Master’s Entry Program in Nursing Preceptor Handbook Fall 2023
5998 Alcalá Park San Diego, CA 92110
The University of San Diego’s Hahn School of Nursing and Health Science recognizes the time and expertise shared by preceptors as a valuable contribution to the professional education of our Master’s of Science in Nursing Program students. Thank You!
Table of Contents Contents Letter from the Associate Dean ........................................................................................................................................... 3 Introduction ................................................................................................................................................................................. 4 MEPN Program....................................................................................................................................................................... 4 Philosophy of the School of Nursing ............................................................................................................................. 4 Valuing Individual Differences ........................................................................................................................................ 5 Learning Outcomes and Course Descriptions .......................................................................................................... 6 MSNC 510P Clinical Nursing Leadership Practicum.............................................................................................. 6 Preceptors ..................................................................................................................................................................................... 7 Definition .................................................................................................................................................................................. 7 Purpose for Utilization of Preceptors........................................................................................................................... 7 Criteria for Preceptor Selection ...................................................................................................................................... 7 Roles and Responsibilities of the Preceptor.............................................................................................................. 7 Roles and responsibilities of the Student ................................................................................................................... 8 Roles and responsibilities of the Faculty Member ................................................................................................. 8 Records to be maintained by the School of Nursing:............................................................................................. 8 Preceptor “To Do” List ............................................................................................................................................................. 9 USD Clinical Faculty “To Do” List ..................................................................................................................................... 10 MEPN Student “To Do” List for Clinical Preceptorships ........................................................................................ 11 Evaluations ................................................................................................................................................................................ 12 Evaluation of the Student .......................................................................................................................................... 12 Evaluation of the Preceptor ...................................................................................................................................... 12 Evaluation of Faculty/Course/Clinical Agency ................................................................................................ 12 Student Assessment of Clinical Preceptor/Site ......................................................................................................... 13 References/Suggested Readings ...................................................................................................................................... 14 Appendix ..................................................................................................................................................................................... 15 Process for Accident/Incidence Occurrences ........................................................................................................ 16 Mid-term Assessment .................................................................................................................................................... 19 Final Assessment – end of term ................................................................................................................................ 20 Clinical Assessment Tool ..................................................................................................................................................... 21
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Letter from the Associate Dean
January 29, 2024
Dear
,
Thank you for agreeing to precept a student in the Master’s Entry Program in Nursing (MEPN) at the Hahn School of Nursing and Health Science, University of San Diego. The purpose of this letter is to confirm the arrangements with you to act as a preceptor for USD student: ______________________. This arrangement will be for: • • •
Fall 2023 The semester begins August 30, 2023, and ends December 20, 2023. The class title is MSNC 510P Clinical Nurse Leader Practicum
The student and USD clinical faculty member will arrange to meet with you at the beginning of the semester to set up dates and hours for this clinical experience, to share the individual learning objectives of the student, as well as obtain the preceptor contract and biographical sketch. An additional meeting will be scheduled mid-term to review the student’s progress and a final meeting will occur before the end of the semester to evaluate the student’s success in the clinical setting. Students are covered for malpractice and liability insurance through the University of San Diego and can provide you with specific information regarding their policy, should you request it. A copy of the course description and clinical learning objectives is included in this handbook for your information. We very much appreciate your cooperation in providing our students with an excellent clinical learning experience. Should you have any questions about these arrangements, do not hesitate to contact me at 619-260-4773. Thank you for your commitment to educating the future of nursing. Sincerely yours,
Kathy K. Marsh, PhD, RN, CNS Associate Dean Hahn School of Nursing and Health Science
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Introduction The Hahn School of Nursing and Health Science at the University of San Diego is dedicated to preparing graduates committed to an ongoing search for truth in the context of intellectual openness and supports scholarly endeavors that will contribute to social change in ways that foster health. The intent of all nursing programs is to graduate individuals who exhibit excellence in clinical practice, a multicultural perspective, and appreciation of the needs of vulnerable populations.
MEPN PROGRAM The Master's Entry Program in Nursing (MEPN) is a pre-licensure Program and is intended for individuals with a baccalaureate degree or higher in another discipline. The program is designed for the person seeking a new career in nursing. Students matriculate into this five-term program every Fall semester. This rigorous program provides the student with a general foundation in nursing as well as Master's level courses that provide the skills necessary to serve in leadership positions. After successful completion of the program, the student receives a master's degree in nursing and eligible to take the National Council Licensure Examination (NCLEX) for registered nursing licensure. Graduates are also eligible to sit for the Clinical Nurse Leader certificate exam, and for post-master's study as an advanced practice nurse. The curriculum is based on the California Board of Registered Nursing (BRN) requirements criteria for entry into practice as well as the American Academy of Colleges of Nursing requirements for the clinical nurse leader role.
PHILOSOPHY OF THE SCHOOL OF NURSING The faculty of the School of Nursing view individuals as unique holistic beings in dynamic interactions within an ever-changing environment. Each person has the potential for self-direction and selfactualization. The faculty believes clients have the right to actively engage in decisions relative to their health and health care. An individual’s potential is achieved through interaction with larger systems such as the family, community, and society. Health is a dynamic state of being which is self-perceived and delineated by certain empirical parameters. This state of being is positively or negatively influenced by interactions with the environment, including the health care system. The faculty believes the health needs of clients are best served by a delivery system that is innovative and responsive to the needs of all people. Nursing is a scientific discipline, which engages in scholarly inquiry to expand its body of knowledge as a foundation for excellence in clinical practice. Nursing care is the translation of intellectual effort into humanistic interventions, which respect the dignity, and worth of each person throughout their life span. Implicit in nursing practice is accountability to individuals, families, and communities to promote, maintain, and restore health. The faculty believes that learning is a continuing process that involves changes in knowledge, attitudes, and behaviors. Consistent with this belief, the faculty provides learning experiences that foster critical thinking and believe that students are accountable for their own learning. The faculty believes that they have a responsibility to assist students to advance in the community of nursing scholars. The faculty of the School of Nursing exemplifies, through teaching, research, and clinical practice, the personal and professional characteristics they seek to develop in their students. They serve as catalysts
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for students’ learning, contributors to nursing’s expanding body of knowledge, and role models in clinical practice.
VALUING INDIVIDUAL DIFFERENCES Cultural and Ethnic Background: Each student entering the nursing program comes with unique cultural, ethnic, sociological, and personal variables. We, the faculty, believe that the common denominators which apply to all individuals pursuing an education in nursing must be a high level of honesty, integrity, and caring for others. The faculty recognizes the unique potential of each student and seeks to help the student grow in self-understanding, awareness, and achievement of professional as well as personal potential. Learning Style/Goals/Support Systems: We, the faculty, believe that learning is an incidental and/or purposeful process which can be experienced by all people and is brought about through interaction with both internal and external environments. The process occurs when the person, either consciously or unconsciously, identifies a goal. This goal creates a motive for learning, an internal condition that arouses, sustains, directs, and determines the intensity of the learning that takes place. During the learning process, positive and/or negative reinforcement can also act to motivate the individual. We also believe that the attitudes of the learner have an effect upon the individual's innate ability, readiness and motivation to learn. Students are encouraged to seek assistance with learning through individual counseling and learning enrichment programs. Teaching/Learning Process: Based upon our understanding of learning, we uphold a teaching/learning process that exemplifies the scientific process. This includes the assessment of students' needs, including individual learning styles, the provision for appropriate learning experiences in an environment conducive to learning, and participation with the learner in the evaluation of their progress. Progress toward learning is evaluated in terms of observable behavior. The end product of learning is seen as a change in behavior. In the learning process, the teacher serves as a role model, resource person, information giver, motivator, and facilitator. Because all individuals are potentially teachers as well as learners, both students and teachers should be given the opportunity to function in both roles.
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LEARNING OUTCOMES AND COURSE DESCRIPTIONS The curriculum for the MEPN program is based on the MSN Essentials for educational preparation.
MSNC 510P CLINICAL NURSING LEADERSHIP PRACTICUM Course Description: Explores and integrates concepts of leadership that are central to the practice of the clinical nurse leader (CNL) including: horizontal leadership, effective use of self, reflective practice, advocacy, lateral integration of care, change theory, and role analysis and implementation. Oversees patient care provided by staff, in collaboration with RN preceptor or mentor, to improve patient outcomes. Serves as a role model for staff in anticipating risks and providing comprehensive care to individuals and clinical cohorts. Reviews and modifies, if necessary, standards of care for specific patient populations. Designs and proposes an implementation and evaluation plan for an evidence-based project designed to effect change in patient/staff outcomes. Completes 144 hours of preceptor and/or faculty guided clinical practice in a health care setting. Learning Outcomes: On completion of this course, students will be able to: 1. Differentiate and implement effective leadership, conflict resolution, critical thinking, and change skills necessary to serve as an MSN prepared clinical nurse providing care to patients and working with staff in a patient care setting. 2. Analyze the roles needed for the multidisciplinary team when providing evidenced-based care to patient or patient cohorts. 3. Collaborate with preceptor and multidisciplinary team to identify risks, complications, sequelae, and contraindications of interventions prescribed for patients and make revisions in care to ameliorate the risks. 4. Evaluate and modify, if necessary, the standards of care to provide safe and developmentally and culturally appropriate care to patients or patient cohorts. 5. Evaluate research and implement evidence-based practice to achieve consistency of clinical care and improved outcomes. 6. Develops and proposes an implementation and evaluation plan for an evidence-based project designed to effect change in patient/staff outcomes. 7. Collaborate with and advocate for culturally diverse consumers and colleagues in the delivery of innovative health care services. 8. Assume responsibility for the delegation and oversight of care delivery by other staff.
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Preceptors DEFINITION The Board of Registered Nursing (BRN) defines a preceptor as: an experienced registered nurse, employed by a health care agency, who is assigned to assist and supervise nursing students in an educational experience that is designed and directed by a faculty member and who meets, at a minimum, the requirements for a clinical teaching assistant (California Code or Regulations 1426.1). The School of Nursing defines a preceptor as a qualified Registered Nurse with a specific area of clinical knowledge and expertise who can facilitate student learning to meet the objectives of clinical nursing courses. As a facilitator of learning, a preceptor is a role model, supervisor, guide, and teacher.
PURPOSE FOR UTILIZATION OF PRECEPTORS Preceptors are clinical experts and role models for nursing students who function as guides and mentors in the learning process of individual students. The one-to-one relationship established between preceptor and student is an effective method for learning. Preceptors provide students with realistic clinical experiences to facilitate the development of knowledge, skill, judgment, and confidence in clinical practice. As teachers, preceptors supervise and assist nursing students to function as safe and effective practitioners in caring for individuals, families and/or groups of clients in the clinical setting. Preceptors provide opportunities for students to develop leadership/management skills required of a professional nurse. The preceptor-student relationship also assists in the socialization of nursing students in the role transition to professional practice, reducing the reality conflicts prior to graduation. Preceptors are selected for their clinical expertise, communication skills, teaching abilities, and willingness to work with students. Goals and objectives: Ask students to identify their personal goals and objectives. Monitor the weekly achievement of goals and objectives. Suggest that student write down questions or problems they encounter to discuss with the preceptor. Set aside time each day/week for discussion and feedback.
CRITERIA FOR PRECEPTOR SELECTION Licensure: Employment:
The RN has a clear active California license The RN has been employed in the institution/agency and specific area for a minimum of one year and holds a position in the clinical agency appropriate to the preceptor function. Nursing Skills: The RN demonstrates nursing expertise in the delivery of care and to direct staff. Attitude: The RN has expressed a desire to work with a student in the preceptor role. Communication: The RN has demonstrated ability to communicate effectively with patients, faculty, students, families, and members of the health care team.
ROLES AND RESPONSIBILITIES OF THE PRECEPTOR • • • •
Model professional role behaviors, clinical expertise, and leadership skills. Assist in orientation and socialization of the student to function effectively in the clinical setting. Provide clinical learning experiences appropriate to expected level outcomes, course objectives, and individual goals. Teach/demonstrate knowledge and skills specific to the clinical setting and course objectives.
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• • • • • • •
Direct supervision of the student in the clinical setting and validate competency prior to student performance of unfamiliar clinical activities. Assist students in the development of clinical problem solving and decision-making skills. Assist students in the application of research and theory to clinical practice. Maintain ongoing communication/feedback with the student and faculty member regarding student performance. Ensure an alternate preceptor will be available in the absence of the primary preceptor. Is aware of what to do if a student is injured in the clinical setting. Be present and available on the patient care unit while the student is rendering nursing services during preceptorship.
ROLES AND RESPONSIBILITIES OF THE STUDENT • • • • • • • • •
Meet pre-arranged time commitments. Demonstrate adequate preparation for clinical experiences and projects. Function under the supervision of the preceptor Seek assistance and utilize resources as needed prior to performing unfamiliar clinical activities. Communicate effectively with the preceptor and faculty member regarding individual learning needs, expectations, limitations, and progress. Demonstrate safe practice and accountability for actions. Display appropriate professional behaviors and academic integrity per the University of San Diego. Take responsibility for personal learning and professional growth. Is aware of what to do if injured in the clinical setting.
ROLES AND RESPONSIBILITIES OF THE FACULTY MEMBER • • •
Meet with preceptor and student prior to start of the preceptorship. Maintain ongoing communication with preceptor and student regarding student performance and evaluation. Assist preceptor by: • Being available for consultation. • Maintaining “on call” status while students are in the clinical setting. • Identifying individual student learning needs. • Identifying clinical learning experiences. • Acting as a resource and support person. • Assisting with the evaluation of student. • Completing student evaluation at the end of the clinical rotation in ProjectConcert at midterm and before end of finals week (final responsibility for student evaluation rests with the faculty member).
RECORDS TO BE MAINTAINED BY THE SCHOOL OF NURSING: USD’s Hahn School of Nursing and Health Science will keep the following records on file: • Preceptor Biographical sketch and Contract • Roles and Responsibilities of Preceptor, Student, and Faculty • Plans for Communication between Preceptor, Student, and Faculty • Forms for Evaluation of Student and Preceptor
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Preceptor “To Do” List As a preceptor you are responsible to meet together with the USD faculty and USD student three times during the semester. (Additional meetings can be scheduled as needed). Meeting #1 (prior to the student beginning clinical rotation)
¨ Review Preceptor Handbook with student and clinical faculty • • • •
Date: ____________________
Course Description and Learning Outcomes Clinical Assessment Tool Student Assessment of Preceptor/Clinical Site Review what to do if a student is injured in the clinical setting.
¨ Complete Biosketch and Contract and return completed form to USD faculty. ¨ Review individual student goals/objectives. ¨ Review calendar with student and identifies work schedule for at least 1 month. ¨ Set date for next meeting. Meeting #2 (Mid-term)
Date: ____________________
¨ Bring completed Clinical Assessment Tool ¨ Review student assessment with USD clinical faculty and USD student ¨ Sign and submit Clinical Assessment Tool to clinical faculty. ¨ Review student goals/objectives and identify ways to accomplish goals/objectives during 2nd half of semester.
¨ Sets date for final meeting. Final meeting (End of Semester)
Date: ____________________
¨ Complete Clinical Assessment Tool and submit to clinical faculty member.
Note: In the case of an accident/incidence occurrence while in the clinical setting, please follow the agency policy and notify the USD clinical faculty member immediately after incident.
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USD Clinical Faculty “To Do” List As a faculty member, you are responsible for meeting with the preceptor and USD student at least three times during the semester. (Additional meetings can be scheduled as needed). Meeting #1 (prior to the student beginning clinical rotation)
Date: ____________________
¨ Provide Preceptor Handbook, Biosketch and Contract forms to preceptor. ¨ Review Preceptor Handbook with preceptor and USD student • • •
Course Description and Learning Objectives Student Clinical Assessment Tool Student Evaluation of Preceptor/Clinical Site
¨ Upload completed copies of Biographical sketch and Contract forms in ProjectConcert. Copies may be submitted to the Clinical Placement Coordinator.
¨ Set date for meeting #2 with student and preceptor. ¨ Review student’s tentative work schedule Meeting #2 (at mid-term)
Date: ____________________
¨ Review Student Clinical Assessment Tool with student & preceptor ¨ Reviews student goals/objectives and identify ways to accomplish goals/objectives during 2nd half of semester.
¨ Enter mid-term student assessment in ProjectConcert. ¨ Sets date for meeting #3 ¨ Review student’s work schedule ¨ Notify USD MEPN Program Coordinator regarding student performance, if needed. Meeting #3 (End of Semester)
¨ Reviews student progress with student and preceptor ¨ Sign and date evaluation tool ¨ Upload final Student Clinical Evaluation Tool in ProjectConcert. ¨ Enter final student assessment in ProjectConcert.
Date: ____________________
Note: In the event of an accident/incidence occurrence while in the clinical setting, please refer to the Process for Accident/Incidence Occurrences While on Clinical Affiliation form and Incident Report Form. Contact the Clinical Placement Coordinator.
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MEPN Student “To Do” List for Clinical Preceptorships As a student you are responsible to meet with your preceptor and USD faculty at least three times during the semester. (Additional meetings can be scheduled as needed). Meeting #1 (prior to the student beginning clinical rotation)
¨ Review • • • •
Date: ____________________
Course Description and Learning Objectives Clinical Assessment Tool Student Evaluation of Preceptor/Clinical Site Review what to do if injured in the clinical setting.
¨ Identify personal goals/objectives and reviews with preceptor and USD clinical faculty. ¨ Review calendar with preceptor and identifies work schedule for approximately 1 month. ¨ Set date for next meeting. Meeting #2 (mid-term)
Date: ____________________
¨ Review student evaluation with preceptor and USD clinical faculty ¨ Sign and date evaluation ¨ Review personal goals/objectives and identify ways to accomplish goals/objectives during 2nd half of semester
¨ Set date for final meeting. Final meeting (End of Semester)
Date: ____________________
¨ Review Clinical Assessment Tool with preceptor and clinical faculty ¨ Sign and date evaluation tool
Upon completion of clinical hours
¨ Completes Student Evaluation of Preceptor/Site form and submits to the Clinical Placement Coordinator no later than one week after completing clinical hours.
¨ Completes course and clinical faculty evaluations on-line.
Note: In the event of an accident/incidence occurrence while in the clinical setting, please refer to the Incident Report Form and contact your clinical faculty member.
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Evaluations Evaluation of the Student Preceptor: • Give frequent verbal feedback to the student regarding performance. • Provide written evaluation of the student at the mid-term and end of the clinical rotation by completing the following: o Clinical Assessment Tool o Preceptor Mid-term Assessment o Preceptor Final Assessment Clinical Faculty Member: • Provide the student with ongoing evaluation of progress. • Hold a formal midterm evaluation conference with students regarding progress in meeting course objectives and individual goals per preceptor feedback. • Hold final evaluation conference with the student at the completion of the rotation. Evaluation of the Preceptor Student • Provide the faculty member with ongoing feedback regarding the perceived effectiveness of the preceptor. • Provide the faculty with a written evaluation of the preceptor by completing the Student Evaluation of Clinical Site/Preceptor at the end of the clinical rotation. Clinical Faculty Member • Evaluate the preceptor’s effectiveness as a clinical teacher, as a professional role model, and clinical evaluator. • Forward pertinent evaluation information to the preceptor. Evaluation of Faculty/Course/Clinical Agency Student • Complete a Course/Faculty Evaluation at the end of each clinical rotation. • Complete a Student Evaluation of Clinical Preceptor/Site at the end of their association with the clinical agency. Note: The Student Clinical Assessment Tool will be shared with the student. Evaluation data will be reviewed each semester by course faculty with recommendations as indicated. Designated faculty will forward pertinent evaluation information to the clinical agency.
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Student Assessment of Clinical Preceptor/Site Course:
Clinical Preceptor:
Semester:
Clinical Agency:
Your feedback is important to us. Using the rating scale provided, please evaluate your preceptor and the clinical site you were assigned. You are encouraged to share your comments below. Rating Scale 5=Strongly Agree
4=Agree
3=Neither Agree or Disagree
2=Disagree
1=Strongly Disagree
N/A
Preceptor Evaluation Learning Climate: Provides additional or special learning opportunities that enrich my experience Provides an atmosphere in which I can ask questions or try out ideas. Stimulates my efforts in thinking through clinical problems. Gives support without making me feel dependent. Creates a learning environment where I have opportunities to think for myself. Encourages me to expand my learning opportunities and increase my skillset. Example or comments about learning climate: Guidance: Supports and guides me to meet my learning objectives. Assists me in integrating theoretical content (class) with clinical experience. Serves as a good role model and as a resource with new procedures or tasks. Always available when I really need help in clinical setting. Does not take over procedures so that I can obtain experience. Example or comments about supervision: Feedback: Provides constructive criticism throughout clinical experience. Bases evaluation on my pattern of performances, rather than on one day. Gives helpful feedback on my nursing care and charting. Provides feedback about my progress. Gives practical suggestions to help me improve Example or comments about feedback: Overall evaluation of Preceptor: 5=excellent; one of the best I’ve ever had 4=very good; surpassed expectations in some respects
3=average; met overall expectations 2=fair; did not meet some expectations
1=poor; learning experience definitely
Clinical Site Patient population was accessible so that I could meet my learning objectives. Facility space was adequate for student placement. Nursing personnel were helpful in learning environment. Unit nurses and other staff were welcoming and supportive of students. Nurses are professional in attire, behavior and communication. Culture of the facility respect diverse populations. Example or comments about site: Overall evaluation of Site: 5=excellent; one of the best I’ve ever had 4=very good; surpassed expectations in some respects
3=average; met overall expectations 2=fair; did not meet some expectations
1=poor; learning experience definitely
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References/Suggested Readings Alonso, N. A., Porter, C. M., Graves, K., & Gordon, M. (2022). How nurse preceptors provide help to new nurses influences perceived relationship quality. Nurse Education Today, 105420. Blevins, S. (2022). The Impact of Effective Preceptors. Medsurg Nursing, 31(3), 193-194. California Code of Regulations. (2023). Section 1426.1 – Preceptorships. https://casetext.com/regulation/california-code-of-regulations/title-16-professional-and-vocationalregulations/division-14-board-of-registered-nursing/article-3-prelicensure-nursing-programs/section14261-preceptorship Johnson, R., Browning, K., & DeClerk, L. (2021). Strategies to reduce bias and racism in nursing precepted clinical experiences. Journal of Nursing Education, 60(12), 697-702. Loughran, M. C., & Koharchik, L. (2019). Ensuring a successful preceptorship. AJN The American Journal of Nursing, 119(5), 61-65. Nelson, D. M., & Joswiak, M. E. (2020). Preceptor Teaching Tools to Support Consistency While Training Novice Nurses. Journal for Nurses in Professional Development, 36(5), 307-312. Powers, K., Herron, E. K., & Pagel, J. (2019). Nurse preceptor role in new graduate nurses' transition to practice. Dimensions of Critical Care Nursing, 38(3), 131-136. Robinson, C. (2022). Nurses as Educators. Are Nurse Preceptors the New Clinical Instructors? Medsurg Nursing, 31(1). Rooke, S., Thevenard, G., Suthendran, S., Jung, S. S., Tolentino, N., Annandale, J. F., & Ward, K. (2022). What makes a great preceptor? Nursing students have their say. Kai Tiaki: Nursing New Zealand, 1-10.
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Appendix Process for Accident/Incidence Occurrences While on Clinical Affiliation Incident Report Form Preceptor Contract and Biosketch Midterm Assessment Final Assessment Clinical Assessment Tool
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PROCESS FOR ACCIDENT/INCIDENCE OCCURRENCES Process for Accident/Incidence Occurrences While on Clinical Affiliation This process applies to USD students and clinical faculty. Students MUST report all accidents and injuries to their clinical faculty. If the student requires IMMEDIATE attention: 1. Utilize the Emergency Room for immediate treatment at Facility/Agency where accident/ incident occurs. 2. When completing the registration forms, indicate the injury will be classified as a Worker's Compensation claim that will be handled by the University. The insurer is Traveler’s Policy Number OR873848. Please contact USD Benefits at (619) 260-4594 or benefits@sandiego.edu 3. As soon as the injured party is capable of returning to campus, go to the Public Safety Office and complete an Employee Injury/Illness report. The officer taking the report will give the person an "Authorization to Treat” form which contains maps to Concentra Occupational Health centers. 4. All follow-up care must be obtained through Concentra. Take a copy of the emergency record to Concentra for continuity of care. 5. If accident/incident is a Needle Stick, injured party also must complete the USD needle stick injury form. Give completed form to clinical supervisor and forward a copy to Benefits/Human Resource, Maher Hall 1 B. If the injury requires URGENT, but not emergent medical attention: 1. Go to the closest Concentra Occupational Health centers. Tell the registration clerk the injury will be classified as a Worker's Compensation claim for USD. Ask them to call , 619260- for treatment authorization. 2. Follow instructions in "A.3" above, as soon as you can return to campus. If the injury does not require immediate medical attention 1. As soon as the injured party is capable of returning to campus, go to the Public Safety Office and complete an Employee Injury/Illness report. The officer taking the report will give the student an “Authorization to Treat” form which also contains the maps to the Concentra Occupational Health centers. 2. Go to any of the Concentra locations for treatment and all follow up. If the site facility requires their incident/occurrence form to be completed, request a copy, and forward same to Benefits/Human Resources, MH101. If the facility refuses to provide a copy of the report, please forward this information to Benefits/Human Resources with the name and contact information for the for the Risk Management office. ** Clinical Supervisors: Once Public Safety completes their reports, they will send a Supervisor's Report of Injury" to the School of Nursing. You must complete this form to the extent applicable and forward the report to Benefits/Human Resources, MH101.
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Incident Report Form Person Reporting Incident:
Date of Report:
Incident Date/Time:
Location of Incident:
Circumstances surrounding incident Who: What:
Action Plan:
Was an incident report filled out at the location (hospital, community clinic, etc.)?
yes
no
Person Completing Form: Printed name
Signature
Date
Preceptor: Submit to Clinical Faculty Clinical Faculty: Contact MEPN Office
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Preceptor Contract and Biosketch Student Name ________________________________ Semester__________ Course ____________ Clinical Faculty ________________________ Hospital ____________________ Unit ____________
Section 1: Preceptor Name Address
Phone Email
RN License Number
License Expiration
Clinical Agency
Position/Title
Section 2: Education and Training A resume or CV will be submitted in lieu of completing this section:
Yes
No
Institution and Location
Degree
Year
Field of study
Professional Experience and Location
Position
Year
Unit/Department
Nursing Certifications (Example: CCRN, CEN, CNL)
Section 3: Agreement I agree to act as a preceptor for _________________________ from __________ to __________. I will review the materials provided in the Preceptor Handbook and accept the responsibilities described for the preceptor within the handbook. _____________________________________________ Signature
______________________ Date
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MID-TERM ASSESSMENT Student: ________________________________________
Faculty: ________________________________________
Strengths:
Areas for Growth:
Student Signature/Date ___________________________________________________ Preceptor Signature/Date__________________________________________________ Page 19
Instructor Signature/Date__________________________________________________
FINAL ASSESSMENT – END OF TERM Student: ________________________________________
Faculty: ________________________________________
Progress since midterm evaluation:
Areas for Growth:
Student Signature/Date ___________________________________________________ Preceptor Signature/Date__________________________________________________ Page 20
Instructor Signature/Date__________________________________________________
Clinical Assessment Tool University of San Diego Hahn School of Nursing and Health Science MSNC 510P Clinical Nurse Leader Practicum Student: __________________________________________________ Benner’s Domains Helping Role
Faculty: _______________________________________________
Course Specific Competencies
Evaluation NA P MS
Comments NI
NA
NI
Intervenes to help patient’s improve ability to adapt, cope, and problem solve Provides comfort for the patient through touch and physical interventions Interprets pain and selects appropriate strategies for pain management and control to improve quality of life. Demonstrates patient advocacy and informational support Guides patient through emotional and developmental changes by providing appropriate options Teaching-Coaching Role Incorporates the patient’s readiness to learn when teaching Provides culturally appropriate teaching and coaching to the patient and family about health promotion, illness prevention, lifestyle changes necessary to manage and stabilize their health problem and promote successful reintegration into the community Uses therapeutic communication with patients and families Provides an interpretation of the patient’s condition and gives rationale for procedures Applies clinically and culturally appropriate information technology to promote quality health care. Assists patients to integrate the implications of illness and recovery into their lifestyle. Page 21
P
MS
Benner’s Domains Course Specific Competencies Diagnostic/Monitoring Anticipates and intervenes with problems during the hospitalization and discharge process Demonstrates advanced beginner clinical expertise with clinical assessment, management, evaluation, recovery, discharge planning, and rehabilitation of patients within specialty population. Uses critical analysis and decision making in application of the nursing process with patients Anticipates patient care needs Interprets & syntheses symptoms, diagnostic studies, drug therapy, and treatment related to identifying and meeting the needs of the patients. Assesses patient’s potential for wellness and response to treatments Management of Rapidly Changing Situations Recognizes and responds to critical changes in patient status and takes safe, appropriate action.
Evaluation NA P MS
NI
NA
P
MS
NI
Administer/Monitor Therapeutic Interventions Competently performs invasive and non-invasive skills with patients. Identifies and implements appropriate interventions to prevent the negative effects of immobility and/or pain on the patient’s recovery Administers and monitors the effects of medications accurately and safely Monitoring and ensuring quality health care Accurately identifies, reports, records, and prioritizes patient data. Recognizes the need for an appropriate and timely response from the physician/provider Integrates strategies for clinical assessment and management, risk anticipation and risk assessment to design and implement safe medical and nursing care. Applies principles of global health knowledge and cultural sensitivity when working with patients and staff. Incorporates evidence-based research in nursing care being provided. Assumes responsibility for legal, ethical, and comprehensive care Evaluates and revises plans of care in collaboration with colleagues and health care team members.
NA
P
MS
NI
NA
P
MS
NI
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Comments
Benner’s Domains
Course Specific Competencies Identifies and evaluates the effectiveness of the discharge plan for successful reintegration of the patient into the community. Evaluates the effect of nursing interventions on the critical physical and mental health changes occurring in patients with acute, complex and/or critical health problems. Recognizes and discusses ethical issues (if appropriate) that arise in the context of their patient care Organizational and work-role competencies Prioritizes patient care Demonstrates ability to be a member of the health care team Demonstrates respect for all members of health team, including patient, family, staff, colleagues, faculty, and physician. Assumes responsibility for the delegation and oversight of care deliver by other staff. Demonstrates cultural sensitivity when working with culturally diverse patients and staff. Coordinates interdisciplinary health care activities with other members of the health care team.
Evaluation
NA
P
Comments
MS
NI
Identifies and participates (if appropriate) in the implementation of clinical research for best practice Provides leadership in implementation evaluation of guidelines, professional standards and policies that affect patient care Integrates evidence-base information to develop innovative changes necessary to promote optimum and current practice, policies, and standards of care. Overall practice behaviors NA P MS NI Professional presentation and interactions with patients, staff, colleagues, faculty Critically thinks, analyzes, and draws appropriate conclusions Makes appropriate decisions and acts upon those decisions. Moves from interdependent to independent practice. NA: Not Applicable S: Satisfactory (independent behaviors possibly with minimal interdependent assistance) MS: Minimally Satisfactory (inconsistent performance of clinical objectives and requires more than expected guidance) NI: Needs Improvement (marginal behaviors, below expected level of achievements) Page 23
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