MANAGER / ASSISTANT MANAGER / CHARGE NURSE FEEDBACK TOOL: Procedural Areas Page 1 of 6 Subject s Name: Evaluator s Name: Requires Evaluati Descriptors (Quality & ) for reference PLANNING & MANAGING CARE 1. Practice adheres to specialty and organizatial standards. 2. Addresses patient safety needs (ex: initiates timeout before procedure, siderails, securing pts, pt i.d., supportive equipment hand, functiing mitor alarms). May be evidenced by absence of safety issues. 3. Applies age-specific / cultural csideratis to care of patient. 4. Triages patient care timely, accurate acuity determinati. 5. Manages patient flow for maximum efficiency and notifies internal resources of changes (ex: call for next pt, identify and manage room turnover and diversi status, facilitates throughput (coordinating ancillary services and results)). 6. Appropriately communicates changes in patient cditi. 7. Organizes work and manages changes in work demands for effective use of time. 8. Takes additial clinical/departmental respsibilities and/or assists others. 9. Delegates to staff appropriately, with csiderati for other team members workload. 10. Patients and families are satisfied with the care this nurse has given.
Page 2 of 6 11. Manages complex clinical situatis. CONTINUUM OF CARE PLANNING Planning for Discharge and/or next level of care. 1. Identifies discharge/transfer needs and initiates plan for movement to next level of care. 2. Uses internal & external referrals & resources that support pt/families through ctinuum of care. 3. Initiates change in plan for next level of care in unexpected, changing and complex situatis. 4. Acts to resolve systems breakdowns, knowledge, behavior issues that impact ctinuum of care needs.
Page 3 of 6 PATIENT / FAMILY EDUCATION Secti not applicable for LifeFlight 1. Incorporates a variety of resources to teach and support patient and family learning (e.g. EZTV, pt ed materials, web sources, drawings, etc). 2. Individualizes patient/family educati for complex patients/families (Ex: resistant, n-compliant, significant barriers to learning). 3. Led in development/revisi/use of teaching tools/aids for specific populati within the last year. RN 4 PROBLEM SOLVING 1. Identifies and takes acti to resolve pt safety problems and other clinical issues. 2. Identifies and takes acti to resolve systems (operatial/workarounds) problems. 3. Follows appropriate chain of command when problem solving. 4. Actively participates in team/group problem solving.
5. Uses interdisciplinary approach to lead others in problem solving projects and evaluates outcomes using data. RN 4 Page 4 of 6 6. Positively supports change. 7. Is a csultant to manager (Ex: clinical, proposed changes, dept enhancements). COMMUNICATION & COLLABORATION 1. Persal behavior positively influences envirment and others (may include attendance, tardiness, team support) 2. Accesses HCT to form plan of care/meet patient s needs. 3. ively communicates and collaborates with patients and families. 4. ively communicates and collaborates with staff and other HCT members. 5. Communicates positively and cstructively in stressful situatis (ex: crew resource management strategies). 6. Provides accurate and objective feedback in a respectful and professial manner while maintaining cfidentiality. 7. Completes assigned evaluati tools within designated timeframe (Ex: end of orientati, self report, peer feedback).
Page 5 of 6 8. Receives peer feedback in a respectful and professial manner. 9. Participates directly in and/or supports orientati of new staff. 10. Facilitates internal and/or external customer satisfacti. 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 e Csistently proficient = model performance exceeding standard with big picture view Csistently an expert = exceptial, masterful performance, specialist 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 d e f Performs independently 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 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
picture perspective, attends to total situati, proactive Expert = highly skilled performance intuitively knowing what to do and expected results Instructis ctinued next/back page g h Page 6 of 6 Facilitates improved group practice = beyd 1:1 individual coaching, does something to improve the practice group s performance: In-service Poster, posting, group email 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. 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 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