UNIVERSITY OF NORTH DAKOTA COLLEGE OF NURSING AND PROFESSIONAL DISCIPLINES
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1 UNIVERSITYOFNORTHDAKOTA COLLEGEOFNURSINGANDPROFESSIONAL DISCIPLINES MASTEROFSCIENCE IN NURSEANESTHESIA CLINICALPRECEPTORHANDBOOK Version 1.4 8/20/2013
2 Version 1.4 8/20/2013 PAGEINTENTIONALLYLEFTBLANK
3 DearClinicalPreceptorsandClinicalCoordinators: ThankyouforyourcontinuedsupportandwillingnesstoprecepttheUniversityofNorth Dakota(UND)CollegeofNursingandProfessionalDisciplinesNurseAnesthesiaTrackstudents. Yourexpertguidanceprovidesourstudentswiththeopportunitytoapplytheirnewlyacquired clinicalskillsandknowledgeinpreparationforanadvancedpracticenursingrole.asabusy professionalwithnumerousdemandsandresponsibilities,yourcommitmenttothisprocessis commendableanddemonstratesyourpersonaldedicationtothecontinueddevelopmentof qualifiednurseanesthesiaprofessionalsandthenurseanesthesiaprofession,asawhole.each studentwillgainconfidenceandvalidationthroughyourexemplaryteaching,coaching,and rolemodeling.itisdifficulttoimaginesuccessfullypreparingqualifiedprofessionalswithout thecollaborationofouranesthesiacolleagues! TheUniversityofNorthDakotaNurseAnesthesiaTrackClinicalPreceptorGuidecontains documentstosupporttheclinicalaffiliationbetweenourprogramandyourorganization.this handbookisintendedtobeusedwithallstudentswhoarecurrentlyenrolledintheprogram. Pleasereviewtheinformationenclosedinthishandbook.Thisguidewillbereviewedand updatedonaregularbasis,sopleasefeelfreetomakecommentsforfutureimprovement. Shouldyouhaveanysuggestionsthatwillmaketheclinicalexperiencemorevaluablefor students,pleasecontactanynurseanesthesiafacultymember. TheUNDNurseAnesthesiafacultyvaluesyourserviceasanexcellentclinician,clinical preceptor,andorclinicalcoordinatorandwelcomesyourrecommendationsformakingthis rolemoreeffectiveandsatisfying.pleasefeelfreetocontactusifyouhaveanyquestionsor concerns. Sincerely, KevinC.Buettner,CRNA,PhD ProgramAdministrator (701)
4 4 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines NurseAnesthesiaTrackFaculty KevinBuettner,CRNA,PhD ProgramAdministrator AmberJohnson,CRNA,MS AssistantProgramAdministrator DarlaAdams,CRNA,PhD ClinicalAssociateProfessor JamieSperle,CRNA,DNP ClinicalAssistantProfessor LaurieNelson AdministrativeAssistant KevinKern,PharmD Instructor JoannaSikkema,PhD ClinicalAssistantProfessor
5 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines NurseAnesthesiaTrack Accreditation TheUniversityofNorthDakotaNurseAnesthesiaTrackisfullyaccreditedbytheCouncilon AccreditationofNurseAnesthesiaEducationalPrograms(COA)until2021,whichisrecognized bytheusdepartmentofeducationandthecouncilforhighereducationaccreditation(chea). TheaddressisCouncilonAccreditationofNursesAnesthesiaEducationalPrograms,222South ProspectAvenueSuite304,ParkRidgeIL Telephone(847) ext1160.Fax NursingisaccreditedbytheCommissiononCollegiateNursingEducation(CCNE)until2020and approvedbythenorthdakotaboardofnursingthrough2021. History TheUniversityofNorthDakota(UND)NurseAnesthesiaTrackishousedintheCollegeof NursingandProfessionalDisciplines.Theprogramwasfoundedin1986attheGrandForks campus,withthefirststudentsadmittedtothetwentyfourmonthprograminaugust1987. TheMasterofScienceprogramhasbeenaccreditedbytheCouncilonAccreditationofNurse AnesthesiaEducationalProgramssinceitsinception. Philosophy ThefacultyandstudentsoftheNurseAnesthesiaTrackbelievethat: 1. Studentsenrolledinthenurseanesthesiaprogrammustbeprovidededucationofsuch qualitythattheyareabletoexcelinthepracticeofanesthesia. 2. Nurseanesthetistsprovideavaluedanddefinitiveroleinthedeliveryofanesthesia care. 3. Itistherightofallindividualstoreceivehighqualityanesthesiacareconducted accordingtorecognizedtenetsofpatientsafetyandrespect. Theeducationalprogramforthepreparationofnurseanesthetistsisconductedasashared responsibilitybetweenstudentandfaculty.studentsmustbeintenselycommittedtoachieving theirgoalsthroughaconsistentdemonstrationofpurpose,motivation,responsibilityto patientsandcolleagues,independenceofthought,creativityandprofessionaldemeanor. Facultyiscommittedtotheresponsibilitiesofservingasresources,facilitatorsoflearningand professionalrolemodels.theprogramiscommittedtoeachstudentthroughindividualized instructionandcounsel. 5
6 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines Ourprimarygoalistoprovidethegraduatestudentwithanadvancedscientificknowledgebase andacomprehensivearrayofclinicalskillsthathallmarkthestandardofcareinanesthesia practice. Ourobligationtograduatesistopreparethemforfullparticipationinthedeliveryofanesthesia careinconcertwithothermembersofthehealthcareteam.graduateswillbecompetentin independentjudgmentasprofessionalnursespracticinginthefieldofanesthesia. Ourresponsibilitytothecommunityisexpressedintheprovisionofaneducationalprogram thatwillpreparethenurseanesthetisttomeetthehealthcareneedsofthepublicina competentandethicalmanner. Ourobligationtotheprofessionistoprepareanurseanesthetistwhowillserveasavaluable resourceinsupportofthegoalsoftheamericanassociationofnurseanesthetistsandthe advancementoftheprofessionofnurseanesthesia. TheanesthesiaprogramadoptstheCollegeofNursingandProfessionalDisciplinesMission Statement:ThemissionoftheCollegeofNursingandProfessionalDisciplinesistoeducate individualsforprofessionalrolesinnursingandnutrition.thecollegestrivestoenhancethe healthofpeopleintheregion,nation,andacrosstheglobebypreparingleadersinnursingand nutritionthroughinnovative,accessibleprograms,andsignificantfacultyandstudent scholarshipandservice. Organizational/CommunicationChart Graduate Department Chair Nurse Anesthesia Track Program Administrator Program Review & Evaluation Committee Assistant Program Administrator and Program Faculty Advisory Council Clinical Coordinators Students 6
7 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines ProgramTerminalBehavioralObjectives/OutcomeCriteria ThebroadbasedobjectivesoftheNurseAnesthesiaTrackaretopreparenurseswhoare: Seekersofnewknowledgebymeansofcriticalthinking,creativereasoning,and scientificinvestigationinanesthesianursingpracticeandtheory; Decisionmakerswhoutilizeadvancedknowledgeinanesthesiaandethicalprinciplesin servingtheneedsofindividualsandsociety; Clinicalspecialistswithexpertiseandadvancedknowledgeinanesthesianursingwho functionindependentlyandcollaborativelywithotherhealthcareteammembers; Leaderscapableofdeterminingstrategieswhichstimulatechangeinnursingpractice, theprofessionandthehealthcaredeliverysystem,and Effectivecommunicatorsofanesthesianursingknowledgeinoralandwrittenforms. Assuch,graduatesoftheTrackmustbeableto: 1. Performapreanestheticinterviewandphysicalassessmentusingpatienthistory, physicalexamination,reviewofmedicalrecords,andappropriatelaboratorydata. 2. Developanappropriateanesthesiacareplanconsistentwiththeoverallmedicaland nursingregimenandestablishedguidelines,utilizingappropriateprinciplesofbasicand behavioralsciencesinprotectingpatientsfromiatrogeniccomplications. 3. Administerphysiologicallysoundanestheticstopatientsofallagesandphysicalstatus categories,utilizinguniversalprecautionsandtheprinciplesofgeneralandregional anesthesiaastheyapplytothediagnostic,operativeandphysiologicconditionofthe patient. 4. Performcomprehensiveandappropriateequipmentchecksandpositionorsupervise positioningofpatientstoassureoptimalphysiologicfunctionandpatientsafety. 5. Recognizeandevaluatephysiologicresponsestotheanesthetic,implementing appropriateactionthatreflectstheuseofsoundphysiologicandpharmacologic principles,referringtoaphysicianthoseresponsesbeyondthenurseanesthetist's abilitytomanageconsistentwithpracticestandardsandpolicies. 6. Useandinterpretabroadvarietyofmonitoringmodalitiesincludingelectronic monitors,takingappropriateactionbasedonsoundprincipleofanesthesia management. 7. Evaluatethepostanestheticcourseofthepatientandrecommendacourseofaction directedtowardcorrectinganyanesthesiarelatedcomplications. 7
8 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines 8. Serveasaresourceperson,teamleaderorteammember,intheareasofacutecare, cardiopulmonaryresuscitation,respiratorytherapyandfluidmanagementandassist otherstoexpandtheirknowledgeintheseareas. 9. Performwithinappropriatemedical,legal,andethicalstandardsofanesthesiapractice, acceptingresponsibilityandaccountabilityforownpractice,recognizingpersonaland professionalstrengthsandlimitations,andtakingappropriateactionsconsistentwith validselfawareness. 10. Demonstrateactiveprofessionalcommitmentandinvolvementinthestate organizationfornurseanesthetists,and,activecommitmentandinvolvementinquality managementactivities. StudentclinicalobjectivesforeachyearandsemesterarelocatedintheUNDNurseAnesthesia TrackStudentandFacultyHandbook. 8
9 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines NurseAnesthesiaTrackCurriculumOutline SemesterI(Fall) 15credithours N500Theories&ConceptsinNursing(3) N504AdvancedPharmacologyI(3) N510AdvancedPhysiology/Pathophysiology(3) N521FoundationsofAnesthesiaPractice(3) N585AdvancedHealthAssessment*(3) SemesterII(Spring) 13credithours N506AdvancedPharmacologyII(3) N507AnesthesiaSeminar&ClinicalPracticumI(4) N511AdvancedPhysiology/PathophysiologyII(3) BIMD510BasicBiomedicalStatistics(2) ANAT591AnatomyforAnesthetists(1) SemesterIII(Summer) 8credithours N517AnesthesiaSeminar&ClinicalPracticumII(5) N520ProfessionalRoseDevelopmentforNurseAnesthetists(3) SemesterIV(Fall) 10credithours N502EvidenceforPractice(3) N527AnesthesiaSeminar&ClinicalPracticumIII(5) N597AdvancedClinicalPracticum(2) SemesterV(Spring) 10credithours N597AdvancedClinicalPracticum(8) N997IndependentStudy**(2) SemesterVI(Summer) 9credithours N597AdvancedClinicalPracticum(9) SemesterVII(Fall) 11credithours N508NurseAnesthesiaReviewCourse(1) N597AdvancedClinicalPracticum(10) TotalCredits:76 *Offeredinonlineformatwithoneweekofcampuslearning **Thesisoptionisavailable 9
10 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines ClinicalEvaluationProcedure Studentsreceivetheirfirstsummativeclinicalperformanceevaluationatthecompletionof theirfirstsummersemester.thereafter,asclinicalparticipationincreasesstudentsreceive formativeclinicalevaluationsatmidterm,followedbyasummativeclinicalevaluationatthe endofthesemester. Studentselfevaluationsarerequiredeachtimeaformativeandsummativeclinicalevaluation iscompletedbyclinicalfaculty.midtermandendofsemesterclinicalperformance evaluationsarebasedonclinicalobjectivesconsistentwiththestudent slevelintheprogram andarepreparedbymembersoftheclinicalfacultythroughreviewofdailyformative evaluationsandpersonalinteractionswiththestudent.dailyperformanceevaluationrecords arecompletedbycrnapreceptorsandarekeptonfileintheclinicalareasofallclinical affiliates.studentsreceivedailyfeedbackontheirclinicalperformance(i.e.,writtenand/or oral). EvaluationsareforwardedbyeachstudenttotheAssistantAdministrator sofficeattheendof eachsemesterforreviewandfiling.inordertotrackstudent sclinicalprogress,photocopies ofeachmidtermandendoftermevaluationfromallclinicalexperiencesmustberetainedin individual3ringbinders.theevaluationsshouldbemadeavailablebystudentstoeachclinical coordinatorasstudentsmovefromclinicalsitetoclinicalsite.studentssignaconsentform titledintersitecommunicationreleasepermittingthesharingofstudentclinicalevaluative informationamongstclinicalcoordinators. TheoriginalcopyoftheseevaluationsisforwardedtotheAssistantProgramAdministrator fromeachclinicalsiteforreviewandplacementinthestudent spermanentfile.informationon theevaluationsisreviewedbytheclinicalcoordinatoronlyandisusedforassessmentand planningpurposesshouldtheneedforfocusingonspecificclinicalconcernsexist. Studentsareprovidedwithselfevaluationformsforcompletionpriortothemidterm formativeandendofsemestersummativeevaluationconferencesandareintendedtoreflect thestudent sperceptionofhis/herprogress.aphotocopyoftheseevaluationsmustalsobe placedinthestudent sthreeringbinder.theoriginalwillbeforwardedtotheassistant ProgramAdministratoralongwiththeoriginalclinicalcoordinatorevaluationform. Theselfevaluationandfacultyevaluationarediscussedsimultaneouslyattheevaluation conference.specificexamplesofclinicalperformancearecitedineachevaluation,alongwith strengths,weaknesses,andsuggestionsandgoalsforimprovementduringthenextevaluation period.studentsarerequiredtosigntheirevaluationsafterreadingthem,andarefreeto makewrittencomments.theseevaluationsbecomeapermanentpartofthestudent srecord. 10
11 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines StudentResponsibilities ProfessionalismandIntegrity Patientrounds,casepreparation,reading,meetingattendanceandothertypesofinquiryoften havetobeperformedonthestudent'sowntime.studentsshallalsoconductthemselvesina professionalandrespectablemannerduringclasstime,clinicaltimeandduringprofessional meetingsandseminars.allstudentsshouldbedressedneatlyandappropriatelywhenon hospitalproperty(noshorts,sweatsuits,etc.)seethevarioushospitals'dresscodepolicy. ProfessionalDecorum TheStudentRegisteredNurseAnesthetist(SRNA)isarepresentativeofthespecialty,the profession,theuniversity,andtheclinicalaffiliates.themaintenanceofaprofessional appearanceanddemeanorfacilitatestheacceptanceoftheprofessionandtheindividualby patientsandotherhealthprofessionals.itisexpectedthatstudentswillassumeresponsibility forobservingthefollowingguidelinesonprofessionalattireanddemeanor.whileattending classesorlaboratorysessionsontheuniversityofnorthdakotacampus,studentsmayexpress theirpersonalchoiceindress.choicesshouldbetastefulandneat. WhileparticipatinginanyProgramactivityoutsideoftheUniversityofNorthDakotacampus, suchastheclinicalsites,studentsshouldpresentaprofessionalappearance.labcoats, programidentification/nametagsmustbewornwhileonthehospitalgroundsandatall clinicaltrainingsites.thehospitaloruniversityissuedidentificationbadgemustalsobewornat alltimeswhileonthosesites.allsrnasmustbeclearlyandcontinuouslyidentifiedasstudents duringclinicalexperiences.noothercredentialswillbedisplayedonthestudenti.d.badge. Professionalattireshouldbeobservedwheneverstudentsareonhospitalorinstitutionalsites. Thisincludesvisitstostudyinthehospitallibrary,didacticexaminationsadministeredinthe hospitalfacility,majorgroupmeetingsetc.jeans,sweatpantsandshirts,sandalsandcasual accessoriesarenotconsideredappropriateinthesesettings.duringclinicalexperiences, studentsareexpectedtofollowpoliciesandproceduresputforthbyeachclinicalsite.students maynotwearartificialnailsordanglyjewelryintheoperatingroomorwhilecaringfor patients. GuidelinesforClinicalConduct Astheprogramoffersnewclinicalchallenges,thedevelopingprofessionalbearsthe responsibilityofrepresentingtheprofessiontopatients,thepublic,andothermembersofthe healthcareteam.thefollowingguidelinesshouldbeobservedinrepresentingtheprofession: Consistentlydemonstrateyourconcernforthewelfareofthepatient. 11
12 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines 12 Bethoughtfulandprofessionalwhenobtainingthehistoryandperformingthephysical exam. Treatpatientswithrespectanddignity,bothinyourinteractionswiththem,andinyour patientrelateddiscussionswithotherprofessionals. Demonstrateyourconcernnotonlyforthemedicalproblembutalsoforthetotal patient. Conscientiouslyrespecttherightsofyourcolleagues. Characterizeallofyourprofessionalencounterswithcooperationandconsideration. Strivetoassumeanappropriateandequitableshareofpatientcareduties. Approachyourresponsibilitieswithdedication. Betruthfulinallprofessionalcommunications. Whenmeetingmultipledemands,establishpatientcenteredprioritiestoguideyouin completionofsuchwork.
13 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines UniversityofNorthDakotaNurseAnesthesiaTrack PositionDescription PositionTitle: Description: ClinicalCoordinator ACertifiedRegisteredNurseAnesthetist(CRNA)whocoordinatesthe clinicaleducationofstudentsenrolledintheundnurseanesthesia Track. Qualifications: 1. CRNAsmustmaintainRegisteredProfessionalNurseandAdvancedPracticeNurse LicensurewiththeapplicableStateBoardofNursingwheretheclinicalsiteislocated. EvidenceofcurrentlicensurewillbekeptonfilewiththeUNDNurseAnesthesiaTrack. 2. CRNAsmustbecertifiedbytheNationalBoardofCertificationandRecertificationfor NurseAnesthetists. 3. CopiesofcurrentCV/resume,certification,andlicensurewillbeonfilewiththeUND NurseAnesthesiaTrack.Uponrenewalofcertificationandlicensure,copieswillneedto befurnishedtotheprogram. 4. Minimumofone(1)yearofexperienceasaCRNA. 5. Currentlyactiveinclinicalpractice. 6. Managerialskillsandexperiencenecessarytocoordinatestudentclinicalactivities. 7. Effectiveinterpersonalandleadershipskillsnecessarytofosterproductiveworking relationships. 8. Effectiveoralandwrittencommunicationsskills. PositionSummary: 1. AssisttheNurseAnesthesiaFacultyinthecoordinationofclinicaleducationofstudents enrolledinthenurseanesthesiaprogram. 2. Directsandparticipatesintheclinicaleducationofthestudentsscheduledatthe institution. 3. Continuallymaintainscommunicationregardingstudenteducationand/orissueswith thenurseanesthesiafaculty. 4. Overseesthequalityofeducationthatstudentsarereceivingintheclinicalarea. 5. Responsibleforcommunicatingstudentissueswithclinicalpreceptorsatthesite. 6. Providesorappointsanothertoprovidethestudentwithanoverallperformance summaryattheconclusionoftheirclinicalexperience. 13
14 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines PositionResponsibilities: ACRNAclinicalcoordinatorisassignedateachclinicalaffiliationtoserveastheprimarystudent contactpersonandstudentresource.theyhaveseveralduties,whichincludebutarenot limitedto: 1. ServeasaliaisonbetweentheaffiliatesiteandtheUNDNurseAnesthesiaTrack. 2. Conveysuggestionsfromtheirclinicalsiteforprogramimprovementorenrichment. 3. SitontheNurseAnesthesiaAdmissionsSubCommittee. 4. Provideongoingcommunication,guidelinesandfeedbacktostudentsassignedto clinicalsite. 5. SitontheNurseAnesthesiaTrackAdvisoryCommittee. 6. Providecaseassignmentstostudents. 7. Monitorstudentprofessionalism,attendance,andclinicalperformance. 8. Informprogramfacultyofanystudentperformancethatisbelowaverage, unsatisfactory,orunprofessional. 9. Functionassecondlineproblemresolutionifdisputearisesbetweenstudentand clinicalfaculty. 14
15 UniversityofNorthDakotaCollegeofNursingandProfessional Disciplines UniversityofNorthDakotaNurseAnesthesiaTrack PositionDescription PositionTitle: Description: ClinicalPreceptor ACertifiedRegisteredNurseAnesthetist(CRNA)orAnesthesiologistwho supervisesthestudentregisterednurseanesthetist(srna)duringthe administrationofanesthesia. Qualifications: 1. CurrentcertificationbytheNationalBoardofCertificationandRecertificationforNurse Anesthetistsorlicensedinmedicineholdinganesthesiaspecialtytraining.Evidenceof currentcertificationwillbeavailableuponrequest. 2. Currentandappropriateprofessionalnursing/physicianlicensurewithStateinwhichthe affiliatesiteislocatedandanesthesiaservicesareprovided.evidenceofcurrent licensurewillbeavailableonrequest 3.Participatesincontinuingeducationandfacultydevelopmentactivitieswhichenhance theirroleasclinicaleducatorsofnurseanesthesiastudents. 4.Consistentlydemonstratecompetencyintheirareaofresponsibilityandbe knowledgeableintheteachingandlearningprocess. PositionSummaryandResponsibilities: 1. SupervisestheSRNAduringtheadministrationofanesthesia. 2. Recognizespathophysiologicalstatesofthepatientthatarepertinenttotheanesthetic. 3. Discussthepatient sstatusandrationalefortheanestheticmanagementwiththesrna andtheanesthesiologist(ifapplicable). 4. EvaluatestheSRNA sclinicalperformanceandconstructivelydiscussesthisperformance withthesrnaandnurseanesthesiaprogramadministration. 5. ProvidestheSRNAwithlearningopportunitiesthatareenhancedthroughdiscussion anddemonstration. 6. InformstheProgramDirector,AssociateProgramDirector,orAffiliateClinical CoordinatoratthesiteofpertinentSRNAperformances. 7. SupervisestheSRNAintheimmediatepostoperativecareandevaluationofthe patient. 8. EncouragestheSRNAtoaskquestionsandthinkcritically. 15
16 NurseAnesthesiaTrackForms StudentDailyCarePlan StudentWeeklyClinicalEvaluation ClinicalEvaluationofStudentPerformance ClinicalInstructorSelfEvaluation ClinicalReleaseTime 16
17 College of Nursing Nurse Anesthesia Track DAILY CARE PLAN Date: Pre-operative Diagnosis: Age: Gender: Allergies: Male / Female Proposed Surgery: Elective / Urgent Emergent Anatomic Position: NPO: ASA Physical Exam: HT WT kg BP HR RR T SaO2 Airway Class: Neck Movement: Dental: Review of Systems: RESP: CV: NEURO: Laboratory and Diagnostic Studies: HGB HCT PLTS Electrolytes: BUN Cl CO2 Na GLUC K Creat HEP/ GI: ENDOCRINE: Coag: PT Other: PTT INR RENAL: OTHER: Medications: Blood Type: Type and Cross EKG: CXR: Previous Anesthesia History: Pathophysiology: ANESTHESIA IMPLICATIONS Surgical Procedure: Aug
18 College of Nursing Nurse Anesthesia Track DAILY CARE PLAN Surgical Implications: Other Concerns: Technique Chosen: GEN REG Reasoning: MAC Backup Technique: GEN REG Reasoning: MAC Special Equipment/ Invasive Lines Reasoning: Pre-Induction: PHARMACOLOGIC PLAN Reasoning: Induction: Reasoning: Maintenance: Reasoning: Emergence: Reasoning: Secondary Medications: Reasoning: FLUID MANAGEMENT EBV ABL MAINT DEFICIT 3 rd SPACE Aug
19 College of Nursing Nurse Anesthesia Track DAILY CARE PLAN CASE MANAGEMENT EBL FLUIDS BLOOD OTHER CHALLENGES ENCOUNTERED Problem Solution / Reasoning Outcome Post-op Problems / Concerns Student Preceptor Date Aug
20 College of Nursing Nurse Anesthesia Track WEEKLY CLINICAL EVALUATION Student Name: Clinical Coordinator: Clinical Site: 1= Unmet, 2= Needs Improvement, 3= Met Expectations, 4= Excellent Evaluation Criteria MON TUE WED THU FRI Preparation: 1. Familiar with patient history (complete review of pt. records) DATE Shift Hrs 2. Care Plan appropriate 3. Knowledge about surgical procedure, anesthesia implications, airway implications, positioning 4. Secondary drug plan (Rx, low BP, high BP, arrhythmias, etc) 5. Comprehensive equipment check & report of problems 6. Starting IV s, A-Lines Induction: 7. Administration of spinal or regional blocks 8. Airway management/intubation skills 9. Patient safety, including use of universal precautions, infection control measures, and protection from iatrogenic complications Maintenance: 10. Integrates knowledge of surgical procedure with anatomy, physiology, pathophys, & pharmacology 11. Patient safety monitors patient, interprets and utilizes noninvasive and invasive monitoring modalities. Recognizes and responds to problems appropriately 12. Adjusts/administers anesthetic in accordance with patient needs 13. Appropriate fluid/blood component management 14. Common sense/independence in practice skills Emergence 15. Shows good judgment in discontinuing anesthetic, extubating, etc 16. Monitors patient through admit to PACU 17. Professional attitude/communication with instructor, surgeons, and peers. Accepts responsibility for own practice 18. Demonstrates flexibility in dealing with change in patient caseload, assignments, or change in anesthetic plan/technique Preceptor Signature: June 2011
21 College of Nursing Nurse Anesthesia Track WEEKLY CLINICAL EVALUATION Student Name: Clinical Coordinator: Clinical Site: DATE CRNA Comments: Student Comments: MON Personal Objective: Self-Evaluation: Signatures: TUE Personal Objective: Self-Evaluation: Signatures: WED Personal Objective: Self-Evaluation: Signatures: THU Personal Objective: Self-Evaluation: Signatures: FRI Personal Objective: Self-Evaluation: Signatures: June 2011
22 College of Nursing Nurse Anesthesia Track Clinical Evaluation of Student Performance Student Mid-term End-of-term Hospital 1 st year 2 nd year 3 rd Year Date completed Student self-evaluation DUE Week of Months in program Clinical coordinator evaluation Semester: Fall Spring Summer PERFORMANCE SKILLS SUPPORTING CLINICAL OBJECTIVES PREPARATION Unmet Needs Improvement Met Excellent 1. Familiar with patient history - appropriate anesthesia care plan 2. Comprehensive anesthesia equipment check & appropriate reporting of problems or malfunctions 3. Knowledgeable about surgical procedure and anesthesia implications - airway implications - positioning 4. Secondary drug plan developed (Rx, low BP, HTN, arrhythmia, etc.) INDUCTION 5. Starting IVs, A-lines, etc. 6. Administration of spinal or regional blocks 7. Airway management/intubation 8. Patient safety, including use of universal precautions, infection control measures, and protection from iatrogenic complications MAINTENANCE 9. Integrates knowledge of surgical procedure with anatomy & pharmacology 10. Patient Safety - Monitors patient, interprets and utilizes noninvasive & invasive monitoring modalities. Recognizes & responds to problems 11. Adjusts/administers anesthetic in accordance with patient requirements 12. Appropriate fluid/blood component therapy (calculations, initiation of) 13. Common sense/independence in practice skills EMERGENCE 14. Good judgment discontinuing anesthetic, extubating, etc. 15. Monitors patient through admit to PACU COMMUNICATION & PROFESSIONALISM 16. Professional attitude/communication with instructor, surgeons, peers. Accepts responsibility and accountability for own practice 17. Demonstrates flexibility with changes in caseload, assignments, anesthesia plan/technique *If a rating of Unmet or Needs Improvement is given, an accompanying statement must be included in the narrative and a plan for resolution incorporated into the goals for the next rating period. Aug 2011
23 College of Nursing Nurse Anesthesia Track Clinical Evaluation of Student Performance IN TERMS OF THE STUDENTS BASIC SKILLS, PLEASE COMMENT ON ANY OF THE FOLLOWING. 1. Readiness/Preparation for Clinical 2. Induction 3. Maintenance 4. Emergence 5. Communication & professionalism 6. Additional Comments/recommendations 7. Goal Setting Overall Evaluation of Student s Clinical Performance at this time is: Satisfactory Unsatisfactory (include comments and improvement plan) HAS STUDENT PARTICIPATED IN THE FOLLOWING? 1. Airway and ventilatory management resource person Yes No If yes, in what patient care areas? PACU ER ICU Other 2. Cardiopulmonary resuscitation leader or team member Yes No 3. Quality management activities, i.e.; QA meetings, product trials, case conferences, journal club, etc. Yes No Examples: 4. Anesthesia outside the operating room, i.e.: MRI, cardio versions, Interventional radiology, etc. Yes No Examples: Number of Days Absent Date of Evaluation Conference SIGNATURES: Clinical Coordinator Student Additional Signatures Aug 2011
24 ClinicalInstructorSelfEvaluation Pleaseanswerthefollowingquestionsandreturntotheclinicalcoordinator.Theformswillbe sentbytheclinicalcoordinatortotheprogramdirector.oncethedirectorhascompletedself evaluationforms,allcompileddatafrompriorstudentevaluationsoftheclinicalinstructorwill beforwardedontheclinicalinstructor.anyongoingtroublesomeorpraiseworthybehaviors willbediscussedwiththeclinicalcoordinatorandchiefanesthetist/anesthesiologistateach respectivesite. ClinicalInstructor KEY: 1=Always2=Usually3=Sometimes4=Seldom5=Never Questions AsaclinicalinstructorIreviewthestudent scareplanand offersuggestions. 2. AsaclinicalinstructorIamavailableifhelpisneededin preparingtheroomfortheday. 3. AsaclinicalinstructorIprovidedirectionandrationalefor interventionswhichoccurduringthecourseoftheanesthetic 4. AsaclinicalinstructorIrespondtostudentquestionsina timelyandappropriatemanner. 5. AsaclinicalinstructorIgivethestudentconstructivecriticism inprivateasopposedtocriticisminfrontofotherpersonnel. 6. AsaclinicalinstructorIseekinputfromthestudentconcerning theanestheticandafterdiscussionallowthestudentto implementappropriatesuggestedchanges. 7. AsaclinicalinstructorIencouragethestudenttogrowinthe fieldofanesthesia.idothisthroughconstructivecriticism, timelyfeedback,appropriatesupervision,andpraiseforwork welldone. Comments: Date ClinicalInstructor
25 NurseAnesthesiaTrack CLINICALRELEASETIMEREQUEST DATE: STUDENTNAME: CLINICALSITE: REQUEST# CLINICALRELEASTTIMEREQUESTED/REPORTED: DATE(S): TIME/HOURS: PURPOSEFORREQUESTING/REPORTINGCLINICALRELEASTTIME: PROGRAMFACULTYCOMMENTS: APPROVED NOTAPPROVED STUDENTSIGNATURE DATE CLINICALCOORDINATORSIGNATURE DATE PROGRAMFACULTYSIGNATURE DATE UND is an equal opportunity/affirmative action institution June2011
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