Affiliating School/College Of Nursing

Affiliating School/College of NursingClinical Experience Manual – StudentClinical Rotations and Role TransitionsFor RN, BSN, and MSN programs (except NP)Clinical Experience Manual - Student (February 2019)1

Affiliating School/College of NursingClinical Experience Manual – StudentClinical Rotations and Role TransitionsRevised February 2019Clinical Experience Manual - Student (February 2019)2

WELCOME TO UPSTATE UNIVERSITY HEALTH SYSTEM! We arecommitted to providing barrier-free access to our educational services and makingappropriate and reasonable accommodations when requested. We strive to makethis a positive experience for you!Please read through this manual carefully as it gives details and guidance relatedto the clinical experiences you will be having at the UUHS.We are very excited to have you at our facility and hope that your experience hereis as productive and enjoyable as possible. If you have any questions or concerns,please do not hesitate to contact us.Sincerely,Caitlin Nye MSN, RN-BCNurse Residency and Onboarding CoordinatorUpstate University Health SystemClinical Experience Manual - Student (February 2019)3

TA BLE OF C ON TEN TSSECTION I - INTRODUCTION . 5A.Before You Begin . 6Purpose of this Manual .6Contractual Agreement for School/College of Nursing Affiliation .6Terminology .6B.Student Professional Standards, Expectations, and Allowances . 8Legal Standards for Nursing Students .8Professional Standards of Conduct .8Student Policy Review .9Health Clearance.9Respiratory Protection Program .9Clinical Systems Training .9Medication Administration .9Incident Reports Including Medication Errors .10Injury Reports .10Attire .11Meals .11Valuables .11Approval of Student Projects & Research .11SECTION II – OVERVIEW AND PROCESSES . 13A.Clinical Rotation . 14Overview .14Clinical Expectations .14Student Registration .15B.Role Transition . 16Overview .16Requests .16Clinical Expectations .16Student Registration .17Student Scheduling .17C.D.E.Obtaining an Upstate ID . 19Clinical Systems Training . 20Evaluation of Student Experiences . 21Clinical Experience Manual - Student (February 2019)4

SECTION IINTRODUCTIONClinical Experience Manual - Student (February 2019)5

A. Before You BeginPLEASE NOTE: Links are identified as italicized, blue,underlined print (example). Clicking on a link will give youaccess to the identified section, document, form, e-mail addressor survey.Purpose of this ManualWelcome to Upstate University Health System (UUHS). We assure the highestquality standards in patient care and student learning by hosting, to the extentpossible, clinical experiences for schools and colleges of nursing that are legallyaffiliated with UUHS. This manual is intended to provide our affiliatedschool/college of nursing coordinators, faculty, and students with the informationthey need related to clinical rotation and role transition policies and procedures.Please note: UUHS reserves the right to make requirement and procedural changesas needed to ensure that the purposes and missions of the health system are met.These requirements are reviewed annually and revised as necessary for the safetyof all.Contractual Agreement for School/College of Nursing AffiliationAll nursing schools, programs and agencies wishing to affiliate with Upstate forclinical learning experiences are required to have a written agreement that outlinesthe conditions and requirements for such affiliation. Once established, theseAgreements are reviewed every three years and signed by the officialrepresentative/s of both parties. The Chief Nursing Officer is the official designeefor UUHS. The Agreement requires Upstate to “review the curriculum content toassure adherence to current clinical practice.” From time to time, reviews andaudits will be conducted to determine adherence and needed changes in eitherpractice or education. If a change in practice or education is required, both theHospital and Affiliating Agencies will negotiate.TerminologyAffiliating School/College of NursingAny educational institution with a nursing degree or nursing certification programthat has a current contractual agreement in affect with UUHS. The affiliatingschool and its faculty and students agree to abide by the tenets set forth by theaffiliation agreement.Clinical Experience Manual - Student (February 2019)6

Clinical ExperienceAny learning opportunity taking place in a clinical setting related to nursingpractice that is supervised by either a school’s clinical instructor or a preceptor.Clinical RotationA clinical experience that takes place during a school’s semester where a group ofnursing students are assigned to provide patient care under the supervision of aclinical instructor.PreceptorA professional nurse employed by UUHS that is assigned by unit leadership tosupervise a nursing student or a transitioning professional nurse.Role TransitionAlso known as a “capstone course” or a “preceptorship”, it is a clinical experiencewhere a nursing student must complete a predetermined number of clinical hoursunder the supervision of a preceptor. This clinical experience is usually a requiredcomponent of a school’s curriculum.Unit LeadershipThe Nurse Manager and Clinical Training Specialists who are responsible for thedaily operations of a nursing unit.Upstate University Health SystemAll inpatient and outpatient healthcare facilities with direct affiliation with UpstateMedical University including, but not limited to, Upstate University HospitalDowntown campus, Upstate University Hospital Community campus, UpstateUniversity Hospital Golisano Children’s Hospital, and University Health CareCenter.Clinical Experience Manual - Student (February 2019)7

B. Student Professional Standards,Expectations, and AllowancesLegal Standards for Nursing StudentsThe New York State definitions of registered professional nursing, licensedpractical nursing, and advance practice nursing govern nursing practice at UUHS.As such, all students delivering nursing care to patients/families are subject to andheld accountable to the legal standard of practice they are learning. A hospitalemployed staff RN must always retain the full responsibility for the care giveneach and every patient. As such, students are always co-assigned and their patientassignments documented fully in EPIC. Nursing students may perform nursingservices based upon their enrollment in a registered nursing education programand in accordance with the Nurse Practice Act.The doctrine of personal liability dictates that each person is responsible for his orher own acts. This applies to students who provide care, as well as staff nurses andfaculty. Each is accountable.The question of delegation bears discussion here, since both the staff nurse and thefaculty member must be fully aware of what is delegated to a student. Theinstructor, in particular, must be fully familiar with the knowledge, ability, andskill level of the student, and be clear on what degree of supervision is necessaryin each given aspect of care. Written assignments that are both posted andcommunicated to the co-assigned staff nurse help eliminate confusion.Professional Standards of ConductStudents are expected to adhere to all UUHS policies and procedures whilepracticing in our various clinical areas. All polices can be located through ourintranet.Students are expected to dress and act professionally in all interactions at UUHS.Unit leadership will immediately address inappropriate dress or conduct whichcould lead to the student being asked to leave the clinical setting.Clinical Experience Manual - Student (February 2019)8

Student Policy ReviewStudents must receive/review the:o Non-Employee Orientation Guide (Downtown Campus)oro Non-Employee Orientation Guide (Community Campus)ando Clinical Experience Manual – StudentAfter reading the Non-Employee Orientation Guide, the certificate of completionmust be filled out and returned to the Nursing Recruitment and Retention Office orverification of completion must be signed and witnessed by the clinical instructor.Health ClearanceAll students are required to be cleared for placement at UUHS prior to starting onany clinical unit or patient care area. Students that arrive at a patient care areawithout health clearance will be asked to leave until such clearance is obtained.For questions related to student and faculty health clearance, refer to Section F ofeither Non-Employee Orientation Guide.Respiratory Protection ProgramThe Respiratory Protection Program at UUHS requires that all direct care-giversbe: (1) Medically screened AND (2) E-Fitted for the appropriate respiratoryapparatus. Faculty are responsible for assuring that their students are fit tested,according to Upstate Respiratory Protection Program, if they assign a student to apatient requiring respiratory protection.Clinical Systems TrainingTraining on our electronic medical record system (EPIC) and medication barcodescanner is required for all students who are new to their usage. Clinical systemstraining is arranged via the clinical instructor.Medication AdministrationEach semester questions arise regarding student administration of medications.Students may administer medications, providing:(1) they have receivedappropriate instruction (pharmacology content, methods of drug administration,calculations, and nursing considerations including patient assessment) within hisor her nursing program, (2) they have been declared “safe,” “competent,” or otherdesignation with similar meaning by his or her school, (3) they have been trainedClinical Experience Manual - Student (February 2019)9

to the medication administration system at Upstate and (4) they have demonstratedthe necessary clinical judgment and maturity to responsibly administermedications.All students administering medications will be trained in using the EPIC-linkedbarcode scanners, and will subsequently use their own Upstate ID number whenadministering medications. Instructors and/or preceptors must removemedications from PYXIS for a student to administer. Medications requiring a twoRN signout (insulin, narcotic wastes, etc) will require another RN to witness.Students may administer medications following the guidelines above and in thepresence of their clinical instructor or preceptor ONLY.Incident Reports Including Medication ErrorsAny untoward patient incident must be documented according to Upstate policy. Ifany type of error or “near miss” should occur, the student will be required todocument the error utilizing the Upstate Safety Alert System online occurrencereporting system, with the assistance of his/her instructor. Medication errors (ornear misses), patient falls, burns, and injuries are examples of untoward incidents.As a reminder, the facts of patient assessment and care are always completelydocumented in the medical record. However, it is never appropriate to documentthat an “Incident Report or Medication Occurrence Report has been filed.”Typical follow-up includes providing a copy of the appropriate form to theSchool/College of Nursing Director, with a cover letter requesting a writtenfollow-up statement from the school within two weeks. It is not the intention ofUUHS to dictate specific action for any incident, but rather to document how anincident is handled within the policies of the respective school or agency. Patientidentification information will be removed from all reporting forms to maintainPatient confidentiality.All incidents and sentinel events are reviewed as part of the UUHS internalQuality Improvement process to assure adherence to quality standards.Injury ReportsAll student, faculty, volunteer and visitor injuries are to be documented using theappropriate form. First aid is given immediately. Any follow-up care is to berequested by the injured person personally, and the individual’s own insuranceClinical Experience Manual - Student (February 2019)10