Clinical Placement

POLICY:

The School of Nursing coordinates clinical placements for required clinical courses for all students and prepares students for those placements. Clinical placement arrangements are made by either the Clinical Placement Coordinator or the primary teacher of the clinical course. All new clinical sites are evaluated to ensure that will be an effective learning environment and will provide an opportunity for students to achieve course learning outcomes. A signed (by a representative of the clinical setting and the Dean of the School of Nursing) Affiliation Agreement must be in place prior to assigning students to any clinical site. Students are required to submit evidence that they meet all requirements stipulated in the agency-specific affiliation agreement prior to starting any clinical rotation. The School of Nursing shall comply with clinical facility placement requirements as stipulated in the formal affiliation agreement(s). All new undergraduate clinical placement sites must be entered into Pennsylvania Licensing System (PALS) and approved by the Pennsylvania State Board of Nursing prior to a clinical rotation at the site.

PROCEDURE:

1. The method used to arrange clinical/practicum placements varies by program/major or area of concentration:
   
   Undergraduate – the primary teacher of the clinical course makes arrangements with specific clinical agencies.
   
   CNL – The primary teacher for each clinical practicum course is responsible for arranging the clinical practicum experience directly with the agency. Students may recommend a site for a clinical practicum course, but faculty will evaluate the site to ensure that it is an effective learning environment that will enable the student to achieve the learning outcomes of each clinical practicum course, has sufficient opportunities to meet the CNL Essentials (as outlined by AACN) and suggested clinical practicum experiences. All clinical sites must be preapproved by the faculty responsible for the clinical course.
   
   Nursing Informatics – the primary teacher arranges the clinical/practicum experience directly with the agency. Students may recommend a site for a practicum course, but faculty will evaluate the site to ensure that it is an effective learning environment that will enable the student to achieve the learning outcomes of each practicum course. All clinical sites must be preapproved by the faculty responsible for the clinical course.
   
   Nurse Anesthesia – The Department of Nurse Anesthesia (DNA) Coordinator for Clinical Education arranges clinical placements. Placements are made in consultation with clinical site coordinators and anesthesia department leaders and is reviewed at each Clinical Advisory Board (CAB) meeting. The clinical rotation schedule is created in advance giving students adequate notice to make travel arrangements. Students are assigned to clinical experiences to meet program outcomes and COA and CCNE accreditation requirements. Additional factors that are taken into consideration when assigning students are formative and summative evaluation results as well as student requests for specific enrichment experiences.
   
   Primary care nurse practitioner areas of concentration and nurse-midwife – the Clinical Placement Coordinator (CPC) contacts all students scheduled to take a clinical course to determine the type of clinical site they need. The CPC identifies the clinical agency(ies) to which the student will be assigned. All clinical sites must be preapproved by the faculty responsible for the clinical course. Primary care areas of concentration include family, pediatric, adult-gerontology primary care, and nurse-midwife. Nurse-midwife primary teacher is responsible for arranging specialty rotations with the clinical agency.
   Psychiatric Mental Health NP –the primary teacher is responsible for arranging specialty rotations with the clinical agency. Students can recommend a potential site themselves, but all sites must be preapproved by the faculty responsible for the clinical course.
   
   Neonatal NP, Adult Gerontology Acute Care NP, & Pediatric Acute Care NP – the primary teacher makes arrangements directly with the clinical agency. Students can recommend a potential site themselves, but all sites must be preapproved by the faculty responsible for the clinical course.
   
   Health Systems Executive Leadership – the primary teacher makes arrangements directly with the clinical agency. Students can recommend a potential site but all sites must be preapproved by the faculty responsible for the clinical course.
2. Students who decline a clinical placement identified by faculty or the CPC will sign the attached form confirming that they are declining the placement and understands that this decision may extend their program of study.
3. Prior to placing a student in any clinical site, a signed affiliation agreement must be in place. Faculty members responsible for the clinical course will check to determine if an active affiliation agreement is in place prior to placing a student (s) in any clinical facility. If there is not an active agreement in place, the faculty member contacts with Clinical Placement Administrator to initiate the process of obtaining an affiliation agreement. If the agency declines to use the School of Nursing’s standard affiliation agreement and either wants us to use their agreement or wants to make changes to the language of our agreement, the agreement will be reviewed and approved by the University legal department prior to it being signed. For some agencies, it may take several months to have an affiliation agreement that can be approved by both the University and the clinical agency. Sufficient time must be allotted for this process when faculty want to place students in a new clinical site.
4. If a new affiliation agreement is being initiated for an undergraduate clinical site, the Clinical Placement Administrator obtains a signed affiliation agreement (see Step 3). The Clinical Placement Administrator will send the clinical coordinator the BSN Affiliation Agreement Request Form to complete. This form collects information that the Pennsylvania State Board of Nursing requires us to enter into PALS. The Clinical Placement Administrator enters the information in the PALS Dashboard and the Associate Dean for Undergraduate Education submits it. The State Board of Nursing will notify us when the request is approved. Approval is required prior to use of the clinical site.
5. Prior to beginning any clinical rotation, faculty and students must meet agency requirements as stipulated in the agency affiliation agreement. Evidence that these requirements were met must be submitted to and approved by the School of Nursing prior to starting any clinical rotations. The Clinical Placement Administrator will confirm that all required paperwork has been submitted, is complete, and is free of potential issues. If there are potential concerns about any of the documents submitted, the Clinical Placement Administrator will consult with a representative of the clinical agency to determine whether the student can complete the clinical rotation in the setting.
6. All School of Nursing faculty and students must be prepared to show evidence that they have met School of Nursing and clinical agency requirements. All School of Nursing students are required to complete the initial and annual health evaluation forms (see Policy 370 Health Evaluations). CPR Certification; urine drug screen; ACT 33, 34, and 73 Clearances; and any other agency-specific requirements are required prior to enrolling in clinical courses (see Policy 369 Required Student Documents). If any of the clearances are positive, a copy will be submitted to the clinical agency who will determine if the student is eligible to do clinical at their site.
7. The University purchases a blanket professional liability policy covering all School of Nursing students and faculty with professional liability insurance in the amount of 1 million per occurrence and 3 million in the aggregate for all programs and majors. Documentation will be provided upon request ( Information | Risk Management | University of Pittsburgh). Medical Malpractice Policy
8. The School of Nursing shall provide faculty to supervise students in clinical experiences. Direct day-to-day instruction may be delegated to clinical placement site preceptors.
9. The School of Nursing shall notify its students of their obligation to comply with all policies and procedures of the clinical agency, including those governing the confidentiality of medical records and the use and disclosure of individually identifiable health information under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Prior to beginning the clinical assignment, clinical faculty will review any and all applicable policies, codes, or confidentially issues related to the clinical experience.

Clinical Placement Site Responsibilities

1. Clinical Placement Sites shall provide the School with documents and/or specific information that is to be reviewed with student nurses at least two (2) weeks in advance of the clinical experience.
2. Clinical Placement Site shall provide information and/or orientation for University faculty and students with respect to the physical facilities, policies and procedures of the clinical placement sites, and, where appropriate, to the needs of individuals and/or groups with which they will be working.
3. Clinical Placement Site, inpatient units, clinics, laboratories and/or selected departments, shall provide opportunities for observation and practical experience, conducive to the learning process of students and to the meeting of the stated learning outcomes.
4. Clinical placement site shall have ultimate responsibility for patient care.

The School of Nursing will collaborate with agencies to maintain various clinical placement databases that are required for clinical placements.

Attachment: Declination of an Assigned Clinical Placement Site Form