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Program of Nurse AnesthesiaSTUDENT HANDBOOK2016-20171


STATEMENT CONFIRMING RECEIPT OF PROGRAM OF NURSE ANESTHESIASTUDENT HANDBOOKI, acknowledge that I have received(Print name)a personal copy of the Samuel Merritt University Program of Nurse Anesthesia StudentHandbook 2016-2017.Furthermore, I understand that it is my responsibility to become familiar with the contents ofthis handbook, and to abide by the policies, procedures and educational objectives containedherein during the course of my matriculation in the program.I accept the fact that policies and procedures may be revised and added at the discretion ofprogram administration and that, when notified in a timely and appropriate manner by theProgram Director, I will hold myself accountable to those new directives.SignatureDateAfter signing this statement, please remove the page from the handbook and return thedocument to the Program Director3


Fall, 2016Dear Graduate Student,Welcome to the Samuel Merritt University Program of Nurse Anesthesia! Your educationalexperience over the next 27 months will serve as the foundation of your professional future asa Certified Registered Nurse Anesthetist. Given the considerable depth and breadth of thefield of anesthesiology and its related sciences, one of your many challenges will be tonavigate your way through the systems and processes of both our academic institution andmultiple hospital facilities that you will be rotating through as a nurse anesthesia resident.The faculty has prepared this handbook to ease your transition period into our graduateprogram and provide guidance throughout your entire period of enrollment. Included are theacademic and clinical policies of the Program of Nurse Anesthesia, and key procedures andprotocols that are utilized in the Program. In addition to this document, you should be familiarwith the Samuel Merritt University Catalog and Student Handbook as we refer to it frequentlythroughout the handbook. An electronic copy of the Catalog and Student Handbook canalways be accessed via the University website. Please familiarize yourself with the contents ofthis program student handbook, especially as you enter the clinical residency - it contains thebehavioral and educational objectives upon which you will be evaluated.We trust that your time with us will be well spent as you receive your education and preparefor clinical anesthesia practice. Our expectations of your abilities and performance are highbecause you represent the best of the nursing profession. Your expectation of us should beequally high, as we represent members of a highly respected advanced practice specialtycharged with enormous responsibility over the patients placed in our care. As nurseanesthesia educators we have an obligation to guide you and provide you with the bestopportunities to evolve into excellent practitioners.Again, the faculty welcomes you to our program. We are eager to be your partners in thiseducational experience and remain firmly committed to your success.Sincerely,Marc Code, DNP, CRNADirector and Assistant ProfessorProgram of Nurse Anesthesia5


TABLE OF CONTENTSACADEMIC CALENDAR. 11FACULTY AND STAFF . 13PROGRAM HISTORY, PHILOSOPHY . 15PROGRAM LEARNING OUTCOMES . 17ORGANIZATIONAL CHARTS . 19PROGRAM COMMITTEE STRUCTURE . 21PROGRAM CURRICULUM TRACKS . 23Full time . 24Senior Year Academic Curriculum . 25Simulation-Based Curriculum . 31Three-Year. 38Post-MSN Certification . 38ACADEMIC POLICIES . 43Academic Integrity . 43Program of Nurse Anesthesia Testing Policies . 43Academic and Clinical Performance Standards . 44Testing and Grading Procedures . 46Disability Accomodations . 47Professional Conduct Standards . 47Procedures for Student Evaluation of Program . 47Graduation Requirements . 48Deferral of Graduation . 48Academic Disciplinary Actions . 49Administrative Suspension . 49Disclosure of Legal or Disciplinary Action . 49Clinical Probation . 49Dismissal . 50Student Complaint Policy and Procedure . 51Dispute Resolution Procedure. 51Attendance Policies . 51Vacations, Holidays & Personal Time Off (PTO) . 52Requests for Personal Time Off . 53Unplanned absences . 55Bereavement . 53Mandatory Attendance Events . 53Professional Meetings . 55Synthesis Options . 57Thesis. 57Special Project . 57PNA Synthesis/Special Project Series . 577

Self-Evaluation Examination (SEE) . 58Professional Activities . 58Associate Membership in AANA . 58Professional Association Meetings . 58Student Participation in Program Committees . 59Policies on Insurance . 59Professional Liability Insurance . 59Health Insurance . 59Student Employment Policy for Work Outside the Program . 59Dress Code . 59Substance Misuse/Pharmaceutical Use . 60Provider Wellness . 60Student Counseling and Wellness . 60Parking, Travel and Housing to Clinical Affiliates . 61Scholarship and Loan Information . 61CLINICAL POLICIES . 63Credentials . 63Institutional Compliance . 64Nurse Anesthesia Student Tracking System (NAST) . 64Student Health Record Confidentiality . 64Orientation to a Clinical Affiliate Site . 64Guidelines for the Clinical Practice of Nurse Anesthesia Residents . 65Professional Conduct . 65Patient Privacy and Confidentiality . 66SMU and Social Media . 66Clinical Supervision of Nurse Anesthesia Residents . 67Supervisory Ratios . 68Procedure for Conflict Resolution . 68Preoperative Consultation with a CRNA or Anesthesiologist . 68Informed Consent for Anesthesia Care . 69Participation in Department Activities . 69Surgical Attire and Hospital Property . 69Radiation Safety and Monitoring Program . 69Reporting Complications of Anesthesia Care . 70Guidelines for the Clinical Hours of Nurse Anesthesia Residents . 71Anesthesia Care Plans . 72Attendance in the Clinical Area . 73Work Related Injuries . 73Clinical Rotation Schedule . 77Out of State Rotations . 77Medical Missions . 78Employment Transition Process: Graduating NARs . 78CLINICAL EVALUATION PLAN . 80Daily Evaluation Form . 80Summative Evaluation Form . 80Agency Evaluation Form . 81Student Advising Procedure . 82Faculty Advisement Sessions . 82Clinical Educational Objectives . 83Phase I Objectives . 838

Phase II Objectives . 85Phase III Objectives . 87APPENDIX 1 - PROFESSIONAL PERFORMANCE/CONDUCT . 89Program of Nurse Anesthesia ADA Guidelines . 91Code of Ethics for the CRNA - From the AANA . 94Standards for Nurse Anesthesia Professionals - From the AANA . 96APPENDIX 2 - PROTOCOLS . 99Program Protocols and FormsProtocol of Anesthesia Crisis Resource Management (ACRM) . 101Conduct of the Oral Comprehensive Exam . 106Conduct of the Pharmacology Comprehensive Exams . 115Conduct of National Certification Exam (NCE) Prep Series . 118Radiation Safety and Monitoring Protocol . 121Clinical Incident Report . 128Anesthetic Care Plan . 131School of Nursing ProtocolsMSN Synthesis Guidelines . 133Dispute Resolution . 142Samuel Merritt University ProtocolsStudent Guidelines for Graduate Courses Taught in the Intensive Format . 143SMU Social Media Policy . 144Social Media Guidelines and Best Practices . 147APPENDIX 3 - PROGRAM EVALUATION FORMS . 150Clinical Agency Evaluation . 152Daily Clinical Evaluation . 156Preceptor Evaluation . 158Student Self Evaluation . 159Summative Clinical Evaluation-Phase I . 162Summative Clinical Evaluation-Phase II . 167Summative Clinical Evaluation-Phase III. 172GLOSSARY OF ACRONYMS . 1789


GRADUATE ACADEMIC /23-11/2512/1612/19-12/2312/30FALL 2016New Student Orientation (SMU)Classes beginAdd/drop periodLast day to register for Fall TermSpring 2017 registrationThanksgiving breakLast day of Fall 2016 classesFinal examsGrades due in Registrar’s OfficeSPRING 4/17-4/214/28Classes beginAdd/drop periodMartin Luther King, Jr. HolidayLast day to register for Spring TermPresident’s Holiday breakSummer 2017 registrationLast day of Spring 2017 classesFinal examsGrades due in Registrar’s OfficeSUMMER 20175/85/8-5/195/195/265/297/3 7/57/31-8/48/118/14-8/188/25Classes beginAdd/drop periodLast day to register for Summer 2017CommencementMemorial Day HolidayIndependence Day HolidayFall 2017 registrationLast day of Summer 2017 classesFinal examsGrades due in Registrar’s Officehttps://www.samuelmerritt.edu/academic calendar11


PROGRAM FACULTY AND STAFFAdministrative and Core FacultyMarc E. Code, DNP, CRNAJoseph Janakes, MSN, CRNADirector and Assistant ProfessorProgram of Nurse AnesthesiaAssociate Director, Program Clinical Coordinatorand Assistant ProfessorBrandi Jones, MPAAdministrative CoordinatorKevin Hamby, MSN, CRNAOra Bollinger, MSN, CRNAAssistant Professor and Simulation CoordinatorAssistant ProfessorJeremy Carter, MSNA, CRNAJennifer Fidge, MSN, CRNA, FNPAdjunct InstructorAdjunct InstructorSarah Zhang, PhD, MSN, CRNAJoseph Burkard, DNSc, CRNAAdjunct InstructorAdjunct Assistant ProfessorJennifer Heavenston, MSN, CRNARegional Clinical Coordinator – SacramentoBilly O’Donnell, MHS, CRNARegional Clinical Coordinator – S.F. Bay AreaKevin Rhoden, MSN, CRNARegional Clinical Coordinator – FresnoBasic Science FacultyJohn J. Nagelhout, PhD, CRNAChristina Lewis, PhDDirectorKaiser Permanente School ofNurse AnesthesiaAssistant ProfessorBasic Sciences DepartmentSamuel Merritt UniversityRaghu Katragadda, MDMedical DirectorAssistant Chief of AnesthesiaKaiser Permanente GSAA13

Clinical CoordinatorsKaren Wolaridge, MSN, CRNANadia Mihaljcic, MS, CRNACommunity Regional Medical CenterDoug Pon, MSN, CRNAArgentina Bogardus, MSN, CRNAKaiser Permanente Santa ClaraMajor Adeleke Oyemade, DNP, CRNADavid Grant Medical Center,Travis AFBRichard Golub, MSN, CRNAKaiser Permanente Santa RosaTom Broach, MS, CRNAFresno Veterans AdministrationMedical CenterKenneth Rogado, MSN, CRNAHenry Morales, MSN, CRNAKaiser Permanente South SacramentoWilliam Miller, MSN, CRNAHighland General HospitalRobin Ridenour, MSN, CRNAKaiser PermanenteSouth San FranciscoAmber George, MSN, CRNAKaiser Permanente Walnut Creek/AntiochDiablo Service AreaMelissa Schwarzenberger, MSN, CRNAKaiser Permanente Vallejo/VacavilleAnthony Cook, MSN, CRNAKaiser Permanente Oakland/RichmondEast Bay RegionFlo Braun, MSNA, CRNAKaweah Delta Memorial HospitalKevin Rhoden, MSN, CRNAKaiser Permanente FresnoScott Johnson, MS, CRNASaint Helena HospitalJaci Cho, MSN, CRNARay Cabagbag, MSN, CRNAKaiser Permanente San Leandro/FremontGreater Southern Alameda Area (GSAA)Mark Smith, MSN, CRNASan Francisco General HospitalBarbara Horton, MSN, CRNAKaiser Permanente HonoluluAmy Liang, MSN, CRNASan Francisco Veterans AdministrationMedical CenterThomas Rexinger, MSN, CRNALewis DeWitt, MSN, CRNAKaiser Permanente North Sacramento/RosevilleDonn Campbell, MSN, CRNASan Joaquin General HospitalJeremiah Tan, MSN, CRNAKaiser Permanente Redwood CityDianna Hiekkila, MSN, CRNASutter Memorial Hospital, SacramentoNanea Meyer, MSN, CRNAKaiser Permanente San FranciscoEthan Eller, CRNA, MSNUniversity of California, Davis Medical CenterBonna Hopper, MSN, CRNASiji Chacko, MSN, CRNAKaiser Permanente San JoseJessica Cushman Denat, MSN, CRNASpencer Yost, MDUniversity of California, San FranciscoMt. Zion, Mission Bay, Moffitt-Long MedicalCentersSteve Montgomery, MSN, CRNAKaiser Permanente San RafaelJohn Huggard, MSN, CRNAVisalia Children’s Dental Surgery Center14

PROGRAM HISTORY AND PHILOSOPHYHISTORYThe Samuel Merritt University Program of Nurse Anesthesia (PNA) was conceived in 1993 as ajoint venture between Samuel Merritt University (SMU) and the Kaiser Permanente NorthernCalifornia Region. It was established to enhance the numbers of well-qualified CRNAs withinthe Kaiser Permanente (KP) system, as well as the nation. The program was housed in theDepartment of Nursing, Samuel Merritt University, and admitted its first class of twelve studentsin the fall of 1994.Clinical affiliates initially participating in the program were KP San Francisco, KP Santa Clara,KP Redwood City, Highland General Hospital, David Grant Medical Center and PrinevilleGeneral Hospital, Prineville Oregon. The clinical education component of the program hasexperienced significant growth during the past 20 years and currently consists of more than 35clinical affiliates, 19 of which are Kaiser Permanente Northern California hospitals.Initial program planning encompassed nearly two years, using a variety of consultants fromacross the nation. The program received initial accreditation in April 1994 from the Council onAccreditation of Nurse Anesthesia Educational Programs (COA). The PNA has undergonethree subsequent accreditation cycles, one in 1997 that resulted in the maximum six years ofrenewed accreditation, again in October 2003 that resulted again in the maximum 10 years ofrenewed accreditation status, and most recently in October 2013 that resulted yet again in themaximum 10 years (to Spring 2024). The School of Nursing (SoN), in which the PNA ishoused, received a coveted 10-year accreditation in 2010 from the Collegiate Commission onNursing Education (CCNE) of the American Academy of Colleges of Nursing (AACN). Since itbegan ranking nurse anesthesia educational programs in 2003, the US News and World Reporton Graduate Education Programs has consistently identified the SMU Program of NurseAnesthesia as one of the top nurse anesthesia programs in the United States.In 1995, SMU approved and implemented the PNA’s proposal to begin an outreach program forpracticing CRNAs to complete a master’s degree. The first class of two students in the MSNOutreach was admitted in the fall of 1995. In 2001 the successful outreach program expandedits applicant pool to nurses in other advanced practice specialties. It was converted to a totalonline modality, called MSN Online. The MSN Online program was closed in 2011.The Doctor of Nursing Practice (DNP) began at SMU in the spring of 2011. The DNP is apractice role that applies and evaluates data in the clinical practice, and provides an advancededucational credential for those who do not need or want a research-focused degree. SMU’sDNP program focuses on developing systems of care based on research utilization. The DNPis offered primarily online.Samuel Merritt University has continuously sought to keep abreast of technology applicationsfor higher education and this is particularly true in the nurse anesthesia program. Selectedcourses of the PNA can be taken online/weekend intensive format and still other selectedcourses are provided using distance learning (Tandberg ) technology, available on the SMUOakland campus. Beginning in 2001 as early adopters of the innovative educational techniquecalled high-fidelity human patient simulation, the PNA faculty and students provided the drivingforce behind successful development of the Health Sciences Simulation Center (HSSC). In2006 SMU opened its first phase, 5,000 square foot state-of-the-art HSSC. In 2009, thesecond phase of the center’s development was concluded adding another 5,000 square feet tothe complex. The CRNA faculty continues to lead the university in simulation-based education,15

which is now integrated throughout the PNA curriculum. Simulation reinforces the program’sheavy emphasis on developing interpersonal skill sets that promote human error reduction andpatient safety. The Simulation Center allows for computer- and mannequin-based simulationexperiences that allow faculty to present and direct a patient care scenario with real-timefeedback and consequences for CRNA decision-making. The HSSC also provides debriefingfacilities where faculty and students can review the video and data captured throughout thesimulation exercise to increase learning by reviewing key decision points, errors, successes,and team interaction. This approach to experiential and reflective learning and critical thinkingis a major value-added asset of SMU’s nurse anesthesia program.As of December 2016, the program will have graduated 21 classes totaling more than 400alumni. Our graduates hold nearly all of the program’s administrative faculty and clinicalcoordinator positions. Program cohorts average 26 students, with an average total studentbody population of 75.Program GovernanceThe Program of Nurse Anesthesia is operated under the sole authority of Samuel MerrittUniversity as one of several graduate nursing programs in the School of Nursing in theUniversity’s Division of Academic Affairs. Since 1993, SMU has maintained a contractualagreement with The Permanente Medical Group (TPMG) of Kaiser Permanente NorthernCalifornia to provide financial, clinical and instructional support. We believe this relationship tobe critical in achieving our collective objective of educating nurse anesthetists of the highestquality.MISSION, VISION, PHILOSOPHY and DIVERSITY STATEMENTMissionThe Program of Nurse Anesthesia strives to educate outstanding clinicians who demonstrate ahigh level of competence in the full scope of anesthesia practice. We are committed toproviding innovative educational opportunities that engender reasoned, safe, culturallysensitive, evidence-based practice, and practitioners who value integrity and professionalism.VisionSamuel Merritt University will become nationally recognized as home to a premier nurseanesthesia educational program. Expert anesthesia faculty and staff shape an inclusivelearning environment whereby students experience best teaching practices and state-of-the-artlearning approaches. The Program of Nurse Anesthesia selects and supports students whoflourish in its rigorous academic curriculum, learn to practice expertly through its clinicalcurriculum, and pass the national certification examination on the first attempt.PhilosophyStudents and faculty are partners in an educational endeavor where mutual respect andcollegiality are expectations, and excellence in all areas of anesthesia practice is the goal.Diversity StatementThe Program of Nurse Anesthesia strives to engender professionals who subscribe to creatinga patient-centered anesthesia management plan that validates age-appropriateness, thepatient’s culture, values, experiences and beliefs when engaging them in the treatment plan.16

PROGRAM LEARNING OUTCOMESIn addition to the goals of the MSN program listed in the SMU Catalog and Student Handbook,a graduate of the program must be able to achieve the following objectives as adapted from theCouncil on Accreditation in the 2015 Standards for Accreditation of Nurse AnesthesiaEducational Programs:The program demonstrates that graduates have acquired knowledge, skills andattitudes/behaviors in patient safety, perianesthetic management, critical thinking,communication, and the professional role.A. Patient safety is demonstrated by the ability of the graduate to:1. Be vigilant in the delivery of patient care.2. Protect patients from iatrogenic complications.3. Participate in the positioning of patients to prevent injury.4. Conduct a comprehensive and appropriate equipment check.5. Comply with all current patient safety goals outlined by both the Joint Commission andthe National Patient Safety Foundation. Utilize standard precautions and appropriateinfection control measures.6. Effectively implement skills and principles of Anesthesia Crisis Resource Management.7. Refrain from engaging in extraneous activities that abandon or minimizevigilance while providing direct patient care (e.g., texting, reading, emailing, etc.).B. Individualized perianesthetic management is demonstrated by the ability of thegraduate to:1. Provide care throughout the perianesthetic continuum.2. Use a varie

Kaiser Permanente Vallejo/Vacaville Anthony Cook, MSN, CRNA Kaiser Permanente Oakland/Richmond East Bay Region Flo Braun, MSNA, CRNA Kaweah Delta Memorial Hospital Kevin Rhoden, MSN, CRNA Kaiser Permanente Fresno Scott Johnson, MS, CRNA Saint Helena Hospital Jaci Cho, MSN, CRNA Ray Cabagbag, MSN, CRNA Kaiser Permanente San

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