UNIVERSITY OF THE CUMBERLANDS Master of Science in Nursing Family Nurse Practitioner (MSN- FNP) Practicum Handbook

Transcription

1 PRACTICUM HANDBOOK UNIVERSITY OF THE CUMBERLANDS Master of Science in Nursing Family Nurse Practitioner (MSN- FNP) Practicum Handbook WELCOME Welcome to the University of the Cumberlands (UC) Master of Science in Nursing-Family Nurse Practitioner (MSN-FNP) practicum experience. This handbook has been created as a resource for UC MSN-FNP students and faculty and clinical site preceptors. The information contained herein describes the roles and responsibilities of preceptors, faculty, and students, as well as guidelines, policies, and procedures pertaining to the clinical practicum for FNP students. The policy elements of this document are adapted from recommendations established by the National Organization of Nurse Practitioner Faculties (NONPF). Preceptors, students, and faculty are encouraged to review these documents thoroughly, as it is important to be familiar with the contents. The University of the Cumberlands has a rich history of serving students primarily, but not exclusively in the area traditionally known as Appalachia. The University s impact can be seen in the achievements of its graduates who have assumed roles of leadership in the region and throughout the nation. In keeping with this long tradition, the University of the Cumberlands Department of Nursing is now offering registered nurses a flexible, online Master of Science in Nursing-Family Nurse Practitioner program designed to provide accessible higher education to shape the nursing profession and heath care environment by developing leaders in education, research, and practice. This new program will extend the University s long-standing mission to preparing students for fulfilling lives of responsible service and leadership in their communities. Along with its successful undergraduate biology major and its master s program in Physician Assistant Studies, the program will broaden the University s commitment to serving the wide-spread and growing health science needs of Kentucky Last Revised TABLE OF CONTENS Welcome/Introduction 1 Letter to Preceptors..2 Mission, Goals, Outcomes & Values The Clinical Experience. 6-8 Site Selection and Approval Health Requirements for Compliance Preceptor, Student & Faculty Responsibilities Attendan Professional Dress & Behavior 16 Professional Misconduct 16 Communication & Collaboration with Faculty 17 Legal Liability & Site Visits 18 Evaluations & TYPHON FNP Student Progression.. 20 Student Responsibility Statement 21 Evaluation & Forms

2 2 Thank you for agreeing to provide a University of the Cumberlands nursing student an educational experience at your facility. We have prepared the following information to introduce you to our school and provide you with important information about the practicum process. The goal of this packet is to provide you with material that will assist you and our student in a mutually successful experience. As a preceptor, you will mentor a student as he/she transitions into the role of an advanced practice nurse. An important responsibility of a preceptor is to facilitate application of the knowledge students learn in their course work with actual clinical experiences. In the clinical setting the student will work directly with you, and under your supervision, to plan, provide, and evaluate patient care. Along with the student you will decide what learning experiences are needed to meet the student s goals and the outcomes of the particular course. While UC nursing faculty is not present on-site, scheduled visits will be made with you and the student and you may call upon a nursing faculty member at any time with questions or concerns. As you read through these documents, please do not hesitate to call the Department of Nursing. In addition, clinical site preceptors and students will be provided with contact information for the UC supervising clinical faculty prior to the student s placement at the clinical site. This faculty member will be available to you at any time. Thank you! Dr. Cailen Wattenbarger Baker DNP, MSN, RN Chief Nurse Administrator Associate Professor of Nursing cailen.baker@ucumberlands.edu Office: Cell: Kyra Gambrel MSN, APRN, FNP-C Family Nurse Practitioner Online Program Coordinator Associate Professor of Nursing kyra.gambrel@ucumberlands.edu Cell: *Clinical Faculty name and contact information is located on the corresponding course syllabus.

3 PRACTICUM HANDBOOK Last Revised Mission The University of the Cumberlands Nursing Program Mission, Philosopy, Goals, Program Outcomes, and Values, reflect and support the University s mission and vision. Our mission is to provide accessible and innovative higher education to shape the profession of nursing and the health care environment by developing leaders in education, research, and practice. Vision The vision of the Masters Nursing program is that the faculty, focusing on the application of clinical reasoning, research, evidence-based practice, collaboration, and leadership skills, will produce graduates that are prepared to become leaders, educators, researchers and clinicians in the nursing profession and to work in collaborative teams in a variety of settings including universities, health service organizations, primary care facilities, research centers, case management and political/legislative settings. Philosophy The philosophy of the Master of Science in Nursing-Family Nurse Practitioner program is based on the premise that advanced practice nurses provide an avenue for access to healthcare for millions of Americans, especially rural populations, through health promotion, prevention and management of disease of individuals across the lifespan. Family Nurse Practitioners utilize a unique blend of clinical practice expertise with evidence-based practice, current practice guidelines, as well as holistic care in order to provide health management, promote wellness and relieve suffering. Advanced practice nurses impact global healthcare by providing diverse and culturally-sensitive medical care to all populations through a comprehensive approach integrating theory, research, technology, interprofessional collaboration and evidence-based practice. In the Family Nurse Practitioner concentration, students builds upon Baccalaureate education and acquire theoretical and specific knowledge to meet health care needs and expand their scope of practice. The Master of Science in Nursing program establishes a foundation for doctoral education in nursing and for continued personal and professional development, as well as empowering the student to recognize the ethical, legislative, economic, regulatory and political aspects that define the scope of professional nursing practice. The curriculum provides the student with a theoretical foundation to practice respectful and sensitive, professional nursing within the primary family practice setting. The University of the Cumberland s Department of Nursing upholds that Family Nurse Practitioners can effectively be utilized to empower individuals, families, groups and communities to achieve their highest levels of self-care competence. The nursing faculty are committed to planning and implementing a quality graduate program for registered nurses that promotes intellectual, personal, ethical and cultural development and the ability to think critically through knowledge and experience. Students in the MSN-FNP program are adult learners. As such, students are viewed as self-directed, active learners who can identify their needs for knowledge, select the strategies that best facilitate their learning, link new knowledge with their current knowledge and utilize faculty feedback to improve their learning. The Goal of the MSN program is to: Goals Expand the integration of scientific findings from nursing, science, humanities, biopsychosicial fields, and organizational science in caring for individuals, families, groups, and communities across the lifespan and the continuum of healthcare environments

4 4 Promote application of research and foster advanced knowledge in translating and integrating scholarship into evidence-based nursing practice Expand critical thinking, problem-solving, and ethical decision-making skills to include servant leadership and the ability to evaluate and improve the quality and safety of healthcare Impact healthcare outcomes through development of collaboration skills, effective communication, and proficient data management through the use of nursing informatics and healthcare technologies Develop nursing leaders who will meet the needs of the healthcare community as well as impact health policy through advocacy, promote clinical prevention and population health, and model interprofessional collaboration Program Outcomes Upon successful completion of the MSN program, graduates will be able to: Integrate nursing theory, concepts from humanities, and related sciences into the delivery of advanced nursing care for diverse populations and the advanced practice role. Apply leadership skills and decision making in the provisions of culturally responsive, safe, high quality nursing care. Implement evidence-based plans based on data to quantify the impact of quality and safety and improve health outcomes across the continuum of care, system, and organization. Integrate theory, research, and interprofessional perspectives to improve practice, healthcare delivery and systems, and health outcomes for patient aggregates. Use information and communication technologies to support the organization, integrate and coordinate care, and improve health outcomes. Analyze how healthy policy and advocacy influence the structure of healthcare delivery, financing of health care, and health outcomes. Use effective communication strategies to develop, participate, and lead interprofessional teams to improve healthcare delivery and advance nursing practice. Integrate clinical prevention and population health concepts in the development of culturally competent care for improving health of patient aggregates. Demonstrate the professional standards of moral, ethical, and legal conduct of the advanced practice role.

5 5 Collaborate with other healthcare professionals to improve systems of care and to optimize patient and population health outcomes. Conceptualize and incorporate an evolving personal nursing philosophy based on professional advanced nursing standards, practice, accountability and life-long learning. Values The core values of the Nursing program are caring, diversity, integrity, leadership, collaboration, respect, and excellence. The values are defined as follows: Caring-offering of self (intellectual, psychological, spiritual, and physical aspects one possesses as human beings) to attain a goal. In nursing the goal is to facilitate and enhance the patient s ability to do and decide for themselves Diversity-embraces not only ethnic groups and people of color, but also other marginal or vulnerable people in society. Response to diversity is the nurse s ability to recognize, appreciate, and incorporate differences (individuality, spiritual, cultural, ethnicity, family configurations, values, socioeconomic status, beliefs) into provisions of care Integrity-acting in accordance with appropriate professional code of ethics and accepted standards of practice Leadership- seen as a role of influence, not just as a position of authority. Leadership is the development of skills that allow the leader to coordinate, guide and direct groups through transformational approachemphasizing a positive work environment, using change effectively, rewarding staff for expertise and performance, and development of staff awareness Collaboration- interdisciplinary and interdisciplinary effort among health care providers, patients and families, in which there is mutual trust and understanding that each partner contributes to the relationship toward achieving optimal, realistic goals Respect for students as autonomous adult learners Excellence-develops nursing workforce that surpasses ordinary standards of care

6 6 The Clinical Experience Students participating in University of the Cumberland s FNP Clinical Experience should participate in clinical practice experiences as planned learning activities in nursing practice that allow students to understand, perform, and refine professional competencies. The clinical practicums are integrated amongst four FNP courses. The practicum courses offer FNP students an opportunity to apply their newly developed evidence-based skills and advance their learning experience through hands on primary care while being guided by professional medical providers amongst the healthcare community. FNP Clinical Practicum Policies and Procedures, Academic Standards, and Student Evaluation Criteria Preceptors and all clinical supervising faculty should review the course syllabus and progression expectations prior to contacting or meeting with the student to ensure academic and professional standards are understood before engaging in clinical supervision and practice. The evaluation criteria that describes student performance standards required to pass a clinical course are located on the Evaluation of the FNP Student form located within this practicum handbook.

7 7 Guidelines for Clinical Practicum Experiences The following guidelines have been developed to clarify the faculty, preceptor, and student s role during their clinical experience. Definition of Terms: Academic warning: Notification to a student by faculty that the student s course work and/or clinical performance is not acceptable or at risk of failing; and/or the student is exhibiting unprofessional behaviors in the clinical settings. The academic warning includes a written plan for the student to work towards successful completion of the course/clinical requirements. Clinical affiliation agreement: A facility contract between UC and the clinical site. Clinical faculty: The faculty assigned to students in a clinical course. Clinical preceptor: A qualified advanced practice nurse or physician who works one-on-one with FNP students at clinical sites to promote attainment of the family primary care learning outcomes. Selection Criteria for Clinical Sites The UC Department of Nursing requires that family nurse practitioner students clinical experiences occur in clinical sites that meet the criteria below. 1. As a family nurse practitioner program, student clinical placements should be in primary care clinics. MSN/FNP students are eligible to obtain some clinical hours in subspecialty clinics and may complete up to 180 hours of the total 720 required in subspecialty areas. These experiences should be based upon student learning objectives and students are encouraged to discuss this with faculty. 2. Patient characteristics represent the appropriate population age for scope of practice and reflect course objectives. 3. Patient characteristics represent diversity (education, income, insurance, race/ethnicity) 4. Patient volume is adequate to ensure sufficient patients per day for student to acquire the skills required to meet core curriculum guidelines, program goals, and practice in a work environment upon graduation 5. Space is available for student (examination room, area for documentation) 6. Adequate resources available on site: a. Preceptor b. Physician, APRN or CNM consultation c. Medical record system (electronic preferred but not required) d. Current medical reference books or Internet access for searching Clinical Preceptors Nurse practitioner students in the MSN-FNP program engage in clinical practice under the guidance of a qualified clinical preceptor. The clinical preceptor must: Be formally educated for professional practice

8 8 Be a graduate prepared advanced practice nurse (APRN) or a Physician (MD or DO). (Each student must spend a minimum of 500 hours with a nurse practitioner nationally certified in family practice during clinical experiences.) Hold an unencumbered and current license to practice in the state where the practice site is located Be nationally certified (APRN or CNM) Be currently practicing (preferably in primary care) with a minimum of one year of practice experience in the advanced practice role and a minimum of 3 months experience at current practice site Not precept more than two students at a time. Provide a current curriculum vitae or resume to the UC Department of Nursing. Provide contact information for current practice site to the UC Department of Nursing, including a valid address. Identifying a Clinical Preceptor At least two semesters prior to a clinical course, the process of identifying an acceptable preceptor will begin. The Clinical Faculty will work with students to arrange clinical placement. Students may choose their own clinical sites. The University is responsible for placement of students at clinical sites and securing preceptors. Student input and participation in identifying preceptors and clinical sites is encouraged. It is important to remember the clinical practicum gives facilities the opportunity to observe students as potential employees. Therefore, students may consider employment goals when selecting a preceptor and site. Approval of Clinical Site and Preceptor For all students obtaining their own preceptor and clinic site: Once a provider (NP, CNM or physician) has agreed to serve as a clinical preceptor, the student should let the Clinical Faculty know when they have identified a preceptor so that the Clinical Faculty can ensure the appropriate forms are completed in a timely manner. The Clinical Faculty at UC will approve all clinical sites and clinical preceptors according to student learning needs and specific course objectives. The Clinical Faculty will verify that an Affiliation Agreement for the approved site is on file. If not, she will request the student to complete and submit the Affiliation Agreement Request. Prior to the start of the clinical experience, a copy of the preceptor s license and certification, and an abbreviated CV must also be on file in Typhon. Criteria for Site Selection Practicum Site Requirements per Practicum Course Course Name Practicum Site Facilities NRSOL 670: FNP Advanced Practice I Family Practice Internal Medicine Total Hour Requirement: 120 Womens Health Clinic OB/GYN Practice Mental Health Facility NRSOL 672: FNP Advanced Practice II Family Practice Pediatric Primary Care Total Hour Requirement: 120 NRSOL 674: FNP Advanced Practice III Family practice preferred Specialties may be considered Total Hour Requirement: 120 Primary Care,

9 9 NRSOL 690: FNP Advanced Practice Internship Internal Medicine Retail or Urgent Care Clinic Family Practice preferred (APRN only) Total Hour Requirement: 360 Requests for clinical experiences in ER, inpatient hospital, long-term care centers, weight loss clinics, dermatology and other specialty practices deemed by clinical faculty to not provide enough family practice exposure will not be considered. Your practice site cannot be in the hospital or inpatient setting. If your preceptor sees patients in a clinic, but also does rounds in a hospital, you may accompany him/her for a limited amount of time. Please notify your clinical faculty if this circumstance arises. Without faculty s prior approval, hours spent in the hospital setting may not be counted toward you practicum requirement. Clinical hour requirements are noted on the table above and also on the course syllabus. Students must complete the assigned clinical hours with a grade of PASS assigned by the Clinical Faculty (See Clinical Final Evaluation form). A grade of PASS is required for successful completion of the clinical course, regardless of the student s grade in didactic content. Students will complete a total of 720 clinical hours with a minimum of those being 500 hours in the family practice setting with a nurse practitioner nationally certified in the area of family practice. Affiliation Agreement The University must have a facility contract with the clinical site prior to the student beginning clinical experiences. A Clinical Affiliation Agreement must be obtained for each clinical site the student plans to utilize. Students who would like to request a specific facility/preceptor may do so my contacting the Clinical Faculty for their course via phone or . The Clinical Faculty can work directly with leadership at the facility to obtain the signed Affiliation Agreement. Initial Contact with the Clinical Preceptor Once a clinical preceptor is approved, the students should contact them prior to the start of clinical. Students are encouraged to call their preceptor s office as the initial contact to make an appointment to meet with them in person. This is a great way for students to learn about their preceptor. Student-preceptor interviews are not required for clinical placement, but in some instances may be arranged. Students are expected to share their course syllabus and the Practicum Handbook with the clinical preceptor prior to the first clinical day. Preceptors are providing mentoring and teaching as part of their professional role. It is important to express appreciation and we encourage all clinical students to write a thank you note at the end of the semester. Progression of Clinical Courses It is intended that students stay with the same clinical preceptor and site throughout the progression of a clinical course semester. If the fit between the student and clinical preceptor/site is not working or the student is not being exposed to the required patient populations, which is determined by the midterm and final clinical evaluations, the clinical faculty and student will discuss the need to identify another clinic site. Irreconcilable issues with a clinical site or preceptor must be submitted in writing via to both the UC Program Coordinator and Clinical Faculty.

10 10 Student Health Requirements for Clinical Practicum Compliance Student personal, health, and immunization records are maintained within Typhon. It is the responsibility of the student to assure the documents are current. Certain diagnostic tests may be required to meet contractual obligations with the clinical agency. Current RN License: All graduate students are required to have documentation of a current RN license, in good standing, to practice as a registered nurse in Kentucky or eligibility to obtain a Kentucky, or meet the Kentucky Board of Nursing regulations regarding multistate licensure. Graduate students living in Kentucky during their enrollment at UC must have an RN license to practice nursing in Kentucky. The most recent license validation should be uploaded following every renewal period. Basic Life Support HCP: Students must maintain current American Heart Association CPR card. Tuberculin Skin Test: Required annually. If positive, proof of follow-up medical care is required. (If diagnosis of active tuberculosis is made, clearance from the Public Health Department is required before admission or for continuation in the nursing program.) In cases where a positive tuberculin test result is present due to previous exposure or vaccination, a chest x-ray or guantiferon gold and sign/symptom checklist will be required. Hepatitis B Vaccine: The Hepatitis B vaccine or titers are required for all students. Tetanus/Tdap: Tetanus, diphtheria, and acellular pertussis (Td/Tdap) vaccination require one-time dose of Tdap to adults younger than age 65 years who have not received Tdap previously or for whom vaccine status is unknown to replace one of the 10-year Td boosters. Varicella: Evidence of immunity to varicella in adults includes any of the following: o Documentation of 2 doses of varicella vaccine at least 4 weeks apart. o Laboratory confirmation of immunity through lgg antibody detection. o A physician statement verifying that the student was previously treated for the varicella virus (chicken pox). Professional liability insurance is provided by the University. However, FNP Student Professional Liability Insurance is strongly recommended. Photo ID (e.g., UC ID, driver s license, passport, etc.) Students are expected to comply with clinical facility rules and regulations regarding required documentation. All students must complete HIPAA and OSHA training within the Castle Branch system. All students must complete background screening and drug test screening within the Castle Branch system. All vaccination and required medical records must be on file within Typhon or Castle Branch. All students must upload a copy of all required documents (excluding Castle Branch documents, those will remain housed in Castle Branch) to the Typhon system. All students must have a satisfactory Health Form on file in Typhon. All required health documentation must be on file within the Typhon or Castle Branch systems prior to the beginning of clinical practicum courses. Failure to comply may result in the student being withdrawn from the course. Students not in compliance will be refused entry to the clinical site and absences during this time will be considered unexcused. These requirements are subject to change based on Centers for Disease Control (CDC) and regulatory agency requirements for healthcare provider immunizations. Some clinical facilities may require additional documentation per facility policy.

11 11 Student Health/Pregnancy It is the intention of the Department of Nursing not to unfairly prejudice the interest of students who are pregnant. A student may choose to continue with her program during pregnancy with the understanding that she is expected to satisfactorily meet the same standards of clinical and classroom performance as other students enrolled in the program. If at any time during pregnancy, the student s ability to meet the performance standards is in question, the student may be required to submit a statement from her private health care provider. This statement shall indicate that the student is able to satisfactorily perform in clinical and classroom activities without undue detriment to herself and/or the unborn fetus or baby. Without such medical assurances, the student may be required to discontinue her program until such medical assurances have been received and accepted. The above policies do not mitigate the student s responsibility for maintaining her own health, as well as that of responsible behavior with respect to the fetus or baby. If at any time the student believes she is medically unable to continue with classroom or clinical responsibilities, the student must notify her clinical preceptor, clinical faculty, and Clinical Faculty. Student Health: Illness/Injury During Clinical In the event of a medical emergency, hazardous materials exposure, needle stick or sharp object injury, or other clinical-related injury as defined by the clinical preceptor, the student should be seen in the agency's emergency room, or if that is not available, sent to the nearest emergency room. The student will be responsible for any bills incurred for these events. The preceptor and student will immediately notify the course instructor and clinical supervising faculty of any such events. In non-emergency situations, the student may verbally tell the course instructor and clinical supervising faculty that they elect to seek care from a private health care provider/clinic. Any costs incurred will be the responsibility of the student. The student and/or preceptor will notify the course instructor and clinical supervising faculty of these events as soon as possible. Documentation of an injury requires the completion of a Student Injury and Incident Report. The student is responsible for writing up a description of the situation/injury and treatment sought, obtaining comments from the preceptor or agency representative. The student is responsible for forwarding the completed report to the clinical supervising faculty as soon as possible following the incident. The Online Program Coordinator and Clinical Faculty will review the information and make appropriate recommendations. The document will be filed in the student's personal file. The Student Injury and Incident Report can be located at the end of this document.

12 12 Clinical Preceptor, Student and Clinical Faculty Responsibilities During the clinical experiences, students are in the learner role and will not assume primary responsibility for client care. Students primary responsibility is for acquisition of advanced clinical knowledge and skills. During each experience, clinical faculty will be available by phone or . If questions or problems arise, students should contact their assigned clinical faculty. Students are expected to see a minimum of 4-6 patients per 8-hour clinical day initially in the first clinical course working up to 8-10 patients per 8-hour day by midterm of their second clinical course. In subsequent clinical courses, students will be expected to see patients in an 8-hour period. Faculty understands that patient numbers may vary depending on the clinical site and level of acuity. Students must see a mixture of patient populations as well as ages. In addition, at mid-term and final evaluation times, preceptors will validate that they have reviewed student time log entries by signature on the student evaluation form. Clinical preceptors are in the clinical site with the students and oversee their clinical practice. All students are also assigned a UC clinical faculty who reviews all of their documentation and evaluations and works with the students to ensure they are progressing in the program. Clinical Faculty Responsibilities The clinical supervising faculty maintains the ultimate responsibility for the student s clinical experience in a specific course. Responsibilities for faculty who are providing either direct or indirect supervision of students in the clinical setting will vary by course. The course syllabus details specific requirements and evaluation criteria for successful student performance. In addition, courses may have specific guidelines describing clinical faculty responsibilities for a particular course and faculty is expected to comply with those guidelines. 1. Ensures that the clinical affiliation agreement between UC and the clinical agency is in place. 2. Assumes responsibility for the over-all coordination of the student's clinical experience to meet the family primary care clinical course learning outcomes. 3. Assures that preceptors meet the UC, Kentucky Board of Nursing, and the National Task Force on Quality Nurse Practitioner Education preceptor requirements. 4. Assures that the student has demonstrated competencies for the level of progression in the FNP program. 5. Monitor and critique student case logs for accuracy and completeness as well as provide student feedback. 6. Monitor documentation of hours for completeness to meet course objectives.

13 13 7. Ensure that students complete an evaluation of the clinical experience, site, and preceptor. 8. Ensure that students submit a preceptor evaluation of their performance in the clinical setting. 9. Review time logs for accuracy and completeness. 10. Monitor attendance and schedule of clinical time. 11. Collaborate with the Program Coordinator and/or Course Faculty regarding student assignments for required specialty clinical experiences. 12. Ensure student clinical experiences commence as soon as feasible at the beginning of a course so that students will be able to complete the required clinical hours within the timeframe of the course. 13. Communicate with preceptor as needed to evaluate student competencies in the clinical setting to ensure students are providing optimal client care and are adhering to agency expectations, guidelines, and standards. 14. Meet with students outside the clinical setting via in-person meetings, phone, or , as necessary. 15. Facilitate faculty/student/preceptor problem solving as necessary, coordinating conferences as appropriate, developing plans for remediation when necessary, and communicating with the Course Faculty. 16. Notify the Course Faculty of student difficulties in meeting clinical objectives. 17. Inform the Course Faculty of clinical agency issues that may affect student practice or clinical placement. 18. Attend FNP faculty meetings, workshops, and other on campus functions as applicable. 19. Maintain a professional working relationship and ability to communicate openly with preceptors and clinical sites as needed. 20. Orientation will include review of the following: a. Mission, goals, and curricular outline of the program. b. Course syllabi including Student Learning Objectives and course outline. c. Roles and responsibilities of the clinical supervising faculty, preceptor, and student. d. Performance expectations of the student. e. Evaluation responsibilities. f. Avenues of communication. g. Student assignments. h. Expected initial level of knowledge, skills and abilities of the student. i. Distribution of MSN-FNP Practicum Handbook and course syllabus to clinical preceptor via print or Ensures that students have all the required health documentation for the assigned healthcare agency. 22. Ensures (in cooperation with the clinical site) that students have knowledge of the safety requirements for the assigned healthcare agency. 23. Establishes communication and maintains availability with the clinical preceptor and the student. 24. Meets with the student, supervising clinical faculty, and preceptor as needed to discuss the student s progress and exchange ideas and/or counseling/suggestions to better achieve outcomes. These meetings may occur in person, by phone, or by Assists the supervising clinical faculty to incorporate data from discussions with the student, preceptor, and clinical supervising faculty, and written evaluations from the preceptor, to provide the final student evaluation and assignment grade. 26. Provides the student with the opportunity to evaluate the preceptor, clinical experience, and the clinical agency and discusses with the preceptor any information from the student concerning ways to improve the clinical experience for future students. 27. Verify preceptor licensure and certification via appropriate licensing board. 28. Verify that preceptor CV or resume is uploaded in Typhon. 29. Verify student nursing licensure at least annually. 30. Communicate with preceptor as needed to evaluate student competencies in the clinical setting to ensure students are providing optimal client care and are adhering to agency expectations, guidelines, and standards.

14 14 Clinical Preceptor Responsibilities The UC Graduate Nursing Program defines preceptors as qualified advanced practice nurses or physicians who work one-on-one with FNP students at clinical sites to promote attainment of the family primary care learning outcomes. Specific preceptor guidelines are defined in the Rules of the Kentucky State Board of Nursing Provide copy of license, specialty certification and current CV or resume (preceptors may also complete the CV/Resume Alternative form located within this packet if an update CV/resume is not readily available). 2. Orient student to the clinical site and agency policies. Discuss with student the preferred method for communication with clinical preceptor and/or clinic site. 3. Review with student the site s patient population, most frequent diagnoses and procedures commonly performed. 4. Discuss preceptor and agency expectations for the documentation of patient encounters. 5. Facilitate an informal collaborative and mutually respectful environment in which to learn. 6. Promptly communicate to UC Clinical Faculty regarding issues of concern or unsafe practice. 7. Review the objectives of the course and student s clinical objectives to determine the type of learning opportunities that will enhance the student s learning. Direct the student to resources and evidence based readings. 8. Provide daily feedback to improve the student s assessment, management, and presentation skills. 9. Provide a variety of learning experiences with appropriate client populations. If available, encourage participation in interdisciplinary team meetings. 10. Facilitate student s progressive independence in clinical knowledge and skills by supporting the student s autonomous assessment and evaluation. 11. Complete student s midterm and final clinical evaluation and communicate with clinical faculty via phone/fax/ results of the evaluation. Mid-semester and final evaluations must be completed by the clinical preceptor and reviewed with the student. Student s final clinical grade will be awarded by the Clinical Faculty. 12. Students will provide clinical preceptors with a copy of their Typhon time log at the midterm and final evaluations. Clinical preceptor will verify the student s time log prior to signing the mid-term and final evaluation. 13. In the event of a planned absence (ex. Vacation) of the preceptor, please notify the student so that they can alert their clinical faculty. The preceptor may make arrangements for a qualified back-up preceptor in the case of an extended planned absence (ex. Maternity leave). Not all preceptor absences may require a backup preceptor depending on student scheduling and timing of absence during the term. Clinical experiences are an essential component of the education of FNP students, and preceptors and clinical faculty play an indispensable role in the success of these experiences. Clinical instruction necessitates both supervisory and evaluative activities. Preceptors provide direct clinical supervision, while the clinical supervising faculty provides direct and/or indirect clinical supervision. FNP students are expected to participate in hands on care. Direct (faculty) supervision occurs when a faculty member is present at the clinical site and is supervising the student in that setting. Indirect (faculty) supervision occurs when a clinical preceptor is supervising the student while the faculty member retains responsibility for the overall clinical components of the course. As an indirect

15 15 clinical supervisor the faculty provides oversight of the clinical learning experience and acts, on behalf of the Department of Nursing, as a liaison to the clinical site. Student Responsibilities 1. Integrate personal learning objectives with course objectives. 2. Ensure Clinical Affiliation Agreement has been approved. The student may then contact approved clinical preceptor and determine the schedule for the clinical experience, including days of week and hours per day. 3. Ensure preceptor CV or resume, license and certification, and Affiliation Agreement form are completed and submitted prior to starting clinical hours. 4. Develop the clinical calendar of dates and times the student will be in clinic with the preceptor. Student must keep a minimum of two weeks schedule visible in Typhon. Clinical hours must be completed during the semester set by the University Academic Calendar. 6. Develop and share clinical learning needs/objectives with clinical preceptor and discuss strategies to meet them. 7. Adhere to professional attire that is in accordance with clinical site requirements and UC MSN-FNP Program dress code (more detailed below). 8. Maintain professional behavior in the clinical setting at all times. 9. Collect and enter all patient encounter data in Typhon (electronic clinical log) within 72 hours of the clinical experience. If not entered within 72 hours, the clinic hours for that day will not count and will need to be made up by the student. 10. Demonstrate increasing competencies in assessment, management and presentation of patients to the clinical preceptor. 11. Function in the role of the nurse practitioner under the supervision of the clinical preceptor incorporating evidence-based practice guidelines. 12. Attend all scheduled clinical experiences on time and be prepared, completing all required clinical hours by the final date of each clinical course. 13. Notify clinical preceptor and UC clinical faculty as soon as possible if unable to attend clinical as scheduled and arrange make-up clinical day. Communicate the date of the makeup day to the clinical faculty via and update calendar in Typhon. 14. Complete clinical preceptor and clinical site evaluations at end of clinical rotation and before the semester ends. 15. Print out a Typhon time log of clinical hours at midterm and final for the clinical preceptor to review and verify in the Typhon evaluation that is ed to the preceptor. Student Attendance on Scheduled Clinical Days The student must attend the number of clinical practicum hours consistent with the program requirements and the clinical schedule the preceptor and student agreed upon. Students should not assume that should they fail to complete the required number of clinical hours for the term that they will be permitted to make up clinical hours with their preceptor. Students are not permitted to complete clinical hours beyond the semester in which the course is taken. If a student cannot complete the required hours due to an unforeseen event, the student must notify the clinical supervising faculty immediately to determine if the situation warrants an extension of the clinical practicum and under what conditions this will occur. If a student is to be absent for a scheduled clinical day (due to illness or an emergency), the student should notify the preceptor prior to the beginning of the clinical day. On the first clinical day, students should identify the procedure for contacting the preceptor in case of absence. Additionally, it is the student s responsibility to notify the clinical supervising faculty of the absence and negotiate make-up clinical time with the preceptor. If the student is not attending clinical days/hours as scheduled, the preceptor should notify the clinical supervising faculty promptly. In the event of a planned absence of the

16 16 preceptor, he/she may make arrangements for a qualified back-up preceptor. The Clinical Faculty and course instructor will determine credentialing needs for back-up preceptor. One no call-no show for clinical is an academic warning. A second no call-no show for clinical is termination from the FNP program. Professional Dress and Behavior Students are expected to dress appropriately and behave in a professional manner at all times consistent with Occupational Safety and Health Administration (OSHA) standards. The clinical site may specify the dress code in accordance with OSHA and state law considerations. FNP students are required to wear a nametag identifying them as a UC student. Lab coats are required and provided by the UC Department of Nursing to be worn at all times, the only exception being if lab coats are in violation of a clinical site policy. Tattoos and piercings (other than ears) should be covered at all times while in the clinical area. Closed toe shoes are required in the clinical area. No jeans will be permitted, students should wear scrubs or business casual clothing per clinical agency policy. A positive attitude, open-professional communication, willingness and eagerness to learn paired with the ability to accept and incorporate constructive feedback in the clinical sites is imperative to a successful learning experience. Impaired Student Policy: Perception of Impairment A student who violates the Alcohol and Drug policy of the University will face immediate sanctions. Possible sanctions include, but are not limited to: counseling, probation, removal from the program. Progression in the program and related activities will be halted while the student is placed under administrative review. Should the preceptor, nursing faculty, or other individuals perceive that a student is mentally or physically impaired, immediate action must be taken to relieve the student of his/her duties and place the student in a safe area away from the clinical setting. The immediate goal is to provide for the safety of patients, the public, other students, and the student who is suspected of being impaired. Once the need for a removal from a clinical site is evidenced, the University and/or its designee will arrange the following: 1. Appropriate drug or alcohol test 2. Ensure the safe transport of incapacitated student. 3. Initiate the Standard of Conduct review procedures highlighted above. The Clinical Instructor must be contacted immediately. The incident will be documented in the student record and results of the administrative review will be reported to the appropriate Board of Nursing. Preparation The student should prepare for the clinical practicum as recommended by the preceptor, course instructor, and clinical supervising faculty. This preparation includes understanding and meeting course learning objectives, conferring with faculty on areas of weakness that need to be refined, and seeking independent learning experiences that will promote self-confidence and competence. It is further recommended that prior to starting the practicum the preceptor will discuss with the student and supervising clinical faculty the patient population and most common health problems the student can expect to encounter at the clinical site. The student is expected to prepare for the clinical practicum by reviewing reference materials that are relevant to the patient population and anticipated health problems. On the first day of the clinical practicum, the preceptor will orient the student to the clinical practice setting, facility policies and procedures, and required safety and learning modules.

17 17 Patient Care Responsibility and Medical Record Documentation The student is expected to document in the patient medical records (paper or electronic) and sign all entries with their first and last name followed by FNP student. Since the preceptor maintains the legal responsibility to examine the patient, establish the diagnosis, and determine the treatment and evaluation plan, he/she must also sign the medical record and all billing documentation. Communication with Faculty The Department of Nursing will provide to the preceptor contact information for the supervising clinical faculty and for the program coordinator. Preceptors may also contact the department any time during the period of student supervision at (606) The preceptor will provide contact information to the student and supervising clinical faculty. The Chief Nurse Administrator and Online Program Coordinator cell phone numbers are provided on page 2 of this document. Student and Preceptor Contact Frequent contact with the student and preceptor in the clinical setting is necessary for the supervising faculty to understand how the student is performing. Frequent contact also facilitates early intervention when a student s performance is not at the level expected for that course. Collaboration with Faculty on Problem/Conflict Management When a conflict or problem related to the student is identified, the preceptor should collaborate with the clinical supervising faculty so that the proper procedure for management and resolution of the conflict or problem is followed. Any problems related to the faculty role in the preceptorship experience should also be discussed between the clinical supervising faculty and the preceptor. If the faculty and preceptor are unable to achieve resolution, the clinical faculty and/or preceptor should notify the Online Program Coordinator immediately. Substandard Care, Unsafe Clinical Performance, and Professional Misconduct The preceptor should notify any student in jeopardy of failure no later than at the mid-point of the clinical rotation. The preceptor must also immediately notify the clinical supervising faculty whenever student performance is substandard, or failing. In the event of unsafe clinical performance by a student, the preceptor must remove the student immediately from the practice setting and notify the clinical supervising faculty. The preceptor will document and report immediately to the clinical supervising faculty any unprofessional behavior or breach of contract by the student. Such a situation will be immediately addressed once the preceptor or clinical agency contacts the UC nursing faculty. Personal safety for all members involved is paramount. Any event involving unsafe clinical performance or professional misconduct requires the preceptor to complete the Student Injury and Incident Report and to contact the Clinical Faculty immediately. Burden of Responsibility Preceptors are ultimately responsible for the actions of the student. Therefore, we encourage development and discussion of clear and specific learning plans addressing the aspects of care for which the preceptor will be responsible, and those for which the student will be held responsible. To ensure patient care is never compromised, it is imperative that preceptors communicate frequently with students regarding the delineation of responsibilities.

18 18 In the preceptor role, the clinician must be able to direct and oversee the FNP student and manage his/her usual responsibilities to patients and other colleagues. Legal Liability During Practicum The preceptor must ensure that all care provided to patients, either care provided directly by the preceptor with the student observing, or care provided by the student under the supervision of the preceptor, must be the same standard of care to which the preceptor is obligated to provide under his/her status as a licensed professional. Preceptors are liable for the care provided to their patients during the clinical experience. Patients should be informed that the preceptor remains the primary care provider, is responsible for final decisions related to patient care, and will continue to provide follow-up care. Preceptors have ultimate decision-making authority and responsibility for the details of patient care, including training activities and direct supervision of student learning experiences. Students do not have authority or independent health care responsibilities for patients and are not to be considered agents, independent health care providers, patient advocates, a preceptor s employee or agent, or individuals practicing in an extended role while being precepted. Site Visits The purpose of a site visit includes evaluation of the student through direct contact with the preceptor. In addition, it provides the clinical supervising faculty, the preceptor, and the student with an opportunity to discuss the student's progress. The Clinical Faculty will make one to two site visits per rotation and not more than three, unless circumstances warrant additional visits. The date and time of the visits are confirmed in advance with the student, and it is the student's responsibility to inform the preceptor of the impending visit. During the site visit, the clinical faculty will evaluate the student s progress, provide feedback to the student, evaluate the clinical site and the preceptor, and complete the Clinical Site Evaluation form. Monitoring Typhon entries to assess student progress in meeting the course requirements and competencies will be done during the site visit and routinely throughout the semester to ensure that hours and documentation are being properly recorded and in a timely manner. Students are required to enter their data within 72 hours of completing the clinical day. Written documentation of the site visit is required, and at the conclusion of the visit the evaluation form will be signed by the student and Clinical Faculty. Whenever possible, site visits will occur via in-person visits by the Clinical Faculty, on occasion, site visits may be completed via phone. Availability The clinical supervising faculty will maintain contact with the student and preceptor at times other than the site visit and will be available by phone on the days students are in the clinical site. Should a scheduling conflict or emergency arise, it is the responsibility of the supervising clinical faculty to make arrangements with another member for coverage and to notify the Program Coordinator of the change. Evaluations Students will be asked to evaluate the clinical experience, agency, and clinical preceptor at the end of the clinical rotation. These evaluations are imperative and provide necessary feedback for future placements with the preceptor/site. The evaluations are located within this document. Students will also provide a self-evaluation via the Evaluation of FNP Student form, to their clinical preceptor mid-semester and at the end of the semester. This will be provided to the clinical preceptor one week prior to evaluations being completed by the clinical preceptor.

19 19 Students will review and sign the mid-semester and final evaluations during each clinical course with their preceptor. Typhon Clinical Logs Students are required to keep a log of all patient encounters and clinical hours throughout their FNP practicum. Students will maintain a clinical log in an electronic format. For this purpose, UC Nursing utilizes Typhon Clinical Tracking Systems. The use of Typhon enables students to track the number of patient encounters, procedures, diagnoses and ICD codes, diagnostic testing ordered, and medications prescribed. Students enter their clinical data into Typhon following each patient encounter or at the end of their clinical day. Clinical case logs must be entered within 72 hours of the clinical day in order to receive credit for clinical time. It is the responsibility of the clinical supervising faculty to routinely evaluate the clinical case and time logs. When determining learning needs, or to evaluate a student s previous experience, it may be helpful for preceptors to review the student s clinical log. Students should encourage preceptors to periodically examine the contents of their log. Patient confidentiality, consistent with the Health Insurance Portability and Accountability Act (HIPAA) must be observed. Specifically, the information in Typhon should not disclose patient identifiers. Students will receive information and instructions on the use of Typhon during orientation to clinical. Students will receive an academic warning if there are no Typhon entries within the first two weeks of a clinical course. Students are expected to complete half of their clinical hours per clinical course by mid semester and the calendar of clinical days and hours should reflect this. Direct patient care clinical hours refer to hours in which direct clinical care is provided to individuals & families; these hours do not include skill lab hours, physical assessment practice sessions, or a community project, as it does not include the provision of direct care. Clinical experiences and time spent in each experience should be varied and distributed in a way that prepares the student to provide care to populations across the lifespan. Documented clinical time in Typhon must be direct patient care. Typhon allows students to divide time into 'Patient time, Consult time, Medical Charting, Procedure Observation time, Conference time, and Shift time. Patient Time" MUST EQUAL your "Shift Time". Students may leave consult, medical charting and conference time at zero. Recording time for medical charting is part of direct patient care and should be incorporated into patient time and not independently in order to ensure earned clinical hours. Clinical faculty are aware that student s time with patients in clinic may vary depending on the problem, diagnosis, etc. Only in an extreme circumstance should medical charting exceed >20 % of your daily clinical hours. Faculty Typhon Responsibilities: Faculty must: Review student Typhon entries weekly and provide educational feedback. Ensure students keep clinical schedule calendar up to date with a minimum of two weeks entered at all times. The Clinical Faculty should be notified via of any schedule changes that occur once the schedule is placed in Typhon. Communicate with the student if there are concerns about the student s clinical performance. Report recommendation for an academic warning for borderline or unsatisfactory academic or professional behaviors to the Program Coordinator immediately once deemed as necessary. Ensure the student submits the mid semester (self-evaluation and evaluation by preceptor via the the Evaluation of FNP Student form) and final evaluation paperwork (self-evaluation and evaluation by preceptor via the Evaluation of FNP Student form and the Student Evaluation of Clinical Practicum Experience, Agency, and Preceptor form) by the due date.

20 20 Progression of a Nurse Practitioner Student during Practicum First clinical semester student: Student should be able to perform a history and physical examination Student should know to utilize evidence based references Student should be able to communicate an adequate patient report identifying assessment results to the preceptor Student management plans need significant guidance. Student needs high level of direction, which decreases as skill level increases. As student progresses, preceptor allows student to take on more independent responsibilities. Second clinical semester student: Student becomes more proficient in analyzing data, determining differential diagnoses, is more skilled with assessing and formulating management plans. Student improves use of time and resources. Student may require assistance in prioritizing and coordinating care. Student requires support and assistance for complex cases. Student is ready to demonstrate other NP functions such as patient/family teaching and participating in teams. Third & Fourth clinical semester student Student consistently applies evidence-based guidelines in the clinical setting. Student is expected to perform all role functions in an organized, efficient, skillful and independent manner. Student is expected to engage in interdisciplinary role collaboration, consultation and referral.

21 21 Student Signature Date

22 22 Student Evaluation of Clinical Practicum Experience, Agency, & Preceptor Student Name/Faculty Name: Preceptor Name: Clinical Site/Agency: Course Name/Number: I. Clinical Practicum Experience Please respond to the following by checking the appropriate box. 4= Excellent 3= Above Average 2= Average 1=Below Average N/A= Not Applicable 1. Practicum provided a balance of learning experiences 2. Practicum allowed for an opportunity to demonstrate advanced practice care 3. Clinical learning objectives were accomplished 4. Practicum provided the opportunity to apply course content, theory, and research to clinical practice 5. Overall organization of clinical practicum II. Clinical Site/Agency Please respond to the following by checking the appropriate box. 4= Excellent 3= Above Average 2= Average 1=Below Average N/A= Not Applicable 1. Orientation of the site included a tour of the unit/facility and an introduction to key people 2. Physical facilities were adequate and student was given adequate space to sit, chart, and access information

23 23 3. The acuity, variety, and volume of patients at this site were sufficient to attain learning objectives 4. Collaborative efforts between the physicians, nurse practitioners, staff, and students facilitated the achievement of learning objectives 5. The practicum site is receptive to student participation in patient care 6. Do you recommend this site for future use? Yes No III. Preceptor Please respond to the following by checking the appropriate box. 4= Excellent 3= Above Average 2= Average 1=Below Average N/A= Not Applicable 1. Demonstrated clinical expertise and knowledge of field/specialty 2. Overall teaching effectiveness 3. Allowed opportunities to assume increasing responsibility, see, assess and manage patients while considering limits according to student s level of training 4. Provided direct observation of student s assessment of patient history and exam 5. Encouraged student to ask questions 6. Challenged student to explain findings and treatment plans

24 24 7. Provided individual feedback on student skill level 8. Preceptor was sensitive to student s learning needs 9. Preceptor was available for consultation 10. Implemented evidence-based practice and applied continuous quality improvement in delivery of care 11. Collaborated and consulted other members of the health care team when needed 12. Do you recommend this preceptor for future use? Yes No IV. Comments 1. What was the most challenging part of the clinical practicum? 2. Are there any issues, concerns, or positive components of this clinical experience faculty needs to be aware of? 3. Additional comments about the clinical experience, site, and/or preceptor. Anything else you would like faculty to know? Student Signature Date

25 25 University of the Cumberlands Masters in Science of Nursing-Family Nurse Practitioner Program EVALUATION OF THE FNP STUDENT semester) STUDENT NAME: PRECEPTOR NAME: PRACTICUM DATES: TO COURSE NUMBER: INDICATE BY CIRCLING: STUDENT SELF-EVALUATION or PRECEPTOR EVALUATION OF STUDENT INDICATE BY CIRCLING: MID-TERM EVALUATION or FINAL EVALUATION The midterm and final evaluations are based on accepted nurse practitioner competencies and provide individualized feedback to students regarding strengths and areas for growth. The faculty has established expected competency levels for each domain that students should meet by the END of each clinical course: Please evaluate the student's performance by scoring each element as MET or NOT MET COMPETENCIES ASSESSMENT OF HEALTH STATUS MET NOT MET 1. Obtains and documents a health history and assesses the influence of family or psychosocial factors (e.g., developmental delays, reproductive health, substance abuse, and violence) on illness for patients of all ages 2. Performs and documents complete or symptom-focused physical examinations on patients of all ages, including developmental, behavioral and mental health screening and physical system evaluations. 3. Demonstrates proficiency in family assessment, including identification of health and psychosocial risk factors of patients across the lifespan and families in all stages of the family life cycle. 4. Assesses specific family health needs and identifies and plans health promotion interventions for families at risk, within the context of community. 5. Assesses the impact of acute and/or chronic illness or common injuries on the family. DIAGNOSIS OF HEALTH STATUS MET NOT MET 1. Identifies signs and symptoms of acute or chronic physical and mental illnesses across the lifespan. 2. Manages diagnostic testing through the ordering and interpretation of age, gender, and condition-specific tests and screening procedures. 3. Applies theoretical knowledge and current research findings in analyzing and synthesizing data to make clinical judgments and decisions, individualizing care for individuals and families. 4. Formulates differential diagnoses and prioritizes health problems, considering epidemiology, life stage development and environmental and community characteristics. PLAN OF CARE AND IMPLEMENTATION OF TREATMENT MET NOT MET 1. Using family theory provides health protection, health promotion and disease prevention to improve or maintain optimum health for all family members. 2. Treats common physical and/or mental illnesses across the lifespan, to minimize complications and promote function and quality of living, including women s reproductive health, perinatal care and end of life issues. 3. Prescribes medications understanding altered pharmacodynamics and pharmacokinetics with special populations, such as infants and children, pregnant and lactating women and older adults.

26 26 4. Manages individual and family responses to the plan of care through evaluation, modification and documentation that includes response to therapies and changes in condition. 5. Evaluates coping and support systems, lifestyle adaptations and resources for patients and families, facilitates transition and coordination of care between and within health care settings and the community and initiates appropriate referrals to other healthcare professionals. NURSE PRACTITIONER-PATIENT RELATIONSHIP & TEACHING/COACHING FUNCTION MET NOT MET 1. Maintains a sustainable partnership with individuals and families and communicates effectively with the individual and the family, provides anticipatory guidance and facilitates decision making. 2. Functions as a patient advocate, while teaching individuals to advocate for self-regarding illness or health among family members, age-related transitions and ethical issues. 3. Develops educational interventions appropriate to individual and/or family needs, values, and cognitive level; reinforces positive health behaviors and incorporates self-care activities. 4. Demonstrates knowledge and skill in addressing sensitive issues, such as sexuality, finances, mental health, terminal illness and substance abuse and provides anticipatory guidance, teaching, counseling and education for self-care. MANAGING/NEGOTIATING HEALTHCARE DELIVERY SYSTEMS & CULTURAL COMPETENCE MET NOT MET 1. Maintains current knowledge regarding state and federal regulations and programs for family healthcare 2. Utilizes research findings and knowledge of cultural diversity in caring for all individuals. Comments: Please indicate by circling your recommendation for a grade of PASS or FAIL for the student being evaluated for this clinical experience. All students must pass the clinical component in order to pass the corresponding course and advance in the program. PASS FAIL I recommend the above clinical grade based upon my evaluation of the student in the clinical setting and have reviewed the Typhon time log and agree with documented hours as indicated by my signature below. Preceptor Signature Date I have reviewed the Evaluation of FNP Student form and am aware of my preceptor s recommendations to improve practice. Student Signature Date

27 27 University of the Cumberlands Masters in Science of Nursing-Family Nurse Practitioner Program Clinical Final Evaluation STUDENT NAME: PRECEPTOR NAME: PRACTICUM DATES: TO COURSE NUMBER: Student has successfully completed the following: Item Required for PASS Complete Incomplete Mid-Term Self Evaluation Final Self Evaluation Mid-Term Evaluation of FNP Student Final Evaluation of FNP Student (PASS required) Student Evaluation of Clinical Practicum Experience, Agency, & Preceptor form at conclusion of clinical Conference with clinical faculty regarding student performance Hours required by course PASS FAIL Clinical Faculty Signature Date

28 28 University of the Cumberlands Masters in Science of Nursing-Family Nurse Practitioner Program Student Injury and Incident Report Date of Incident: Semester: Time of Incident: Course: Student s account of Incident. Please use a separate sheet of paper if needed. Signature of Student: Date of Report: Comments by Clinical Instructor or Preceptor: Signature and Title: Agency Name: Agency Address: Agency Phone: Date:

29 PRACTICUM HANDBOOK University of the Cumberlands Masters in Science of Nursing-Family Nurse Practitioner Program Curricular Outline of Program Semester One Semester Two Semester Three Bi-Term I Bi-Term II Bi-Term I Bi-Term II Single 16 week course NRSOL 510 NRSOL 530 NRSOL 532 NRSOL 590 NRSOL 670 NRSOL 520 NRSOL 550 NRSOL 594 NRSOL 592 Course Content: Women's Health and Psych Clinical Requirements: 120 hours Semester Four Semester Five Semester Six Single 16 week course Single 16 week course Single 16 week course NRSOL 672 NRSOL 674 NRSOL 690 Course Content: Neonatal and Peds Course Content: Adult Gero and Family/Across the Lifespan Course Content: Family/Across the Lifespan Clinical Requirement: 120 hours Clinical Requirement: 120 hours Clinical Requirement 360 hours Course Legend NRSOL 510 Theoretical Basis for Advanced Nursing Practice NRSOL 520 Issues in Advanced Practice NRSOL 530 Epidemiology NRSOL 550 Advanced Nursing Research and Evidence Based Practice NRSOL 532 Healthcare Technologies and Informatics in Advanced Nursing Practice NRSOL 594 Advanced Pathophysiology NRSOL 590 Advanced Pharmacology NRSOL 592 Advanced Health Assessment *NRSOL 670 FNP Advanced Practice I *NRSOL 672 FNP Advanced Practice II *NRSOL 674 FNP Advanced Practice III *NRSOL 690 FNP Advanced Practice Internship Last Revised * denotes clinical course

30 30

31 PRACTICUM HANDBOOK University of the Cumberlands Masters in Science of Nursing-Family Nurse Practitioner Program Academic Warning Form Student Name: Date: Course Prefix, Number & Title: Faculty of Record: Last Revised

32 32 Referrals & Options Discussed (check all that apply): Referred student to appropriate program director or Chief Nurse Administrator Referred student to the UC Catalog/Student Handbook and/or program guidelines and/or Practicum Handbook Student will address areas of concern and continue in course. Student is to withdraw from the course. (Faculty to contact Registrar for appropriate procedure.) Student is to go on Leave of Absence or Withdrawal from UC. (Requires course drop and notification of Chief Nurse Administrator and Academic Affairs) Faculty Signature & Date: Student Signature & Date: Optional Student Comment: Copies to: Faculty of Record Chief Nurse Administrator FNP Online Program Coordinator Clinical Faculty Student & Student File Vice President for Academic Affairs Director of Academic Affairs

33 33 University of the Cumberlands Masters in Science of Nursing-Family Nurse Practitioner Program CV/Resume Alternative This form may be completed by the preceptor in lieu of a CV or resume. Preceptor Name: Credentials/Certification: Licensure/Certification Date: Telephone: Preceptor Work History-list Current and Previous two Employer Dates of Employment Role Education College/University Degree Awarded Graduation Year