Augusta State University Department of Nursing Self-Evaluation Survey 1. How much are you currently engaged in nursing practice?   Not currently working as a Registered NurseWorking part-time in nursingWorking full-time in nursing 2. Current Employer (Please give name of health care facility or agency/office): 3. Date of Employment: 4. Present Position: 5. Name of immediate supervisor: Instructions: Please rate your level of attainment of the following educational outcomes for nursing program and sub-categories using the scale below. Please put a check in the box that best describes YOUR level of attainment for each item. 6. Identifies human responses to actual or potential health problems through the utilization of critical thinking in order to apply a problem solving approach and intervene appropriately to promote, maintain and restore health. Utilizes therapeutic communication when interacting with patients and significant support persons Well Attained   Moderately Attained   Somewhat Attained   Not Attained   Documents relevant, accurate and complete information in writing or through technology.         Communicates relevant, accurate and complete information verbally with members of the health care team.         Performs comprehensive patient assessment including physical, developmental, emotional, psychosocial, cultural, spiritual and functional status.         Makes appropriate clinical judgment and management decisions to ensure accurate and safe care.         Evaluates effectiveness of care provided in meeting patient care outcomes.         Teaches the patient and or significant support person information and skills needed to achieve desired learning outcomes.       7. Identifies human responses to actual or potential health problems through the utilization of critical thinking in order to apply a problem solving approach and intervene appropriately to support the patient end of life care. Utilizes therapeutic communication when interacting with patients and significant support persons. Well Attained   Moderately Attained   Somewhat Attained   Not Attained   Documents relevant, accurate and complete information in writing or through technology.         Communicates relevant, accurate, and complete information verbally with members of the health care team.         Uses knowledge of the patient's development, emotional, cultural, religious, and spiritual needs to deliver end of life care.         Makes appropriate clinical judgment and management decisions to ensure accurate and safe care.         Evaluates effectiveness of care provided in meeting patient care outcomes.         Teaches the patient and/or significant support person information and skills needed to achieve desired learning outcomes.       8. Manages and coordinates patient care through goal directed interactions with individuals, groups and members of the multidisciplinary health team in a variety of settings. Prioritizes patient care. Well Attained   Moderately Attained   Somewhat Attained   Not Attained   Delegates aspects of patient care appropriately to qualified assistive personnel.         Provides coast efficient care.         Demonstrates competence with current technology.         Collaborates with patent, significant support persons, and members of the health care team to achieve positive patient outcomes within and across health care settings.         Coordinates implementation of the plan of care with patient, significant support persons and other health care providers.       9. Demonstrates caring behaviors toward patients regardless of diagnoses, personal characteristics, background or actions. Performs nursing skills competently. Well Attained   Moderately Attained   Somewhat Attained   Not Attained   Protects and promotes the patient's dignity.         Provides accurate and safe nursing care in diverse settings.         Supports the patient and significant support persons when making health care and end-of-life decisions.       10. Practices within the discipline's ethical and legal framework. Implements the prescribed care regimen within the legal, ethical and regulatory framework of nursing practice. Well Attained   Moderately Attained   Somewhat Attained   Not Attained   Demonstrates accountability for nursing care given by self and/or delegated others.         Advocates for patient rights.         Maintains organizational and client confidentiality.       11. Anticipates changes and assumes responsibility for personal and professional growth to meet the challenges of an ever evolving health care system. Participates in ongoing professional development. Well Attained   Moderately Attained   Somewhat Attained   Not Attained   Recognizes the impact of economic, political, social and demographic forces on the delivery of health care.       12. Overall, how do you view the Associate of Science in Nursing program at Augusta State University?   Extremely Positive Somewhat Positive Somewhat Negative Extremely Negative Uncertain 13. What suggestions for change of the nursing program do you have? 14. Have you completed, or are you currently enrolled in a Baccalaureate in Nursing program?   Yes, completed programYes, currently enrolled in programNo, have neither completed or enrolled in program 15. If graduated, please indicate where enrolled or when and where graduated and year: 16. If you answer "No" to question 14, how likely is it that you would enroll in an educational program to complete your Baccalaureate Degree in Nursing within the next three (3) years?   Extremely Likely Somewhat Likely Somewhat Unlikely Extremely Unlikely Uncertain 17. Please list professional organizations to which you belong: 18. Please list the professional journals you read on a regular basis: Thank you for your time and interest in completing this questionnaire!

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