboratory and diagnostic test results, medical and nursing interventions as shown in the clinical prep guide and with clinical observation and discussions.

k. Utilizes informatics processes and technology to manage and improve delivery of safe, high-quality, efficient care.

• Use EHR Tutor during skills lab and simulation.
• Use EHR Tutor to enter accurate patient care data.
• Use appropriate data in EHR when planning care.
• Effectively use electronic communication tools if applicable (phones, computer, texting)
• Consistently use the safety processes in the electronic health record such as comparing the patient armband and scanning to correlate info prior to giving meds.
• Safely employ use of healthcare devices such as the blood glucose monitor, automated blood pressure machines, and oxygen saturation monitors in the J1 clinical setting.

Domain 1

a. Adheres to university, College of Nursing, and agency policies regarding professional appearance, behavior, attitude, and attendance.

• Turn in assignments on time,
• Arrives to all scheduled clinical events on time (pre-con, post-con, simulation/skills, orientation, etc.)
• Follows clinical policies and procedures as communicated by preceptor/instructor.
• Communicates with instructor when late or absent ASAP.
• Wears appropriate WSU scrubs.
• Arrives with all necessary supplies/equipment (stethoscope, badge, etc.)
• Attends 100% of clinical experiences or approved make-up opportunities.
• Demonstrates positive and respectful attitude.
• No phones or electronic devices in clinical spaces
• Does not gossip or speak negatively about a patient EVER (at the nurses’ desk, at home, anywhere).

b. Adheres to registered nurse scope and standards of practice, including bioethical and legal principles.

• Complete Scope and Standards of Practice ATI Module assignment and discuss in clinical conference.
• Participate in discussions of multiple ethical dilemmas and principles in post-conference and discuss implication to care.

c. Assumes accountability for own behaviors and practices, and acts, including seeking assistance and feedback, as appropriate.

• Demonstrate awareness of patient safety by arriving at clinical site prepared for all anticipated aspects of care including assigned Clinical Prep Guides.
• Ready to answer questions from clinical instructor including procedures, cares, or medication questions.
• Asks questions of nurse preceptor or instructor if unsure of the correct way to do something.
• Seeks assistance for skills that require more than one person – do not do it alone!
• Communicate with instructor immediately if an error occurs.
• Know where your code or staff assist call buttons and emergency equipment are in your patient’s room.
• Seek help immediately if patient deterioration or emergency identified.

d. Conducts oneself in a professional manner in all interactions with members of the interprofessional team.

• Introduces self to person receiving care and any significant others, staff members and peers.
•  Asks and answers questions politely.
• Respectful and courteous to all members of the healthcare team and ancillary staff (housekeeper, etc.)
• If you have down time, ask your team if you can help them with tasks.
• Show your appreciation for their help, knowledge, precepting – say thank you often!

e. Incorporates diverse, equitable, and inclusive practices in all professional settings.

• Explores and considers diverse values and cultures.
• Recognizes personal bias and how that may influence the care they are providing.
• Asks person for preferred name.
• Avoids stereotypes in speech or writing.
• Students will seek opportunities to ensure all members of their clinical group can participate in clinically related group activities.

f. Advocates, promotes, and protects the client’s rights to privacy, autonomy, and confidentiality.

• Does not take any identifying information out of clinical site.
• Does not use any patient identifiers in course work.
• Listen to person’s requests for care and respects those.
• Does not discuss person’s information in public setting or with those who do not need to know.
•  Maintain and obey HIPAA laws.
• ALWAYS ask permission when performing an assessment or skills with patient, especially if you must expose any skin.
• Pull the curtain in the room and make sure the patient has privacy.
• No posting on social media about hospital, patient, or clinical experience.

g. Analyzes own limitations in nursing skills and technologies and demonstrates initiative in seeking learning opportunities and resources to further professional growth.

• Reviews skills with instructor or staff prior to performing with person.
• Seeks out experiences that are within scope to participate in during clinical day.
• Asks for help if does not know how to use a piece of equipment.
• Take ownership of your learning – ask questions or find appropriate resources (not Wikipedia) when you don’t know the answer or identify a gap in knowledge.
• Share with your peers if you learn about something new (clinical conference is a great opportunity for this).

h. Employ leadership strategies and skills in the delivery of nursing care to individuals and groups in a variety of health care settings.

• Complete clinical evals in depth—looking at strengths and weakness objectively for self.
•  Participates in post clinical reflection of shift.
•  Completes peer feedback activities i.e., SimCapture peer review for skills.
• Willingness to give/receive feedback and then adjust their strategies based on the feedback.

i. Practices the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

• Practice self-care and self-compassion, be able to describe these and how they help.
• Get enough sleep, especially before clinicals.
• Take care of yourself to minimize stress – exercise, meditation, etc.
• Prepare by reading assigned material before clinicals or simulation.

Domain 2

a. Conveys clear, relevant, organized, and thorough behaviors in all forms of written and non-written communication. 

Written communication:

• Correct spelling, grammar, and sentence structure in documentation in health record and in school assignments.
• Completes written clinical prep guides with minimal guidance.
•  Inputs accurate assessments and other patient care data into EHR Tutor or EHR at site.

Non-written communication

• Use active listening.
• AIDET method
• Communication and hand off information is accurate, clear, and organized.

b. Effectively utilizes ISBAR (or other acceptable communication tools) to communicate patient condition, changes, and recommendations to interprofessional team.  

• Effectively utilize ISBAR (or other acceptable communication tools) to communicate patient condition, changes, and recommendations to health care team and/or instructors or peers in at least 10 shift reports throughout the course.

c. Utilizes culturally and linguistically responsive communication strategies.

• Determine what interpretation services are available a clinical site.
• Recognize when need to use an interpretation service.
• Recognize cultural practices that may influence how care is delivered for populations encountered most frequently at clinical site.
• Recognize that culture may not be the same as race.
• Examines own culture and how it affects communicate with clients.
• Provides culturally safe communication by allowing patient to direct how culture is meaningful to them in context of healthcare.

d. Exhibits timely, legally accurate, and appropriate documentation.

• Document patient care and pertinent findings in a timely, legally accurate and appropriate manner in the clinical/simulation electronic health record or facility system according to agency policies and guidelines at least 10 times throughout the course.

e. Communicates in a therapeutic and developmentally appropriate manner using utilizing verbal and nonverbal skills.

• Utilizes therapeutic communication techniques appropriate for clients and families (i.e., active listening, sharing empathy, providing information, etc.)
• Using therapeutic touch and reassurance (ask permission first!)
• Incorporates patient/family cultural and religious beliefs and desires related to therapeutic communication.

f. Applies principles of team dynamics to improve quality and assure safety in a variety of healthcare settings.

• Interact positively with peers in clinical group and instructor.
• Identify team dynamics and how good teams’ function.
• Can work easily and effectively in groups/pairs with other students, health care workers/staff, patients, and families to address problems, questions, issues.
• Displays a team mentality (offering help, jumping in to assist in a procedure, offering to get supplies, etc.)
• Demonstrate teamwork in an urgent/emergent situation.
• Demonstrate role delegation in simulation.

g. Communicates priorities and rationale for decisions to instructor.

• Participates in presentation of patient including reason for seeking care, medical diagnosis, nursing diagnosis, interventions, pathophysiology and Pathopharm, etc.
• Using clinical judgment model, discusses priorities for patient care (prioritize cues) depending on assessment data (recognize and analyze cues) and condition.
• Prioritizes care based on the best evidence.
• Demonstrate rationale for the plan of care.

h. Acknowledges implicit biases and how they may affect communication and the delivery of care.  

• Able to have discussions or express in writing about learning situations that challenge personal bias and bring about self-awareness (interacting with possible child abuse perpetrators, etc.)
• Acknowledges own implicit biases that may affect team dynamics, communication, or collaboration (E.g., working with a nurse from a different culture or background who is difficult to understand)
• Identify biases and consider what challenges they pose to the delivery of quality care.

i. Develops and maintains effective partnerships with the interprofessional team and key stakeholders.

• Demonstrate effective and respectful collaboration with all members of the healthcare team.
• Be accountable to the client/family and healthcare team.
• Utilize clinical instructor as mediator/resource for clinical site.
• Brings staff issues to clinical instructor to mediate with clinical site leadership if needed.
• Attempt to create a working relationship with nurse they are assigned to on a clinical day.

Domain 3

a. Establish relationships of mutual respect with clients and family built on empathy and compassion.  

• Shows empathy towards patient so that the patient feels cared for.
• Maintain eye contact, slow down cares, and answer questions (even if feeling rushed or hurried).
• Be aware of negative body language, sit down at level of patient and ask questions.

b. Utilizes clinical judgment to identify, prioritize, and organize the care of actual or potential health problems and needs.  

• Review NGN Clinical Judgement model and practice the parts while at clinical.
• Practice synthesizing pathophysiology of patient’s disease process with interventions.
• Recognize and analyze cues for common med-surg conditions and prioritize care (prioritize hypotheses and generate solutions) for the patient.
• Identify how student makes decisions, and how that skill becomes part of clinical judgement.

c. Perform appropriate assessment skills given patient presentation and situation.

• Perform an age-appropriate assessment with special consideration to patient status.
• Recognize need to perform focused assessments as indicated.
• Can identify when more information or an alternative method or sequence of assessing a patient may be needed.

d. Synthesize the needs and preferences of the client with assessment data when developing a plan of care with realistic goals and expected outcomes.

• Identifies person(s) preferences when addressing unmet need and considers when providing potential interventions.
• Identify expected outcome from intervention and determine how it will be measured.
• Work with the patient to develop a plan of care consistent with patient needs and assessment findings.
• Articulate patients need to faculty.

e. Plans and implements evidence-based interventions that are congruent with assessment data.  

• Explain the role of evidence in determining best clinical practice.
• Implement standardized, evidence-based processes for providing care.
• Displays ability to use EBP and apply to learning in the clinical setting. (i.e., participates in a new procedure/protocol… can look up relevance to experience and discover new information, considerations). 
• Seeks out appropriate resources available in a clinical setting (i.e., uses embedded EHR tools, look up procedures in online facility library, seek clarification from the pharmacists about an off label med).

f. Performs nursing skills and therapeutic procedures safely and competently.

• Utilize CON skills lab and simulations to learn and practice skills.
• Follow correct procedures when performing skills (if you haven’t been checked off, ask for help).
• Know where to find current hospital procedures, policies or who to ask.
• Shows ability to prepare and deliver nursing skills while recognizing potential issues related to developmental age or condition.
• Integrate didactic learning to enhance skill delivery, ex. Considers effects of dehydration when placing an IV catheter.

g. Contributes to a culture of safety for all in clinical settings.   

• Identifies types of workplace violence —nurse to nurse, patient to nurse-and methods to avoid or mitigate.
• Patient safety—Applies skills for patient mobility, medication administration, patient procedure prep.
• Follows protocols and policies of agency or facility.
• Assess, identify, and act upon safety issues in the clinical setting.
• Speak up (report) when you see or hear something that is harmful or unsafe.
• Asking for help or assistance when performing a skill/intervention student has not performed.

h. Reports abnormal data and changes in client condition to instructor or appropriate health team member.

• Student reports any abnormal vital signs, labs, assessment findings to person RN and instructor.
• Identify and communicate abnormal findings (cues): VS changes, respiratory distress, etc.

i. Evaluates sources of data for appropriateness, usefulness, and accuracy.

• Know what sources are considered reliable for health care information i.e., Up-To-Date site, WSU or hospital libraries, nursing/medical journals,
• Utilize principles of research to evaluate levels of evidence (EBP project, clinical worksheets).

Domain 4

a. Demonstrates accountability for the delivery of care.  

• Comes to clinical site prepared by having gathered information on person as possible.
• Actively listens in bedside or shift report.
• Gives shift report at end of clinical day to peer or staff member. Documents cares as completes them.
• Practices what they are legally able to with proper supervision and considers other domains in their client/nurse interaction, i.e., if a mistake is made student notifies appropriate personnel immediately. Open to feedback and asks how can improve.
• Considers environmental and other factors that affect client well-being.
• Takes every advantage to take part on the care of the pt. and extra (checks on patient with our RN telling them to, asks appropriate questions when unclear).

b. Accurately determines priorities for care.

• Can list priorities for care, interventions and rationale depending on pt status.
• Uses standards of care and empirical frameworks for priority setting.
• Can respond to questions about the care for the patient at any time during the entire shift.
• Can explain new orders, interventions and rationale regarding new situations occurring during the shift.

c. Modifies plan of care as needed based on continued evaluation of health outcomes. 

• Relates assessment data to underlying physiology /pathophysiology.
• Identifies when a patient’s assessment is changing (vitals changing, mental status change).
• Utilizes multiple assessment techniques to determine patient condition change– listening, asking questions, observation, etc.
• Re-prioritizes nursing actions as the client’s condition changes.
• Organizes client assessment information according to changes, patterns, and trends.
• Understands and plans for the potential impact of selected interventions i.e., Giving a medication and planning for the expected side effects.

d. Advocate for and include the client and family as the center of the caregiving team when setting and modifying care goals.

• Practice shared decision making.
• Continuously provides information about goals of care and includes the patient/significant other in determining if the goals are appropriate or need to be updated.
• Incorporate client preferences and needs when performing nursing actions.

e. Recognizes barriers to care such as socioeconomic factors, environmental factors, and support systems.

• Discuss person’s plan for discharge—where would they go and what help might they have?
• Ask person what they may see as needs for care.
• Assess client for barriers to care (sometimes SDOH information is documented in the chart or ask them)
• Don’t assume someone has everything they need at home to take care of themselves.

f. Integrates family and client input to effectively and proactively coordinate resources to provide safe, quality, equitable care to diverse population.

• Involve client/family and utilize informed consent and shared decision making when assessing for additional needs (I.e., social work consult, PT/OT, etc.)
• Provide resources to clients with special situations.
• Seek opportunities to observe and participate in client care teaching and to include family members in teaching if possible.

g. Demonstrate organizational skills in collaboration with members of the healthcare team when providing care in a variety of healthcare settings.   

• Recognize flow of clinical unit working on, when are meals, when are patient cares done (showers, baths, therapies).
• Documentation completed with assistance or review of staff member to learn where and how to put in data gathered in this specific clinical site.
• Ability to delegate to members of the team when applicable to coordinate care.
• Use teamwork to accomplish goals of patient care.

h. Educate individuals and families using evidence-based strategies to ensure health promotion, illness prevention, and illness management.   

• Assess levels of understanding prior to providing education to client/family.
• Find areas of knowledge gap in talking with patient regarding their health status and history.
• Individualize care and evaluate for understanding (teach-back, etc.).
• Use any opportunity to teach – while giving meds, performing assessments, etc.
• Explain to patients the “why” behind the skills you perform.
• Determine patient teaching areas by looking at chart information and patient diagnosis.

i. Uses time management when providing care in a variety of health care settings.

• Establishes a clear plan for the day with preceptor/instructor at beginning of the shift in all settings.
• Complete assessments within first 2 hours of clinical day, document cares as they are completed.
• Finish work in a timely manner, hand off completed with precepting RN, etc. by the end of the clinical shift.
• Provides appropriate care/education/service within a reasonable amount of time independently.

j. Integrates and applies didactic nursing knowledge into care.

• Bring concepts learned in Med-Surg didactic course into the clinical setting.
• Use components of the Clinical Judgment model when caring for clients.
• Relate pathophysiology and epidemiology of disease(s) to clients’ assessment findings, medications, laboratory and diagnostic test results, medical and nursing interventions as shown in the clinical prep guide and with clinical observation and discussions.

k. Utilizes informatics processes and technology to manage and improve delivery of safe, high-quality, efficient care.

• Use EHR Tutor during skills lab and simulation.
• Use EHR (Epic) to enter accurate patient care data.
• Use appropriate data in EHR when planning care.
• Effectively use electronic communication tools if applicable (phones, computer, texting)
• Consistently use the safety processes in the electronic health record such as comparing the patient armband and scanning to correlate info prior to giving meds.
• Safely employ use of healthcare devices such as the blood glucose monitor, automated blood pressure machines, and oxygen saturation monitors in the J2 clinical setting.

Domain 1

a. Adheres to university, College of Nursing, and agency policies regarding professional appearance, behavior, attitude, and attendance. 

• Arrives in appropriate clothing per WSU and agency guidelines (Community vs hospital setting).
• Follows med admin guidelines, unit protocols. Arrives on time for each setting (managing various sites start times).
• Arrives with an eager, optimistic attitude.  
• Arrives with all necessary supplies/equipment (stethoscope, badge, etc.).
• Arrives with evidence of preparation for clinical day.
• Attends 100% of clinical experiences or approved make-up opportunities.
• Does not use phones or electronic devices in clinical spaces.
• Does not gossip or speak negatively about a patient ever (at the nurse’s desk, at home, anywhere).
• Student demonstrates professionalism throughout the clinical.
• Written work is thorough, complete, and representative of their level of education.
• Actively participants in post conference and simulated activities.

b. Adheres to registered nurse scope and standards of practice, including bioethical and legal principles. 

• Distinguishes when collaboration/guidance is needed on fragile situations (CPS/family dynamics).
• Differentiates nursing roles in various settings.
• Assesses need for mandatory reporting and apply an ethical approach for caring for a vulnerable population.
• Applies the registered nurse scope and standards of practice, including legal and ethical frameworks of nursing throughout the course in clinical and simulation activities. 
• Identifies and reports unethical practices, behaviors, communications.

c. Assumes accountability for own behaviors and practices, and acts, including seeking assistance and feedback, as appropriate. 

• Reports errors, mistakes. Evaluates own needs and seek instructor guidance.
• Reports appropriate information to precepting nurses, etc. in a timely manner.
• Seeks out and utilizes resources and information when needed.

d. Conducts oneself in a professional manner in all interactions with members of the interprofessional team. 

• Flows between settings (clinic, unit, school staff) and adjusts to interacting and collaborating with different individuals (patients, students, health care team members, staff) recognizing their contribution to the care of the population.
• Values and takes advantage of learning from interdisciplinary partners, etc. (discusses patient status with RT, initiates inquiries about distraction techniques with child life specialist, asks about autism interventions with ECEAP teacher).
• Introduces self to person receiving care and any significant others, staff members and peers.
• Asks and answers questions politely. 
• Displays respect and courtesy to all members of the healthcare team and ancillary staff (housekeeper, etc.)
• Asks how they can help or participate during downtime.
• Shows appreciation for clinical site staff/health care team member for sharing their knowledge and time. 
• Says thank you often.

e. Incorporates diverse, equitable, and inclusive practices in all professional settings. 

• Is able to examine needs of a population in different settings and apply interventions to meet those needs.
• Considers the whole picture of health and ecosystem components.
• Applies concepts, such as the resiliency wheel, in a consistent manner to assess supports, identify risks and formulate appropriate interventions. 
• Explores and considers diverse values and cultures in application of knowledge base to clinical problems.
• Asks person for preferred name, pronouns, etc. when applicable. 
• Recognizes personal bias (if they have them) and how that may influence the care they are providing.

f. Advocates, promotes, and protects the client’s rights to privacy, autonomy, and confidentiality. 

• Recognizes different developmental stages that may require more consideration (puberty, adolescence).
• Understands consent and parental impact on privacy. (Rooming 13 yr olds, addressing sensitive issues with parent out of room, Minor consent laws in WA).
• Encourages developmentally appropriate decision making and involvement in care.
• Does not take identifying information out of clinical site and keeps it protected in the clinical site. 
• Does not use any patient identifiers in course work.
• Collaborates with patient and family regarding requests for care and respects those.
• Does not discuss person’s information in public setting or with those who do not need to know.
• Maintains and obeys HIPAA laws. 
• Depending on age and parent/guardian presence, ask permission when performing an assessment or skills with patient.
• Pulls the curtain in the room and makes sure the patient has privacy when they may be exposed.   Does not post clinical related information on social media about hospital/setting, patient/family, or clinical experience.

g. Analyzes own limitations in nursing skills and technologies and demonstrates initiative in seeking learning opportunities and resources to further professional growth.

• Communicates learning needs. Is able to explain learning goals and outcomes in a particular setting (community vs hospital).
• Displays ability to use high quality EBP to further knowledge in journals or ad lib.
• Reviews skills with instructor or staff prior to performing with patient.
• Seeks out experiences that are within scope to participate in during clinical day.
• Asks for help if does not know how to use a piece of equipment.
• Is open to feedback, not defensive.
• Takes ownership of your learning – ask questions or find appropriate resources.
• Shares learning experiences with peers in a meaningful way.

h. Employ leadership strategies and skills in the delivery of nursing care to individuals and groups in a variety of health care settings.

• Able to have a two-way conversation and collaborate to devise a plan to improve clinical actions, behaviors, thinking processes.
• Able to frequently reflect on actions and behavior to monitor progression of professional behavior in the clinical setting.

i. Practices the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

• Alerts instructor or precepting nurse of individual goals for the day and discuss potential skill opportunities.
• Increases practice of independent thinking and problem solving while caring for patients and families.
• Articulately shares thinking with instructor or preceptor.
• Develops plan of care for the day, identifies priorities and organizes interventions with the collaboration with patient, family, precepting nurse and other interdisciplinary team members.

Domain 2

a. Conveys clear, relevant, organized, and thorough behaviors in all forms of written and non-written communication.  

• Completes written patient care logs with minimal guidance. 
• Inputs accurate assessments and other patient care data into EHR with RN cosign.
• Carries out communication and hand off information in a  accurate, clear and organized manner.

b. Effectively utilizes ISBAR (or other acceptable communication tools) to communicate patient condition, changes, and recommendations to interprofessional team.   

• Reports on patient condition and status at any time during shift. 
• Provides information that is organized, accurate and clear in a timely manner without prompting.
• Utilizes ISBAR (or other acceptable communication tools) effectively to communicate patient condition, changes, and recommendations to health care team and/or instructors or peers.

c. Utilizes culturally and linguistically responsive communication strategies.

• Quickly assesses for cultural cues or the need for a specialized approach regarding communication strategies (interpreter, Martti, non-English language print outs, extra resources, altered time for education, developmental level)

d. Exhibits timely, legally accurate, and appropriate documentation. 

• Completes assessment with RN cosign in a timely manner.
• Documents data per unit protocol and expectation for pt condition.
• Practices documentation in real time (in patient’s room) or as soon as possible after leaving room after cares.
• Completes documentation in community settings (ie. vaccine clinics, vision/hearing screenings in schools) in a timely manner according to agency guidelines.

e. Communicates in a therapeutic and developmentally appropriate manner using utilizing verbal and nonverbal skills. 

• Assesses patient and families for appropriate communication strategies. Implements various forms of therapeutic communication to meet the need of patients and families. Uses play, drawing, stories, etc. to communicate with different ages.  Uses family as a resource to guide care of the child.

f. Applies principles of team dynamics to improve quality and assure safety in a variety of healthcare settings. 

• Works easily and effectively in groups/pairs with other students, health care workers/staff, patients, and families to address problems, questions, issues. 
• Displays a team mentality (offering help, jumping in to assist in a procedure, offering to get supplies, etc.)

g. Communicates priorities and rationale for decisions to instructor.

• Reports priorities and specific interventions, especially as they change, during a rotation. 
• Provides rationale for interventions and decisions.

h. Acknowledges implicit biases and how they may affect communication and the delivery of care.   

• Participates in discussions or expresses in writing about learning situations that challenge personal bias and bring about self-awareness (interacting with possible child abuse perpetrators, etc.)

i. Develops and maintains effective partnerships with the interprofessional team and key stakeholders.

• Recognizes importance of student behavior and performance that build’s trust and positive reputation beyond the individual student (WSU CON). 
• Student understands the contribution they provide to the patients and families, as well as the clinical agency’s mission.

Domain 3

a. Establish relationships of mutual respect with clients and family built on empathy and compassion.   

• Approaches family and the patient as one unit, understanding the role and dynamic each person has on the whole unit. 
• Shows empathy towards patient so that the patient feels cared for (maintains eye contact, slows down cares to answer questions (even if feeling rushed or hurried), utilizes active listening, avoids negative body language, sits down at level of patient.)

b. Utilizes clinical judgment to identify, prioritize, and organize the care of actual or potential health problems and needs.   

• Understands developmentally appropriate norms and differences in all realms of health (language, motor, cognitive, etc.) needed to recognize problems and needs. 
• Can recognize when opportunities arise to tailor interventions for a particular age group, condition, or issue to produce more effective outcomes.

c. Perform appropriate assessment skills given patient presentation and situation. 

• Can perform an age-appropriate assessment with special consideration to patient status. 
• Able to recognize need to perform focused assessments as indicated. Is able to identify when more information or an alternative method or sequence of assessing a patient may be needed. 
  • (Ask parent to hold child to decrease crying during respiratory assessment). 

d. Synthesize the needs and preferences of the client with assessment data when developing a plan of care with realistic goals and expected outcomes.

• Able to assess a patient & family using an ecosystem approach to explore various components of health and wellness, illness/accident prevention and health promotion.
• Able to develop and implement interventions and evaluate outcomes.
• Utilize a family centered approach to care.

e. Plans and implements evidence-based interventions that are congruent with assessment data.   

• Displays ability to use EBP and apply to learning in the clinical setting. (i.e. participates in a new procedure/protocol… can look up relevance to experience and discover new information, considerations). 
• Seeks out appropriate resources available in a clinical setting (ie. asking teacher in ECEAP class how to communicate with a particular child with autism, seeking clarification from the pharmacists about an off label med)

f. Performs nursing skills and therapeutic procedures safely and competently.

• Shows ability to prepare and deliver nursing skills while recognizing potential issues related to developmental age or condition. 
• Is able to integrate didactic learning to enhance skill delivery. 
  • (Considers effects of dehydration when placing a IV catheter).

g. Contributes to a culture of safety for all in clinical settings.    

• Can articulate mission and values of each clinical setting and carry out agency intentions. 
• Can assess, identify, and act upon safety issues in the clinical setting. Speak up (report) when you see or hear something that is harmful or unsafe. 
• Asking for help or assistance when performing a skill/intervention student has not performed. 
• Follows protocols and policies of agency or facility.

h. Reports abnormal data and changes in client condition to instructor or appropriate health team member.

• Can recognize cues of change in patient condition and advocate for assistance or intervention (rash, cough, decreased circulation, vital sign changes, abnormal lab results, acute pain, etc. develops)

i. Evaluates sources of data for appropriateness, usefulness, and accuracy.

• Can locate and utilize appropriate, high quality EBP for coursework and when creating interventions and educating patients and families in the clinical setting.

Domain 4

a. Demonstrates accountability for the delivery of care.   

• Can respond to questions about the care for the patient the at any time during the entire shift. 
• Can explain new orders, interventions and rationale regarding new situations occurring during the shift. 
• Takes every advantage to take part on the care of the pt. and extra (checks on patient with our RN telling them to, asks appropriate questions when unclear).

b. Accurately determines priorities for care.

• Can list priorities for care, interventions and rationale depending on pt status. 
• Organizes client assessment information according to changes, patterns, and trends. 
• Uses standards of care and empirical frameworks for priority setting.

c. Modifies plan of care as needed based on continued evaluation of health outcomes.  

• Can organize interventions based on mutually agreed upon goals with the patient/family and other health care team members.
• Student can recognize improvements or declines in patient health and can reevaluate priorities.

d. Advocate for and include the client and family as the center of the caregiving team when setting and modifying care goals.

• Enacts concept of pt/family centered care in every setting.
• Encourages mutual decision making with pt/family and health care team, answers questions/find answers to questions in a thorough, efficient manner). 
• Recognizes when advocacy is being carried out or when it is needed. 
• Recognize the ethical aspects and implications of caring for a vulnerable population.

e. Recognizes barriers to care such as socioeconomic factors, environmental factors, and support systems.

• Assess and evaluate impact of these barriers, knowing they will all effect care. 
• Exhibits the ability to problem solve to counter act barriers with education, resource allocation, referrals, etc.

f. Integrates family and client input to effectively and proactively coordinate resources to provide safe, quality, equitable care to diverse population.

• Able to assess multifactorial aspects that can be strengths or weaknesses for health care delivery and outcomes.
• Can perform a ecosystem assessment to understand risks, needs and strengths of patients and families.

g. Demonstrate organizational skills in collaboration with members of the healthcare team when providing care in a variety of healthcare settings.    

• Able to keep consistent, timely, clear record of current patient status and interventions. 
• Keeps instructor/preceptor updated of any changes in location status at clinical.
• Displays genuine curiosity and respect for all health care team members contributions to patient outcomes and takes initiative to ask questions and learn more about interdisciplinary work and efforts.

h. Educate individuals and families using evidence-based strategies to ensure health promotion, illness prevention, and illness management.    

• Use various forms of teaching to educate client or patient. 
• Knowledgeable and accountable for relaying key information and education. 
• Can show ability to teach various ages and conditions of patients in various settings (Schools, community settings, hospital).

i. Uses time management when providing care in a variety of health care settings. 

• Establishes a clear plan for the day with preceptor/instructor at beginning of the shift in all settings. 
• Can finish work in a timely manner, hand off completed with precepting RN, etc. by the end of the clinical shift.
• Student provides appropriate care/education/service within a reasonable amount of time independently.

j. Integrates and applies didactic nursing knowledge into care.

• Can tie information learned in theory courses to the clinical setting (lab work, identification of signs and symptoms, side effects of medications, interventions, etc.)

k. Utilizes informatics processes and technology to manage and improve delivery of safe, high-quality, efficient care.

• Can learn and practice using various technologies in the documentation and delivery of care (EHR, patient coordination monitors, equipment, online resources).

Domain 1

a. Adheres to university, College of Nursing, and agency policies regarding professional appearance, behavior, attitude, and attendance. 

• Arrives to all scheduled clinical events on time (pre-con, post-con, simulation/skills, orientation, etc.)
• Follows clinical policies and procedures as communicated by preceptor/instructor
• Arrives with all necessary supplies/equipment (stethoscope, badge, etc.)
• Attends 100% of clinical experiences or approved make-up opportunities
• Wears appropriate WSU scrubs, identification badges as required by CON and agency
• Demonstrates positive and respectful attitude
• Appropriate use of electronic devices in clinical spaces or during post-conference (not in front of staff, patients, family members)
• Debriefs negative clinical experiences in appropriate location and manner. Does not gossip or speak negatively about a patient outside of debriefing session.

b. Adheres to registered nurse scope and standards of practice, including bioethical and legal principles. 

• Provides safe and competent care defined by standards of practice
• Practices ethical decision making (what is the right thing to do for this patient without consideration of your own beliefs/values, etc.?)
• Identifies and reports unethical practices, behaviors, communication

c. Assumes accountability for own behaviors and practices, and acts, including seeking assistance and feedback, as appropriate. 

• Asks questions of nurse preceptor or instructor if unsure of the correct way to do something
• Seeks assistance for skills that require more than one person – don’t do it alone!
• Communicates with instructor immediately if an error occurs
• Knows where your code or staff assist call buttons and emergency equipment are in your patient’s room
• Seeks help immediately if patient deterioration or emergency is identified

d. Conducts oneself in a professional manner in all interactions with members of the interprofessional team. 

• Is respectful and courteous to all members of the healthcare team and ancillary staff (housekeeper, etc);
• Asks team if they need help when there is down time.
• Shows your appreciation for their help, knowledge, precepting – say thank you often!

e. Incorporates diverse, equitable, and inclusive practices in all professional settings. 

• Acknowledge implicit biases that may affect patient care in the OB setting (i.e. people with substance use disorder (SUD), race, gender identity, etc.)
• Includes the entire family in nursing care (support person, doula)
• Demonstrates cultural sensitivity and humility in practice

f. Advocates, promotes, and protects the client’s rights to privacy, autonomy, and confidentiality. 

• Maintains and obeys HIPAA laws
• ALWAYS asks permission when performing an assessment or skills with patient, especially with skin exposure (i.e. placing EFM monitors, doing an SVE, etc.)
• Pulls the curtain in the room and ensures patient privacy
• No posting on social media about hospital, patient, or clinical experience

g. Analyzes own limitations in nursing skills and technologies and demonstrates initiative in seeking learning opportunities and resources to further professional growth.

• Takes ownership of your learning – ask questions or find appropriate resources (not Wikipedia) when you don’t know the answer or identify a gap in knowledge
• Shares with your peers if you learn about something new (post-con is a great opportunity for this)
• Integrates reliable evidence from many credible sources of knowledge

h. Employ leadership strategies and skills in the delivery of nursing care to individuals and groups in a variety of health care settings.

• Focuses on providing nursing excellence
• “Walk the walk, talk the talk”
• Demonstrates integrity
• Develops plan of care for the day, identifies priorities and organizes interventions while collaborating with patient, family, precepting nurse and other interdisciplinary team members.

i. Practices the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.

• Takes care of self in a manner which allows student to maintain safety and mental focus
• Prepares for all clinical experiences and requirements by reading assigned material or completing prep work

Domain 2

a. Conveys clear, relevant, organized, and thorough behaviors in all forms of written and non-written communication.  

• Nursing notes are organized, succinct, and accurately convey patient situation
• Prioritizes communication in urgent/emergent situations
• Corroborates assessment cues with healthcare team to minimize mistakes/errors when unsure

b. Effectively utilizes ISBAR (or other acceptable communication tools) to communicate patient condition, changes, and recommendations to interprofessional team.   

• Shift report/SBAR contains all relevant information about the patient and situation
• “R” (recommendation) of SBAR is appropriate to the patient situation and realistic
• Can accurately communicate SBAR to other team members/provider

c. Utilizes culturally and linguistically responsive communication strategies.

• Asks patient and family their preferred language and cultural beliefs and practices related to care
• Uses interpreter or appropriate device if patient does not speak English
• Identifies patient’s ability to read English before providing written materials

d. Exhibits timely, legally accurate, and appropriate documentation. 

• Documents in real time (in patient’s room) or as soon as possible after leaving room after cares
• Sticks to factual communication and only documents what is relevant to patient’s care
• Communicates with nurse what you have charted

e. Communicates in a therapeutic and developmentally appropriate manner using utilizing verbal and nonverbal skills. 

• Utilizes therapeutic communication techniques appropriate for childbearing families (i.e. active listening, sharing empathy, providing information, etc.)
• Examines own culture and how it affects the ways you communicate with clients
• Incorporates patient/family cultural and religious beliefs and desires related to therapeutic communication
• Provides culturally safe communication by allowing patient to direct how culture is meaningful to them in context of childbearing
• Able to have difficult conversations about sensitive subjects with patients (perinatal loss, SUD, domestic violence, perinatal mood disorders)

f. Applies principles of team dynamics to improve quality and assure safety in a variety of healthcare settings. 

• Offers to help and assist other caregivers when finished with patient cares
• Demonstrates teamwork in an urgent/emergent situation (PPH or NRP simulation)
• Demonstrates role delegation and teamwork in simulation

g. Communicates priorities and rationale for decisions to instructor.

• Using clinical judgment, discusses priorities for patient care based on assessment data and condition
• Prioritizes care based on the best evidence
• Demonstrates rationale for the plan of care

h. Acknowledges implicit biases and how they may affect communication and the delivery of care.   

• Acknowledges own implicit biases that may affect team dynamics, communication or collaboration (E.g. working with a nurse from a different culture or background who is difficult to understand)

i. Develops and maintains effective partnerships with the interprofessional team and key stakeholders.

• Demonstrates effective and respectful collaboration with all members of the healthcare team
• Accountable to the client/family and healthcare team

Domain 3

a. Establish relationships of mutual respect with clients and family built on empathy and compassion.   

• Shows empathy towards patient so that the patient feels cared for: Maintain eye contact, slow down cares and answer questions (even if feeling rushed or hurried), let your patient know you are listening to them, be aware of negative body language, sit down at level of patient and ask questions
• Examples of empathetic communication:
  • “It seems like you are worried about your baby withdrawing from narcotics. It must be frustrating to be away from your baby. Would you like me to help you go see your baby in the nursery?”

b. Utilizes clinical judgment to identify, prioritize, and organize the care of actual or potential health problems and needs.   

• Using clinical judgement can identify abnormal assessment findings for common OB and newborn conditions:
  • PPH
  • Preeclampsia
  • Problems with lactation
  • Perinatal mood and anxiety disorders
  • Newborn respiratory distress
• Prioritizes and organizes care based on findings
• Evaluates outcomes

c. Perform appropriate assessment skills given patient presentation and situation. 

• Performs assessment for healthy newborn
• Performs assessment for postpartum patient
• Perform focused assessment on postpartum patients experiencing postpartum hemorrhage, preeclampsia

d. Synthesize the needs and preferences of the client with assessment data when developing a plan of care with realistic goals and expected outcomes.

• Shared decision making!
• Examples:
  • Ask about their preferences/desires for their birth
  • How do they plan to feed their baby
  • Make a plan for cares during the day so that the patient/family know when to expect you

e. Plans and implements evidence-based interventions that are congruent with assessment data.   

• Explains the role of evidence in determining best clinical practice
• Implements standardized, evidence-based processes for providing care

f. Performs nursing skills and therapeutic procedures safely and competently.

• Follows correct procedures when performing skills (if you haven’t been checked off, ask for help)
• Utilizes CON skills lab, immersion, modular skills trainer (MST), and simulations to learn and practice skills as needed to fulfill requirements
• Knows where to find current hospital procedures, policies or who to ask
• Knows the correct procedure (didactic understanding) of nursing skills that may be performed during clinicals before performing them in person (see full skills list):
  • OB skills: starting and removing IVs, correctly administering medications, fetal monitoring, placing foley, etc.
  • Newborn skills: Vital signs, baby bath, medication administration, etc.

g. Contributes to a culture of safety for all in clinical settings.    

• Speak up (report) when you see or hear something that is harmful or unsafe
• Asking for help or assistance when performing a skill/intervention student has not performed

h. Reports abnormal data and changes in client condition to instructor or appropriate health team member.

• Identifies and communicates abnormal findings (cues): VS changes (mom or baby), bleeding, newborn respiratory distress, etc.

i. Evaluates sources of data for appropriateness, usefulness, and accuracy.

• Utilizes principles of research to evaluate levels of evidence (EBP project, clinical worksheets)

Domain 4

a. Demonstrates accountability for the delivery of care.   

• Selects and provides appropriate interventions based on patient assessment cues
• Acknowledges and takes responsibility for care not being done or being done incorrectly

b. Accurately determines priorities for care.

• Organizes client assessment information according to changes, patterns and trends
• Uses standards of care and empirical frameworks for priority setting
• Understands and plans for the potential impact of selected interventions (I.e. giving a medication and planning for the expected side effects)
• Relates assessment data to underlying physiology /pathophysiology

c. Modifies plan of care as needed based on continued evaluation of health outcomes.  

• Identifies when a patient’s assessment is changing (vitals changing, labor progressing)
• Re-prioritizes nursing actions as the client’s condition changes
• Utilizes multiple assessment techniques to determine patient condition change– listening, asking questions, observation, etc.

d. Advocate for and include the client and family as the center of the caregiving team when setting and modifying care goals.

• Shared decision making
• Continuously provides information about goals of care and includes the patient/significant other in determining if the goals are appropriate or need to be updated
• Incorporates client preferences and needs when performing nursing actions

e. Recognizes barriers to care such as socioeconomic factors, environmental factors, and support systems.

• Assesses client for barriers to care (sometimes SDOH information is documented in the chart or ask them)
  • Example: If a postpartum patient is single, ask if they have support at home- don’t assume someone has everything they need at home to take care of themselves or their baby

f. Integrates family and client input to effectively and proactively coordinate resources to provide safe, quality, equitable care to diverse population.

• Involves client/family and utilize informed consent and shared decision making when assessing for additional needs (I.e. social work consult, PT/OT, etc.)
• Provides resources to clients with special situations (I.e. newborn is in the NICU, SUD/NOWS, congenital anomaly, perinatal loss)

g. Demonstrate organizational skills in collaboration with members of the healthcare team when providing care in a variety of healthcare settings.    

• Ability to delegate to members of the team when applicable to coordinate care
• Uses teamwork to accomplish goals

h. Educate individuals and families using evidence-based strategies to ensure health promotion, illness prevention, and illness management.    

• Assesses levels of understanding prior to providing education to client/family
• Individualizes care and evaluate for understanding (teach-back, etc.)
• Uses any opportunity to teach – baby bath, when giving newborn shots, fundal massage
• Understands the “why” behind the performed skills

i. Uses time management when providing care in a variety of health care settings. 

• Cares for at least one postpartum/newborn couplet (or multiple clients) simultaneously and prioritizes/organizes care depending on each patient’s needs
• Establishes a clear plan for the day with preceptor/instructor at beginning of the shift in all settings
• Finishes work in a timely manner, hand off completed with precepting RN, etc. by the end of the clinical shift.
• Provides appropriate care/education/service within a reasonable amount of time independently.

j. Integrates and applies didactic nursing knowledge into care.

• Recalls concepts learned in OB didactic course when caring for patients in the clinical setting
• Uses clinical judgment when caring for patients

k. Utilizes informatics processes and technology to manage and improve delivery of safe, high-quality, efficient care.

• Uses EHR Tutor correctly during immersion and simulation
• Uses EHR (Epic) to enter accurate patient care data
• Uses appropriate data in EHR when planning care
• Effectively uses electronic communication tools if applicable (phones, computer, texting)