University of South Alabama College of Nursing Bachelor of Science in Nursing

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ADMISSIONS POLICY Enrollment into the University (pre-professional component) as a nursing major does not assure the student admission to the Professional Component. Enrollment in the Professional Component is limited and competitive. Students are admitted without regard to race, color, creed, national origin, sex, or qualified disability. Please Note: Students must be accepted to the University before applying to the! Students are admitted every semester (fall, spring, and summer) to both campuses for the regular five-semester program. For the accelerated programs, students are admitted in the fall and spring to the Baldwin campus only. Applications are available online at www.southalabama.edu/nursing. Applications are reviewed carefully to determine that students have satisfied all pre-nursing requirements of conduct, health, scholastic achievement, and aptitude for nursing. Transfer credit must comply with College of Nursing policies. Students are selected based upon the following factors: 1. Submission of a completed application. 2. Payment of $50 non-refundable application fee. 3. A minimum GPA of 2.90 on all prerequisite courses for the Traditional Track 4. A minimum GPA of 3.0 on all prerequisite courses for the Accelerated Track 5. A minimum grade of C in all prerequisite courses. 6. Health records and immunizations required For details see http://www.southalabama.edu/colleges/con/clinical/healthrequirements.html. 7. CPR certification is required. 8. Drug screening is required. 9. Background check is required. Applications should be submitted for admission to Fall semesters by March 15. Applications should be submitted for admission to Spring semesters by July 15. Applications should be submitted for admission to Summer semesters by January 15. Submit an application packet via US Postal Service to: University of South Alabama, Health Sciences Building, Mobile, Alabama 36688-0002 or via UPS or FedEx to: University of South Alabama College of Nursing, Student Services, Health Sciences Building, 5721 USA North Dr., Mobile, AL 36688. **Please Note: Activate your Jagmail email account immediately this is our means of communicating with you! We will notify you of any missing documents at your Jagmail email address. The Admissions Committee and the Dean of the reserve the right to select the applicants best qualified for and most likely to succeed in the study of nursing. Failure to comply with legal, moral, and legislative standards for licensure to practice as a registered nurse in the State of Alabama merits immediate dismissal from the nursing program. In keeping with the dynamic changes in the nursing and health field, the baccalaureate curriculum may undergo change. Changes in curricula and/or admission requirements will be published as far in advance as possible. Advisors are available to assist students in adapting to those changes and planning their course of study accordingly. It is strongly recommended that you meet with your advisor at least two semesters before applying to the Professional Component.

Medical Documents Manager Below are medical requirements for the program. Start the profile early to ensure everything is completed on time! Complete instructions for Clinical Health Requirements can be located at http://www.southalabama.edu/colleges/con/clinical/healthrequirements.html. 1. MMR Measles (Rubeola), Mumps, and Rubella Titer You must have a positive titer for each of the above to be cleared If you have a negative or equivocal titer, you must receive the appropriate immunization or booster Submit each record to Castle Branch as you progress through the immunizations Re-draw the titer one month after your final immunization and submit the positive result If negative or equivocal, submit the result, along with a note from your doctor stating you are a non-responder Submit all tests and records from your healthcare provider; no special forms needed This is a one-time submission 2. Varicella (Commonly known as Chicken Pox ) Titer You must have a positive titer to be cleared; history of disease is not accepted If you have a negative or equivocal titer, you must receive the appropriate immunization or booster Submit each record to Castle Branch as you progress through the immunizations Re-draw the titer one month after your final immunization and submit the positive result If negative or equivocal, submit the result, along with a note from your doctor stating you are a non-responder Submit all tests and records from your healthcare provider; no special forms needed This is a one-time submission 3. Hepatitis B Titer A positive titer is required for admission If you have never received the 3-series Hepatitis B immunizations, you must begin the series of 3 immunizations. Submit each record to Castle Branch as you progress through the immunizations 30 days after the third immunization, have your titer drawn; if positive, submit your record If negative, a booster immunization is required Re-draw the titer one month after your final immunization and submit the positive result If the titer is again negative, submit the result, along with a note from your healthcare provider stating you received the series and booster and are a non-responder Submit all tests and records from your healthcare provider; no special forms needed This is a one-time submission 4. Tuberculosis Testing A negative, 2-step PPD test, Quantiferon Gold, or T-spot is required upon entry into the nursing program The 2-step refers to two TB skin tests performed and read within a 21 day time-frame and must be current, and must remain current for the duration of the term Thereafter, a 1-step renewal is required each year The 1-step MUST be drawn within 12 months of the last test, or it will not be accepted If you fall outside of the 12 month renewal period, you must have another 2-step test Submit all tests and records from your healthcare provider; no special forms needed This must be renewed annually TB Skin Test: Positive Result If you have ever tested positive for TB, you must submit the following instead of the above: A record of the date of your positive result, along with the amount listed in mm (one-time submission) A clear chest x-ray from the year you started Level 1 of the nursing program (one-time submission) A clear TB Monitoring Form (submitted annually) You may only submit the above if you have tested positive for TB!.

5. TDAP Tetanus, Diphtheria, Pertussis Vaccination Immunization within the past 10 years is required The TDAP must remain current throughout your enrollment in the nursing program If your TDAP has an expiration that falls during a semester, you must renew prior to the start of the term Submit all tests and records from your healthcare provider; no special forms needed You may need to submit more than once, depending on your expiration date 6. Influenza Vaccination All students are required to submit proof of an annual Influenza Vaccination The influenza vaccine is not available until late August/early September Students who apply after flu season should submit the previous season s proof of vaccination to satisfy this requirement 7. CPR certification Note: American Heart Association (AHA) AHA BLS (Basic Life Support) for Healthcare Provider Card is required We do not accept any other CPR certification, as per clinical facility requirements BLS cards are good for 2 years, but must remain current for the duration of the semester If your card has an expiration that falls during a semester, you must renew prior to the start of the term. Submit a copy of the front and back of your card You will need to submit more than once, depending on your expiration date Military issued CPR cards that use the AHA for healthcare workers curriculum will be accepted and require a special override from Clinical Affairs. See contact us information below if this applies to you 8. Health Insurance Proof of current health insurance is required; submit a copy of your card (front and back) that includes your name If you are covered under another person's policy, you must submit a copy of that card, along with a letter from the insurance company stating you are covered under the policy If your health insurance changes, contact Castle Branch so you can upload your new proof of insurance 9. Physical Examination Download the Physical Examination Form found in your Castle Branch profile The form must be completed, stamped, and cleared by your healthcare provider This is a one-time submission 10. HIPAA Instruction Statement and Waiver of Liability Provide certification of both HIPAA and OSHA training Students who do not have the required HIPAA and OSHA training should complete one or both of the following elearning courses provided in Castle Branch, by using the order numbers below: NV37hipaa - HIPAA elearning Tracker ($15) NV37osha - OSHA elearning Tracker ($15) NV37el - HIPAA/OSHA elearning Tracker ($30) 11. OSHA / Blood Borne Pathogens (BBP) Provide certification of both HIPAA and OSHA training Students who do not have the required HIPAA and OSHA training should complete one or both of the following elearning courses provided in Castle Branch, by using the order numbers below: NV37hipaa - HIPAA elearning Tracker ($15) NV37osha - OSHA elearning Tracker ($15) NV37el - HIPAA/OSHA elearning Tracker ($30) 12. Confidentiality Statement Download this form found in your Castle Branch profile. Complete the form per instructions and upload back to the Castle Branch requirement. 13. Statement of Continued Health Responsibility Download this form found in your Castle Branch profile. Complete the form per instructions and upload back to the Castle Branch requirement. 14. Communicable Disease Statement and Waiver of Liability Download this form found in your Castle Branch profile. Complete the form per instructions and upload back to the Castle Branch requirement.

APPLICATION FOR ADMISSION TO THE PROFESSIONAL COMPONENT Name of Applicant Social Security # Jag# Jagmail Home Phone Work Phone Cell Phone Street/P.O. Box City State Zip Code Please list the name and phone number of your parents, spouse, or others who should be notified in case of an emergency. Name: Relationship: Phone# Address: City State Zip Code Indicate below the year you wish to enter the professional component and preference of campus: Fall applicant Year Traditional BSN Program taught only at main campus Accelerated Program *(Baldwin Campus only-limited enrollment-prior BA or BS required) If not chosen for Accelerated, do you wish to be considered for the Traditional Program? Yes No Spring applicant Year Traditional BSN Program taught only at main campus Accelerated Program *(Baldwin Campus only-limited enrollment-prior BA or BS required) If not chosen for Accelerated, do you wish to be considered for the Traditional Program? Yes No Summer applicant Year Traditional BSN Program taught only at main campus Accelerated Program *(Baldwin Campus only-limited enrollment-prior BA or BS required) If not chosen for Accelerated, do you wish to be considered for the Traditional Program? Yes No List all educational institutions you have attended since high school. Please Note: Applicants may not disregard any part of their educational history and failure to report all institutions previously attended will be cause for cancellation of the admissions process and/or dismissal from the University. Name of Institution City/State Dates Attended Degree Applicant s Signature Date PRIOR RN PROGRAM ACCEPTANCE STATEMENT

Have you attended any other RN Program? NO YES If you answered yes, you must immediately provide the following: Letter of Good Standing from the Nursing Program, signed by the Nursing Administrator of the program Transcript of all Nursing courses taken with grades earned Please Note: The University of South Alabama does not accept transfer of Nursing course credit no previous course work will be considered. Student Signature Date Witness Signature Date

BACKGROUND CHECK POLICY AND PROCEDURE The curriculum at the includes, as a condition of admission to the Professional Component of the, each student be required to have a background check, and to submit, as requested, to additional checks once enrolled in the Professional Component. The College of Nursing must certify to clinical agencies where students practice that each student has had an acceptable background screen. Background Checks Upon Admission to the Professional Component Students selected for admission to the Professional Component of the are admitted pending the background check. Admission will be withdrawn for students who in the judgment of the Dean and the Admissions committee has been convicted of or has pending a charge that would not be acceptable to our clinical agencies. Procedure for Background Check Students selected for admission to the Professional Component will be notified of the procedure to follow for the background check in their letter of admission. Students will be required to follow the procedures established by the College. The background check will be conducted by a qualified agency using established methods and procedures. Confidentiality of the student will be protected. Background Check After Admission A background check for any student in the Professional Component can be requested by the College of Nursing at any time. Refusal by a student to submit to the check will result in that student s dismissal from the Professional Component of the. Depending upon results of the background check, continued participation in the program will be at the discretion of the Dean. Admission/Readmission After an Adverse Background Check A student whose admission is withdrawn or who is dismissed from the Professional Component of the due to adverse findings from a background check will be considered for readmission on a case by case basis depending upon the particular situation.

BACKGROUND WAIVER AGREEMENT I understand that as a requirement for admission to the University of South Alabama, I must submit to a background check of which the results will be provided to the Dean of the College of Nursing or designee. I understand that I may be denied admission to the Professional Component if the background check is unfavorable. I further understand that I will be subject to background checks while enrolled in the. Any adverse findings may result in dismissal from the. BY SIGNING THIS DOCUMENT, I INDICATE THAT I HAVE READ, I UNDERSTAND, AND I AGREE TO THE COLLEGE OF NURSING BACKGROUND CHECK POLICY. THIS NOTARIZED DOCUMENT CONSTITUTES MY CONSENT FOR BACKGROUND CHECKING BY A COLLEGE OF NURSING DESIGNATED VENDOR. IT ALSO CONSTITUTES CONSENT FOR THE VENDOR TO RELEASE THE RESULTS OF MY BACKGORUND CHECK TO THE DEAN OF THE COLLEGE OF NURSING OR DESIGNEE AND FOR THE DEAN TO RELEASE MY BACKGROUND INFORMATION AS REQUIRED TO ANY CLINICAL AGENCY WHERE I AM ASSIGNED. In Witness Whereof, this instrument is executed this day of, 20. WITNESSES: Witness #1 Signature Applicant s Signature Witness #2 Signature Applicant s Printed Name STATE OF COUNTY OF On this day of, 20, before me appeared To be known to be the person described in and who executed the foregoing instrument. Given under my hand and seal on the day and year above written. SEAL NOTARY PUBLIC My Commission Expires: DRUG POLICY AND PROCEDURE STATEMENT

The mission of the is to provide educational programs to a diverse student body, to participate in research and scholarly activities, and to provide service to the University, the profession and the public. The College accomplishes this by providing a caring, engaging environment for the empowerment of student learning potential, the professional development of faculty, and the promotion of the nursing profession. Therefore, in order to uphold the highest standards of the nursing profession, the has adopted a drug free environment. As a condition of admission to the professional component of the, each student will be required to submit to a drug screen, and to submit, as requested, to additional screening once enrolled in the professional component. The University of South Alabama Drug and Prevention Program Statement of Policy regarding drug use is the foundation for this policy statement. However, the Drug Policy and Procedure Statement is particular to this College. Drug Screening upon Admission to the Professional Component Students apply for admission to the professional component of the nursing program once they have completed freshman and sophomore level prerequisite courses. Students selected for admission to the professional component of the are admitted pending a negative drug screen. Admission will be withdrawn for a student screening positive. Procedure for Drug Screening Students selected for admission to the professional component will be notified of the procedure to follow for the drug screen in their letter of admission. Students will be required to follow the procedures established by the College and should not obtain a drug screen prior to being notified. All costs associated with screening are the responsibility of the student. Screens will be conducted by a qualified laboratory using established methods and procedures. Confidentiality of the student as well as the integrity of the urine sample will be protected. The procedure for collection is determined by the collection site. A drug screen will be presumed positive if any of the drugs listed in Exhibit A (attached hereto) are found. Presumed positives will be confirmed by a second screen from the original urine sample. If the screen is positive, the available evidence, including health history, will be used to determine the presence or absence of drug abuse. The screening laboratory will notify the Dean of the (or designee) with screen results. The College of Nursing will ensure confidentiality of results by making the information available only to the student and appropriate Administrators.

Drug screening after Admission Drug screening for any student in the professional component can be requested by the College of Nursing. The cost of this Drug screening will be borne by the. The procedure for screening as described in the above section, Drug Screening Procedure, will be followed. Refusal by a student to submit to Drug screening will result in that student s dismissal from the professional component of the. A student with a positive result from a drug screen will be dismissed from the professional component, and referred for counseling at the University of South Alabama Substance Education/Prevention Center (USA-SAEPC). Other appropriate disciplinary action may be initiated as necessary. Any student who voluntarily reports that they have a chemical dependency problem will be counseled by the Dean s office at the. Conditions, if any, for continued participation in the program will be at the discretion of the Dean. The student will submit to drug screens as requested by the and will be dismissed if a positive drug screen is obtained. Admission/Readmission A student whose admission is withdrawn or who is dismissed from the professional component of the due to a positive drug screen will be considered for readmission if the following conditions are met: 1. Submit to an evaluation for substance abuse by a approved evaluation and/or treatment agency and complete the prescribed treatment program (USA students should call the USA Substance Education/Prevention Center for an evaluation (251-460-7980). 2. Submission to a drug screen prior to admission/readmission. This drug screen will be at the student s expense. A positive drug screen will result in ineligibility for admission/readmission. 3. Submission to drug screens for cause as requested by the after admittance to the professional component. A positive drug screen will result in permanent dismissal from the EXHIBIT A The Medical Professional Panel Drug Screens includes common street drugs and those drugs that health care workers have access to and abuse. Drugs monitored include: Amphetamines Barbiturates Benzodiazepines Cocaine Meperidine Methadone Opiates Oxycodone Phencycidine Propoxyphene THC Tramadol

DRUG SCREENING WAIVER AGREEMENT I understand that as a requirement for admission to the University of South Alabama, I must have a drug screen at a designated laboratory, which will provide the result of the test to the Dean of the College of Nursing or designee. I understand that if the screen result is positive, I will be denied admission to the College of Nursing Professional Component. I further understand that I will be subject to drug screen while enrolled in the. A positive drug screen or refusal to submit to screening will result in dismissal from the. BY SIGNING THIS DOCUMENT, I INDICATE THAT I HAVE READ, I UNDERSTAND, AND I AGREE TO THE COLLEGE OF NURSING DRUG SCREENING POLICY. I UNDERSTAND THAT A NEGATIVE DRUG SCREEN IS REQUIRED FOR ADMISSION AND FOR PROGRESSION IN THE COLLEGE OF NURSING. THIS NOTARIZED DOCUMENT CONSTITUTES MY CONSENT FOR DRUG SCREENING BY A COLLEGE OF NURSING DESIGNATED LABORATORY. IT ALSO CONSTITUTES CONSENT FOR THE LABORATORY TO RELEASE THE RESULT OF MY DRUG SCREENING TO THE DEAN OF THE COLLEGE OF NURSING OR DESIGNEE AND FOR THE DEAN TO RELEASE ANY POSITIVE FINDINGS TO THE APPROPRIATE LICENSING BOARD IF INDICATED. In Witness Whereof, this instrument is executed this day of, 20. WITNESSES: Witness #1 Signature Applicant s Signature Witness #2 Signature Applicant s Printed Name STATE OF COUNTY OF On this day of, 20, before me appeared To be known to be the person described in and who executed the foregoing instrument. Given under my hand and seal on the day and year above written. SEAL NOTARY PUBLIC My Commission Expires: