Clinical Setting Policies and Procedures

Clinical Setting Policies and Procedures

Health/Illness/Injury Incident Policy

(Refer to university policy)

PURPOSE:

The University of Massachusetts (UMass) Amherst Elaine Marieb College of Nursing is committed to maintaining a safe, healthy and productive environment. This policy informs faculty, staff and students of the steps to follow to insure the immediate care of the student in the event of a health incident.

I. POLICY STATEMENT:

Any health/illness/injury incident, that occurs to a student in any teaching environment within the college or its affiliated clinical agencies must be documented and reported by the faculty member and student. All students must provide the college with emergency contact numbers during orientation, including a local number in case they require transportation from the college or clinical facility. It is the student’s responsibility to ensure a safe transportation alternative. The UHS website http://www.umass.edu/uhs/ mentions two transportation options that may be helpful. The UHS Shuttle offers free rides from any on-campus location to UHS (call 413- 577-7425). If the student is referred by the healthcare provider to off-campus services, then HealthRide is an option (email a voucher request to https://www.umass.edu/uhs/accesstocare/rides/healthride or another mode of transportation of the student’s choice.

II.  PROCEDURE:

A. On Campus

1. If the incident is an emergency, call 911. This will trigger EMS. If the incident is not an emergency, call the UMass Police Department at 413-545-2121. If the individual is in need of mental health services, call the Center for Counseling and Psychological Health at 413-545- 2337.

2. Notify the Dean’s office at 413-545-5093 or the Executive Associate Dean for Academics, Research and Engagement office at 413-545-9576 and report the location and nature of the incident as well as the faculty, staff or student’s name.

3. If necessary, the student’s emergency contact will be notified by the Office of the Dean or the Office of the Executive Associate Dean for Academics, Research and Engagement.

4. The student may be referred to University Health Services or the student’s healthcare provider

5. of choice. The student is responsible for all healthcare costs for her/himself incurred in treatment of said injury, both immediate care and any necessary follow-up care. The College is not financially responsible for any costs incurred by the student.

6. The faculty or staff member and student will complete the Elaine Marieb College of Nursing Health Incident Report Form within one business day (see Appendix F). This form includes a clear statement of the incident that occurred, who was involved, action that was taken, and any plan for follow-up. The description should be factual in nature and free of interpretation and impressions. If a student is unavailable to sign the Elaine Marieb College of Nursing Health Incident Report Form within one business day, the Nursing faculty member should indicate this on the form and obtain the student’s signature as soon as possible. The form must be submitted to the office of the Executive Associate Dean for Academics, Research and Engagement who will oversee any investigation or remediation necessary.

7. If warranted, the student must provide documentation from a healthcare provider stating that she/he can return to clinical without restrictions.

B. Off Campus

1. If the incident is in a clinical facility, the policies and procedures set forth by that site must be followed. Neither the faculty nor the CON is responsible for the cost of any treatment involved in the student’s care.

2. The faculty member will notify the office of the Executive Associate Dean for Academics, Research and Engagement at 413-545-9576 as appropriate and report the location and nature of the incident as well as the student’s name and contact information.

3. If necessary, the student’s emergency contact will be notified by the Office of the Dean or Office of the Executive Associate Dean for Academics, Research and Engagement.

4. The student may receive appropriate and necessary care at an acute facility emergency department, employee health office or be referred to University Health Services or the student’s healthcare provider of choice. The student is responsible for all healthcare costs for her/himself incurred in treatment of said injury, both immediate care and any necessary follow-up care. The College and clinical facility are not financially responsible for any costs incurred by the student.

5. The faculty member and student will complete the College of Nursing Health Incident Report Form within one business day, which includes a clear statement of the incident that

occurred, who was involved, action that was taken, and any plan for follow-up. The description should be factual in nature and free of interpretation and impressions. If a student is unavailable to sign the Elaine Marieb College of Nursing Health Incident Report Form within one business day, the Elaine Marieb College of Nursing faculty should indicate this on the form and obtain the student’s signature as soon as possible. The form must be submitted to the office of the Associate Dean for Academic Affairs who will oversee any investigation or remediation necessary.

6. If warranted, the student must provide documentation from a healthcare provider stating that she/he can return to clinical without restrictions.

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Health Requirements

Health Requirements

Health Requirements 

Students in the Elaine Marieb College of Nursing are required to adhere to certain health maintenance procedures in compliance with standards prescribed by affiliating clinical agencies and The Commonwealth of Massachusetts General Laws, Chapter 76, Section 15C, entitled Immunization of college health science students. Students may use the services of their own family health care providers or the University Health Services. The policies are intended to protect the health and well-being of the client as well as the nursing student engaged in clinical practice. The health maintenance plan is as follows: 

All students need to set up an account with CastleBranch after admission to the Elaine Marieb College of Nursing. You will be responsible for uploading evidence of your immunizations and required documents into the self-service system before your first clinical. Certified Background Check will also perform a national background check on all students, which is necessary before entering clinical placements. 

All students must carry health insurance at all times while registered as a student. 

CPR Requirement 

American Heart Association Course: BLS for the Healthcare Provider. This is the only course accepted by our affiliating agencies. Online courses are not acceptable. 

Professional Liability Insurance 

Professional Liability Insurance: Contact  www.nso.com (Upload the one-page “Certificate of Insurance” for your file.) 

Students are required to acquire and submit proof of medical malpractice insurance before entering courses with a clinical component. Students are also responsible for ensuring that a copy of the one-page certificate of insurance is on file at least three weeks prior to the start of the semester. Students are not allowed to participate in clinical experiences until this documentation is on file. Students will upload this insurance certification to their CastleBranch.com account. 

Annual Update 

CastleBranch will send an email reminder for annual updates at least two weeks prior to their due date.  Healthcare agencies will not allow students to begin clinical experiences until this information has been received. Timely submission will prevent a student’s clinical status from being in jeopardy. 

Students are required to notify the Elaine Marieb College of Nursing of any significant change in their health status that may affect clinical experiences. Examples include serious illness, accidents, injuries, or surgery which would require health care provider clearance prior to returning to the clinical setting. 

NOTE: It is the student’s responsibility to make arrangements with the University Health Services (UHS) or their private family health care provider in a timely fashion in order to comply with the above policies. When applicable, the College of Nursing will publicize the availability of special clinics set up by UHS to assist with required immunizations or updates. 

STUDENTS MUST PROVIDE THE COLLEGE OF NURSING WITH THE REQUIRED APPROPRIATE DOCUMENTATION OF HEALTH STATUS TO PARTICIPATE IN CLINICAL PRACTICUM.  A delay in returning the necessary documentation will prevent a student from attending clinical experiences. 

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CORI and Fingerprinting

CORI and Fingerprinting

Criminal Offender Record Information (CORI/SORI) Checks and Fingerprinting 

CORI ([Massachusetts] Criminal Offender Records Index) and SORI ([National] Sex Offender Records Index) checks are required by most clinical agencies and will be completed on all students and faculty once they are admitted to the program and yearly thereafter. Progression and clinical placements in the nursing program may be contingent upon a satisfactory CORI/SORI investigation. Please review the website at http://www.mass.gov/eohhs/gov/laws-regs/hhs/criminal-offender-record-checks-cori.html for more details on CORI checks. 

Note: Some clinical agencies may require a National Background Check and Fingerprinting; this process will be explained as necessary. 

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Undergraduate Credentialing Policy

Undergraduate Credentialing Policy

As part of your professional role, nursing students are required to have very specific credentials in order to be present in hospitals, clinics, and community settings where we interact with the public. These are very similar, if not identical, to the requirements that you will have soon with an employer in the health care industry. Part of your education in nursing is learning to be prompt and meticulous about ensuring that all your documentation is on time and kept current to attend clinical. Please read this policy carefully to the end. 

It is the student’s responsibility to maintain their current credentials that may include CPR, a criminal background check, fingerprinting, immunizations, special training, etc. It is recommended that you begin a file with copies of all your documents, so you always have them at the ready for clinical agencies and employers. 

  1. At the Elaine Marieb College of Nursing, we use an external company that assists us in assuring clinical agencies that our students are credentialed for clinical. CastleBranch (CB) is the name of the company that securely maintains documents for the College, and this is where you must submit your materials for credentialing. 

  2. Before you come to nursing school, you may begin the credentialing process by taking an American Heart Association BLS for Healthcare Providers CPR class, seeing your healthcare provider, undergoing TB testing, and getting immunized. 

  3. When you enroll, you will be directed by email to register with CastleBranch. 

  4. As soon as you register with CastleBranch, you will get an email to begin uploading your documents into their secure site. You must have everything uploaded into CastleBranch by: 

    • Accelerated students - July 1 for fall clinicals, November 1 for spring clinicals and March 1 for summer clinicals. 
    • Nursing majors - May 1 for fall clinicals and November 1 for spring clinicals. 
    • All students- Between August 1-15th each year, you must upload modules to Centralized Clinical Placements at www.mcnplacement.org/orientation. 
    • All students – October 1 for flu immunization verification. 
  5. You may from time to time receive an email from Castle Branch informing you that something has expired, and these must be attended to immediately. Never ignore reminders from CastleBranch, as it is likely you have a new requirement that has triggered a reminder email. 
  6. Anything marked INCOMPLETE in your CastleBranch account must be completed before you go to clinical. Anything marked REJECTED is incorrect documentation and the CastleBranch site will direct you how to correct the error. Anything marked OVERDUE must be completed immediately. 
  7. Students must attend to this in the term prior to a clinical course to have everything completed in a timely way and should not leave for vacation without ensuring that everything is complete. Some components must be completed in Massachusetts. 
  8. Each term, on the first day of class in any clinical course and before you go to the clinical site, we will check to make sure you have completed all the requirements for students on the CastleBranch site. 
  9. You may not attend clinical and will be sent home if you are not properly credentialed. 
  10. At that point, a better use of your time will be going to complete whatever you failed to complete, but you will be missing precious learning time in clinical, and it will be recorded as a 0.5 deduction in your clinical evaluation in the area of unprofessional behavior. This will also be an unexcused clinical absence and cannot be made up, potentially impacting your ability to be successful in the course. 

If you have questions or trouble uploading documents, please contact the Database Administrator, Jennifer Heim at the Elaine Marieb College of Nursing, jheim [at] umass [dot] edu (jheim[at]umass[dot]edu), phone # 413-545- 5049. 

University Health Services (UHS) collects state required immunization data through their New Student Immunization Office which is required for all UMASS students and a separate process.  

Please also follow any instructions you receive from UHS (https://www.umass.edu/uhs/immunizations).

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Good Moral Conduct Policy

Good Moral Conduct Policy

The Massachusetts Board of Registration in Nursing [BORN] establishes policies (based on MGL c. 112, ss. 74, 74A and 76 and Board regulations at 244 CMR 8.00) for initial licensure as a registered nurse or licensure by reciprocity in the Commonwealth of Massachusetts. One of the criteria for application for licensure involves the determination of “good moral character.” Failure to meet this criterion could delay or prevent licensure. Please refer to the Mass.gov website:  https://www.mass.gov/service-details/good-moral-character-requirements-for-nursing-licensure for complete information. It is the student’s responsibility to seek legal guidance with any concerns about meeting these criteria.

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Conduct in Clinical Settings

Conduct in Clinical Settings

It is expected that every student in the College of Nursing will adhere not only to the University of Massachusetts at Amherst Code of Student Conduct, but also to the American Nurses Association Code of Ethics for Nurses. The statement of the Code, included in the next section, provides guidance for conduct and relationships in carrying out nursing responsibilities consistent with the ethical obligations of the profession and quality in nursing care.  All students who are completing clinical courses will be evaluated for conduct using a course-specific Clinical Evaluation Tool (CET). Please see Appendix B for a sample CET format.

Clinical Practice 

The Elaine Marieb College of Nursing maintains contractual agreements for student experience with a variety of agencies. Students must meet the expectations of both the college and the agency for appropriate professional conduct and attire. In the event that a cooperating clinical agency asks a student to withdraw because the student’s conduct or clinical performance is unacceptable to the agency, the University will attempt to arrange for the student to obtain the clinical experience at another agency where the objectives of the course can be met. However, the effort of the University to place the student in another agency will depend upon the circumstances under which the student was dismissed from the first agency. If a student cannot demonstrate ability to deliver safe care at the level required in a course, the instructor has a responsibility to remove the student, so that the safety and welfare of clients are not compromised. (For example, inadequate knowledge of care or medications needed by clients, inappropriate or disruptive behavior or communications with clients, faculty or agency staff.) The student will receive a grade of “F” in the clinical course. 

Attendance at all scheduled clinical practice experiences is mandatory. Absence for any reason must be explained and will be evaluated by the instructor, who will decide whether an alternative experience must be arranged. Should the university be officially closed, e.g. during a snowstorm, clinical practice may be cancelled. 

The clinical instructor will use feedback from a variety of sources in determining your clinical grade. These sources may include both written and verbal communication from all members of the healthcare team, including patients and family members. However, the final determination of your grade is the responsibility of the clinical instructor. 

Clinical experiences are based on students’ learning needs and course objectives. Clinical experiences are primarily based in clinical agencies outside the University.

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Medication Administration Policy

Medication Administration Policy

Students must adhere to the Elaine Marieb College of Nursing policy, Clinical Facility policy, and/or the State Regulations in the administration of medications.

1. A written medication dosage calculation test is required in each semester when students will be passing medication.

a. Students must pass a practice medication dosage calculation test with a score of 100% before taking the official medication dosage test.

b. Students are required to pass the official medication dosage calculation test with a score of at least 90% in order to administer medications in the clinical setting.

2. Students may be limited in the medications that they can administer according to the course specific administration guidelines or Clinical Facility policy.

3. All medication administration must be approved and directly observed by the faculty, Registered Nurse, or preceptor.

4. Students must follow any course-specific guidelines regarding medication administration.

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Transportation

Transportation

Students are required to provide their own transportation to clinical and community sites that are contracted with the program. To provide maximum clinical experience for students, multiple sites are used seven days a week with the potential of evening, weekend, and night hours. For this reason, public transportation or sharing transportation have not been workable as means to get to the clinical agencies. Instead, students must provide their own transportation to the clinical sites assigned by their course faculty. 

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Unsafe Nursing Practice Policy

Unsafe Nursing Practice Policy

The faculty of the Elaine Marieb College of Nursing has an academic, legal, and ethical responsibility to prepare graduates who are competent in safe nursing practice to protect health of individuals and communities. It is within this context that students are disciplined or dismissed from the Elaine Marieb College of Nursing for unsafe practice or unsafe behavior that threatens or has the potential to threaten the safety of a client, a family member or substitute familial person, another student, a faculty member, or other health care provider. 

Practices or behaviors that warrant disciplinary action include, but are not limited to: 

  • Excessive use of faculty time to ensure safe practice by one student to the detriment of other students in the clinical rotation. 
  • Inadequate or poor preparation for or understanding of nursing care, patient’s medications, or patient’s nursing needs. 
  • Acts of omission or commission in the care of clients including, but not limited to: 
    • physical abuse 
    • placing clients in hazardous positions, conditions, or circumstances 
    • mental or emotional abuse of others 
    • failure to rescue 
    • failure to use appropriate judgment in administering safe nursing care consistent with the level of nursing preparation 
    • violating or threatening the microbiological safety of the client, such as by breaking aseptic technique 
    • failure to use standard and transmission-based precautions in clinical procedures 
    • inability to apply previously learned skills and principles in providing nursing care 
    • failure to observe or report critical assessment results regarding patients in a timely fashion 
    • failure to assume responsibility for completing nursing actions 

Unsafe nursing practice is defined as any behavior determined to be actually or potentially detrimental to the client and/or to the health care agency. 

  • A student may be removed from a clinical area immediately if, in the professional judgment of a faculty member, the student has demonstrated unsafe practice in a clinical area. 
  • A faculty member who removes a student from the clinical area due to unsafe clinical practice during the clinical assignment is required to notify the course coordinator within 24 hours, and to consult with the appropriate Track Director or Executive Associate Dean for Academic Affairs. 
  • The faculty member will identify and document in writing the student’s unsafe clinical practice, advise the student regarding the unsafe clinical performance and the requirements for addressing the deficiencies, and if appropriate, refer the student for remediation or assistance using the CON clinical learning contract. Students are expected to respond to the remediation plan within 48 hours by contacting the designated person who will assist them with remediation. Students need to be self-directed for remediation because unsafe practice involves skills that have been previously taught. This means that the independent use of class material, practice in lab, and use of recommended resources is expected. 
  • The faculty member’s documentation of the student’s unsafe clinical practice and recommended remedial action plan will be provided to the course coordinator, Assistant Dean of Undergraduate Education, Associate Dean, and the student’s file. 
  • A student may be reinstated to the assigned clinical area only after the recommended action plan has been followed, successfully completed, and appropriately documented. 
  • If, following the remediation plan completion, the student’s clinical performance continues to remain unsafe; the Assistant Dean of Undergraduate Education or Associate Dean for Academic Affairs, in collaboration with the faculty member, may require additional remediation or may remove the student from clinical activities. 
  • If the same student needs to be removed from the clinical area more than one time, the student may be dismissed from the program due to unsafe behavior. 
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Uniform Policy

Uniform Policy

Uniform Policy

More information and how to order uniforms may be found online: https://www.umass.edu/nursing/academic-programs/nursing-major/clinical-information-undergraduate-nursing-majors

As nurses and nursing students, it is our role to care for the public in many settings. The rationale for a consistent uniform policy is to present a professional image as well as to be mindful of disease transmission. The Elaine Marieb College of Nursing uniform policy is intended to maintain a consistent professional image, consider medical asepsis, and to be congruent with dress code policies of agencies used for clinical experience. The uniform for clinical experiences (with the exception of clinical settings that have different uniform requirements) will include:

1. Plain navy-blue uniform quality scrub pants and a white scrub/uniform top and jacket with the UMass Elaine Marieb College of Nursing logo are required. Two sets are recommended. No shirt sleeve showing beneath the scrub top is allowed.
2. The University of Massachusetts name badge must be worn on the front of the scrub/uniform top or jacket.
3. Clean, all white or all black, leather or vinyl, (no canvas) nursing shoes are required. Nursing clogs, if permitted by the clinical agency, must be closed toe and heel. White, navy blue or black hose or socks must be worn.
4. Uniforms must be kept clean and pressed.
5. Hair must be restrained and off the collar.
6. Make-up must be kept to a minimum.
7. No artificial nails or nail polish shall be worn. Fingernails must be neat and clean, and length should not exceed ¼”. There is strong evidence that artificial nails and nail polish harbor bacteria and can cause infection.
8. Facial piercings (nose, tongue, eyebrows, etc.) must be removed in the clinical area and tattoos covered to the extent possible.
9. Jewelry must be limited to watches, small inconspicuous rings such as a wedding band and neck chains. No bracelets are allowed. Earrings must be stud type, no dangling earrings.
10. Use of colognes and perfumes or odor of tobacco or cannabis is not permitted in the clinical setting, as they may have an adverse effect on individual patients. Students in this situation will be asked to change their clothes or sent home from the clinical site.
11. Clinical agency dress code policies, if stricter than College of Nursing policy, must be adhered to while in that setting.
12. If street clothes are required by the clinical agency, they must meet the standards of the clinical setting.

Students who do not comply with the uniform policy will not be allowed in the clinical setting.

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Undergraduate Health Facilities Identification Badge Policy

Undergraduate Health Facilities Identification Badge Policy
  • Students are responsible for any identification badges issued by health care facilities and are responsible for returning badges at the end of the clinical rotation or the end of the program.
  • Students who have not returned badges will receive an incomplete for the clinical course.
  • Students are responsible for the cost of replacing any lost or missing badges.
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Health/Illness/Injury Incident Policy

Health/Illness/Injury Incident Policy

(Refer also to university policy)

PURPOSE:

The University of Massachusetts (UMass) Amherst Elaine Marieb College of Nursing is committed to maintaining a safe, healthy and productive environment. This policy informs faculty, staff and students of the steps to follow to insure the immediate care of the student in the event of a health incident.

I. POLICY STATEMENT:

Any health/illness/injury incident, that occurs to a student in any teaching environment within the college or its affiliated clinical agencies must be documented and reported by the faculty member and student. All students must provide the college with emergency contact numbers during orientation, including a local number in case they require transportation from the college or clinical facility. It is the student’s responsibility to ensure a safe transportation alternative. The UHS website http://www.umass.edu/uhs/ mentions two transportation options that may be helpful. The UHS Shuttle offers free rides from any on-campus location to UHS (call 413- 577-7425). If the student is referred by the healthcare provider to off-campus services, then HealthRide is an option (email a voucher request to https://www.umass.edu/uhs/accesstocare/rides/healthride or another mode of transportation of the student’s choice.

II.  PROCEDURE:

A. On Campus

1. If the incident is an emergency, call 911. This will trigger EMS. If the incident is not an emergency, call the UMass Police Department at 413-545-2121. If the individual is in need of mental health services, call the Center for Counseling and Psychological Health at 413-545- 2337.

2. Notify the Dean’s office at 413-545-5093 or the Executive Associate Dean for Academics, Research and Engagement office at 413-545-9576 and report the location and nature of the incident as well as the faculty, staff or student’s name.

3. If necessary, the student’s emergency contact will be notified by the Office of the Dean or the Office of the Executive Associate Dean for Academics, Research and Engagement.

4. The student may be referred to University Health Services or the student’s healthcare provider

5. of choice. The student is responsible for all healthcare costs for her/himself incurred in treatment of said injury, both immediate care and any necessary follow-up care. The College is not financially responsible for any costs incurred by the student.

6. The faculty or staff member and student will complete the Elaine Marieb College of Nursing Health Incident Report Form within one business day (see Appendix F). This form includes a clear statement of the incident that occurred, who was involved, action that was taken, and any plan for follow-up. The description should be factual in nature and free of interpretation and impressions. If a student is unavailable to sign the Elaine Marieb College of Nursing Health Incident Report Form within one business day, the Nursing faculty member should indicate this on the form and obtain the student’s signature as soon as possible. The form must be submitted to the office of the Executive Associate Dean for Academics, Research and Engagement who will oversee any investigation or remediation necessary.

7. If warranted, the student must provide documentation from a healthcare provider stating that she/he can return to clinical without restrictions.

B. Off Campus

1. If the incident is in a clinical facility, the policies and procedures set forth by that site must be followed. Neither the faculty nor the CON is responsible for the cost of any treatment involved in the student’s care.

2. The faculty member will notify the office of the Executive Associate Dean for Academics, Research and Engagement at 413-545-9576 as appropriate and report the location and nature of the incident as well as the student’s name and contact information.

3. If necessary, the student’s emergency contact will be notified by the Office of the Dean or Office of the Executive Associate Dean for Academics, Research and Engagement.

4. The student may receive appropriate and necessary care at an acute facility emergency department, employee health office or be referred to University Health Services or the student’s healthcare provider of choice. The student is responsible for all healthcare costs for her/himself incurred in treatment of said injury, both immediate care and any necessary follow-up care. The College and clinical facility are not financially responsible for any costs incurred by the student.

5. The faculty member and student will complete the College of Nursing Health Incident Report Form within one business day, which includes a clear statement of the incident that occurred, who was involved, action that was taken, and any plan for follow-up. The description should be factual in nature and free of interpretation and impressions. If a student is unavailable to sign the Elaine Marieb College of Nursing Health Incident Report Form within one business day, the Elaine Marieb College of Nursing faculty should indicate this on the form and obtain the student’s signature as soon as possible. The form must be submitted to the office of the Associate Dean for Academic Affairs who will oversee any investigation or remediation necessary.

6. If warranted, the student must provide documentation from a healthcare provider stating that she/he can return to clinical without restrictions.

Sue Cassidy

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