Student:_________________________________ Instructor: _________________________

Clinical Rotation: _________________________ Setting: ___________________________

Course Objectives and Clinical Correlate Objectives:
The student will:

1. Perform nursing asssessment of families, incorporating factors such as primary and secondary prevention, health promotion, developmental status, and nutrition.
   • Gather assessment data from variety of sources.
   • Identify developmental stage of the family and its members.
   • Complete a nutritional assessment of the family.
   • Derive nursing diagnoses for families and/or family members from functional health pattern assessments.
   • Demonstrate accountability and responsibility by negotiating times and dates of visits with assigned families.
     • Grade: ________
   • RATIONALE:

     
     
     
     
     

2. Incorporate principles of primary and secondary prevention and health promotion into planning family-focused health care.
   • Identify primary and secondary prevention and health promotion activities appropriate for assigned families.
   • Use family based data in establishing primary or secondary prevention or health promotion family problems
   • Use appropriate procedure in implementing nursing techniques.
   • Maintain client safety during nursing care.
   • Provide explanation to clients prior to and/or during nursing techniques.
     • Grade: ________
   • RATIONALE:

     
     
     
     
     

3. Incorporate principles of primary and secondary prevention and health promotion into carrying out family-focused health care.
   • Identify primary and secondary prevention and health promotion activities appropriate for assigned families.
   • Use family based data in establishing primary or secondary prevention or health promotion family problems
   • Use appropriate procedure in implementing nursing techniques.
   • Maintain client safety during nursing care.
   • Provide explanation to clients prior to and/or during nursing techniques.
     • Grade: ________
   • RATIONALE:

     
     
     
     
     

4. Analyze the need for change within family systems, respecting the right to choose.
   • Demonstrate respect for values of families.
   • Demonstrate respect for individuality and cultural patterns of families.
   • Establish goals mutually with families.
     • Grade: ________
   • RATIONALE:

     
     
     
     
     

5. Implement teaching related to primary and secondary prevention with assigned families.
   • Assess and plan for family-centered teaching needs.
   • Use appropriate teaching activities with families.
   • Demonstrate accountability and responsibility by teaching effective primary and/or secondary prevention measures to families.
     • Grade: ________
   • RATIONALE:

     
     
     
     
     

6. Test application of a clinical conceptual framework with families.
   • Identify theories and/or research findings which apply to the family situation.
   • Include concepts from a range of sources in determining appropriate nursing actions.
   • Report outcomes from using the clinical framework to colleagues and/or assigned families.
     • Grade: ________
   • RATIONALE:

     
     
     
     
     

7. Recognize the impact of ethical dilemmas on families and the nurse
   .
   • Grade: ________
   • RATIONALE:

     
     
     
     
     

8. Explore opportunities for client advocacy with assigned families.
   • Grade: ________
   • RATIONALE:

     
     
     
     
     

9. Examine need for change in health care to more effectively meet family health needs.
   • Classify health care issues affecting health status of assigned families.
   • Recommend measures families might consider in bringing about changes needed in their health care situation.
     • Grade: ________
   • RATIONALE:

     
     
     
     
     

10. Evaluate own learning activities directed toward meeting self-identified learning needs.
    • Share learning experiences with peers during clinical conferences.
    • Evaluate gaps in own knowledge base.
    • Plan, with faculty assistance, opportunities for remedying knowlege and/or experience gaps.
      • Grade: ________
    • RATIONALE:

      
      
      
      
      

• Course Letter Grade: ________

Faculty Comments:

Date of Home Visit(s):_________________________

___________________________________________________
Instructor's Signature and Date

___________________________________________________
Student's Signature and Date

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