KAPLAN UNIVERSITY Nurse Practitioner Program Clinical Information

Transcription

1 1 KAPLAN UNIVERSITY Nurse Practitioner Program Clinical Information Thank you for providing Kaplan University nursing students an educational experience at your facility. This information provides an introduction to the School of Nursing and the Nursing clinical process. This information is provided to assure that you, the student, preceptor and faculty have a mutually successful experience. THE KAPLAN NAME Kaplan, Inc. has been a leader in educational and career achievement since Today, we serve more than 65,000 students through Kaplan higher education, which consists of online programs at Kaplan University, 70 campus-based schools in 22 states, and a growing number of international divisions. Also, Kaplan Test Prep is internationally recognized for its NCLEX exam preparations course and other test review programs... Kaplan University is accredited by The Higher Learning Commission and a member of the North Central Association of Colleges and Schools (NCA). The baccalaureate and master s degree programs at Kaplan University are accredited by the Commission on Collegiate Nursing Education (

2 2 Kaplan University offers the following nursing education programs: Associate of Science in Nursing (ASN) degree (available in limited locations), Bachelor of Science in Nursing completion program (RNBSN), Master of Science in Nursing (MSN), and an RN-MSN option, which is for nurses that have an associate of science in nursing or a diploma in nursing and wish to complete both the BSN and MSN degree. The MSN degree offers five specialization areas: nurse educator, executive leader, informatics, adult-gerontology nurse practitioner, and family nurse practitioner. The RN-BSN and MSN programs are for registered nurses that are seeking to increase their nursing education. Additionally, the University offers a Doctor of Nursing Practice (DNP) degree. The DNP program offers students the option to complete additional education in the specialty areas of family nurse practitioner, adultgerontology nurse practitioner, and executive leader. We also offer certificate programs for nurses that have attained an MSN but are seeking education in a specific specialization area. For more information about the admission criteria and the programs, please see the following link: online.kaplanuniversity.edu/nursing/pages/school_of_nursing.aspx MISSION The Kaplan University nursing programs prepare students to enter the nursing profession at many levels of practice, from basic to advanced, and enable graduates to develop and apply the knowledge, skills, and values gained from their education to serve effectively in whatever nursing roles and settings they choose. The University promotes nursing education focused on providing excellent care, serving as leaders, and being accountable and responsive to the ever-changing global health care climate. PHILOSOPHY The philosophy of the School of Nursing flows from the mission of Kaplan University and supports the University's core values of integrity, knowledge, support, opportunity and results. The faculty believes an educational environment that fosters mutual respect, integrity, intellectual inquiry, and effective communication will promote learning. The faculty believes those theories and knowledge from nursing and the physical, social and behavioral sciences contribute collectively to promote, protect, and restore health for persons, families, groups, and communities. The faculty believes that basic and applied research in nursing and other health care fields guide and supports advances and refinements in the practice of nursing. CLINICAL ROLES AND EXPECTATIONS Nurse Practitioner (NP) students enter the program possessing basic nursing knowledge and skills. The clinical experience is to expand students knowledge of advanced nursing practice and prepare them to fulfill the role of advanced practice nurses. Family Nurse Practitioner students will complete four clinical rotations during their program of study two-ten week rotations of 185 hours each, one-ten week rotation in pediatrics of 120 hours, and then 185 additional hours that are completed across two

3 3 consecutive courses (twenty weeks total). The final 185 hours will allow students to continue to refine their clinical skills while also working to complete a final capstone project. Adult-Gerontology Nurse Practitioner students complete the same rotations described above but do not complete the 120-hour pediatric rotation. More detailed information about appropriate clinical settings for each course can be found in Appendix A. Specific course objectives for each clinical course are located in Appendix B. Example project information can be found in Appendix C. The preceptor's responsibility is to provide NP students with guidance and clinical experiences and to foster the students development of the skills necessary to manage care of individuals and families across the lifespan. Preceptors are expected to support the Kaplan University School of Nursing mission and philosophy during their work with students. Students will be expected to provide primary, acute, chronic and health maintenance care to individuals and families across the lifespan. The preceptor will facilitate students clinical experiences and achievement of clinical objectives through formative and summative assessments of performance. Preceptors are responsible for the following activities: Sign the preceptor agreement form Provide a copy of professional license, all required certifications and current CV/Résumé Introduce student to facility staff and provide orientation to the setting Serve as preceptor to no more than one student per term Provide guidance to the NP student, serve as a professional role model, and demonstrate clinical expertise in the area of practice. Assure there is appropriate space and room facilities for the student s clinical experience Select and oversee appropriate clinical experiences to meet the student s course objectives and clinical expectations

4 4 Assess the student s knowledge and skills on an ongoing basis, providing timely and formative feedback Provide the student ongoing feedback related to clinical performance, including areas for improvement Notify the designated faculty and/or the Practicum Manager of any problems related to the student's behavior or performance Provide the student and faculty with evaluation of clinical performance at the end of the term, and at intervals during the term. Verify student clinical hours via RxPreceptor throughout the course. Submit student evaluation form via RxPreceptor at the end of the term. The Kaplan University School of Nursing faculty is grateful for your support of our students. We appreciate your expertise, time and effort in preparing NP students to meet clinical expectations. We will provide a written document verifying the number of preceptor hours provided at the end of the student clinical experience. Student Role and Expectations Nurse Practitioner (NP) students are required to comply with facility policies, rules and regulations, and apply ethical standards in providing care to individuals across the lifespan. Students must behave in a respectful manner, perform in a manner that respects cultural differences, and accept guidance from the assigned preceptor. NP students are to collaborate with assigned preceptors, and be active participants in assessing, diagnosing, and managing care of patients across the lifespan. Throughout the clinical experience, NP students are required to: Demonstrate professionalism in appearance, behavior, and communication Complete the assigned number of clinical hours Be punctual for all scheduled clinical sessions Assume accountability for practice Seek opportunities to enhance knowledge and skills Accept and respond to performance feedback in a professional manner Maintain confidentiality and privacy Demonstrate appropriate interviewing techniques, demonstrating awareness of age, cognitive deficits, spirituality, cultural differences, emotional/mental status, functional deficits, and environmental/social influences Obtain appropriate history for focused/episodic, comprehensive, acute and/or interval visits Create a climate of mutual trust while interacting with patients

5 5 Perform appropriate and organized examination for episodic/focused, comprehensive, acute and/or interval situations and modify examination technique to the individual and setting Apply critical thinking and diagnostic reasoning skills to develop differential diagnoses with rationales, and formulate actual diagnoses Demonstrate knowledge of common lab values and diagnostic studies, and accurately interpret results Demonstrate sound judgment in developing the treatment plan including pharmacology and non-pharmacological therapy Demonstrate knowledge of appropriate time frame for follow-up appointment/care Accurately document assessment findings Deliver safe care Accept personal responsibility for professional development Document evaluation of clinical site, clinical experience and preceptor and submit document to assigned faculty Students are responsible to promptly inform faculty members and the Clinical Placement Team of any changes in the assigned clinical site, preceptor, or planned schedule, as well as any unanticipated events that occur during the clinical experience. Students are responsible for having the appropriate contact information with them at all times. Graduate Nursing Faculty Role and Responsibilities The School of Nursing Clinical Placement Team will facilitate the clinical process by communicating with students and preceptors to assure required documents are submitted prior to beginning clinical. An assigned faculty member will facilitate the learning process through collaboration with the preceptor to optimize students clinical experiences and professional role development. Nursing faculty will assume the following responsibilities: Orient students and preceptors to clinical roles and responsibilities Identify clinical objectives with the student and preceptor Communicate periodically with preceptor and student about progress in meeting goals, and provide feedback Assess selection of patients within the preceptor environment to ensure adequate learning experiences through periodic review of clinical logs Respond to concerns of student and preceptor in a timely manner Evaluate student s clinical progress through communication with the student and preceptor, review of clinical log and documentation, and written evaluation by preceptor and faculty

6 6 ACCEPTING A STUDENT FOR CLINICAL Completing an Affiliation Agreement is the first step for hosting a student for a clinical experience. Attached is the Kaplan University Affiliation Agreement that has been developed for our Nursing Programs. The agreement must be signed and returned for the Kaplan Dean of Nursing s signature prior to the student beginning the clinical experience. We will provide your facility with a copy of the completed agreement. If your facility has a required affiliation agreement format, please a copy of the agreement template in Word format to the appropriate Clinical Student Manager for your state (contact information below). The Clinical Student Manager will then submit the facility agreement to Kaplan s legal department for review. Kaplan staff is available to answer any questions you may have regarding the affiliation agreement. Preceptor Selection is the second step in hosting a student for clinical. Please review the attached Preceptor Agreement, which must be signed by the Preceptor. Preceptors for the NP program must be appropriately credentialed and be either a MSN-NP, MD, DO, or PA. All preceptors must have a minimum of one year s experience in the institution/agency, and be recommended by the employing institution. Each preceptor will be responsible for one nursing student during an academic term. Insurance: Clinical students provide their own professional liability insurance. Criminal Background Check: All students in the School of Nursing must complete a criminal background check through Kaplan University s designated provider prior to enrolling in the clinical course. Time Log: Throughout the clinical experience, the student is required to document the time and activities spent in the agency. The preceptor will be responsible for verifying and signing the timelog on a regular basis. This will be done through the RxPreceptor electronic system. Preceptors will receive notifications requesting verification of student clinical hours. Preceptor s Evaluation of the Student: At the end of the clinical, the preceptor is required to complete a Student Evaluation and discuss that evaluation with the student. This evaluation will be completed and submitted electronically through the RxPreceptor electronic system. Preceptors will again receive notification for evaluation needs. CONTACT INFORMATION Contact information for the states of Arkansas, Illinois, Iowa, Kansas, Michigan Minnesota, Missouri, Montana, Nebraska, North Dakota, South Dakota, and Wisconsin with additional questions or needs should contact: Dr. Hope M. Bauman, DNP, FNP Practicum Manager, Kaplan University School of Nursing hbauman@kaplan.edu (preferred method for affiliation agreement needs)

7 7 Phone: Fax: Contact information for the states of Alaska, Arizona, California, Colorado, Georgia, Hawaii, Idaho, Kentucky, Louisiana, Nevada, New Mexico, Oklahoma, Oregon, Tennessee, Texas, South Carolina, Utah, Washington, and Wyoming with affiliation agreement needs should contact: Dr. Hope M. Bauman, DNP, FNP Practicum Manager, Kaplan University School of Nursing (preferred method for affiliation agreement needs) Phone: Fax:

8 8 Contact information for the states of Alabama, Florida, and Mississippi, as well as Puerto Rico, Guam, US Territories, or International sites with additional questions should contact: Tara Saucier, RN, MSN Clinical Student Manager, Kaplan University phone: fax: Contact information for the states of Connecticut, Delaware, Indiana, Maine, Massachusetts, New Hampshire, New Jersey, New York, North Carolina, Maryland, Ohio, Pennsylvania, Rhode Island, Vermont, Virginia, Washington DC, and West Virginia with additional question should contact: Nicole Walters, MEd, RN Clinical Student Manager, Kaplan University phone: Kaplan University School of Nursing CLINICAL/PRACTICUM AFFILIATION AGREEMENT This Clinical/Practicum Affiliation Agreement (hereinafter referred to as Agreement ) is effective as of this day of, 20, between Iowa College Acquisition LLC d/b/a Kaplan University (hereinafter referred to as the University ), and, (hereinafter referred to as the Facility ). RECITALS University is a regionally accredited university, which has established and sponsored certain bachelors and masters level health education programs, including a program providing education and training in the field of Nursing (the Program ), subject to applicable accreditation standards and regulations; Facility is licensed in the state of ( State );

9 9 The Program requires the fulfillment of certain supervised practical experiences ( Clinical/Practicum Experience ) for completion of the training obtained therein; It has been determined that it is in the best interest of the University s students ( Students ) that the facilities of the Facility be used to provide the requisite Clinical/Practicum Experience for the Students education; The Facility has agreed to provide the Students with the required Clinical/Practicum Experience at its facilities, subject to the terms and conditions of this Agreement; and This Agreement is intended, in part, to satisfy the standards set forth in applicable accreditation and other regulatory requirements. NOW THEREFORE, in consideration of the terms and conditions herein contained, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows: ARTICLE I University Responsibility A. Provide a School of Nursing Practicum Coordinator ( Coordinator ) to facilitate the guidance of Students during the Clinical/Practicum Experience. The Coordinator will also manage the Clinical/Practicum Experience and coordinate schedules in collaboration with the Facility s supervising staff member and designated Preceptor ( Preceptor ), a School of Nursing faculty member who is not required to be physically on-site at Facility ( Faculty ) and the Student. All Faculty and Preceptors shall maintain licensure and/or certification and be in good standing with all applicable regulatory and accrediting agencies. B. If applicable to the Clinical/Practicum Experience, ensure that all Students assigned to the Facility are properly licensed. C. Provide for classroom theory and practical instruction to Students prior to their Clinical/Practicum Experience at Facility. D. Advise all Students to comply with applicable policies, rules, regulations and procedures provided by Facility while participating in the Clinical/Practicum Experience. E. Attest to Facility that each student assigned to the Clinical/Practicum Experience has completed a Criminal Background Check. A Criminal Background check includes, at a minimum, all of the following elements: (1) seven year criminal background check in current and previous counties of residence and employment, (2) a check of the national sex offender registry and (3) evidence that the Student is not ineligible to participate in all federal and state health programs and verification that the Student is not on the OIG or GSA exclusion list.

10 10 F. Advise all Students that they must be prepared to provide University with written verification of the immunization and diagnostic tests conducted in compliance with Facility s health policy and an overall health status report listing physical limitations, if any, and any other pertinent information in order to participate in the Clinical/Practicum Experience. In accordance with applicable laws, and upon Facility s request, University will provide this information to Facility. G. Maintain any necessary accreditation, licenses or certifications for the operation of University and notify Facility of the results of any accreditation, licensing or certification which is probationary or in which approval is denied or removed. H. Provide Facility with documentation of the educational requirements to be satisfied during the Students Clinical/Practicum Experience and any required evaluation forms for Facility to assist school in evaluating Students and the Clinical/Practicum Experience. I. Defend, indemnify and hold Facility, its directors, officers, agents and employees harmless from and against any and all damages, claims, demands, suits, judgments, penalties, settlements, and costs (including reasonable attorney s fees and expenses) and liability imposed by law ( Damages ) to the extent arising from or in connection with (i) any action taken by University or its agents solely as a function of the educational aspects of the Program (ii) the negligent acts or omissions of Students (unless taken at the direction of Facility or its agents) and (iii) any breach by University of any provision of this Agreement. This indemnification obligation shall survive any termination of this Agreement. As used throughout this Agreement, the term Damages shall mean direct Damages and shall exclude consequential, punitive, exemplary or other indirect Damages. ARTICLE II Facility Responsibility A. Provide all reasonable accommodations necessary for the training of Students participating in the Clinical/Practicum Experience and retain control over the organization, administration, operations and financing of Facility and its health services. B. Designate an appropriately credentialed Preceptor who will provide written agreement to serve as Preceptor for one student during the Clinical/Practicum Experience (1:1 ratio required). University maintains the right to review and approve such Preceptor. C. Provide orientation for the Student along with necessary information related to the Clinical/Practicum Experience to facilitate a successful learning experience. D. Provide the Coordinator, Student and Faculty written information regarding Facility s policies and procedures (and any changes thereof) relevant to the Clinical/Practicum Experience. E. Permit representatives of University, upon establishing a mutually satisfactory plan, to inspect the Clinical/Practicum facilities and services available for the Clinical/Practicum Experience.

11 F. Maintain any necessary accreditation, licenses or certifications for the operation of Facility and notify University of the results of any accreditation, licensing or certification which is probationary or in which approval is denied or removed. G. Maintain a policy whereby staffing levels at the Facility will not be reduced based on the availability or presence of Students participating in the Clinical/Practicum Experience and a policy whereby Students will be supervised at all times while performing services during the Clinical/Practicum Experience. H. Defend, indemnify and hold harmless University and its affiliates and their respective directors, officers, agents, students and employees from and against any and all Damages to the extent arising from or in connection with (i) the negligent acts or omissions of Facility, including its staff, employees and agents, (ii) the negligent acts or omissions of Students taken at the direction of Facility or its agents and (iii) any breach by Facility of any provision of this Agreement. This indemnification obligation shall survive any termination of this Agreement. 11 ARTICLE III Joint Responsibilities A. The Preceptor and Coordinator will work collaboratively to assure systematic planning and adherence to the proposed intent of the Student s Clinical/Practicum Experience. B. The Student s Clinical/Practicum Experience at Facility will be under the direction and supervision of a member of Facility s staff and/or Preceptor. Although University is responsible for the overall direction and administration of the Program, The University does not provide patient care and, as such, shall have no responsibility or liability for patient care decisions at Facility. C. The Facility shall retain the right to require the removal from and deny access to its facilities to any student whose professional conduct is, in the opinion of the Facility s administration, unacceptable or disruptive of the established practices of the Facility. Such actions shall be reported immediately to the Coordinator or, in his/her absence the University s Dean of Nursing. Disciplinary action relative to the Student will be the responsibility of the University, which provides for investigation, hearing, and appropriate disposition. D. (i) University and Facility shall secure and maintain at all times during the Term of this Agreement (as defined in Article IV below), at their respective sole expense, commercial general liability insurance covering themselves and their respective agents and employees. Such coverage provided by University and Facility may be afforded via commercial insurance, selfinsurance, a captive, or some combination thereof at limits of at least $1,000,000 per occurrence. Such insurance shall not be cancelable except upon 30 days prior written notice to the other party. Such coverage shall be primary and non-contributory. Upon either party s reasonable request, the other party shall provide a certificate of insurance evidencing such coverage.

12 (ii) To the extent required by law, University and Facility shall each secure and maintain at all times during the Term, at their respective sole expense, workers compensation and employers liability insurance covering their respective agents and employees. Such coverage provided by University and Facility may be afforded via commercial insurance or self-insurance. (iii) University and Facility shall secure and maintain at all times during the Term, at their respective sole expense, professional liability insurance (medical malpractice) covering their respective employees and agents. University s professional liability insurance shall provide for coverage of Students providing services to Facility pursuant to this Agreement. Such coverage as provided by Facility or University shall be afforded via commercial insurance, self-insurance, a captive, or some combination thereof at limits of at least $1,000,000 per occurrence and $3,000,000 aggregate. Upon either party s reasonable request, the other party shall provide a certificate of insurance evidencing such coverage. E. Both parties agree that all Students participating in the Clinical/Practicum Experience shall be, at all times, unpaid externs without the expectation of or entitlement to compensation or benefits from either party. F. There shall be no discrimination on the basis of race, national origin, religion, creed, sex, age, sexual orientation, veteran status, disability or other legally protected classification in either the selection of Students, or as to any aspect of the Clinical/Practicum Experience; provided, however, that with respect to disability, the disability must not be such as would, even with reasonable accommodation, in and of itself preclude a Student s effective participation in the Clinical/Practicum Experience. G. Where areas of difference exist or occur in rules, regulations or questions on nursing practices, Facility and University representatives will resolve these differences mutually. H. Each party agrees to comply fully with all applicable federal and state laws, rules and regulations in performing their obligations under this Agreement, including the Health Insurance and Portability and Accountability Act of 1996, as codified at 42 U.S.C. 1320d (HIPAA) and any current and future regulations promulgated thereunder. The parties further agree to comply fully with the final regulations of the Occupational Safety and Health Administration (OSHA) governing employee exposure to bloodborne pathogens in the workplace. The parties acknowledge that the services being provided to the Facility by the University pursuant to this Agreement are not intended to create a Business Associate relationship as that term is defined in 45 CFR ARTICLE IV TERM AND TERMINATION This Agreement shall commence on the Effective Date and shall continue for a period of one year (the Term ), and shall automatically renew for successive one year periods, unless earlier terminated as follows:

13 13 A. The parties may terminate this Agreement at any time by mutual written consent and such termination shall be effective upon the date stated in the consent. B. Either party may terminate this Agreement without cause at any time upon not less than ninety (90) days prior written notice. Notwithstanding anything contained herein to the contrary, any without cause termination of this Agreement shall not be effective with regard to Students participating, at the time of such termination, in the Clinical/Practicum Experience until all such Students have completed or otherwise discontinued participation in such Clinical/Practicum Experience. C. This Agreement may be immediately terminated if (i) University s licenses, accreditations or certifications required to operate the Program are terminated or revoked or any material disciplinary action is taken against University by an accreditation or regulatory agency or (ii) Facility s licenses, accreditations or certifications required to operate Facility are terminated or revoked or any material disciplinary action is taken against Facility by an accreditation or regulatory agency. D. Either party shall have the right to terminate this Agreement for cause, upon not less than thirty (30) days notice upon the violation by another party of any material provision of this Agreement provided that, following receipt of written notice by the other party specifying such violation with reasonable particularity, such violation is not cured prior to the effective date of termination stated in such notice. ARTICLE V MISCELLANEOUS A. Amendment. This Agreement may be amended only by written agreement of each of the parties hereto. B. Notice. All notices and other communications required hereunder by either party to the other shall be in writing, delivered personally, by certified or registered mail, return receipt requested, or by overnight courier, and shall be deemed to have been duly given when delivered personally or received when using overnight courier or three business days after being deposited in the United States mail, postage prepaid, addressed as follows: If to School: with a copy to: Kaplan University 6301 Kaplan University Avenue Fort Lauderdale, FL ATTN: Clinical Placement Kaplan University (which copy shall not constitute effective notice) 6301 Kaplan University Avenue

14 14 Fort Lauderdale, Florida Attn: Legal Department If to Institution: or to such other persons or places as either party may from time to time designate by written notice to the other. C. Assignment. No party may assign this Agreement or any interest herein or subcontract its obligations hereunder, without the prior written consent of the other party. D. Binding Effect. This Agreement shall be binding upon the parties hereto and their respective successors and permitted assigns. E. Severability. If any part of this Agreement should be held to be void or unenforceable, such part will be treated as severable, leaving valid the remainder of this Agreement notwithstanding the part or parts found void or unenforceable. In such event, the parties hereto agree that the court or other authorized entity in the proceeding in which any such provision hereof is determined to be void or unenforceable shall reform the offending provision in such a manner as to cause it, if at all possible, to be valid and enforceable while at the same time accomplishing, as nearly as possible, the parties original intent in including such provision in this Agreement. F. Dispute Resolution. The parties acknowledge and expressly agree to waive any and all rights to a trial by jury for all claims and disputes arising under this Agreement. In the event that the governing law does not allow for jury waiver, any dispute or controversy arising under, out of or in connection with, or in relation to this Agreement, or any amendment hereof, or the breach hereof shall be determined and settled by arbitration in the County in which the Facility is located, in accordance with the American Health Lawyers Association Alternative Dispute Resolution Service Rules of Procedure for Arbitration and applying the laws of the State. Any award rendered by the arbitrator shall be final and binding upon each of the parties, and judgment thereon may be entered in any court having jurisdiction thereof. The costs shall be borne equally by both parties, unless the arbitration award specifies otherwise. The prevailing party s attorneys fees and costs shall be paid by the non-prevailing party unless the arbitration award specifically provides otherwise, in which case the terms of the arbitration award shall govern responsibility of attorneys fees and legal costs. During the pendency of any such arbitration and until final judgment thereon has been entered, this Agreement shall remain in full force and effect unless otherwise terminated as provided hereunder. The provisions set forth herein shall survive expiration or other termination of this Agreement regardless of the cause of such termination.

15 15 G. Governing Law. This Agreement shall be governed by and construed and enforced in accordance with the laws of the state where the Facility is located, except to the extent its principles of conflicts of law would result in the application of the law of another jurisdiction. H. Waiver. No waiver of any provision of this Agreement shall be effective unless in writing and signed by the Party to be charged. No waiver of any of the provisions of this Agreement shall be deemed, or shall constitute, a waiver of any other provisions, whether or not similar, nor shall any waiver constitute a continuing waiver. No delay in acting with regard to any breach of any provision of this Agreement shall be construed to be a waiver of such breach. I. Exclusivity. This Agreement is nonexclusive and does not affect either party s ability to contract with other entities. ARTICLE VI ENTIRE AGREEMENT This Agreement represents the entire agreement between the parties as described herein and as incorporated herein by reference and supersedes all prior, written or verbal understandings. No third parties shall be deemed to be beneficiaries of any provisions of this Agreement. IN WITNESS WHEREOF, the parties authorized representatives below have executed this Agreement. University: Iowa College Acquisition LLC Kaplan University Facility: [Insert Facility Full Business Name] d/b/a Chandice Y. Covington, PhD, RN, C-PNP, FAAN Signature [insert signor's name] VP and Dean, School of Nursing [insert signor's title] Date Date

16 16 Please submit this completed and signed form via the RxPreceptor website. Kaplan University School of Nursing Please direct all questions about this form to the appropriate Clinical Student Manager for your state. Student Information Nurse Practitioner Clinical Preceptor Agreement Name: Jen Holm Last 4 digits of SSN: Preferred Telephone: Place of employment/immediate supervisor and contact information: Term/Course of for this preceptor: MN560 MN561 MN562 MN599/MN600 (check all terms that apply for this preceptor) Preceptor Information Name and Credentials (BSN, MSN, NP, etc.): Sharon Romulo FNP-C State and License Number:_MN Type of clinical practice: Family Practice care This practice is best described as: Primary Care Acute Care X Specialty Care (specify) _Urgent Care Types of patients seen in practice: Ages newborn to elderly with acute and chronic problems sharon.romulo@yahoo.com Preferred Telephone: Preceptor Agency Information Agency Name: Health Partners Address: 2500 Como Ave City, State, Zip:_St. Paul MN 55108

17 17 Agency Phone Number: _ Agency Accreditations: Declarations I am willing to function as a preceptor for Jen Holm (student name) Preceptor Signature Sharon Romulo (electronic signature) Date7/7/15 **Please note that for the preceptor agreement to be approved, a copy of the preceptor s résumé or CV must also be submitted along with license verification. Appendix A General Clinical Course Guidelines for NP Students FNP students should focus on Internal Medicine, Family Practice, Pediatric, OB/GYN & Geriatric care. AGNP students should focus on Internal Medicine (adult), Geriatric & Urgicare. Both FNP and AGNP students should devote a few hours to radiology to enhance knowledge of XRAY interpretation. Clinical patient contact hours refers to all hours that it takes to provide effective care which includes previewing patient charts, charting the visit, following up on diagnostic testing, telephone f/u with patients or other providers, etc. Pretty much any time spent in the office will be patient contact hours. If there are no patients (cancellations, no-show, etc) students are to be reviewing other charts to see charting style, following up on diagnostics, reviewing in-office reference materials, discussing prior cases with preceptor if he/she is available, etc., and those hours WILL count as clinical patient contact hours. What is NOT considered patient contact hours? Lunch whether spent in the office or out, listening to drug reps who are merely selling a product, travel time to, from or between sites (if traveling from one site to another), hospital rounding (primary care NPs should not be in the hospital setting but occasionally a preceptor may ask a student to accompany him/her. This would be observational and not counted towards hours), and continuing education sessions or seminars. MN560 and MN561 (first two clinical courses): Family Practice Settings Internal Medicine Settings **PLEASE NOTE: ER and URGICARE SETTINGS ARE NOT APPROPRIATE SITES FOR MN560 AND MN561 MN562 (pediatric rotation-fnp only): Dedicated primary care pediatric practice settings seeing patients between the ages of newborn and 21 years NO FAMILY PRACTICE SETTINGS WILL BE APPROVED FOR THIS ROTATION. Sites may include:

18 Private pediatric offices Pediatric primary care clinics that deal with well child or sick child issues NOT related to another condition (i.e no specialty clinics) Adolescent sites that do intake and medical management (would need a second site that sees additional patients that are younger). Examples include juvenile detention centers, mental health facilities, and teen clinics NP preceptors are preferred, but other appropriate preceptors may also include MDs, DOs, and PAs in these clinical settings. It is preferred that you complete all clinical hours within one setting, but you may use up to two settings or two preceptors to complete the hours required for this course. MN599 and MN600: Family Practice Settings Internal Medicine Settings ER Urgicare Retail Clinic Settings (CVS, Walgreens clinics) During these courses, students will be continuing to develop clinical skills while working on a capstone project. Students are encouraged to select a setting where they have completed clinical hours previously for these courses. 18 **PLEASE NOTE: NO MORE THAN 24 clinical hours can be spent in specialty practice in the final clinical course. We recognize that there are valuable experiences that can be obtained in specialty areas and would encourage students to use those 24 hours to explore a specialty or sharpen their skills in a specialty area where they may feel they have a deficit, but in order to best prepare students for the certification examination after graduation, the majority of clinical hours need to be spent in a primary care setting, including family practice, internal medicine, ER, or Urgicare or Retail clinic settings. While we appreciate that students are beginning to think about where they might want to work and the areas of interest they have for their NP practice, the NP programs at Kaplan University are primary care programs, which means that they are not intended to prepare students for practice in acute care or specialty settings. The clinical site, preceptor and all other required paperwork must be approved by the Clinical Placement Team before you will be allowed to register for each clinical course. You will not be eligible to enroll in a clinical course until the required documentation is submitted. Clinical documentation is due by 11:59pm 3 weeks before the start of each clinical course. Any document that is incomplete or not submitted at that time will be considered late and you will not be allowed to register for the clinical course for the upcoming term-no EXCEPTIONS! APPENDIX B

19 19 CLINICAL COURSE OBJECTIVES MN560: Advanced Practice Nurse Clinical I Demonstrate advanced skill in client evaluation while using diagnostic reasoning skills. Formulate a differential diagnoses and evaluation and management plan for clients experiencing acute, episodic, and chronic diseases across the adult age continuum. Employ the concepts of health promotion, health maintenance, health restoration, and health teaching when treating adults. Incorporate clients cultural preferences, health beliefs, spiritual beliefs, behaviors, and traditional practices into the individualized management plan. MN561: Advanced Practice Nurse Clinical II Apply advanced interviewing and physical examination techniques in developing differential diagnoses. Interpret historical, physical, and diagnostic findings when evaluating clients with acute, episodic, or chronic illness. Incorporate cultural preferences, health beliefs, spiritual beliefs, behaviors, and traditional practices into the management plan. Implement a plan of care in collaboration with the client, preceptor, and other health providers, for adults at risk for primary care issues. Select pharmacologic and non-pharmacologic agents for the treatment of acute, episodic, and chronic diseases common among adults. MN562: Advanced Practice Nurse Clinical Pediatrics (FNP Students Only) Collect age-appropriate comprehensive or focused health and developmental histories from the parent/guardian or child. Distinguish between normal and abnormal variations of child development through the use of screening tests. Implement an evaluation and management plan in collaboration with the patient, preceptor, and other health providers, for children at risk for a range of illnesses and conditions. Apply knowledge of pharmacological agents, therapeutic equipment, and patient assessment data in the prescription of medication and equipment. Utilize community resources to provide comprehensive health and illness care for infants, children, and families. MN599: Advanced Practice Nurse Clinical III and MN600: Evidence Based Project Proposal Appraise an individual or group's health status using clinical reasoning skills when performing the health assessment and physical examination, formulating differential diagnosis, and ordering and interpreting diagnostics. Devise an evidence-based and cost-effective evaluation and management plan for clients with primary care issues. Outline community resources for clients and their caregivers to help establish, retain, and maintain health maintenance and health promotion activities.

20 20 Ensure quality care through consultation, collaboration, continuing education, certification, and self-reflection Evaluate all aspects of the nurse practitioner role such a provider, educator, and collaborator when providing primary care. Appendix C NP Capstone Project Information The EBP project is focused on making a change (students do not implement the EBP as part of the course requirements for the MSN program). Many topics are saturated and further work would be redundant, e.g., Technology /Simulation in Nursing The Nursing Shortage / Nursing Retention You will need to be both creative and specific if you choose saturated topics, e.g., Creating a Tool to Assess Critical Thinking in Simulated Cardiac Emergencies Addressing Spiritual Needs to Promote Nurse Retention in the Hospital Setting Here is a list of some EBP topics students have used in the past for the MSN program: Central Line Infection Reduction Through Evidence Based Nursing Education Supporting New Graduate Nurses Throughout Their Transitioning and Beyond Prevention of Hospital Acquired Infections in Out Patient Settings Healthcare Navigator Program for Community Based Geriatric Patients Gentle Cesarean: Evidence Based Project Reduction of a Hospital Blood Contamination Rate Promoting Breast Feeding During the First Six Weeks Post-Partum