MEDICAL CENTER POLICY & PROCEDURE MANUAL
Title: / S.10.00 Students, Healthcare
Category: / Administrative / Leadership
Executive Sponsor: / Chief Nursing Officer
Policy Owner: / Director Education Services
Policy Custodian: / Sr Staff Assistant - Quality Administration
Scope/Applicable Areas: / Medical Center Wide
Review Period: / Three Years
Original Date: / 09/1998 / Review/Revised Date(s): / 10/2003, 03/2007, 10/2010
Committee Approvals: / Patient Care Team
Policy and Procedure Committee
Medical Executive Committee / 10/4/2010
10/12/2010
10/20/2010
1.0 Policy Statement
1.1. Kaiser Permanente (KP) supports the education of students through the provision of opportunities for highly relevant clinical experiences with an emphasis on safety and quality.
1.2. All student placements will be coordinated / processed through Education Services.
2.0 Purpose
2.1. Stipulate requirements to be met by healthcare students and clinical faculty prior to student observational experience, group rotation or preceptorship at any KP facility.
2.2. Insure that patient care or operational standards are maintained in all student learning situations.
2.3. Define responsibility and accountability for assignment of nursing students and the patient care they provide.
2.4. Clearly delineate any limitations on nursing student clinical practice based on regional or medical center policy.
2.5. Medical students, interns and residents are not covered by this policy. Contact Medical Staff Office at extension 3389. (see policy S.17.00 Students, Medical)
3.0 Scope
3.1. This policy applies to healthcare students and faculty from approved schools of nursing or allied health with which KFH and TPMG have established a Student Agreement, permitting said faculty to supervise and students to participate in clinical, operational or observational experiences.
3.2. A Student Agreement must be initiated by a K P representative and is established by the Regional Provider Relations Coordinator, Medical Services Contracting Department (510-987-5863 (tie line 8-428).
4.0 Definitions
4.1. Clinical Rotation- a group of nursing students under direct supervision of a registered nurse who has been identified by the educational institution as clinical instructor for the course.
4.2. Observational Experience- An approved experience in which the student observes patient care and other activities in a clinical area and does not participate in direct patient care.
4.2.1. Faculty communicates requests for observation to the KP facility’s Education Services Department.
4.2.2. The observational unit provides school with information regarding specific opportunities.
4.3. Student Preceptorship-A student preceptorship is a clinical rotation in which a student is assigned to work with a designated staff preceptor for a specified period of time, typically for one or more semesters. School faculty does not provide direct supervision.
5.0 Policy / Provisions
5.1. The Medical Center retains responsibility for the care of all patients and operations, including those assigned to students. The RN or other designated professional (e.g., Respiratory Therapist, Pharmacist, Health Information Specialist) assigned to manage the care of a patient for a given shift or perform operational functions retains ultimate accountability for decisions regarding supervision and direction of patient care or operations.
5.2. Patients/Members have the right to decline to be seen or followed by a student.
5.3. During a clinical rotation students practice under the supervision and direction of the clinical faculty identified by the educational institution.When a student is participating in a preceptorship, the student functions under the direction and supervision of an assigned preceptor.During an observational experience, a designated staff person, present in the area where the observation occurs, assumes responsibility for directing the student.
5.4. The school is responsible for assuring that students are prepared to carry out assigned nursing or operational responsibilities commensurate with their course objectives, verifying competence by evaluation in the skills lab setting before assigning such responsibilities in the clinical setting.
5.5. Students are authorized to be on-site and involved in patient care or other aspects of medical center operations under the following conditions:
5.5.1. A Student Agreement has been established between NCAL KFH/TPMG and the school/program wherein students are enrolled and required Certificates of Insurance are on file.
5.5.2. A placement has been approved by the Director or Education Services / designee who serves as the point of contact for student and faculty matters.
5.5.3. Students and faculty, if on-site, meet health clearance (as defined by Employee Health and Safety), criminal background check, and BLS for Healthcare Provider/Professionals training requirements (If required by the staff member). A BLS card from AHA or an agency with which AHA has reciprocal agreements is acceptable.
5.5.3.1. Students with a background check indicating any of the following felony and/or misdemeanor convictions within the last 7 years are not eligible for clinical placement:
5.5.3.1.1. Violent crimes such as murder, rape, sexual assault and robbery, kidnapping, attempted murder, assault with deadly weapons
5.5.3.1.2. Crimes involving theft, embezzlement, burglary, forgery, fraud, arson, identity theft
5.5.3.1.3. Sex crimes including sexual molestation and sex crimes against children, or any conviction for which a candidate is required to register as a sex offender with a state or federal government agency
5.5.3.1.4. Drug related crimes such as drug theft, sales, distribution, manufacturing and possession of controlled substances
5.5.3.1.5. Multiple convictions (more than one conviction for same or different crime)
5.5.3.1.6. Posted name on any government sanctioned or debarred list
5.5.4. Students and faculty complete appropriate training for utilizing the electronic medical record and obtain access codes.
5.5.5. Students and faculty have signed statements on the following: Confidentiality, HIPAA and Protected Health Information education, guidelines for Standard Universal Precautions, child abuse reporting, dependent and elderly abuse reporting, annual compliance training, and, if appropriate, HC training. Such health clearance records, card of completion, and/or attestation forms shall be maintained by facility Education Services or department designated by Education Services.
5.5.6. Students and faculty have been oriented to the clinical environment and policies governing care delivery or hospital operations therein. Faculty new to the facility have participated in on-site orientation to the clinical areas in which they supervise students as well as orientation to applicable facility policies, procedures and initiatives. All clinical faculty will meet facility requirement for demonstration of competence in performance of nursing responsibilities for which they will supervise students.
5.5.7. Display school photo ID badge and facility specific identification
5.5.8. Are not included in staffing ratios for the facility.
5.5.9. Kaiser Permanente may request the school to withdraw a student from the clinical program for reasons stated in the contract with the school. The process is managed by the Education Services Director.
6.0 Procedure
6.1. Requests for nursing or allied health clinical rotations and preceptorships must be submitted through the Centralized Clinical Placement System (CCPS). The school will be notified in a timely manner by Education Services via the CCPS and/or in writing of approval or denial of clinical rotations and preceptorships.
6.1.1. Each request for a clinical rotation or preceptorship is reviewed with nursing management to determine ability to accommodate the request.
6.1.2. A current list of facility academic liaisons and a list of clinical coordinators from the schools of nursing are available from Kaiser Permanente Northern California Academic Relations.
6.2. Roles and Responsibilities of School and Kaiser Permanente representatives and nursing students-See Appendix 1.
6.3. Student Injury/Exposure Guidelines
6.3.1. For a work related injury or exposure, the student is sent to Employee Health or the Emergency Dept (as appropriate) for assessment, triage and/or treatment as appropriate.
6.3.2. Notify the instructor, management or area and Education Services immediately. Complete appropriate forms for Employee Health and/or Risk Management. Workers Compensation reporting is managed by the school.
6.4. Scope of Practice
6.4.1. Prelicensure nursing students may perform responsibilities normally associated with performance of the role/job for which they are preparing that are consistent with the California Nurse Practice Act and Business and Professions Codes, and that are deemed appropriate to the student’s level of knowledge and skill by their faculty. See Appendix 2-Limitations to Nursing Student Scope of Practice.
6.4.2. Prelicensure allied health student may perform responsibilities normally associated with the performance of the role/job for which they are preparing and consistent with the appropriate California laws, regulations and scope of practice.
7.0 References
7.1 Title 16 CCR, Division 14, Board of Registered Nursing, Section 1427.
7.2 Title 16 CCR, Division 25, Chapter 1-Vocational Nurses, Article 5.
7.3 Joint Commission HR.01.04.01, EC.03.01.01, HR.01.07.01, and RI.01.07.03
7.4 HIPAA Privacy Rule.
7.5 High Alert Medication Policy.
7.6 Appendix 1 Roles and Responsibilities of Parties Directly Involved in Nursing Student Clinical Experiences at Kaiser Permanente
7.7 Appendix 2 Limitations to Nursing Student Scope of Practice
8.0 Appendix 1 - Roles and Responsibilities of Parties Directly Involved in Nursing Student Clinical Experiences at Kaiser Permanente (KP)
8.1. Director of Education Services or designee
8.1.1. Validates that a current Student Agreement covering students in the requested educational program (e.g. LVN-to-RN, BSN) exists with the school.
8.1.2. Approves group rotations, senior preceptorships requests, and supplementary observational experiences directly with school clinical coordinators. See 6.1- Procedures.
8.1.3. Provides and/or facilitates medical center orientation and clinical orientation for nursing faculty.
8.1.4. Provides information to school representative/faculty regarding required health screening, immunizations, background checks, and pre-clinical compliance training materials when rotation or preceptorship is approved. Provides regulatory and compliance information for faculty/student review prior to participating in clinical activities. Receives required documentation, including attestation statements for compliance topics, from instructor/school prior to beginning of student experience.
8.1.5. Facilitates scheduling of students and faculty for a HC training class and obtains and submits to HC IT support representative the required identification information for assignment of an access code for each student and faculty.
8.1.6. Arrange for student on site faculty to obtain photo identification badges prior to clinical experience.
8.1.7. Meets annually with affiliating schools of nursing to discuss clinical learning experiences available, to elicit feedback from faculty and students on quality of student experiences at KP, and to provide updates on facility policies and initiatives.
8.1.8. Provides exit survey forms for nursing student feedback. Reviews completed forms and forwards regional documents to Regional Academic Relations and local for feedback to appropriate manager.
8.2. Regional Academic Relations Education Consultant
8.2.1. Introduces schools to KP facilities in their community. Promotes positive working relationships between schools of nursing and area facilities.
8.2.2. Assists medical centers to resolve school/student related concerns/problems.
8.2.3. Compiles data from student exit surveys and presents to KP Executive Director of Patient Care Services for consideration by Chief Nursing Office (CNO) peer group
8.3. Manager or designee
8.3.1. Refers all requests for student clinical placement to the Manager/Director of Clinical Education or designee.
8.3.2. Facilitates the unit orientation of the clinical faculty.
8.3.3. Coordinates staff RN assignments with nursing faculty to facilitate student learning.
8.3.4. Provides to clinical faculty any unit specific policies and procedures relevant to the student clinical experience, e.g. infant security policy on postpartum unit.
8.3.5. Fosters collaboration through ongoing communication with faculty to achieve the best learning outcomes and positive relationship between KP and affiliating schools of nursing.
8.3.6. In the event of a student conflict or problem which cannot be resolved to the manager’s satisfaction:
8.3.6.1. Remove the student from the area
8.3.6.2. Contact the instructor or school
8.3.6.3. Contact the Education Services Department
8.3.7. Notifies Education Services of any student injury or reportable event immediately.
8.4. School of Nursing representative (clinical coordinator/program director)
8.4.1. Ensures students (and faculty if on-site) meet KP Human Resources policies for health care providers (see 5.4.2. and 5.4.3.).
8.4.2. Informs medical center of school’s policy related to injury/exposure sustained by student during clinical rotation/preceptorship.
8.4.3. Provides to Clinical Education department and unit manager:
8.4.3.1. Course clinical objectives.
8.4.3.2. Faculty and student contact information.
8.4.3.3. Clinical rotation schedule.
8.5. Clinical Faculty
8.5.1. Completes orientation process which includes at a minimum the following:
8.5.1.1. California RN license number (Education Services will complete Primary Source Verification).
8.5.1.2. Documentation to support health clearance
8.5.1.3. Criminal Background Check
8.5.1.4. Completion of hospital determined education and attestations.
8.5.1.5. Cards of Completion (BLS)
8.5.1.6. KP HealthConnect training
8.5.1.7. 1 shift of on unit orientation with a preceptor
8.5.2. Annually completes the following:
8.5.2.1. Patient Care Services’ Annual Skills Validation and Unit Specific Competency Program.
8.5.2.2. Update of health clearances, cards of completion and hospital determined education and attestations.
8.5.3. Ensures students are competent and knowledgeable regarding medical center policies and procedures.
8.5.4. During a clinical rotation, is responsible to provide a level of supervision commensurate with the level of the students in the nursing curriculum and must be available (whether on premises, by phone or pager) to students and staff at all times during the students' clinical hours.
8.5.5. Collaborates with RN staff, charge nurse, and or assistant nurse manager to determine student assignments focused on clinical objectives. Posts same per preferred unit procedure.
8.5.6. Is responsible for reporting to the charge nurse and/or department manager, by start of shift, any student absence.
8.5.7. Obtains Pyxis access from pharmacy for self, enabling students to administer medications.
8.5.8. Once supplementary assignments in specialty areas, i.e. operating room, outpatient clinics, are approved by Director of Education/designee, contacts appropriate manager(s) at the beginning of the semester to arrange scheduling and determine special requirements.
8.5.9. Is responsible for assessing and evaluating student competence and clinical performance.
8.5.10. Promptly informs nurse manager or designee of any patient care problem involving a student and submits appropriate documentation of problem/event.
8.5.11. Is encouraged to discuss any issues or concerns with the department manager or designee.