the case management program student handbook · the second layer includes advanced health...

Samuel Merritt University | 2016-2017 Case Management Handbook 1

THE CASE MANAGEMENT PROGRAM

STUDENT HANDBOOK


Message from the Director

Dear Graduate Student, Welcome to the Samuel Merritt University Case Management Program. Over the next four to seven semesters, the CM faculty will provide you with the foundation for your professional future as a nurse case manager. This handbook has been prepared to ease your transition into our graduate program and to provide guidance throughout your entire period of enrollment. In addition to this document, you should be familiar with the Samuel Merritt University Catalog and Student Handbook. An electronic copy of the Catalog and Student Handbook can be accessed via the University website. We look forward to providing you with the best academic experience to prepare you for your profession. Again, the faculty and staff welcome you to our program. Sincerely,

Fusae Kondo Abbott, DNSc. RN Professor and Director, Case Management Program


TABLE OF CONTENTS

Message from the Director ...............................................................................................2 Table of Contents ............................................................................................................. 3 Graduate Calendar ........................................................................................................... 4 Faculty and Staff .............................................................................................................. 5 Historical Perspective of Case Management................................................................... 6 Standards of Practice ....................................................................................................... 6

CM Program Overview ...................................................................................................... 7 Curriculum ...................................................................................................................... 10 Course Sequence ........................................................................................................... 13 Samuel Merritt University, CM Policies ......................................................................... 15 Specific CM Policies ........................................................................................................ 18

Safe and Professional Practice in Clinical Settings ...................................................... 19

Clinical Performance ...................................................................................................... 21

Typhon Student Tracking System ................................................................................. 23 Simulation ...................................................................................................................... 24

Synthesis Projects ........................................................................................................ 24 Evaluation ....................................................................................................................... 24 Graduate Progression .................................................................................................... 24


GRADUATE ACADEMIC CALENDAR


CM PROGRAM FACULTY AND STAFF

Full Time Faculty

Fusae Abbott, DNSc. RN [email protected]

Janet Rowland, EdD, RN, [email protected]

Lisamarie La Vallee, MSN, RN [email protected]

Kate Shade, PhD, RN [email protected]

Administrative Coordinator – Linda Kendig [email protected] 510-879-9200 X7436

Adjunct Faculty

Kimberly Anderson, MSN, RN Jeanette M. Broering, PhD, MPH, RN Crystal Casaleggio, MSN, RN Lois Cross, MSN, RN Heather Gosliner, MSN, RN Winnie Huang, MSN, RN

Halley Johnson, MSN, RN Fraulein Nelson, MSN, RN Shirley Ng, MSN, RN Lauren Smith, MSN, RN Helen Pagilagan, MSN, RN

Karen Preston, MS, RN Rachel Ross, MS, RN

mailto:[email protected]





HISTORICAL PERSPECTIVE OF NURSE CASE MANAGERS

The specialty of nursing case management is widely viewed as a recent development in response to a changing health care environment. The antecedents of today’s nurse case managers are the nurses who coordinated care and services in public health and communicable disease control in the crowded tenements of early 20th century American cities. Following the end of World War II, the demand for greater coordination of care for wounded veterans led to an increased demand for case managers. This need for management of significant injuries later spread to the workplace and nurses were employed as Workers Compensation Case Managers. The introduction of Medicare, Medicaid and the Prospective Payment System resulted in increased demand for improved coordination of care across the health care continuum. In addition, the emergence of utilization management in the 1970’s further demonstrated the need for nurse case managers to ensure patients were in the right place, receiving the right care, at the right time, thus serving as stewards of resource management. With the aging of the American population, the need to address chronic illness became apparent. Today’s nurse case managers are found in acute and subacute settings, disease management programs and community settings. They assess, analyze, and adapt to relationships between healthcare finance, health policy, best-practices in disease management, and patient outcomes. Nurse Case Managers are responsible to see that patients receive high quality care in the most appropriate level of care, in a cost-effective manner.

CASE MANAGERS: STANDARDS OF PRACTICE

The approved definition of nursing case management by the American Nurses Credentialing Center (ANCC) states:

Nursing Case Management is a dynamic and systematic collaborative approach to providing and coordinating healthcare services to a defined population. It is a participative process to identify and facilitate options and services for meeting individuals’ health needs, while decreasing fragmentation and duplication of care, and enhancing quality, cost-effective clinical outcomes. The framework for nursing case management includes five components: assessment, planning, implementation, evaluation, and interaction (Llewelyn & Leonard, 2009, p. 12).

The Case Management Society of America’s Standards of Practice (2010) are the nationally accepted guideline for the practice of case management. They include:


• Assessment of health and psychosocial needs, including health literacy, and development of a case management plan collaboratively with all stakeholders

• Planning with all stakeholders to maximize healthcare responses, quality, and cost effective outcomes

• Facilitating communication and coordination among stakeholders, involving the patient in the decision-making process in order to minimize service fragmentation

• Educating the patient and all stakeholders on treatment options, community resources, insurance benefits, and psychosocial concerns so that timely and informed decisions can be made

• Empowering the patient to problem solve by exploring care options and alternative plans, when necessary, to achieve desired outcome

• Encouraging the appropriate use of healthcare services and striving to improve the quality of care and maintain cost-effectiveness on a case-by-case basis

• Assisting the client in safe transitions of care to the next most appropriate level • Striving to promote patient self-advocacy and self-determination • Advocating for both the patient and stakeholders, to facilitate positive outcomes.

However, if a conflict arises, the patient must be the priority” (CMSA, 2010).

CM PROGRAM OVERVIEW The CM Program has two tracks: Post-Professional (PP) and Entry Level Master’s of Science in Nursing (ELMSN-CM). Baccalaureate-prepared nurses are admitted to the PP track, which requires 37 didactic units and 270 clinical hours of course work. The ELMSN-CM track – for those with a baccalaureate degree in non-nursing fields – is a seven-semester program (93 units and 225 clinical hours of course work) of which the first four semesters are for pre-licensure and the latter three semesters are for master’s education. The PP-CM track and the post-licensure part of the ELMSN track can be completed on either a full- or part-time basis. The PP-CM applicants, if they did not successfully complete a nationally accredited BSN program, must present their portfolios with evidence that they received BSN equivalent experience through their work. SMU awards an MSN degree for those who complete the CM Program. The CM program is offered on a year-round basis. For the ELMSN-CM Program we admit the students in the fall semester for the Oakland campus and in the spring semester for the Sacramento campus. For the PP-CM Program we admit the students in all semesters. The curricula for the PP CM program and ELMSN-CM program are slightly different (see the Course Sequence Tables for ELMSN-CM and PP-CM). The curriculum is consistent with the highest national standards, including guidelines established by the American Nurses Credentialing Center and the Case Management Society of America. The philosophy of the CM program is expressed in its curriculum and instructional materials. The curriculum structure is built upon several layers of foundations. The base of the structure


includes Research, Healthcare Policy, Program Evaluation and Quality Improvement, Healthcare Finance, and Epidemiology. Quality of care and costs of care are the main foci of case management practice. Issues related to the cost structure of the US healthcare system are covered by “N602 Analysis of Health Policy Issues,” and “N612 Health Care Finance.” Issues related to quality care (safe, effective, efficient, personalized, timely and equitable outcomes) are covered by “N607 Program Evaluation and Quality Improvement.” Efficient and cost-effective strategies are very important for achieving desired outcomes in CM practice. “N603 Epidemiology and Bio-Statistics” provides a good foundation for population management practice, which is a new trend in CM practice. The second layer includes Advanced Health Assessment for Nurse Case Managers, Advanced Pathophysiology for Nurse Case Managers, and Advanced Pharmacological Management for Nurse Case Managers. These three courses were added in 2013 in response to the 2011 “Essentials of Master’s Education” standards. These courses strengthen the CM curriculum by providing the student with knowledge about scientific evidence for Case Management practice. The third layer is Case Management Theory and Clinical. In “N620 Case Management Theory,” the students further study the issues surrounding health care insurance and reimbursement through examination of federal and state health care regulations and implementations, particularly the eligibility, benefits, reimbursements, or appeals/denials of Medicaid and Medicare. The students take clinical courses (5-unit N620L for ELMSN-CM students and 3-unit N620L and 3-unit N621L for PP-CM students) and can apply their learning through actual practice and have hands-on experiences. Because case management practices are varied, and in order to provide the students with a wide range of experiences, the program utilizes a variety of clinical placements, such as acute care hospitals (community, HMO, county, university, and VA hospitals), physician groups, health plans, insurance companies, community-based not-for-profit case management agencies, public health agencies, hospices, and independent case management companies. The fourth layer includes Leadership and Management and the final capstone course. “N608 Leadership, Management and Organizational Behavior in Health Care” covers the executive leadership role, communication, leadership and management characteristics within organizations, patterns of decision-making and concepts of change, and innovation relative to health care organizations. Regarding the synthesis project, the students must develop a case management program, or develop a case management tool for a target population with health conditions, or develop an efficient case management process in an acute care setting. Each student proposes an evidence-based case management program/ tool/ process through extensive literature review of the problems and healthcare needs of the population and of effective treatment modalities and services. The proposal should include a plan of program evaluation and policy considerations. These requirements clearly indicate that the students must synthesize content from all the courses they have taken in the CM program.


Core concepts of systems approach, inter-professional collaboration, evidence-based and population-based practice, quality improvement, leadership, and professional accountability are threaded throughout the program and clinical experiences.

Case Management Student Learning Outcomes Upon graduation the student will be able to…

• Ensure coordination, continuity and quality of care for a selected population. • Assume nursing case management roles in a variety of health care settings. • Demonstrate a clinical nursing foundation in the application of case management

principles.


CURRICULUM COURSE DESCRIPTIONS

N601 - Research Methods (3 units) This course presents an overview of the research process, with emphasis on using the scientific method to identify and investigate problems in clinical practice. Major topic areas include: types of research approaches, formulation of research problems and hypothesis/research questions, preparing a literature review including theoretical/conceptual framework, study designs and selecting a research method, sampling, measurement of variables, data collection and analysis. N602 - Analysis of Health Policy Issues (3 units) This course focuses on political structures, the political process, and development of health care policy. The course begins with an overview of the health care system as shaped by cultural and societal values, perceived purposes of health care, and modern technology. Attention will be given to issues of economics, finance, regulatory systems, and social justice for consumer groups.

N603 - Epidemiology and Biostatistics (3 units) This course presents an introduction to the principles, methods, and uses of epidemiology in determining the distribution of populations at high risk, surveillance of health status, and planning and evaluation of health services. The course focuses on determining the relevance of the findings of epidemiological studies to clinical practice of individuals, families, and communities.

N607 - Program Evaluation and Quality Improvement (3 units) This course focuses on methodology for successful evaluation of health care programs, including comparative analysis of program purposes, cost-benefit analysis, and cost-effectiveness. A conceptual framework for quality improvement is presented and techniques for establishment of comprehensive quality improvement programs in a variety of settings are analyzed.

N608 - Organizational Behaviors in Health Care Delivery Systems (3 units) This course begins with an overview of organizations, foundations and elements of organizational theory, and elements of organizational functioning in health care settings. The student studies the executive leadership role, communication, leadership and management characteristics within organizations, patterns of decision-making and concepts of change, and innovation relative to health care organizations.

N612 - Health Care Finance (3 units) This course investigates the mechanisms by which health care is financed and health care providers are compensated in the United States. The effects of financing and reimbursement mechanisms on health care delivery systems, health care organizations, health care


providers, and the patient are explored. Both public and private mechanisms of financing will be analyzed. The impact of current reimbursement patterns on health care delivery, professional practice, and the health care consumer are discussed and critiqued.

N620 - Case Management Theory (3 units) The course provides an overview of the health care delivery system and managed care systems as part of the delivery system. Health care organizational theory and structure, economics of health care, systems management, and ethical and legal issues are discussed in relation to managed care. Interdisciplinary collaboration and the role of nursing on the health care team and in managed care systems are examined.

N620L - Case Management Clinical (3 units) The clinical experience provides the student with an opportunity to apply theories and concepts to a select group of clients.

N621L - Case Management Clinical Practicum (3 units) The clinical focus course provides students the opportunity to expand skills in the delivery of nursing care within a managed care/case management framework to a population of interest. The seminar component of the course will allow students to share insights into their developing roles.

N623/N623L - Advanced Health Assessment for Nurse Case Managers (2 units theory, 1 unit lab) This course focuses on the strategies and skills needed to assess individuals throughout the life span in a case management setting. The expected outcome is competency in advanced health assessment as a Nurse Case Manager. The analysis of assessment data, based on developmental and ethnic variation, is integrated into the case management clinical decision making process. Advanced health/physical assessment includes the comprehensive history, physical and psychological assessment of signs and symptoms, pathophysiologic changes, and psychosocial variations of the client: the individual, family, or community. If the client is an individual, the assessment should occur within the context of the family and community and should incorporate cultural and developmental variations and needs of the client. The purpose of this comprehensive assessment is to develop a thorough understanding of the client in order to determine appropriate and effective health care including health promotion strategies.

N624 - Advanced Pathophysiology for Nurse Case Managers (2 units) This course provides the theoretical framework for understanding disease processes and physiological aberrations in all ages, including chronic illness and population health. Emphasis will be placed on the application of pathophysiology in the identification of common disease processes, clinical syndromes, and the trajectory and management of illness throughout a lifespan.


N625 - Advanced Pharmacological Management for Nurse Case Managers (2 units) The focus of advanced pharmacological management for nurse case managers is clinical therapeutics, and it builds on prior knowledge of drug classifications, actions, interactions and side effects. The course concentrates learning on medications that are used in case management practice. Emphasis is placed on learning the clinical use of drugs in the management of specific illnesses, including therapeutic dosages, clinical endpoints, patient monitoring plans and patient education. Health-related information and medication compliance issues are of foremost concern throughout the course. This course builds on a sound foundation of pharmacology to facilitate comprehensive disease management.

N606 - Synthesis Options - Special Project (3 units) The special project may take one of three forms: (a) Preparation of a scholarly paper for publication in concert with a faculty member. This assignment, which requires considerable student initiative, will include participation in the development of a topic, literature review, data collection and analysis as appropriate, and preparation of a scholarly paper for publication. (b) Preparation of a scholarly report on the implementation of a major health program or instructional innovation designed to improve health care to high-risk populations in the community. Such a project is the culmination of work initiated in the core theory and clinical courses in the student’s area of concentration. (c) Completion of a comprehensive exam specific to the student’s clinical specialty. The format, content and timing of administration of this exam vary with each of the MSN program tracks. Refer to the MSN Synthesis Guidelines of the School of Nursing and program-specific documents for these details. Other scholarly projects are possible by arrangement. Three semester units of credit are awarded upon successful completion of the special project.


ELMSN-CM FULL TIME COURSE SEQUENCE

6 Semesters Course Number

Course Title Units

PRELICENSURE N520 Integration of Pathophysiology and Pharmacology

5

Semester 1 N500 Transition to Professional Role of Nursing 2 N524/524L Health Assessment 3 N534/534L Mental Health Nursing 5 N542L Nursing Skills I 1 N546/546L Nursing Care of Adults & Older Adults 10

Semester 2 N543L Nursing Skills II 1 N562 Professional, Legal, and Ethical Issues 3 N550 Nurses as Consumers of Research 2 N566/566L Nursing Care of Critically Ill Adults 5

Semester 3 N556/556L Nursing Care of Pediatric & Youth Populations 5 N540/540L Reproductive Health Care 5

PRELICENSURE N594L Clinical Internship 5

Semester 4 N560 Leadership, Management, & Organizational Behavior in Healthcare

3

N570/570L Community Health 5 POSTLICENSURE N601 Research Methods 3

Semester 1 N602 Analysis of Health Policy Issues 3

N624 Advanced Pathophysiology for nurse case managers

2

N625 Advanced Pharmacological Management for nurse case managers

2

Semester 2 N623/623L Advanced Health Assessment for nurse case managers

3

N603 Epidemiology and Bio-Statistics 3 N607 Program Evaluation and Quality Improvement 3 N612 Healthcare Finance 3

Semester 3 N620/620L Case Management 5 N605/606 Synthesis Requirement 3


Post-Professional CM - Full Time Course Sequence


Course Title Units

Semester 1

N601 Research Methods 3 N602 Analysis of Health Policy Issues 3 N624 Advanced Pathophysiology for nurse case managers 2 N625 Advanced Pharmacological Management for nurse

case managers 2

Semester 2

N603 Epidemiology and Bio-Statistics 3 N612 Healthcare Finance N623/N23L Advanced Health Assessment for nurse case

managers 3

Semester 3

N607 Program Evaluation and Quality Improvement 3 N620/N620L Case Management 6

Semester 4

N621L Case Management Clinical Practicum 3 N606 Synthesis Requirement 3 N608 Organizational Behaviors in Health Care

Delivery Systems 3

(These courses may be taken in a different sequence or term; Subject to change).

Post-Professional CM - Part Time Course Sequence


Course Title Units

Semester 1 N601 Research Methods 3 N602 Analysis of Health Policy Issues 3

Semester 2 N624 Advanced Pathophysiology for nurse case managers

2

N625 Advanced Pharmacological Management for nurse case managers

2

Semester 3 N623/N23L Advanced Health Assessment for nurse case managers

2

N612 Healthcare Finance 3 Semester 4 N603 Epidemiology and Bio-Statistics

N607 Program Evaluation and Quality Improvement

3

Semester 5 N620/N620L Case Management 6 Semester 6 N621L Case Management Clinical Practicum 3

N606 Synthesis Requirement 3 N608 Organizational Behaviors in Health

Care Delivery Systems 3

(These courses may be taken in a different sequence or term; Subject to change).


SAMUEL MERRITT UNIVERSITY - CASE MANAGEMENT PROGRAM POLICIES

Attendance and Participation Students are expected to participate in all coursework and classroom activities, and complete all assignments by the posted due date and time.

The faculty recognize that events may occur that interfere with participation and/or the completion of coursework by the assigned due date. It is imperative that students communicate with the course faculty as soon as they are aware of any conflict that interferes with the above stated expectations (preferably PRIOR to due dates). Time spent logged into Canvas and posting assignments meet the attendance and participation requirements for courses delivered online.

Academic Performance

Academic integrity is expected of all faculty, staff and students in order to promote a productive and safe environment for learning. Key components of academic integrity are communication and mutual respect among the members of the Samuel Merritt University community. Faculty, staff, and students are expected to abide by the codes of conduct and ethics of this University, as well as the code of ethics of their respective professions, which includes reporting misconduct to the appropriate authorities. Lack of academic integrity includes, but is not limited to, plagiarizing, cheating, deception, breach of confidentiality, failure to report a clinical error, falsifying research results, and failure to confront and/or report misconduct of others.

Faculty members reserve the right to evaluate individual cases of academic dishonesty by a student and to take appropriate action, which may include failure on a paper or exam or failure in the course. Faculty may also recommend censure, probation, suspension or dismissal to the Academic Vice President. A written report of any action will be placed in the student’s file in the Office of the Registrar. If the student’s status in the program is affected, a permanent notation will be made on his/her transcript.

Regardless of any action taken by the course faculty member, lack of academic integrity constitutes grounds for suspension or dismissal from Samuel Merritt University through the Office of the Academic Vice President.

Academic Honesty and Plagiarism Policy Individual Assignments – graded assignments that are the students’ original work. No portion of any assignment submitted may be the work of any other student in this course, or any other course.

Group Assignments – graded assignments that are the work and collaboration of a group of students (as assigned by instructor), that cumulatively is submitted as one assignment


and will be graded based on the submission of the group. No portion of any assignment submitted may be the work of any other student in this course, or any other course. Group assignments must have a page added to the submitted assignment that indicates the students’ names and the work designated and completed by each student in the group.

Collaboration – students speaking with one another, or otherwise working on assignments together, in discussion settings. Collaboration is allowed only on a case-by-case basis, as allowed by the Instructor. All students involved in any collaboration will be named on all assignments submitted.

Course expectation – all assignments will be either individual or group (please refer to syllabus). Collaboration is allowed at the Instructor’s discretion and with clear instruction to students, otherwise all students must work individually or in their group. No student may submit any assignment that is not original, and completely their own work. Please refer to SMU Academic Student Handbook and Course Policies regarding academic dishonesty and plagiarism.

Communication, Professionalism, and Conduct

We recognize that students in the Case Management program have overcome many challenges to get to this level in their education. It is our desire to support you in your learning processes and to support the reputation and quality of the SMU CM program at the highest caliber. We further recognize that our students are mature, responsible, competent at studying and learning, and are hard‐working adults with many duties and responsibilities outside of the SMU CM experience. In order to support you and ensure the mutually beneficial reputation of the SMU Case Management program, we will clarify expectations between us.

As your CM administration, faculty and staff, you can expect:

1. We will strive to be current in our academic, political, and professional knowledge in advanced practice nursing.

2. We will be prepared for your learning in all CM courses and clinical rotations. 3. We will be present for CM courses and clinical rotations with an “I am here to learn

with you” attitude, on time, and as scheduled. 4. We will “set the bar high” in our expectations of you in the CM student role. 5. We will strive to communicate effectively orally and in writing, in a timely manner. We will strive to provide feedback on papers and assignments to you in a timely

manner. We will strive to answer your emails and phone calls to us within 72 hours. If we are unavailable to you during these time frames for any reason, we will

contact you at a minimum of two weeks in advance and inform you either through


Canvas or email and provide the name of a reliable contact person that can return your emails and phones in our absence.

We will use graduate level wording, and proper English composition, spelling and grammar in our communications to you.

5. If we change our class, lab or schedule in a way that impacts your classes or your clinical rotations, except in an extreme emergency, we will give you a minimum of a two week notice.

6. We will strive to be CM role models for you. 7. We will work together to see every adverse or challenging situation as an opportunity

to learn. 8. Whenever possible, we will provide a minimum of a two week notification of your

upcoming clinical rotation sites.

As SMU CM students, we expect:

1. You will be prepared when coming to CM theory and clinical rotations. This means, you have read the required material, when appropriate, and have a positive, “I am here to learn with you” attitude, will commit to show up on time, be engaged, and attend and participate during the full time scheduled.

2. You will demonstrate an effective meaningful professional communication manner, both orally and in writing, in a timely manner. You will use graduate level wording and proper English composition, spelling and grammar in your communications to us. When you receive an email or written communication from us, we expect an acknowledgement of that communication in a timely manner written within 72 hours.

3. You will to strive to “set the bar high” in your expectations of us in CM administration, faculty and staff roles.

4. If you change your attendance schedule to a class, lab, clinical or other University based activity, except in an extreme emergency, you will give us a minimum of a two week notice, and if you are going be absent from clinical, we expect you to notify your preceptor as soon as possible.

5. You will strive to be role models and mentors for other CM students. 6. You will strive to see each adverse or challenging situation as an opportunity to

learn. 7. You will keep your clinical hours current and documented, and respond rapidly to

requests related to potential or current clinical sites timely.

Late Submission of Assignments

Up to 50% point deduction can occur for assignments submitted late. Assignments will not be accepted unless prior arrangements are made with the course faculty.

A student who does not attend required course meetings/activities will receive a lower grade for the course.


Test Scores

A failing score of <75% on any course exam or equivalent assignment may be remediated one time only. The maximum score allowed for a remediation is 75%.

SPECIFIC CASE MANAGEMENT POLICIES For All Courses

Students are expected to arrive to class and/or clinical site meetings on time, appropriately attired, wearing SMU nametag, and adequately prepared.

Students are expected to maintain professional communication with staff, faculty, and peers at all times.

Online students are expected to participate on time in Discussion Boards and other assigned activities.

For Theory Courses

It is the student’s responsibility to be familiar with all course requirements. Students are expected to be attentive to classroom activities and NOT spend time on

personal email or other unrelated activities while class is in session.

For Clinical Courses

It is of mutual understanding that the CM Program Policies include the following:

Students cannot precept in the same work-unit where they are employed. Students cannot precept with a relative, friend or anyone with whom they have a

relationship (e.g. a care provider). Students are expected to attend clinical days as if it were their place of employment.

Therefore, students must notify the clinical faculty, preceptor, and clinical site as soon as possible if they cannot attend clinical, will be late, or there is a change in hours.

o An absence of more than one day of clinical during the semester jeopardizes meeting competencies, and must be discussed with the clinical faculty for remediation.

Students are expected to provide the names and contact information of their preceptors to their clinical instructor at the beginning of the semester and throughout the rotation.

Students at risk in clinical are expected to: o Meet with their clinical faculty to review expectations as soon as possible. o A letter of concern and learning contract will be initiated. o At any time during the student’s clinical rotation, a learning contract can be

initiated as soon as concerns or problems are noted. o A midterm student self-evaluation, along with a learning contract will be

initiated for review during the student’s final evaluation. o Complete a plan for remediation, including learning goals. This midterm

evaluation or when concerns are first noted will be completed in writing.


SAFE AND PROFESSIONAL PRACTICE IN CLINICAL SETTINGS

Policy A student whose pattern of behavior is found to be unsafe and/or unprofessional may be excluded from a clinical practicum at any time and could receive a failing grade in the course. The student is referred to the program director/department chair and may be subject to further disciplinary action.

Guidelines The student will demonstrate patterns of healthcare professional behavior which follow the legal and ethical professional codes; promote the well-being of clients, healthcare workers, and self in the biological, psychological, sociological, and cultural realms; demonstrate accountability in preparation, documentation and continuity of care; and show respect for the human rights of individuals.

Indicators to Be Used as Guidelines for Evaluating Safe and Professional Practice Are:

Regulatory The student practices within the boundaries of the applicable State Practice Act, the guidelines and objectives of the department, and the rules and regulations of the healthcare agencies. Examples of safe and/or professional practice include, but are not limited to the following:

1. Notifying the agency and/or instructor of clinical absence. 2. Adhering to the dress code. 3. Presenting for clinical practicum free from the influence of un-prescribed

psychoactive drugs, including alcohol. 4. Demonstrating accountability by making up missed clinical experiences, as

designated by faculty member. 5. Arriving promptly for clinical assignments. 6. Meeting obligations in a timely manner.

Ethical The student practices according to the relevant professional association’s Code of Ethics, Standards of Practice, and the State Practice Acts. Examples of safe and/or professional practice include, but are not limited to the following:

1. Accepting assignments in keeping with the University’s policy of non-discrimination. 2. Appropriately performing any activity related to clinical practice. 3. Reporting unethical behavior of other healthcare providers, including other students. 4. Demonstrating honesty in all aspects of clinical practice.


Biological, Psychological, Social, and Cultural Realms The student’s practice meets the needs of the human from a biological, psychological, sociological and cultural standpoint. Examples of safe and/or professional practice include, but are not limited to the following:

1. Displaying stable mental, emotional and physical behavior. 2. Following through on referrals or interventions to correct own areas of deficiency in

clinical practice which, if ignored, may result in harm to others. 3. Building interpersonal relationships with agency staff, coworkers, peers and/or

faculty that result in clear, constructive communication, promoting quality client care and/or unit functioning.

4. Being physically capable of carrying out essential procedures.

Accountability The student’s practice demonstrates accountability in the responsible preparation, documentation and promotion of continuity in the care of clients. Examples of safe and/or professional practice include, but are not limited to the following:

1. Communicating concisely both orally and in writing. 2. Documenting client behavior accurately and comprehensively. 3. Reporting questionable professional practices. 4. Undertaking activities with adequate orientation, theoretical preparation and

appropriate assistance. 5. Demonstrating honesty in all aspects of practice.

Dress Code Students are expected to dress professionally in appropriate clothing for their clinical setting. The following serves as a guideline for the CM program and is in conjunction with the clinical agency's expectations.

1. It is expected that compliance with the dress code of each individual clinical agency will be respected.

2. Appropriate attire and a neat personal appearance are required when interacting with faculty and peers in classroom situations.

3. Appropriate attire and neat personal appearance are required during interactions with patients and clinical colleagues.

4. Lab coats should be worn with name tags during every clinical rotation, as dictated by the clinical site.

5. Business casual or more formal professional attire should be worn depending on the setting.

6. Scrubs are not proper attire for nurse case managers. 7. Appropriate, closed toed and low-heeled shoes should be worn in clinical settings

(No flip-flops, sandals or open toes). 8. Hair should be arranged so as not to interfere with patient care and safety. 9. Nails should be clean, short and maintained to ensure patient safety.


10. Perfumed or scented products should not be worn, as many patients are intolerant. 11. Jewelry should not interfere with patient care or safety.

CLINICAL PERFORMANCE The Clinical Coordinator and faculty will help prepare you for your practicum by providing a clinical guide, set up training to learn our Clinical Database - Typhon and work with you on Clinical Placements.

Case Management Student Expectations

1. Attend all prearranged clinical conferences in a timely manner. Notify preceptors promptly if you are unable to be at clinical.

2. Share with clinical faculty and clinical coordinator regarding strengths, weaknesses and learning needs and preferences.

3. Provide clinical faculty and preceptor with written personal objectives that are consistent with overall course objectives.

4. Participate in self-evaluation as well as preceptor and faculty evaluation. 5. Participate appropriately in the clinical agency in relation to dress, demeanor,

nametag, confidentiality and use of resources. 6. Develop collaborative and considerate working relationships with all client and

staff colleagues in the clinical agency. 7. Advocate for clients/families rights for appropriate care and self-determination

above the student's learning needs.

Preparation for Case Management Clinical Practicum: The ‘Basics’ & Site Specific Requirements

Clinical rotations are contingent upon up-to-date ‘basic’ requirements which consist of current health records, Basic Life Support (BLS) card, and Healthstream requirements. Dates must be valid (not expire) through the end of the clinical semester to be considered ‘current’. Please determine that your student health records are complete and current according to the following requirements. If any of the following need updating, please complete and submit documentation via the student health portal before the start of the clinical semester OR by the date determined by the Program Director.

1. Flu Vaccine: An annual flu vaccine is required every August. Students who decline flu vaccine must wear a mask when they are in clinicals.

2. Tdap (Tetanus, Diphtheria, Pertussis): Verification of Tdap vaccine within the last 10 years. Td will not satisfy this requirement.

3. The University Medical History and Physical Examination Form. Examination conducted within 12 months before program start date, which includes a physical exam, vision exam, urinalysis, and complete blood count (CBC).


4. Hepatitis B: 3 doses required. Dose 1 to Dose 2: minimum 4 weeks apart. Dose 2 to dose 3: minimum 8 weeks apart AND at least 16 weeks after first dose OR Positive Hepatitis B sAb Titer (surface antibody).

5. MMR: Measles (Rubeola), Mumps, and Rubella: 2 doses required (no age exception due to our health science institution.) Minimum 4 weeks apart between Dose 1 to Dose 2 OR Positive Rubeola IgG Titer, positive Rubella IgG Titer, and positive Mumps IgG Titer.

6. Varicella: Documentation of positive varicella titre or two doses of varicella vaccines received minimum 4 weeks apart, regardless of prior history of chicken pox.

7. Tuberculosis Skin Test (TST) aka PPD: • Negative 2-step PPD: Must be done within 6 months before your program

start day. 2-step as defined by CDC: 1st test placed and read within 48-72 hours. 2nd test placed at least 1 week after 1st placement, but no longer that 3weeks, and read within 48-72 hours or

• A negative Quantiferon TB Gold blood test (IGRA) (Must be done within 6 months before program start day) or

• Individual with a history of Positive TST (PPD): A negative chest x-ray (within 12 months before program start date; CXR report is required.) AND Completed Tuberculosis Screening Survey. Depending on date of conversion, evidence of latent tuberculosis treatment may be required.

In addition the following requirements must be submitted to the School of Nursing:

1. Basic Life Support (BLS) card through American Heart Association 2. Transcript showing of four required Health Stream modules

Along with current health records and basic requirements, each clinical site will have site-specific requirements which will need to be completed, which may include a copy of a student’s RN license. Students will be given access to an online ‘course’ which lists site-specific requirements and instructions on how to complete them. Students will not be permitted to begin the clinical rotation until all ‘basic’ and site-specific requirements have been met.


TYPHON STUDENT TRACKING SYSTEM Typhon Overview

The clinical work begins with the student and preceptor discussing and agreeing upon the student’s goals and objectives, learning activities, and methods of evaluation for the clinical experience. The student’s clinical progress is monitored by using Typhon, a student clinical tracking system. Typhon tracks students’ clinical experiences on a per-encounter basis. Case notes are entered in Typhon after every clinical experience (daily). They are reviewed by the faculty and approved or returned for resubmission. Typhon is also used as the point of ongoing communication from the student to the clinical instructor. Journal entries (in narrative format) are posted weekly on Typhon to be reviewed by the clinical instructor. The contents of the entry include: 1) a discussion of the student’s personal reactions to the clinical environment; 2) correlation of the student’s experience with theory/information from the theory course and literature; 3) case studies for 4 clients; 4) a life care plan for one client, 5) reflections regarding the seminars; and 6) a tally of the days and hours spent in the clinical setting.

In addition, the student’s progress is monitored through bi-weekly seminar attendance and participation. Also, the clinical instructor is in close communication with the student’s preceptor; and, if any problems or issues are raised by the preceptor, the clinical instructor has meetings with the preceptor and the student.

A mid-term evaluation is conducted for the purpose of assessing the student’s progress in clinical work and to evaluate the appropriateness of the clinical site so that the student, the clinical instructor, and the preceptor can adjust or modify the student’s plan of study. The student is instructed to indicate the areas that need to be worked on and present a modified plan to accomplish the goals/objectives for this practicum. After completing the mid-term evaluation on Typhon, the student has a meeting with the clinical instructor to adjust the clinical practicum plan.

Every student is fully oriented to the use of Typhon just prior to first clinical rotation; thereafter it is the student’s responsibility to maintain their account as directed during the orientation. The Clinical Coordinator and clinical instructors are responsible for monitoring and maintaining designated components of the site. The importance of maintaining all documents up to date on Typhon cannot be overemphasized.


Typhon Requirements

Documentation of hours and patient encounters are expected to be entered into Typhon on a daily and/or weekly basis. You are expected to meet the minimum clinical hour requirement for each clinical course by the end of the respective semester.

SIMULATION

Patient encounter simulations are conducted throughout the CM curriculum beginning in Advanced Health Assessment. To realistically reproduce a patient encounter, standardized patients (SPs) are sometimes utilized. These SPs portray patients during an interview and assessment with the student. Through these interviews, students learn how to communicate with patients in certain clinical situations, followed by the appropriate case management assessment and plan.

SYNTHESIS PROJECT

In the CM program each student must complete N606 Synthesis Requirement. The student must choose one option from the following: 1) to develop a case management program, 2) to develop an interdisciplinary CM tool, 3) to develop a cost-effective and efficient CM process within an acute care setting or in the transition from acute care to the next level of care, and 4) to develop an agency-requested special project. The student chooses an option and must develop an evidence-based proposal, then conduct a 15-minute presentation in front of classmates, faculty, and CM-related professionals.

EVALUATION

Student Outcome Evaluation/Program Evaluation:

All students are required to complete evaluations assessing the outcomes of their educational program. Ongoing evaluations are conducted in all programs to assess and ensure quality educational experiences. The evaluation instruments are collected each semester and/or during the final term prior to graduation. Students are asked to complete and submit an evaluation each semester reviewing current clinical site, preceptor and Clinical Faculty Evaluation. The electronic evaluation will be submitted to you through Typhon, the SMU clinical database.


GRADUATE PROGRESSION AND GRADUATION

All students must satisfactorily complete all required prerequisite courses to progress in the major. Graduate students in the Master of Science in Nursing programs must achieve satisfactory academic performance, including: a minimum grade of “C” in all required courses; a grade of “S” on all clinical experiences; and a cumulative grade point average 3.0. Graduate students are also required to complete evaluation instruments assessing their learning experiences, including clinical coursework, at periodic intervals.

the case management program student handbook · the second layer includes advanced health...

Documents