V. Clinical Requirements

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Section V.I: Introduction

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1—Purpose of Clinical Nursing Practice

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Clinical nursing practice is conducted every semester of the nursing curriculum, always under the supervision of nursing faculty, and frequently in concert with professional clinical nurse mentors. The purpose of this tandem clinical practice with theory courses is to:

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• Progressively develop proficiency in the applied science of professional nursing.

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• Meet state licensure, program approval, accreditation, and national requirements.

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• Build learner confidence in clinical nursing care, care management, and leadership.

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2—Expectations Prior to Entering a Clinical Site

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While the State of Washington has certain requirements of nursing students and the Center for Disease Control has recommendations for health care workers, the following requirements of the Buntain College of Nursing may go above and beyond these requirements in order to comply with the expectations of the clinical facilities with which we are partnered.

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The following information will be submitted by each student to American Databank. Students who have not met these requirements will not be allowed to participate in clinical. 

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a. Health history and physical examination that includes immunization and vaccination documentation and titer levels, conducted and signed by a licensed medical doctor or nurse practitioner:

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• Immunizations

  • Tdap completed after the age of 18

  • TD required every ten years after Tdap

  • Hepatitis A - a series of two immunizations.

  • Hepatitis B - a series of three immunizations (with required evidence of immunity by titer)

  • MMR - a series of two immunizations or evidence of immunity by titer

  • Varicella (Chicken Pox) - a series of two immunizations or evidence of immunity by titer

  • Polio Series

  • A seasonal influenza vaccination is required each year

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• TB Testing

  • A TWO-STEP TB test or a TB-IGRA is required before program entrance. These tests cannot be done earlier than June 1st before program entrance.

  • A standard ONE-STEP TB test (TST) or TB-IGRA is required before the fall of the Senior year.

  • A standard TST or TB-IGRA is required at the end of the Senior year after the students return from the NURS 4963 Nursing Practice of Ministry Trip.

  • If a TST or TB-IGRA is positive, followup with the student's healthcare provider for chest X-ray, possible treatment, and a symptom questionnaire.

  • If there is a history of positive TB, chest X-ray results, a negative symptom questionnaire, and documentation of any treatment received is required.

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b. Current American Heart Association (AHA) BLS Healthcare Provider certification.

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c. A national background check, OIG, GSA, and Washington State WATCH are required. Students seeking admission to the nursing program must be aware a record of criminal conviction may impact admission. Students should discuss this matter with the Dean before making final application to the nursing program.

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d. A passport that is current and valid through October 31st after a student’s graduation date.

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e. A valid driver's license.

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f. Proof of personal health insurance must be submitted every three months to ADB.

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g. Health Information Portability and Accountability Act (HIPAA) training and Universal Precautions/Blood Borne Pathogens training is required before entering the clinical agencies. Training is provided by the Buntain College of Nursing.

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• In accordance with HIPAA, students may not take any photocopies or electronic copies of client information from healthcare facilities or organizations.

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• Students must follow the Buntain College of Nursing Social Media Networking Policy and Guidelines as well as the Social Media policy of each assigned clinical facility.

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Section V.II: Clinical Hours

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1—Junior Year

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• Thursdays and Fridays are designated for clinical practice. (During the acute care rotation students may be required to visit the clinical setting on a day prior to choose a client.)

• The actual hours may vary. Typically the earliest a student will be required to be at a clinical site is 6 am. Typically the latest a student will be required to be at a clinical site is midnight.

• In addition to clinical site time, demonstration and practice of selected nursing skills will take place in the on-campus Nursing Skills Lab. The time and days for this practice vary depending upon the skill and the section in which the student is enrolled.

• Students who have not practiced a specific skill during the expected time in Skills Lab will not be allowed to practice that skill at a clinical site.

• A significant amount of time outside the clinical site or the Skills Lab is required to complete preparatory study and care plans.

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2—Senior Year

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• First Semester

  • Mondays and Tuesdays are designated for clinical practice at clinical sites.

  • Wednesday is designated for clinical practice at clinical site or on campus.

  • Actual hours may vary. There is the potential that students may be asked to practice at a clinical site during any client care hours.

• Second Semester

  • During the month of February, students are in a cross-cultural site in which ministry and nursing practice are expected at the discretion of the culture in which the student is practicing.

  • In the month of April students will complete a minimum of 120 hours of clinical.

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Section V.III Liability Insurance

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Northwest University purchases Professional Liability Insurance which covers the student while engaged in faculty-authorized nursing learning experiences. The student may wish to consider purchasing additional Professional Liability Insurance. Upon graduation, the purchase of personal Professional Liability Insurance is highly recommended.

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Section V. IV Uniforms

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1—Students should be well groomed, clean, neat, and conservative in appearance.

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• Clothes should be clean and wrinkle free.

• Students should be odor/fragrance free.

• Fingernails should be short, clean, neat, and without polish. Clear nail polish is allowed if it is not chipped. No acrylic nails.

• Jewelry is not allowed except for a watch with a second hand, and wedding/engagement rings. Small petite earrings are permitted.

• Hair should be conservative in appearance, and should be combed, neat, and clean. Hair color must be genetically possible. Hair below shoulder-length must be pulled up neatly off the neck when in uniform. Facial hair on men should be neatly groomed.

• When students visit a clinical site while not providing direct care, such as when making client selections prior to clinical, they should wear a lab coat over their street clothes and an ID badge. Clothing should be professional in appearance, no jeans, t-shirts, sweats, hats, short skirts or open footwear.

• In adherence with the Buntain College of Nursing contractual agreements with clinical sites a student is required to meet the standards of no facial or tongue jewelry and no visible body art.

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2—The nursing student full uniform will consist of the following, unless otherwise specified for a particular setting. Approved college uniforms are only ordered through Acorn Uniforms.

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• Dark gray scrub top with white embroidered Buntain College of Nursing logo

  • If a t-shirt or camisole undergarment is worn, the color is to be white or black and the length should not extend below the hem of the scrub top. Undergarment may be short or long sleeved.

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• Dark gray scrub bottoms

  • Length of pants should reach below the ankle and above the floor

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• White lab coat with embroidered Buntain College of Nursing logo

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• White Shoes—NO COLOR ON THEM

  • Sport shoes are permitted, but must be all white

  • White nursing clogs are permitted

  • Shoes must be closed toe

  • Hosiery – White or black socks

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• College/Clinical facility ID badge

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3—Clinical sites may have further specific requests regarding the appearance of students during clinical practice. Students should be considerate of, and compliant with, these requests. This is especially true during the cross-cultural experiences.

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4—The required uniform in the skills lab includes lab coat worn over street clothes, and closed toed shoes unless otherwise specified.  Jewelry must be minimal and hair must be pulled back during skills practice.

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Section V.V Student Equipment:

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Students are expected to have the following equipment:

• Stethoscope

• Blood pressure cuff

• Watch with second hand, easy to read (water resistant recommended)

• Sharpie marker

• Retractable black pen

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Section V.VI Identification Badges

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ID badges must be worn at all times when in the clinical area for any reason. Students will not be allowed in the clinical setting without an ID Badge. A student may be asked to wear the ID badge when representing Buntain College of Nursing in other venues. For safety reasons the Northwest University ID card cannot be substituted for the Buntain College of Nursing ID badge.

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The badges will be made using the picture and process used to make the Northwest University ID card. The ID badge may be purchased for $10.00 from the Northwest University Information Service in the Health and Sciences Center at the College of Nursing Orientation. The cost of replacing a lost or damaged ID badge is the responsibility of the student.

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Section V.VII Confidentiality of Information

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Students will have information entrusted to them in the clinical settings that requires complete confidentiality. In order to protect client confidentiality and to assure compliance with the federal Health Insurance Portability and Accountability Act it is our College policy that students do not retain or take from any clinical site a written or electronic record of client identifiers such as name, Social Security number, or health insurance number. Likewise, nursing students are not permitted to share such personal identifier information verbally with anyone outside of the clinical setting. When discussing client cases with other students for learning purposes, a fictitious identifier such as “Client A” should be used when referring to a case.

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Students are strongly cautioned against making any comments regarding clinical experience via social media including Twitter, Facebook or similar public posting venues.  Communicating information in this format can result in a student being dismissed from a clinical site. Social Media Networking Policy and Guidelines

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Section V.VIII Legibility

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Because student’s charting is part of a legal client record, writing done in the clinical sites must be legible to colleagues, site staff, and instructors.

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Section V.IX Clinical Policies & Expectations

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1—Attendance Expectations: Skills Lab

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• The student is assigned sessions for faculty demonstration of clinical skills, practice time in each of the demonstrated skills, and opportunities for the student to demonstrate to the faculty that the skill has been acquired.

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• Faculty expect students to come prepared to Skills Lab by completing assigned reading and reviewing assigned ATI skills modules.

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• The student is responsible to make arrangements with faculty for any necessary make-up skills activities (i.e., faculty demonstration, student practice, or student demonstration) due to student absence.

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• A student will not be allowed to perform skills in the clinical setting for which make-up skills activities have not been accomplished.

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2—Attendance Expectations: Clinical Site

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Clinical practice is an essential component of a nursing education. Successful completion of the clinical component of the curriculum is a mandatory requirement for graduation. Clinical nursing practice requires professional accountability, which includes on-time arrival and departure, full preparedness, and complete attendance. Therefore, absences from clinical practice are closely monitored by faculty and should occur only in extraordinary circumstances.

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1. Attendance is mandatory at all scheduled clinical experiences. Students should not expect to be excused from clinical or skills lab for personal/family events.

2. Transportation to and from clinical sites is the responsibility of the student.

3. Any absence from a clinical experience may place a student in jeopardy of failing the course.

4. Any absence from a scheduled clinical experience must be reported by the student to the clinical faculty prior to the start of the clinical experience. Any absence is considered unexcused if the instructor is not notified.

5. Students who miss a clinical experience for any reason are required to meet with the clinical faculty to discuss the resulting course of action and must present appropriate documentation of the reason for their absence.

6. Specific arrangements for clinical makeup for an excused absence will be individualized to the students’ needs and will be at the discretion of the clinical faculty. All clinical time missed must be made up.

7. An unexcused absence is a breach of the Buntain College of Nursing standards and is grounds for a Progression Warning and may result in course failure or dismissal from the program.

8. Failure to complete the designated make-up clinical experience as scheduled will result in course failure.

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3—Policy on Changing Clinical Assignments

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No changes will be made in clinical assignments (days, hours, sites, or clients) without prior approval from the supervising faculty. Any changes made by the student without first obtaining approval from supervising faculty will be considered a clinical and/or professional error, placing the student at risk for not successfully completing the course.

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4—Medication Proficiency

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Quality and Safety Education for Nurses (QSEN) addresses the responsibility of preparing nurses with the competencies necessary to improve the quality and safety of the health care systems in which they work. Medication administration is a high risk nursing skill. Medication errors are commonly linked to morbidity and mortality reports. To ensure safe and accurate client care during clinical rotations that involve medication administration, the student nurse is required to complete a Medication Proficiency Quiz prior to each clinical rotation and adhere to quidelines in accordance with the College of Nursing and clinical facility policies and procedures and Washington State regulations        (WAC 246-840-519 and WAC 246-874-070). 

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Section V.X NURS 4963: Nursing Practice as Ministry

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Seniors will spend four (4) weeks in a cross-cultural experience immersed in another culture. Preparation for this course will begin the fall semester of the senior year, although credit is not given until the end of the senior year.

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• Each student must have a valid passport that will not expire until after October 31st of the year of graduation.

• Prior to travel, students must be aware of the health and safety requirements of the country to which they will travel.

• The International Travel Policy is an agreement to represent Northwest University and the Buntain College of Nursing during travel; it must be signed.

• Participation in a cross-cultural experience is required to complete the objectives for a BSN. Except in the case of a medical emergency, students are expected to travel to and be immersed in a culture different from their own.

• A student who finds she/he cannot travel is strongly encouraged to interrupt progression in the program until such time as she/he is able to travel.

• Any student who is unable to travel must pay the same dollar amount as a student traveling to a remote site. 

• Payment for the cross cultural trip is a fee that is attached to a nursing course each semester. The fee varies from year to year and is not refundable and nontransferable. The fees collected result in a pool of funds used for all site preparation, travel expenses, reciprocal expenses, and any other expenses necessary for the cross cultural experience.

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Section V.XI Unusual Occurrences 

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 1- Blood Borne Pathogens

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In order to minimize the risk posed to students and/or clients by persons infected with blood-borne pathogens (BBP) as identified by the CDC and OSHA, all nursing students are required to complete BBP training prior to participating in clinical experiences.

 

All nursing students are required to have personal health insurance to cover the expenses of any health care or treatments in case of an injury within or outside the clinical setting. (See Blood Borne Pathogen Exposure policy, Unusual Occurrence/Injury Report Form and Northwest University Report of Injury Form)

 

2 - Client Harm or Unreasonable Risk of Client Harm

 

If a student, during his/her clinical experience in any clinical agency, is involved in an unusual occurrence that the clinical facility and/or College of Nursing has reason to believe results in client harm or an unreasonable risk of client harm, the steps listed in the Unusual Occurrence Reporting/Client Harm, Risk of Harm, Diversion of Drugs policy must be followed. (See Unusual Occurrence/Injury Report Form)

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3 - Student Injury

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If a student, during his/her clinical experience in any clinical agency, is involved in an unusual occurrence that results in a suspected or actual injury, the steps listed in the Student Injury Reporting policy must be followed. (See Northwest University Report of Injury Form and Unusual Occurrence/Injury Report Form)

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Section V.XII Drug Testing 

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Students may be required to undergo drug screening for selected agencies as a prerequisite to practicum. As this is a clinical requirement, it is the student’s responsibility to pay for this screening. The cost of drug screening is approximately $80.00.

 

Please refer to the Northwest University Student Community Handbook, Lifestyle Standards, and Student Accountability Process for university policy regarding alcoholic beverages, hallucinogenic drugs, and substances (including marijuana) or narcotics not authorized by a physician.

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