PEER FEEDBACK TOOL: Operative Services- HR & PACU Nurses

Transcription

1 Page 1 of 5 PEER FEEDBACK TOOL: Operative Services- HR & PACU Nurses Subject s Name: Evaluator s Name: Requires Evaluati Descriptors (Quality & ) for reference PLANNING & MANAGING CARE Descripti 1. Practice adheres to ASPAN and organizatial standards. 2. Addresses patients safety needs (ex: correctly id pt, verifies correct procedure, site and side, operati of equipment, radiati safety, care of anesthetized pt., positiing, skin care, fluid & electrolyte balance). 3. Applies age-specific/cultural csideratis to care of patient. 4. Assessment is accurate and care given is specific to patient needs (ex: positiing for pt s limited functial status, safety measures for pt identified at increased risk of infecti or malignant hypertensi). 5. Evaluates respses to treatments/interventis through clear and ccise documentati/report. 6. Manages complex clinical situatis RN 2-4 including systems/operatial barriers. It is required to describe specific example(s) for each Key Functi. Please enter specific example(s) below:

2 Page 2 of 5 CONTINUUM OF CARE PLANNING Planning for the next level or phase of care. Descripti 1. Accurately assesses and plans for the appropriate next level of care. 2. Patient hand off to next level of care according to SBAR. It is required to describe specific example(s) for each Key Functi. Please enter specific example(s) below: PATIENT / FAMILY EDUCATION Descripti 1. Incorporates a variety of resources to teach and support patient and family learning (ex: EZTV, pt ed materials, web sources, drawings, etc). 2. Individualizes patient/family educati for complex patients/families (ex: resistant, ncompliant, significant barriers to learning). RN 3-4 It is required to describe specific example(s) for each Key Functi. Please enter specific example(s) below: PROBLEM SOLVING Descripti 1. Identifies and takes acti to resolve systems (operatial/workarounds) problems. 2. Actively participates in team/group problem solving.

3 Page 3 of 5 3. Uses interdisciplinary approach to lead others in problem solving projects and asks for feedback to evaluate change. RN 4 4. Cstructively supports change. It is required to describe specific example(s) for each Key Functi. Please enter specific example(s) below: COMMUNICATION & COLLABORATION 1. Persal behavior positively influences envirment and others (e.g.: attendance, tardiness, team support, helping others, managing up and other CREDO behaviors). Descripti 2. ively communicates and collaborates with patients and families (AIDET). 3. ively communicates and collaborates with staff and other HCT members. 4. ively and positively communicates in stressful situatis. 5. Report is clear, ccise and complete, including family status when applicable. 6. Documentati clearly reflects what happened to patient during the procedure. 7. Gives and receives peer feedback in a respectful and professial manner a day to day basis. 8. Models and leads others in cflict resoluti. RN 3-4 It is required to describe specific example(s) for each Key Functi. Please enter specific example(s) below:

4 Page 4 of 5 Evaluati Scoring Descriptors ive May 2006 For each criteri, evaluator csiders 2 dimensis and chooses ly 1 descriptor for each: How well the subject performs this behavior, the quality or degree of expertise The subject s effect of the team when performing this behavior Quality / team a Does not perform a Unaware or ignores standards and/or directi b Performs incsistently or not to standard b Requires much directi c Csistently competent = performing to standard csistently c Requires some support = what would be expected of a new nurse within their first year d Csistently proficient = model performance exceeding standard with big picture view d Performs independently e Csistently an expert = exceptial, masterful performance, specialist e Role model & resource to others (beyd precepting) = a positive example for others to try to meet; demstrates knowledge & expertise that others recognize and go to (outside the preceptor relatiship), persal behavior demstrates interest in sharing knowledge/expertise with others Benner s definitis for above descriptors: Competent = uses experience-based practical knowledge to apply this criteria appropriately and efficiently while mindful of goals Proficient = has achieved a global big picture perspective, attends to total situati, proactive Expert = highly skilled performance intuitively knowing what to do and expected results Instructis ctinued next/back page f g h Initiates informal coaching 1:1 with others (beyd precepting) = Takes opportunities to share expertise with the intenti of facilitating other s professial development Isn t waiting until asked (resource), sees a situati and sptaneously coaches Not telling how, but uses questis, etc. to prompt critical thinking Random, and perss and topics vary Facilitates improved group practice = beyd 1:1 individual coaching, does something to improve the practice group s performance: In-service Poster, posting, group Develop or update a standard, protocol, etc. Debrief a critical incident for the benefit of the group present Formally mentors individuals &/or groups by mutual agreement = Individual Active, persal relatiship by mutual agreement focused specific persal &/or professial goals Group Commits to perform an operatial or clinical activity or service for a group or practice area, e.g. chart rounds, competency training, review of policies, pathways, area super-user, etc.

5 Page 5 of 5 As the evaluator read each criteria- even above level criteria choose the 1 descriptor for each of the 2 dimensis that fits best with the subject s performance of that specific criteria If above level criteria is not applicable, skip it, do not select any descriptors The selected descriptors eventually are tallied from all evaluati tools into overall key functi scores related to the subject s RN level One specific example is required for each key functi: Planning & Managing Care, Patient/Family Ed, etc. For advancement evaluatis ly: One specific example is required for each RN 3-4 level criteria in additi to key functi examples If e example will cover > 1 criteria or key functi, you can refer to it rather than add another