NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

NURSE PRACTITIONER (NP) STUDENT CLINICAL ORIENTATION

Walden University

Nurse practitioner program

AGACNP

AGPCNP

FNP

PMHNP

Welcome

This power point will discuss highlights of our clinical courses and will provide a quick access guide , with classroom requirements and reminders.

Dr. Jennifer Stone – Clinical Supervisor, jennifer.stone2@mail.waldenu.edu

Dr. Tara Harris – PT Clinical Supervisor, tara.harris4@mail.waldenu.edu

2

Welcome to NP Program

Dr. Linda Steele – NP Program Director

Dr. Timothy Legg – PMHNP Coordinator

Dr. Salma Hernandez – AGACNP & AGPCNP Coordinator

Dr. Phyllis Morgan – FNP Coordinator

Dr. Stefanie Gatica – FNP Coordinator

Dr. Jennifer Stone – Clinical Supervisor

Dr. Tara Harris - Clinical Supervisor

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

NP Full time faculty

Dr. Rachel Carlton

Dr. Eva Hvingelby

Dr. Mahaman Moussa

Dr. Erica Sciarra

Dr. Jeani Thomas

Dr. Cindy Trent

Dr. Gretchen Zunkel

Chain of Command and Course Coordinator Support

Any questions or concerns about your clinical course:

First point of contact is the Clinical faculty

Didactic faculty – clinical faculty will contact if help is needed.

Lead faculty – didactic faculty will contact if help is needed.

Course coordinator – lead faculty will contact if help is needed

Clinical Supervisors – faculty will contact for specific clinical issues or questions

Course Coordinators

Timothy Legg – 6512, 6630, 6640

Salma Hernandez – 6501, 6540, 6550, 6560

Phyllis Morgan – 6521, 6551, 6565

Stefanie Gatica – 6531, 6541

Student resources

Student Assistance Program - Students, and anyone in their households, who want to use this service or are referred for assistance should be encouraged to call 1-866-465-8942 (TDD: 1-800-697-0353) or visit http://inside.WaldenU.edu/sap for more information. When students request services from the program, they will be asked for a Walden ID. That ID is SAP4EDU.

Writing Center - http://academicguides.waldenu.edu/writingcenter/home

Walden library - http:// academicguides.waldenu.edu/library

Technical support – 800-925-3368

PRE-CLINICAL INFORMATION

Students are to create a schedule for clinical hours that the student and preceptor have agreed upon and email it to your clinical faculty

Please save it in a calendar format and include your contact information as well as preceptor’s contact information on the schedule

Save the file name and “clinical schedule”NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

You must email the schedule to Clinical Faculty

Clinical faculty will call or email student and preceptor to set up a minimum of 1 phone conference and 2 email contacts during the quarter

PRECLINICAL INFORMATION FOR STUDENTS

You should reflect and prepare learning goals and objectives for the course

Review the course objectives

Review SOAP notes article

Review the preceptor evaluation of student

Review the Competencies for your specialty (AGACNP, AGPCNP, FNP, PMHNP) by visiting the following sites:

Core Competencies for nurse practitioners http :// nonpf.com/associations/10789/files/NPCoreCompetenciesFinal2012.pdf

AGPCNP Competencies http:// nonpf.com/associations/10789/files/Adult-GeroPCComps2010.pdf

FNP Competencies http:// www.nonpf.org/associations/10789/files/PopulationFocusNPComps2013.pdf

AGACNP Competencies http:// www.aacn.nche.edu/geriatric-nursing/Adult-Gero-ACNP-Competencies.pdf

PMHNP Competencies: http:// www.aacn.nche.edu/education-resources/PopulationFocusNPComps2013.pdf

8NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

CLINICAL ATTIRE

STUDENTS MUST WEAR APPROPRIATE ATTIRE

Appropriate Inappropriate
Comfortable and practical Clothing that is distracting or offensive to others
Lab Coat with name tag Clothing with words, terms or pictures that may be offensive to others
Pressed and clean Clothing that works for the beach, yard work, dance clubs, exercise sessions
Fashion brand names on clothing Clothing that reveals too much cleavage, your back, your chest, your stomach or your underwear
Professional appearance Torn, dirty or frayed clothing
Closed-toe shoes Jeans
Clean nails

Name Tag

Instructions for making your name tag

Students go to myWalden Portal

Welcome Center tab

Get Prepared tab

Scroll to bottom of page #7

Print ID badge

If your clinical site requires a photo ID, please add a passport photo (scan your photo with name tag)

10

Resources STUDENTS should take to CLINICAL

Practice guidelines for your specialty program: FNP, AGACNP, AGPCNP, and PMHNP

Ask preceptor if acceptable to use smartphones, etc. while in the setting

Pharmacology applications on your smartphone or iPad, etc.

Ask preceptor what resources they use most often

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

STUDENT Expectations

Print the Syllabus for the Course and hand deliver to your preceptor and review the objectives for the course

Students should see the minimum number of patients outlined in this presentation.

Generally you should:

Ask the patient if they mind if you see them in combination with your preceptor

Perform your assessment: Subjective, Objective Data

Make a list of differential diagnoses

Form a tentative plan of care – look for teaching opportunities – look for evidence to back your plan

Consult with your preceptor and revise your assessment, diagnoses and plan

STUDENTS First Day

Students should be oriented to the clinical site by preceptor or office personnel for a maximum of 8 hours

The lay out of the office

Office procedures

Lunch

Restroom locations

Other

Orientation/observation to the site

**NEW **Requirements for patient encounters per course

Consensus of patient numbers by course. These are MINIMUM numbers of patients:

NURS 6531 – 144 patients in 144 hours

NURS 6540 – 100 patients in 144 hours

NURS 6541 – 144 patients in 144 hours

NURS 6550 – 75 patients in 144 hours

NURS 6551 – 100 GYN patients; 25 OB patients in 144 required hours

NURS 6560 – 75 patients in 144 hours

NURS 6565 – 144 patients in 144 hours

PMHNP Courses: NURS 6640, NURS 6650, NURS 6660, NURS 6670:

“Students in the PMHNP program will need to complete 144 hours of practicum in EACH of the four practicum courses. It is acknowledged that a variety of factors will influence the number of clients seen, but students should strive to see as many clients possible each clinical day.”NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

*A minimum of 144 clinical hours are required in each practicum course. More hours can be completed but cannot transfer to another clinical course.

Meditrek

Students are to upload their information on the time log and patients log every 48 hours.

Midterm and final evals by preceptor need to be completed in Meditrek.

Midterm eval should be completed prior to midterm conference call, then reviewed.

Didactic faculty are responsible to ensure ALL clinical students have their time logs signed and final evals completed prior to entering final grade.

Meditrek Contact Information

If the preceptor does not receive an email with login information, the student or the preceptor should email the preceptor’s name and email, along with the student’s name and Walden ID number to SONPreceptor@waldenu.edu and the login information will be sent to the preceptor directly.

How do STUDENTS document patient encounters at clinical site?

This will be up to the preceptor and clinical faculty

It is a good idea to learn from each site as many have electronic medical records

The preceptor may want you to hand write your SOAP note

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

Documenting Clinical Experiences for the Course

To prepare for this course’s Practicum Experience, address the following in Practicum Journal (AGPCNP and FNP students ONLY):

Select and describe a nursing theory to guide your practice.

Develop goals and objectives for your Practicum Experience in this course. When developing r goals and objectives, students are to be sure to keep the competency domains of practice in mind.

Create a timeline of practicum activities based on your practicum requirements.

Documenting Clinical Experiences for the Course

All patients must be entered on the NP Patient Log within 48 hours of each clinic day.

All clinic hours must be entered on the Time log within 48 hours of each clinic day.

Clinical faculty will review all NP patient logs and Time logs periodically throughout the course. Students are to keep them up-to-date at all times.

Weekly Journal Entries are required but only submitted Weeks 3, 7 and 10 (or as directed in clinical course).

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

Grading CLINICAL JOURNALS and Time Logs

For the Journal Entries and Practicum Time Logs—which are assessed with a Satisfactory (S) or Unsatisfactory (U) score—the numerical grade will show as 0 points and the “S” or “U” will be posted in the Feedback area by your Instructor. These scores of 0 points do not affect your grade; they simply allow for a placeholder to place the “S” or “U” scoring. *All journal entries must be done and graded satisfactorily before a passing grade in clinical can be achieved.

Midterm and Final Evaluations

All students are required to have their preceptor complete a midterm and final evaluation in order to pass the course

Midterm evaluation is done through Meditrek and should be completed by the preceptor during weeks 4-6; the preceptor will receive login credentials to Meditrek beginning in week 3.

Students must have a satisfactory final evaluation by preceptor in Meditrek by end of week 10.

All students are required to have their preceptor and practicum site evaluation in Meditrek by end of week 10.

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

What happens if…

Student or preceptor is ill or has an emergency

Students are to notify their clinical faculty and make plans to obtain the missed hours

If student is ill, please make sure you notify your preceptor

If student and/or preceptor terminate the agreement

Students are to notify clinical faculty immediately and be proactive in securing another preceptor

Clinical Failure

Behaviors constituting clinical failure include, however are not limited to, the following:

Demonstration of unsafe performance and/or decision-making skills.

Failure to complete clinically related class assignments and/or clinical log.

Failure to complete the required clinical hours and patients numbers

Falsification of clinical hours, records, or documentation.

Failure to complete clinical hours with approved preceptor. All preceptors must be approved or clinical hours will not count.

Students Must Remember…

Students are a guest in the clinical setting and should act politely at all times

Students are not make personal phone calls. Turn your phones on vibrate and take calls only during breaks

Always thank the patient and preceptor and office staff

Be active in the learning process

You are there to learn to be a health care provider. You are not a nurse in the clinic.

It is ok to be wrong. We expect that as part of the learning process.

Ask questions!

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

IF YOU DON’T KNOW…

Ask preceptor

Ask clinical faculty

Ask didactic faculty

We all want students to learn and be successful

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 5

Practicum Site

A practicum site is a health agency or other appropriate setting at which students have supervised,

applied practice experiences that are consistent with their education and training. Officials at practicum

sites enter into an affiliation agreement with Walden, stating they will provide appropriate support and

supervision for students during the practicum experience. Virtual sites are not allowed for practicum

courses.NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

In general, students must spend the majority of their clinical experience time in general primary care

settings seeing a good overall mix of age groups over the lifespan (FNP) or with adolescents and adults

(AGACNP, AGPCNP) with a broad range of health promotion, disease prevention, and acute and chronic

health problem assessment and management needs. Appropriate practicum sites for the AGPCNP/FNP

specializations can include physician’s offices (family practice, pediatric practice, women’s health, or

internal medicine); clinics that provide primary care, such as health departments; and hospital-based

primary care clinics. AGACNP students may use some of these sites in NURS 6531 and 6540 and acute

care facilities for NURS 6550 and 6560.

Psychiatric-mental health nurse practitioners will have practicum experiences in a wide range of setting

with children, adolescents, adults, and older adults. NURS 6640 and NURS 6650 focus on psychotherapy

practice where NURS 6660 and NURS 6670 are integrative experiences (psychopharmacology coupled

with psychotherapy).NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

Primary Care

A primary care practice serves as the patient's first point of entry into the healthcare system and as the

continuing focal point for all needed healthcare services. Primary care practices provide patients with

ready access to their own personal physician. These practices provide health promotion, disease

prevention, health maintenance, counseling, patient education, diagnosis, and treatment of acute and

chronic illnesses in a variety of healthcare settings. These practices are organized to meet the needs of

patients with undifferentiated problems, with the vast majority of patient concerns and needs being

cared for in the primary care practice itself. Primary care practices are generally located in the

community of the patients, thereby facilitating access to healthcare while maintaining a wide variety of

specialty and institutional consultative and referral relationships for specific care needs. The structure of

the primary care practice may include a team of physicians and non-physician health professionals.

Appropriate settings for primary care should be in outpatient primary care settings.

All students in NP specializations require primary care experiences. FNP students must complete all

clinical hours in primary care settings, AGPCNP students may complete clinical hours both in primary

care and specialty care settings, and AGACNP and PMHNP students may complete clinical hours in

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 6

primary care, specialty care, and acute care settings.NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

Acute Care

Acute care refers to a level of specialty care focused on the management of severe injuries, urgent

medical conditions, exacerbation of chronic illnesses, and/or recovery after surgical procedures. Acute

care settings provide patients with secondary healthcare services that address active healthcare

problems. Acute care practices provide access to healthcare teams that span the gamut of nursing,

medical, and surgical specialties. Acute care practitioners perform assessments, order and interpret

diagnostic tests, formulate diagnoses, perform procedures, and develop and/or implement treatment

plans. The quintessential acute care setting is the in-patient hospital, but acute care is also provided in

emergency rooms, urgent care centers, or surgery centers. Essentially, comprehensive care of patients

with acute, critical, and/or exacerbated, complex, chronic conditions falls under the realm of the acute

care provider regardless of the practice setting. The acute care provider is specialized in addressing the

needs of high acuity patients along the illness-to-wellness spectrum.NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

Supervision

Supervision by a preceptor is composed of a tutorial and mentoring form of instruction in which

practicum preceptors monitor students’ activities in the practicum during the provision of primary care

and facilitate learning and skill-development experiences. Preceptors guide students and provide

feedback on their practicum work.

Field Experience Roles

Preceptors

Preceptors are qualified practitioners within a clinical site who are responsible for guiding students’

practicum experiences (see Preceptor Requirements in Section 3). Preceptors must be employed at the

field site. Walden expects preceptors to be accessible to students and to provide guidance and feedback

that promotes growth of knowledge, skills, and competencies consistent with Walden’s educational

goals as well as with best nursing practices. Preceptors provide mentoring and guidance appropriate to

students’ roles in their clinical sites, including ongoing feedback about the students’ progress in meeting

clinical goals.

Students

Students at Walden are considered to be adult learners who are capable of seeking educational

opportunities to meet their personal and professional goals. Walden expects students to collaborate

with faculty members and be self-directed to meet educational requirements. Students work with

faculty members, clinical instructors, and preceptors to ensure they obtain a well-rounded educational

experience.NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 7

Students are expected to complete adhere to the following:

 Develop a learning contract to meet course objectives and outcomes for the practicum.

 Adhere to the learning contract as established by the student, clinical instructor, and preceptor.

 Comply with the policies and protocols established by the practicum site.

 Seek direct and indirect supervision from the clinical instructor and preceptor.

 Be appropriately prepared for each laboratory and clinical experience.

 Incorporate theory and research into clinical practice to provide evidence-based care to patients.

 Provide safe, competent, and quality care under the supervision of the clinical instructor and preceptor.

 Maintain an ethical and professional manner at all times.NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

 Use acquired knowledge and clinical skills for appropriate clinical setting.

 Use various educational resources to provide evidence-based care to patients.

 Be on time and be prepared for each clinical session.

 Develop a clear and concise plan to meet course outcomes.

 Be respectful and professional.

 Participate in regular conferences with the clinical instructor.

 Seek regular feedback from the clinical instructor and preceptor about progress in the clinical setting.

 Adhere to Health Insurance Portability and Accountability Act (HIPAA) guidelines at all times.

 Maintain a clinical journal, time logs, patient logs, and other pertinent clinical records as required by the clinical instructor and/or preceptor.

 Be adaptable and flexible learners.

 Evaluate the course, clinical experience, and preceptor.

 Develop long-term and short-term goals during the program.

 Participate in group and individual conferences.

 Complete the required hours needed for the didactic and clinical portions of the courses.

 Complete all course assignments satisfactorily.NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

 Contact the clinical instructor and practicum site if unable to attend a clinical experience.

 Use critical-thinking skills and sound clinical judgment in providing patient care.

Students With Disabilities

The School of Nursing at Walden will not discriminate on the basis of disability and is committed to

providing all qualified students with disabilities equal access to its programs, services, and activities in

accordance with the Americans with Disabilities Act and section 504 of the Rehabilitation Act of 1973.

MSN Practicum Manual: Nurse Practitioner Specializations (April 2017) Page 8

In postsecondary education, it is the students’ responsibility to self-identify disability status and register

with the Office of Disability Services prior to requesting accommodations. To register, students should

submit documentation of disability along with Walden’s Accommodation Request form to

disability@mail.waldenu.edu.NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

The process and form are available from the Office of Disability Services. Students with disabilities

requesting accommodations to access field experiences, such as a practicum and/or internship, should

register with the Office of Disability Services prior to registering for those field experiences and clarify

their specific accommodation needs. In most cases, field experience sites have their own systems for

ensuring equal access for employees/interns with disabilities. The Office of Disability Services will help

address any gaps in those systems.

Practicum Course Faculty Members

Walden nursing faculty members, who are doctorally prepared, teach the didactic portion of the courses

and communicate with clinical instructors and preceptors regarding the students’ successful mastery of

all competencies prior to recording the final course grades. Practicum course faculty members

collaborate with students and clinical instructors and inform specialization coordinators about any

difficulties that arise during the practicum experience. Didactic faculty members may also serve as

clinical faculty.NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

Clinical Instructors

Clinical instructors are a critical element of the NP student practicum experience. These instructors

monitor and assess appropriate learning experiences to facilitate students’ achievement as it relates to

the practicum course objectives. The clinical instructors are NPs responsible and accountable for

assuring that students meet the course objectives at a specific practicum site and work closely with

preceptors.NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT

Clinical instructors communicate on a regular basis with NP students and their preceptors regarding

student progress and learning needs; they are also available to resolve problems that may arise. Clinical

faculty make practicum site visits (virtually and/or physically) to review students’ experiences and the

appropriateness of the setting. Clinical instructors are responsible for evaluating the students’ clinical

work.

Specific clinical instructor responsibilities include the following activities:

 Providing guidance to students in formulating the learning

NURS 6600: CAPSTONE SYNTHESIS PRACTICUM DISCUSSION ASSIGNMENT