Nursing 360-Degree Feedback


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Instructions

When you enter text comments into the boxes below, please focus your comments on work behaviors and styles. The comments that you type will be viewed by the individual receiving the feedback.

A. Patient Skills

Delivery of Care:
Coordinate Plans, coordinates, implements, and evaluates nursing care designed to promote, restore and/or maintain optimal outcomes. Identifies short- and long-term goals and selects interventions in conjunction with client.
Assess Performs comprehensive health and social assessment, history and physical exam. Considers complex interactions of actual and potential nursing diagnoses. Effective observational and communication skills, including listening.
Act Maintains dignity, privacy and confidentiality of patients. Provides essential first aid and emergency procedures. Provides emotional, physical, and personal care. Exhibits safety and health when moving and handling patients.
Document Undertakes and documents a comprehensive and accurate assessment of the physical, psychological, social and spiritual needs of patients. Assists in the development of clinical practice guidelines to plan, implement and evaluate nursing care.
Evaluate Evaluates and documents the outcomes of nursing and other interventions.
Does Not Apply
Needs Significant Improvement
Could benefit from Development
Capable and Effective
Role Model
Comments:

Advocate:
Responsibilities Explains about rights and responsibilities to patient, confirms understanding and acts to uphold these rights. Disseminates information about health policy and consumer rights and responsibilities. Uses knowledge of patient's rights and responsibilities to plan care for and intervene on behalf of patients.
Intervention Identifies, reports and intervenes with members of the health care team on behalf of the client. Develops community partnerships to identify health promotion goals and strategies to meet these goals.
Does Not Apply
Needs Significant Improvement
Could benefit from Development
Capable and Effective
Role Model
Comments:

Communicator/Counselor
Interpersonal Communication Establishes fundamental interpersonal and therapeutic communication. Interact effectively on an interpersonal level with clients, families, and groups from a variety of social, cultural, emotional, and educational backgrounds.
Written and Oral Communication Conveys ideas clearly and concisely both orally and in writing.
Teamwork Demonstrates the ability to communicate and interacts effectively and appropriately with peers and other health care professionals. Demonstrates effective management of group process.
Does Not Apply
Needs Significant Improvement
Could benefit from Development
Capable and Effective
Role Model
Comments:

B. Development

Pedagogy
Teaching Designs, coordinates, implements, and evaluates comprehensive teaching plans. Develops appropriate teaching methods to accommodate societal/cultural differences. Assesses teaching skills of self and members of health care team; modifies as needed.
Patient Learning Identifies and assesses situations in which the client needs information, education and support to promote, maintain and restore health at any point on the continuum of wellness-illness. Evaluates learning out comes of the client or family members receiving instruction. Research Uses current research findings to develop appropriate instructional material.
Does Not Apply
Needs Significant Improvement
Could benefit from Development
Capable and Effective
Role Model
Comments:

Professional Development
Self Demonstrates commitment to life long learning. Participates in continuing education. Uses self-evaluation process to improve own nursing practice.
Others Contributes to the professional development of health care providers. Enhances the professional development and safe practices of others through peer support, leadership, supervision and teaching.
Profession Supports and participates in professional nursing organizations. Analyzes the impact of current issues and trends on the nursing profession.
Does Not Apply
Needs Significant Improvement
Could benefit from Development
Capable and Effective
Role Model
Comments:

C. Professional Skills

Teamwork
Seeks consultation when clinical problems fall outside current knowledge or scope of practice. Contributes to the nursing team in the delivery of health care to individuals. Establishes and maintains effective working relationships as an integral member of the interdisciplinary team.
Does Not Apply
Needs Significant Improvement
Could benefit from Development
Capable and Effective
Role Model
Comments:

Professional and Ethical Practice
Accountability Demonstrates accountability for own ethical behavior and for delegated actions. Accepts accountability and responsibility for own actions in the provision of care.
Respect Respects the privacy and dignity of patients. Maintains confidentiality of information concerning patient/institution.
Knowledge Demonstrates knowledge of relevant legislative. Relates pertinent legislation and examples of how they can be applied to nursing practice. Discusses the legal concepts of confidentiality and the rights of individuals. Values research in contributing to knowledge, practice and improved standards of care.
Action Takes appropriate action when a breach of professional ethics occurs. Acts in a manner that enhances the professional development of self and others.
Practice Practices nursing in a legal, fair, and anti-discriminatory way, acknowledging the difference in beliefs and cultural practices of individuals or groups.
Does Not Apply
Needs Significant Improvement
Could benefit from Development
Capable and Effective
Role Model
Comments:

Manager
Works with Others Participates in discussion relating to the evaluation of client care with members of the health care team. Demonstrates flexibility and effectively influences the change process. Demonstrate an understanding of the role of others by participating in interprofessional working practice.
Costs Demonstrates fiscal accountability for one's own practice while providing quality care. Understands the financing of health care, determinants of cost and the nurse's role in cost containment and improved access.
Does Not Apply
Needs Significant Improvement
Could benefit from Development
Capable and Effective
Role Model
Comments:

Critical Thinking and Decision Making
Uses resources within the work setting to assist in decision-making. Seeks consultation when clinical problems fall outside current knowledge or scope of practice. Creates alternative solutions to clinical problems.
Does Not Apply
Needs Significant Improvement
Could benefit from Development
Capable and Effective
Role Model
Comments:


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