NURSE EVALUATION INSTRUMENT - Rockwood School · PDF fileNURSE EVALUATION INSTRUMENT ... Ph.D. Human Resources, Assistant Superintendent ... nurses have in implementing the nursing

Nurse evaluation instrument adoptedApril 8, 2009

NURSE EVALUATION INSTRUMENT

ROCKWOOD SCHOOL DISTRICT NURSE EVALUATION INSTRUMENT

TABLE OF CONTENTS Page Foreword.................................................................................................................................................. i Committee Members .............................................................................................................................. 1 Philosophy .............................................................................................................................................. 2 Evaluation Process.................................................................................................................................. 3 Focused Improvement Plan (FIP)........................................................................................................... 5 Focused Improvement Plan (FIP Form ....................................................................................... 9 Nurse Evaluation Instrument ................................................................................................................ 11

a. Program Management .................................................................................................... 14 b. Nursing Process .............................................................................................................. 16 c. Environment ................................................................................................................... 19 d. Professionalism............................................................................................................... 22

Nurse Submitted Data Log (optional) .................................................................................................. 27 Resources.............................................................................................................................................. 29 Nurse Look Fors ........................................................................................................................ 31 References/Works Cited ....................................................................................................................... 33

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Foreword The performance-based evaluation system outlined in this manual represents the collaborative efforts of nurses and administrators of the Rockwood School District as they researched benchmark districts and best practices across the nation with the purpose of developing an instrument that not only assessed nurse performance, but also promoted individual reflection and professional growth. As such, the instrument departs from past practice in several essential areas. The Nurse Evaluation Instrument (NEI) has moved to a more objective process whereby levels of performance are clearly defined for nurses and administrators. The NEI scoring guides have individual descriptions of levels of performance to be shared, discussed and reflected upon by nurses and administrators in collaborative professional conversations. Ultimately, the performance-based evaluation in the Rockwood School District creates the optimal learning environment for each student to acquire and apply knowledge and skills. The NEI reflects changes in best practices which indicate that it is not only the nurse behavior which is important, but also the impact that behavior has on students. Outstanding performance can be characterized by practices that result in students’ personal motivation, active engagement, and ownership of their health. Therefore, this NEI has four levels of performance with the fourth level being a level of performance that “exceeds expectations.” This fourth level of performance is written with the impact on the student in mind. The NEI is more than just the assessment of a nurse’s skill and competency. The NEI and process have been designed to encourage professional conversations between nurses and evaluators regarding goals, professional growth, and best practices.

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COMMITTEE 2008-09

NURSES Mary Beagen Wild Horse Elementary School, RAN President

Grace Oberle Ellisville Elementary School

Patti Siefert Wildwood Middle School

Donna Vogel Eureka High School

ADMINISTRATORS

David Cobb Bowles Elementary School, Principal

Kirti Mehrotra, Ph.D. Lafayette High School, Assistant Principal

Linda Miller, Ed.D. Rockwood South Middle School, Principal

OBSERVERS Bob George NEA, Uniserve Director

Kelvin McMillin, Ph.D. Human Resources, Assistant Superintendent

Stacy Neely Human Resources, Coordinator

Amy Wehr Wellness and Health Services, Supervisor

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Philosophy

A performance-based evaluation system is critical to improving health services, thus improving student knowledge and performance. A performance-based evaluation system has three purposes: performance assessment, professional growth, and student learning. An evaluation system should assist the district in determining the level of skill and competency individual nurses have in implementing the nursing process. This system should guide individual building administrators as they monitor performance, help employees that need improvement, and recognize professionals with outstanding skills. Conversely, an evaluation system should promote professional growth by helping nurses learn about, reflect upon and identify areas of their personal talents that they can develop and grow. Further, the evaluation system should be a mechanism to nurture professional growth in common goals of the district and building, and should support a learning culture in which people are encouraged to improve and share insights regarding the elements of best practices in the profession. Ultimately, the performance-based evaluation in the Rockwood School District supports an optimal learning environment for each student to acquire and apply knowledge and skills. The ability to apply these competencies successfully in any setting throughout the world becomes the essence of Rockwood School District’s “World Class Education."

Nurse ● Evaluation Process ● 04/08/09 3

Evaluation Process

I. Evaluation Responsibilities

A. Human Resources At the beginning of the school year, the Human Resources and/or the Staff Development Department will conduct yearly training on the evaluation process for the following:

1. New nurses during their employment orientation. 2. New administrators (new to the district or first-time administrators).

B. Building Principal The building principal is responsible for the evaluation process of all nurses assigned to the building. The building principal may delegate the evaluation process of nurses to those holding administrator certification and serving in administrative roles (i.e. associate principals, assistant principals). The Supervisor of Wellness and Health Services will provide input to the building administrator regarding the performance of nurses for evaluation purposes. C. Nurse All nurses new to the district will participate in an in-service of the evaluation process.

II. Evaluation Evaluation includes the on-going process of data collection, documentation, conferencing, and assistance with professional growth.

A. Data Collection

Performance data may be classified as formal or informal.

Conferences with the nurse regarding their performance as noted or referenced below are not necessary unless it leads the evaluator to have concerns about the nurse’s performance prior to it being included or referenced in the Nurse Evaluation Instrument. It is recognized that observations may occur as appropriate in the view of the evaluator. Data sources for evaluation instruments may include but are not limited to the following:

• Discussions/conferences with nurse • Participation in committee, staff and staffing meetings • Review of materials and resources used • Parent, student, and/or peer feedback • Physical appearance of the health room • Review of record keeping and other required tasks

Nurse ● Evaluation Process ● 04/08/09 4

• Review of assessment tools/measures • Documentation of professional growth experiences • Documentation of policy/procedure compliance • Observation of nursing procedures • Nurse submitted information • Memo to file

B. Documentation

Documentation may include formal or informal data. This documentation becomes the basis for discussions between nurses and evaluators about job performance. Any documentation which may be used in the evaluation process must be shared with the employee in a timely manner.

C. Professional Growth

The purpose of professional growth is to enhance the quality of school nursing. Therefore, a part of the evaluation process shall include the nurse and evaluator having open discussions regarding continuous growth during the annual evaluation conferences. At the evaluation conference, the nurse may choose to write a professional growth statement on their Evaluation Instrument. A nurse who has a level of performance at “Does Not Meet the Standard” or “Partially/ Approaching the Standard” shall, in collaboration with the supervising evaluator, write a professional growth statement addressing that domain/component or the domain/component of greatest need for professional improvement.

III. Annual Evaluation The Nurse Evaluation Instrument (NEI) is the document used to summarize the evaluator’s rating of performance for each domain. The evaluation conference is the discussion between evaluator and nurse about the information on the Evaluation Instrument. Ratings for levels of performance on the Evaluation Instrument must be grounded in observable data or relevant artifacts gathered during the year. It is of particular importance to note that ratings of “Does Not Meet the Standard” or “Partially/Approaching the Standard” must be discussed and documented prior to the rating on the Evaluation Instrument. The Evaluation Instrument must be completed by the evaluator before May 1. The Evaluation Instrument must be signed by the evaluator and the person being evaluated on the cover sheet confirming receipt of the NEI. The nurse’s signature will indicate that a copy was received, read and discussed; it will not indicate the nurse’s agreement with the contents of the instrument in whole or in part. If the nurse wishes to respond to the NEI in writing, he/she will need to provide a copy of the response to the evaluator and the Human Resources Department within five working days. The evaluator will provide a copy of the Nurse Evaluation Instrument to the Human Resources Department where it will be placed in the nurse’s file. A copy will also be retained by the nurse and evaluator. .

Focused Improvement Plan (FIP)Nurse

Nurse ● Focused Improvement Plan ● 04/08/09 6


Focused Improvement Plan (FIP)

The purpose of a Focused Improvement Plan (FIP) is to provide remediation and assistance to improve employee performance as related to a documented deficiency within one or more of the four performance domains. Steps in the FIP process include: 1. Documentation of Performance Concern(s)

The employee is notified of performance concerns by an evaluator via methods such as conferences, memos to file, documentation of failure to perform professional responsibilities, etc.

2. Documentation of Performance Deficiency

When an evaluator gathers information and documentation regarding a performance concern, the evaluator will schedule a conference to discuss, clarify concerns, share perceptions, and define issues. This conference will be documented in a summary written by the evaluator and a copy will be given to the employee. The conference summary will include the specific elements of concern. The outcome of this conference may result in the development of a FIP immediately. In order for the conference to result in an immediate FIP, the evaluator must provide documentation that the type of concern noted had been addressed with the employee previously, or that the concern is sufficiently egregious in nature to warrant an immediate FIP. The conference summary may be used to develop a FIP in the future if the discussed concerns are documented again at any time.

If a FIP is being considered, the evaluator confers with the Assistant Superintendent of Human Resources/designee. If a FIP is not needed, the evaluator will continue to monitor the deficiency.

3. Joint Development of a FIP

A meeting will be held between the evaluator and employee to develop the FIP. The evaluator will develop the FIP with the employee’s input and include the following:

• Element(s) in need of improvement (including domain and component). • Directives for specific changes in employee performance (meets the

standard). • Directives/strategies for professional improvement activities.

o Employee directed strategies o Evaluator guided strategies that include feedback

• Continued dialogue with evaluator to determine progress. • Method to be used to determine if activities have been completed. • Method to be used to determine if improvement has been made. • Timeline for review of progress. • Date for official notification of completion or continuation into the next

school year.


Both the evaluator and employee will sign the FIP. The employee’s signature will indicate understanding of the purpose and steps needed for improvement. The employee may request that a silent observer be present during the FIP development meeting. The employee can request two working days to review the FIP between the development of the FIP and the finalization/signing of the FIP. A single FIP may be written for several elements within each domain exhibiting a deficiency, or separate FIPs may be written for each deficient element within a domain. An FIP may be developed for a single element in which an employee exhibits a deficiency.

FIP Review

The evaluator and employee will meet periodically to review progress toward the FIP. The FIP will continue as needed with a review conference held minimally at mid year and the end of year regarding progress towards completion or continuation of the FIP. Employees will additionally receive an official notification on their Nurse Evaluation Instrument regarding completion or continuation into the next school year. Once the FIP is completed, it is signed by both the evaluator and employee. An employee who does not meet all requirements of the FIP according to the time specified will receive a “Does Not Meet Standard” rating on the Summative Evaluation Report. An evaluator may give an employee a “Partially/Approaching the Standard” rating if the employee has improved on the deficiencies of the FIP, but has not improved sufficiently to be removed from the FIP. The FIP will be renewed with a new timeline and the employee will be considered for continued employment or termination.

Miscellaneous

Some performance concerns may not merit the development of a FIP. Misuse of sick leave or chronic tardiness to work are examples of performance concerns which, if discussed with the employee and documented, could result in a memo to file but may not result in the development of a FIP. If the incident is severe enough, or a second incident occurs, an unsatisfactory rating on the Nurse Evaluation Instrument, FIP, or termination may result.


Focused Improvement Plan (FIP) Nurse Location List the Domain, Component, and Element(s), for the FIP: Expectation for change in performance of nurse to complete the FIP: Professional Improvement Strategies:

Strategies Evidence of Strategy Completion

Review conference to be held on or before: _____________________________ Evaluator’s Signature Date Nurse’s Signature Date Supervisor of Health Services’ Signature (optional) Date Signatures indicate development and implementation of FIP.


Focused Improvement Plan (FIP) (Continued)

Data Regarding Improvement in Nurse Performance

Signatures Date Met Summary on Progress

(attach memo) Evaluator Nurse

Date of FIP review conference: ____________________________ Review Comments:

_____ Continue FIP _____ FIP completed Evaluator’s Signature Date Nurse’s Signature Date Supervisor of Health Services’ Signature (optional) Date

Nurse Evaluation Instrument

Nurse Evaluation Instrument ● 04/08/09 12



Name: School: Date: Annual Due Date: May 1

Evaluator’s Summary Statement

Professional Growth Statement. Optional. Required for Nurses who have a level of performance of “Does Not Meet the Standard” or “Partially/Approaching the Standard.”

Nurse’s Comments

Recommendation for continued employment (check one) If Nurse is on a FIP (check one)

Recommended for continued employment. Performance has improved. Remove from FIP.

Not recommended for continued employment Performance concerns exist. Continue FIP into next school year.

Signature of Nurse Date Signature of Evaluator Date Signature of Supervisor, Wellness and Health Services (optional) Date (Signatures indicate the contents of this document have been discussed. It does not necessarily mean agreement with its contents). Distribution: Original to Human Resources Copy for Nurse Copy for Evaluator


ROCKWOOD SCHOOL DISTRICT

NURSE EVALUATION INSTRUMENT DOMAIN #1 –PROGRAM MANAGEMENT

LEVELS OF PERFORMANCE

ELEMENT Does Not Meet the Standard

Partially/Approaching the Standard

Meets the Standard Exceeds the Standard

COMPONENT #1a.: DEMONSTRATES KNOWLEDGE OF STUDENT(S)

1) Identifies health needs of students

Nurse does not identify health needs of students.

Nurse sometimes identifies health needs of students.

Nurse consistently identifies health needs of students.

Nurse uses extensive knowledge of health needs to help students develop, implement and evaluate individual goals.

2) Demonstrates understanding of child and adolescent development

Nurse does not display knowledge of child and adolescent development.

Nurse sometimes displays knowledge of child and adolescent development.

Nurse consistently displays accurate understanding of the child and adolescent developmental characteristics.

Nurse consistently displays accurate understanding of the child and adolescent developmental characteristics, as well as exceptions to the general patterns.

COMMENTS



NURSE EVALUATION INSTRUMENT DOMAIN #1 –PROGRAM MANAGEMENT



Partially/Approaching the Standard Meets the Standard Exceeds the Standard

COMPONENT #1b.: MANAGES AND MAINTAINS A COMPREHENSIVE SCHOOL HEALTH SERVICES PROGRAM

3) Establishes goals for providing comprehensive health services

Nurse does not establish goals for providing comprehensive health services.

Nurse sometimes establishes goals for providing comprehensive health services.

Nurse consistently establishes goals for providing comprehensive health services.

Nurse extensively establishes goals for the health services that have been developed following consultation with students, parents and colleagues.

4) Demonstrates knowledge and skills aligned with Rockwood health policies and regulations

Nurse does not display knowledge and skills aligned with Rockwood health policies and regulations.

Nurse sometimes displays knowledge and skills aligned with Rockwood health policies and regulations.

Nurse consistently displays knowledge and skills aligned with Rockwood health policies and regulations.

Nurse displays extensive knowledge and skills aligned with Rockwood health policies and regulations.

5) Plans responsive services

Nurse does not utilize current or appropriate resources to plan for student, parent, school, and community needs.

Nurse sometimes utilizes current and appropriate resources to plan for student, parent, school, and community needs.

Nurse consistently utilizes current and appropriate resources to plan for student, parent, school, and community needs.

Nurse demonstrates extensive knowledge of current and appropriate resources to plan for student, parent, school, and community needs. Nurse takes initiative to learn about more effective resources.

6) Demonstrates knowledge of resources both within and beyond the school and district

Nurse does not demonstrate knowledge of resources available for students and teachers in the school, the district, and in the larger community to advance program goals.

Nurse demonstrates limited knowledge of resources available for students and teachers in the school, the district, and in the larger community to advance program goals.

Nurse consistently demonstrates knowledge of resources available for students and teachers in the school, the district, and in the larger community to advance program goals.

Nurse consistently demonstrates knowledge of resources available for students and teachers and actively seeks out new resources from a wide range of sources to enrich the school’s program.

7) Maintains health room equipment and supplies

Nurse does not maintain health room equipment and supplies.

Nurse inconsistently maintains health room equipment and supplies.

Nurse consistently maintains health room equipment and supplies.

Nurse extensively maintains and updates health room equipment and supplies in a proactive manner.

COMMENTS



NURSE EVALUATION INSTRUMENT DOMAIN #2 – NURSING PROCESS




COMPONENT #2a.: ASSESSMENT – COLLECTS COMPREHENSIVE DATA

1) Uses appropriate procedures to systematically collect and document information regarding students, families, staff, and healthcare providers

Nurse does not use appropriate procedures to systematically collect and document information regarding students, families, staff, and healthcare providers.

With supervision, nurse collects and prioritizes a variety of individual and collective student health data including immunizations, screenings, health forms, doctor’s orders, and student interactions.

Nurse independently collects and prioritizes a variety of individual and collective student health data including immunizations, screenings, health forms, doctor’s orders, and student interactions.

Nurse independently collects and utilizes data to positively impact the health and academic achievement of students, families, and the community.

COMMENTS

LEVELS OF PERFORMANCE ELEMENT Does Not Meet the

Standard Partially/Approaching

the Standard Meets the Standard Exceeds the Standard

COMPONENT #2b.: DIAGNOSIS – FORMULATES NURSING DIAGNOSIS

2) Uses diagnosis to develop student’s nursing care plan

Nurse does not initiate the development of nursing care plans to meet students’ health care needs.

With direction, nurse initiates development and implementation of nursing care plans.

Nurse consistently develops nursing diagnoses to formulate a comprehensive nursing care plan.

Nurse extensively develops nursing diagnoses using current trends to guide planning for future programs.

COMMENTS







COMPONENT #2c: OUTCOMES IDENTIFICATION – DEVELOPS MEASURABLE GOALS

3) Collaborates with student, family and/or staff to identify measurable goals

Nurse does not collaborate with student, family and/or staff to identify measurable goals.

Nurse sometimes collaborates with student, family and/or staff to identify measurable goals.

Nurse consistently collaborates with student, family and/or staff to identify measurable goals.

Nurse consistently collaborates with student, family and/or staff to identify measurable goals and acts as a resource in developing health and educational student outcomes.

COMMENTS




COMPONENT #2d: PLANNING – DEVELOPS STRATEGIES TO ACHIEVE GOALS

4) Develops strategies using interventions to achieve expected outcomes

Nurse does not develop nursing intervention strategies to achieve expected outcomes.

Nurse inconsistently develops nursing intervention strategies to achieve expected outcomes.

Nurse consistently develops nursing intervention strategies to achieve expected outcomes.

Nurse involves others in the school community in developing nursing interventions for the benefit of students.

COMMENTS







COMPONENT #2e.: IMPLEMENTATION – IMPLEMENTS NURSING CARE PLAN

5) Executes and documents nursing interventions in a safe, appropriate manner

Nurse does not execute or document nursing interventions in a safe, appropriate manner.

Nurse inconsistently executes and documents nursing interventions in a safe, appropriate manner.

Nurse consistently executes and documents nursing interventions in a safe, appropriate manner.

Nurse extensively evaluates factors related to safety and effectiveness in executing and documenting nursing intervention.

6) Administers and documents medication in accordance with District policy

Nurse does not administer and document medication in accordance with District policy.

Nurse inconsistently administers and documents medication in accordance with District policy.

Nurse consistently administers and documents medication in accordance with District policy.

Nurse extensively supports student and family in administering and documenting medications by alerting parents and/or physicians of possible side effects, adverse reactions, or effectiveness of dosage concerns.

COMMENTS




COMPONENT #2f.: EVALUATION – EVALUATES PROGRESS TOWARD GOALS

7) Evaluates client responses to nursing interventions in relation to expected outcomes

Nurse does not evaluate client responses to nursing interventions in relation to expected outcomes.

Nurse sometimes evaluates client responses to nursing interventions in relation to expected outcomes.

Nurse consistently evaluates client responses to nursing interventions in relation to expected outcomes.

Nurse uses extensive knowledge based on scientific evidence and best practice to evaluate nursing interventions and expected outcomes.

8) Uses evaluation data to document and revise nursing care plan as appropriate

Nurse does not use evaluation data to document and revise nursing care plan as appropriate.

Nurse sometimes uses evaluation data to document and revise nursing care plan as appropriate.

Nurse consistently uses evaluation data to document and revise nursing care plan as appropriate.

Nurse extensively uses evaluation data to initiate revision of nursing care plan in collaboration with school and family.

COMMENTS



NURSE EVALUATION INSTRUMENT DOMAIN #3 – ENVIRONMENT




COMPONENT #3a.: CREATES AN ENVIRONMENT OF RESPECT AND COLLABORATION

1) Interacts with student(s)

Nurse does not demonstrate respect for each student and his/her individual differences.

Nurse inconsistently demonstrates respect for each student and his/her individual differences.

Nurse consistently demonstrates respect for each student and his/her individual differences.

Nurse promotes programs or activities which encourage respect, understanding, and acceptance of individual differences.

2) Collaborates with building and district staff

Nurse does not collaborate with building/district staff in planning and implementing health services.

Nurse collaborates with building/district staff on an inconsistent basis in planning and implementing health services.

Nurse facilitates collaboration with building/district staff on a regular basis in planning and implementing health services.

Nurse assumes a leadership role in initiating collaboration with building/district staff on a regular basis in planning and implementing health services.

3) Collaborates with community (parents, outside services, agencies)

Nurse does not collaborate with parents and other community members.

Nurse collaborates with parents and other community members on an inconsistent basis.

Nurse facilitates collaboration with parents and other community members on a regular basis.

Nurse assumes a leadership role in initiating collaboration with parents and other community members on a regular basis.

COMMENTS



NURSE EVALUATION INSTRUMENT DOMAIN #3 – ENVIRONMENT




COMPONENT #3b.: MANAGES ROUTINES AND PROCEDURES

4) Manages routines and procedures

Nurse’s schedule and procedures are nonexistent or disorganized.

Nurse’s schedule and procedures are not clearly defined or not clearly communicated.

Nurse has a clearly defined schedule and established procedures that ensure equitable access for all students, families, and staff.

Nurse has a clearly defined schedule and established procedures that ensure access for all students, families, and staff. Routines and procedures are prioritized to efficiently respond to student needs.

COMMENTS




COMPONENT #3c.: ORGANIZES PHYSICAL SPACE

5) Organizes physical space and creates a safe environment

Nurse does not organize physical space or create a safe environment.

Nurse inconsistently organizes physical space to create a safe environment.

Nurse consistently organizes physical space and creates a safe environment.

Nurse consistently organizes physical space and creates a safe and inviting environment.

6) Provides for student confidentiality

Nurse does not provide for student confidentiality.

Nurse inconsistently provides for student confidentiality.

Nurse consistently provides for student confidentiality.

Nurse promotes and extensively communicates preservation of student confidentiality.

COMMENTS



DOMAIN #3 – ENVIRONMENT




COMPONENT #3d.: SUPPORTS POSITIVE STUDENT BEHAVIOR

7) Supports school-wide expectations for student behavior

Nurse does not support school-wide expectations for positive student behavior.

Nurse sometimes supports school-wide expectations for positive student behavior.

Nurse consistently supports school-wide expectations for positive student behavior.

Nurse extensively supports school-wide expectations for positive student behavior and embeds them into the nursing program.

COMMENTS




COMPONENT #3e.: PROMOTES HEALTH AND WELLNESS

8) Promotes preventive and self-care strategies with students

Nurse does not promote preventive and self care strategies with students.

Nurse sometimes promotes preventive and self care strategies with students.

Nurse consistently promotes preventive and self care strategies with students.

Nurse takes a leadership role in promoting preventive and self care strategies with students to facilitate optimal student independence.

9) Acts as a resource or building and District-wide wellness opportunities

Nurse does not act as a resource for building and District- wellness opportunities

Nurse sometimes acts as a resource for building and District-wide wellness opportunities

Nurse consistently acts as a resource for building and District wellness opportunities

Nurse effectively and actively develops and provides resources for building and District wellness opportunities.

10) Provides collaborative health education to students, staff, and/or specific groups

Nurse does not collaborate with students, staff and/or specific groups to provide health education.

Nurse sometimes collaborates with students, staff and/or specific groups to provide health education.

Nurse consistently facilitates collaboration with students, staff and/or specific groups to provide health education.

Nurse assumes a leadership role in initiating collaboration with students, staff and/or specific groups on a regular basis to provide health education.

COMMENTS



NURSE EVALUATION INSTRUMENT DOMAIN #4 – PROFESSIONALISM




COMPONENT #4a.: GROWS AND DEVELOPS PROFESSIONALLY

1) Engages in ongoing professional development

Nurse does not engage in professional development activities to enhance knowledge or skill.

Nurse sometimes participates in professional development activities.

Nurse consistently engages in professional development based on individual assessment, student needs, or district initiatives.

Nurse seeks out opportunities for professional development based on individual assessment, student needs, and/or district initiatives and applies the new knowledge through offering workshops, trainings, departmental sharing, or mentoring.

2) Attains required CEUs (Continuing Education Units)

Nurse does not attain required CEUs.

Nurse partially attains required CEUs.

Nurse attains required CEUs.

Nurse exceeds attaining required CEUs.

COMMENTS







COMPONENT #4b.: COMMUNICATES EFFECTIVELY

3) Communicates and collaborates with students

Nurse does not communicate or collaborate with students.

Nurse sometimes communicates and collaborates with students about the nursing program and individual student needs.

Nurse consistently communicates and collaborates with students about the nursing program and individual student needs.

Nurse is proactive in providing and exchanging information with students about the nursing program and individual students through a variety of methods.

4) Communicates and collaborates with staff

Nurse does not provide information to staff.

Nurse sometimes provides information to staff.

Nurse consistently provides appropriate and accurate information to staff about the nursing program, individually or through groups.

Nurse is proactive in providing and exchanging information with staff about the nursing program through a variety of methods.

5) Communicates and collaborates with families

Nurse does not provide information to families.

Nurse sometimes provides information to families.

Nurse consistently communicates and collaborates with families about the nursing program and about individual students in order to engage families.

Nurse is proactive in providing and exchanging information with families about the nursing program and individual student needs through a variety of methods.

6) Participates in student referral process (IEP, 504, etc.)

Nurse does not participate in the student referral process.

Nurse inconsistently participates in the student referral process.

Nurse provides student information and actively participates in the student referral process.

Nurse has the background knowledge of the student and is able to help develop intervention strategies to meet individual needs, in accordance with district expectations.

COMMENTS







COMPONENT #4c.: SUPPORTS A POSITIVE SCHOOL COMMUNITY

7) Maintains relationships with colleagues

Nurse’s relationships with colleagues are negative.

Nurse maintains minimal relationships with colleagues.

Nurse demonstrates support and cooperation in relationships with colleagues.

Nurse demonstrates support and cooperation in relationships with colleagues and initiates discussions (problem-solving) as needed.

8) Participates in decision-making

Nurse does not participate in team or departmental decision-making.

Nurse inconsistently participates in team or departmental decision-making.

Nurse consistently participates in team or departmental decision-making and intermittently assumes a leadership role.

Nurse takes a leadership role in team or departmental decision-making.

9) Supports a positive school climate

Nurse makes little or no contribution to a positive school climate and behaviors may even have a negative impact.

Nurse contributes to a positive school climate on a limited basis.

Nurse actively participates in contributing positively to the overall school climate.

Nurse takes a leadership role in building a positive school climate.

10) Contributes to school, District and community

Nurse does not participate in school, District, or community activities.

Nurse participates in school, District, or community activities only when specifically asked.

Nurse volunteers to participate in school, District, or community activities.

Nurse volunteers to participate in school, District or community activities and assumes a leadership role.

COMMENTS







COMPONENT #4d.: MAINTAINS ACCURATE RECORDS

11) Maintains student records

Nurse’s reports, records, and documents are not systematic, efficient, accurate, or timely.

Nurse’s reports, records, and documents are sometimes missing, late and/or inaccurate.

Nurse’s approach to record keeping is systematic, efficient, accurate, and timely.

Nurse’s approach to record keeping is systematic, efficient, accurate, timely, and is a model for others.

12) Utilizes District’s information system

Nurse ineffectively utilizes the District’s information system to communicate current and accurate information.

Nurse inconsistently utilizes the District’s information system to communicate current and accurate information.

Nurse consistently uses the District’s information system to communicate current and accurate information.

Nurse effectively utilizes the enhanced features of the District’s information system to communicate current and accurate information.

COMMENTS







COMPONENT #4e.: DEMONSTRATES PROFESSIONALISM

13) Demonstrates ethical, and professional standards

Nurse does not follow the profession’s ethical standards.

Nurse is inconsistent in following the profession’s ethical standards.

Nurse consistently adheres to the profession’s ethical standards.

Nurse consistently adheres to the profession’s ethical standards, demonstrating professional judgment and addressing ethical risks, benefits and outcomes.

14) Follows District policies and legal guidelines

Nurse does not follow the District policies and legal guidelines.

Nurse is inconsistent in following the District policies and legal guidelines.

Nurse consistently adheres to the District policies and legal guidelines.

Nurse consistently adheres to the District policies and legal guidelines, demonstrating professional judgment and effectively sharing information on a need to know basis.

15) Reflects on and evaluates practice

Nurse does not reflect on or evaluate practice.

Nurse inconsistently reflects on and evaluates practice.

Nurse consistently reflects on and evaluates practice.

Nurse consistently reflects on and evaluates practice which results in changes to enhance health services.

COMMENTS

Nurse ● Submitted Data Log ● 04/08/09

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NURSE SUBMITTED DATA LOG (OPTIONAL)

Nurse School Evaluator School Year This form is kept by the nurse and discussed with the evaluator prior to each evaluation conference. This form should reflect professional growth and involvement in the school which could include conferences/ workshops, attendance at activities, committees, leadership roles, coursework and professional organizations. Nurses may attach samples that demonstrate the data listed.

DATE

EVENT

Nurse ● Submitted Data Log ● 04/08/09

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Resources

Nurse ● Resources ● 04/08/09 30


Resources

Domain One Program Management includes knowledge of students individually and services based on age/development as well as a plan and goals for the year Items of Interest:

• Personal knowledge of students (names, health concerns) • Adequate supplies and functioning equipment • Goals for the year for the health services program

Domain Two Nursing Process is the process by which all care is to be delivered. Items of Interest: Care plans for students with chronic illnesses with each of the following components

• Assessment • Diagnosis • Outcomes Identification (Goals) • Planning • Implementation • Evaluation

Domain Three Environment includes the physical space of the nurse’s office (is it welcoming?) as well as management of routines and student behavior Items of Interest:

• Organized/safe environment • Rapport with students, staff, families • Routine within health room • Manages student behavior in health room • Bulletin boards, newsletter articles • Staff postings or e-mails regarding wellness opportunities (mammo vans, flu shots, CPR)

Domain Four Professionalism addresses communication skills, participation in building and District activities as well as nursing professionalism; ethical conduct, appropriate documentation, organizational skills, etc. Items of Interest:

• CEUs (need 7 annually for FT) • Communication skills • 504/IEP/Care Team info regarding health provided, participation as requested • Appropriate decision-making • Participates in “extras” in building/District • Comfortable with use of Infinite Campus • Health records organized, retrievable • Monthly reports done in a timely fashion


Reference Works Cited

Nurse ● Reference Works Cited● 04/08/09

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Nurse ● Reference Works Cited● 04/08/09

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References/Works Cited

Manual for School Health Programs: Standards of Care of Professional School Nursing Practice

Competencies of Personnel Providing Health Services in Schools Standards for the School Nurse [23.120] 2nd Edition 2002 The Journal of School Nursing http://jsn.sagepub.com School Nurse Competencies Tool based on School Nursing Standards of Practice (ANA & NASN, 2005) American School Nurse Association School Nursing: Scope and Standards of Practice Nationwide school districts providing information and sample evaluations selected as best practice: Rockwood School District Teacher, Counselor, and Library Media Specialists Evaluation Instruments Hamilton County Educational Service Center Ohio Board of Nursing North Branford Public Schools Northford, Connecticut Special School District St. Louis, Missouri Washoe County School District Reno, Nevada

Notes

NURSE EVALUATION INSTRUMENTS

111 East North Street Eureka, MO 63025-1229636-938-2200www.rockwood.k12.mo.us

Documents

NURSE EVALUATION INSTRUMENT - Rockwood School · PDF fileNURSE EVALUATION INSTRUMENT ... Ph.D. Human Resources, Assistant Superintendent ... nurses have in implementing the nursing