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iRubric: Med-Surgical Clinical Concept Map Rubric

iRubric: Med-Surgical Clinical Concept Map Rubric

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Med-Surgical Clinical Concept Map Rubric Med-Surgical Clinical Concept Map Rubric Clinical SBAR for NUR121 Medical Surgical Nursing Clinical. Student is to complete the SBAR form for one client they have cared for in clinical week 1 or 2. Rubric Code: HX9AAXX By plbehan Ready to use Public Rubric Subject: Nursing Type: Assessment Grade Levels: Undergraduate

SBAR
	Proficient 10 pts	Competent 9 pts	Advanced Beginner 8 pts	Novice 7 pts	Unsatisfactory 6 pts
Chief Complaint/Pathophysiology Patient chief complaint or admitting medical diagnosis. Includes discussion of underlying illness, including the pathophysiology.	Proficient Medical Diagnoses clearly presented with explanation that demonstrates student understanding. Pathophysiology shows understanding of medical diagnosis and comorbidities and identifies etiology based on the specific patient's condition.	Competent Medical Diagnoses present with adequate explanation. Pathophysiology doesn't take into account the comorbidities and does not give specific etiology for the patient's condition.	Advanced Beginner Medical Diagnoses present with inadequate or unclear explanation. Pathophysiology and etiology presented but difficult to understand the connections to this patients condition.	Novice Medical Diagnoses present with minimal explanation. Pathophysiology information minimal with no correlation to patient condition.	Unsatisfactory No medical diagnosis or correlation to patient condition given. Pathophysiology absent.
Assessment Form Objective and Subjective data from physical assessment and medical chart. Information obtained from patient, family and other health care providers.	Proficient Assessment Form complete with both objective and subjective data addressed at a thorough level, using both patient, family, chart and other health care providers.	Competent Assessment Form complete with objective and subjective assessment addressed at a basic level with utilizing patient, family and health care providers assistance.	Advanced Beginner Assessment Form incomplete, does not include both objective and subjective assessment data. Only obtained data from EMR and minimal amount from patient.	Novice Assessment Form is incomplete, with minimal assessment data from objective or subjective data. Data only obtained from 1 source.	Unsatisfactory Assessment form is absent or includes no significant data.
Labs Lab values presented with abnormal lab values including rationale and correlation to patient illness.	Proficient Lab results documented and abnormals addressed and related to the patient's specific condition(s) with further discussion linking the abnormal results to pathophysiology.	Competent Lab results documented and abnormals addressed and related to the patient's condition.	Advanced Beginner Lab results incomplete. Abnormal labs addressed, but not complete. Minimal correlation included.	Novice Lab results given with no discussion of abnormals and no correlation included.	Unsatisfactory No lab values presented.
Medications Patient medication list with reason for why medication prescribed for this patient.	Proficient Complete medication list included with rationale for medication to the student's specific patient.	Competent Complete medication list done, but lacks rationale for medications.	Advanced Beginner Medication list done only for medications given but not prn and other regularly scheduled medications. Rationale minimal and only for medications listed.	Novice Medication list present but incomplete. Missing at least 25% of the medications Lacks rationale to the patient.	Unsatisfactory No medications or rationale listed.
Nursing Problems List at least 3 nursing problems/diagnoses, show prioritization of care based on patient's needs.	Proficient More than three nursing problems/diagnoses given with prioritization based on the patient's condition/need(s).	Competent Three nursing problems/diagnoses given with prioritization based on patient condition/need(s).	Advanced Beginner At least three nursing problems/diagnoses are given with lack of prioritization or inappropriate prioritization based on patient needs.	Novice Less than three nursing problems/diagnoses given. Lacks any prioritization.	Unsatisfactory Only 1 or no nursing problems listed.
Goals Include 3 goals for each nursing diagnosis.	Proficient Goals present for all problems/diagnoses listed with measurable outcomes and timeframes.	Competent Goals present for 3 problems/diagnoses with measurable outcomes and timeframes noted.	Advanced Beginner Goals present for some of the problems/diagnoses but, are not measurable or no timeframe identified.	Novice Goals not present for each identified nursing diagnosis. Goals not measurable.	Unsatisfactory No goals present.
Interventions Determine 3 interventions for each goal. Include rationale and justification and outcome for each goal.	Proficient Outstanding relationships noted between problem/diagnosis, goal and interventions for each goal.	Competent Acceptable number of interventions per goal with relationship noted between the problem, goal, and interventions given.	Advanced Beginner Less than the acceptable number of interventions for each of the patient's problem(s) and goal(s) listed and each goal identified. Lacks rationale for the interventions.	Novice One specific intervention or less for each of the patient problem(s) and goal(s) listed for the patient's designed problem and goal identified. Limited or no connections.	Unsatisfactory No interventions included.
Evaluation Include reassessment data and any modifications to care needed.	Proficient Synthesizes connections between interventions and reassessment data. Demonstrates exceptional critical thinking for this patient assignment.	Competent Has thorough reassessment data and demonstrates adequate critical thinking for this patient assignment.	Advanced Beginner Has reassessment data but lacks demonstration of critical thinking skills for this patient assignment.	Novice Reassessment data poor with no critical thinking skills demonstrated.	Unsatisfactory No reassessment completed.
Grammar/Spelling/Grammar Concept map needs to be well organized, easy to read, logical, & neat. Proper spelling expected.	Proficient Eloquent execution with demonstration of advanced terms and knowledge in writing style with no grammatical or spelling errors. Map is well organized, logical, and neatly presented.	Competent Inviting to look at with excellent organization. Correct spelling and no grammatical errors.	Advanced Beginner Neat with minor spelling, and grammatical errors. Lacks organization and map is difficult to follow.	Novice Disorganized, several spelling or grammatical errors. Lacks logic and is very difficult to follow.	Unsatisfactory Not organized, spelling and grammar errors noted in every section. Lacks logic and map was unable to be followed.
APA Citations Citations must be present for each nursing diagnosis and must be per the 6th edition of the APA handbook.	Proficient Sources cited per APA format.	Competent One source citation missin or incorrectly cited per APA format.	Advanced Beginner More than one source citation missing or incorrectly cited per APA format.	Novice More than source citation missing or incorrectly cited per APA format.	Unsatisfactory No citations present.

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Nursing Concept Map

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