Field Internship Rotations Policies & Procedures

Field Internship Rotations Policies & Procedures

Introduction:

The purpose of the field internship rotation is to continue to build upon the assessment, management and treatment skills developed during the clinical internship rotation experience and to apply these skills to the out-of-hospital setting under the direct supervision of a designated preceptor. Students will be exposed to a wide variety of medical and trauma patients ranging from the routine to the complex. During the field internship students shall follow the direction of their designated preceptor. At no time shall a student perform any skills outside their scope of training or without direct supervision of their preceptor. During field rotations students must keep in mind that while your preceptors are there to assist and educate you their FIRST and PRIMARY responsibility is to provide patient care. Please remember that from time to time situations may arise that your preceptor may not be able to involve you or answer your questions immediately. If or when these situations occur follow your preceptor’s instructions and do not interfere. Your questions will be answered at the appropriate time. A majority of the preceptors you will encounter during your internship have worked closely with CMTI and their students to help provide the best field internship experience possible.

Field Internship Rotations:

Paramedic students entering the field rotation phase of the program will be assigned their field rotations by the CMTI Paramedic Program Director or Field Internship Coordinator. Field rotations will involve assignments to a either a private ambulance service or fire department based service. During field rotations, the paramedic intern will be assigned a preceptor at each field site. The preceptor will directly observe and supervise the student during the performance of their skills.In accordance with OEMS A/R 2-305 (Appendix – B)the student riding during the course of his or her field internship, should always be considered a “third” rider and never be considered or mistaken as a member of the assigned ambulance crew. Additionally only one student will be allowed on an ALS ambulance at a time.

Students who are working for an ambulance service may perform skills and receive credit while on duty only if they are under the direct supervision of an approved preceptor. No credit toward the required number of field hours may be credited while a student is on duty.

In accordance with OEMS A/R 2-305 (Appendix – B – in your log book) and CMTI requirements completion of the minimum requirements does not constitute successful completion of the field internship. CMTI will review all documentation for completeness and determination that all requirements for successful completion of the field internship have been met. If after the review of all field documentation it is determined that a student will require additional field time the student will be notified and will meet with the Program Director to discuss and review the need for additional field time.

Eligibility to Participate in Field Internship:

As outlined in the Office of Emergency Medical Service’s Administrative Requirement A/R 2-305 (attached to log book) and CMTI requirements the prerequisites for students to participate in the field internship include:

·  Successful completion of the Clinical Internship Rotation

·  Maintaining current Massachusetts and/or National Registry EMT-B or EMT-I /EMT-A certification

·  Maintaining current American Heart Association Basic Life Support- Health Care Provider certification

·  Maintaining current American Heart Association Advanced Cardiac Life Support certification

·  Maintaining current American Heart Association Pediatric Advanced Life Support certification

·  Successful completion of all required education and training prerequisites of the paramedic course

·  Authorization from the Program Director and/or Field Internship Coordinator to enter the field internship

·  Proof of and maintaining of liability/malpractice insurance

·  Submittal of required immunization documentation

Scheduling of Field Time:

Scheduling of field internship rotation shifts will be through the CMTI Paramedic Program Director or Field Internship Coordinator. Students shall follow their assigned shift schedule only. No student is allowed to schedule their own shift with a field site or to show up to a field site for a shift they have not been assigned to. In the event a student is unable to make their assigned shift they shall notify the Paramedic Program Director or Field Internship Coordinator as soon as possible to reschedule the shift. If a student must cancel a shift with less than 24 hours notice or will be late arriving to an assigned shift the student shall notify the field site’s Shift Supervisor or preceptor and the Paramedic Program Director or Field Internship Coordinator immediately. Repeated cancellations or late arrivals to field shifts may result in a student’s removal from the program.

Confidentiality:

The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that took effect in April 2003. The law provides for the protection of personal health information (PHI) of all patients. During the course of the field internship rotation students will be exposed to some of the patient’s personal health information. Students are to remember this information is protected and shall never be given out to any unauthorized persons or entities. Students shall follow the HIPAA policies and guidelines of each field site. Failure to follow these policies and guidelines or the release of any patient’s PHI to any unauthorized persons or entities will result in the student’s removal from the program.

Professional Behavior:

All CMTI students are to conduct themselves in a professional manner during field internship rotations. Students shall not vacate their assigned positions without the permission of their Preceptor or Program Director or Field Internship Coordinator. Failure to follow this policy can result in the student’s removal from the program. Students must remember that they are representing CMTI and any behavioral problems during the field setting will not be tolerated.

Examples of unacceptable behavior include:

·  Sexual harassment

·  Stealing

·  Disrespectful or argumentative behavior toward patients or ambulace staff

·  Intoxicated during rotation

·  Excessive tardiness or absence

·  Sociably unacceptable behavior

·  Inappropriate use of cell phones (IE: In front of or during evaluation of a patient ) Students shall follow each field site’s policy regarding cell phone use

Field Attire:

The following clothing shall be worn by all CMTI students during their clinical rotations:

·  Black CMTI golf shirt with approved logo

·  Black shoes

·  Name tag with picture ID

·  Khaki or Navy Blue EMS pants

·  Stethoscope

Failure to follow this policy may result in the student being removed from the site

Personal Hygiene:

All students attending/representing CMTI during their field internship rotations will maintain an acceptable appearance. Student’s hair shall be clean and must be secured back for long hair that is shoulder length or longer. Male students shall be clean shaven or maintain their beard/mustache in a neat/clean fashion. Jewelry that may pose a risk, such as neck chains and long earrings will not be permitted at any field site. Facial piercings are not allowed in the field setting. Students may not wear cologne or perfume during field rotations. Failure to follow this policy may result in the student being removed from the site.

Universal Precautions:

During the field internship rotation students will be at risk of exposure to blood borne pathogens and infectious diseases. Students are to remember to take proper body substance isolations (BSI) and don the necessary/required personal protective equipment (PPE) during all patient contacts. Students shall follow each field site’s universal precautions policies and procedures at a minimum.

Examples of PPE include:

·  Gloves

·  Gowns

·  Mask

·  Eye Protection

·  Hand Washing

Unprotected Exposures:

Any student who experiences an unprotected exposure shall immediately report the incident to their designated preceptor and/or their supervisor. Students shall follow the field site’s decontamination procedures and complete the site’s required exposure reporting procedures. Students shall also report the incident to CMTI’s Paramedic Program Director and/or Field Internship Coordinator.

Examples of unprotected exposures include:

·  Needle Stick

·  Exposure to infectious disease

·  Unprotected exposure to blood, vomit, body fluids

·  Body fluid splash in eyes or mouth

Documentation:

Students are responsible for completing their field documentation completely and accurately. Students shall complete the documentation as outlined in the Field Internship Rotation Requirements and the Field Internship Skill Log book. Additionally students must also complete the electronic field internship skills log for each patient encounter and skill performed. Upon completion of the field internship the student shall turn their skill log book into the CMTI Paramedic Program Director or Field Internship Coordinator to be reviewed for completeness and accuracy. All entries must be legible and entered in black or blue ink. Illegible entries will be discarded. All required information must be entered and each skill must be signed off by your designated preceptor. Any mistakes in an entry shall be corrected by drawing a single line through the entry and initialing it. The corrected entry shall be entered into a separate line/space. All time entries shall be in the military time format (IE: 9:00 am = 0900 / 1:00pm = 1300 hrs)

Field Internship Requirements:

The minimum requirements for the field internship are outlined in OEMS A/R 2-305 (Appendix – B).Students shall achieve these requirements as well as CMTI’s field internship requirements as listed in this document and the Field Internship Skill Log Book.

Minimum Hours: (250)

ALS Patient Contacts: (30)

Contacts as Team Leader: (15)

Field Skills to include: Patient Assessment – IV Therapy – Airway management, Electrical Skill Therapy – Cardiac EKG Recognition/Interpretation – IV Bolus Medication Administration – IV Infusion Medication Administration – Miscellaneous Medication Administration.

Students are to remember that All patient contacts must be an ALS contact in order to count. BLS contacts will not be counted toward the minimum patient contact requirements.

Students should make every effort to make patient contact with as many of the patient categories (IE: Pediatric – Adolescent – Adult – Geriatric - Psychiatric) as possible during their rotation. Students shall make every effort to assess and treat at a minimum of two (2) patients per category.

The minimum number of each skill to be performed in the field:

IV Cannulation – (10)

Cardiac EKG Recognition/Interpretation – (10)

Cardiac 12 Lead EKG Recognition/Interpretation – (4)

IV Bolus/Miscellaneous Medication Administration – (5)

IV Medication Infusion – (1)

Electrical Skill Therapy – (1)

Endotracheal Intubation – (1)

**Note: If the student does not get the opportunity to perform a skill in the field they may demonstrate the skill in a lab setting in front of the Medical and/or Program Directors

In addition to the listed skills students must assess and formulate a treatment plan for the following chief complaints:

Complaint Minimum

Chest Pain (2)

Respiratory (2)

Syncope (2)

Abdominal Pain (2)

Altered mental Status (2)

Trauma (2)

Liability/Malpractice Insurance:

Students will be required to provide proof of continued liability/malpractice insurance prior to the start of field internship rotations. Students will be responsible for providing and maintaining their own liability/malpractice insurance throughout the duration of their field internship rotation. Lapse or loss of liability/malpractice insurance will result in the student’s immediate removal from field rotations.

Student Health Requirements:

Comprehensive Medical Teaching Institute is committed to providing a safe environment for patients, staff and students. Due to the nature of the environment, any student entering the field internship rotation phase of the program must maintain the required immunizations to protect the health and safety of the student, patients and field site staff.

All students shall maintain health insurance during their field internship rotation. Prior to the start of the field internship students are required to have on file current evidence of the following immunizations:

·  TB test: Must be a Mantoux (PPD) within six (6) months prior to the start of the first field rotation

·  Rubella (measles and German measles): proof of immunity may be documented by:

o  A positive titer to Rubella and a positive titer to Rubella

o  Proof of two (2) immunizations to Rubella or MMR, and proof of immunization to Rubella or MMR vaccine

·  Hepatitis B vaccination

·  Students who have not had chicken pox must notify the Course Director and/ or the Field Coordinator

·  Flu shot

Any lapse in the required immunizations/health requirements will result in the student’s suspension from the field internship rotation until such time they can provide proof of

Drug Screening Policy:

At this time CMTI does not require students to submit to a drug screening test for entry into the field internship. CMTI does reserve the right to require a drug screening, for any student, due to any reasonable suspicion or allegation of drug use.

Students may be subject to a drug screening at any field internship site in accordance with their policies, procedures and requirements.

Field Site Conflicts:

Any conflicts that may arise at a field site during your field internship shall be reported to the CMTI Paramedic Program Director and/or Field Internship Coordinator for resolution. At no time shall a student engage in a debate with their preceptor or other site personnel. Any opinions or concerns regarding site preceptors or personnel, policies or procedures should be directed to the Program Director and/or Field Internship Coordinator. Students who engage in a debate/ argument with site preceptors or personnel will be subject to removal from the field site and possible removal from the program.