Clinical/Lab Attendance

1. Clinical/Lab attendance is mandatory.
2. Unexcused absences will not be accepted. All clinical hours missed must be made up.
3. The student is expected to notify the appropriate persons regarding any absences including an emergency requiring tardiness or absence from the class or clinical experience. Notification procedures are identified in specific course syllabi. This notification must occur in a timely manner; that is, prior to the beginning of the clinical/lab experience. The student should be aware of the specific requirements for each course and to follow course procedures.
4. Habitual tardiness to clinical/lab, defined as more than one occurrence may result in course failure.

Clinical Incident
A clinical incident is any injury, unprotected exposure to a pathogen, or accident which occurs during a clinical practicum/placement. Promoting student and patient safety is the first priority in responding to a clinical incident.

All students are required to carry health insurance. It is helpful if students keep health insurance coverage information with them during clinical practice and if they submit information about coverage along with their health history information.

Students are encouraged to keep notification information current on Cardinal Station so that correct and prompt notifications of family members may be made in the case of serious incidents.

Clinical Incident Procedures

1. Any injury requiring immediate, emergency care should be treated at the nearest emergency facility. Please notify the faculty member as soon as possible; the faculty member is responsible for contacting the clinical coordinator and then the Office of the Dean as soon as possible to report the incident and to ask for help, if needed, for the student.
2. When a student is exposed to a blood or body fluid pathogen, the agency clinical coordinator/supervisor, agency employee health, and the Conway School of Nursing administration are to be notified immediately. If an employee health department is available, follow hospital/agency guidelines for immediate treatment. If an employee health department is not available, contact the nearest emergency department for immediate treatment guidelines. Students are responsible for treatment costs incurred.
3. Institute any necessary treatments that should be carried out on site.
4. Students should contact their own health care provider or the University Health Services for recommendations for follow-up treatment.
5. A Conway School of Nursing report and agency incident report must be completed by faculty and the injured party. Copies of both should be given to the injured party and the Office of the Dean. The agency should be provided with a copy of their incident report. The Conway School of Nursing incident report should document the date, type of incident, individuals present, response/treatment, notification, and documentation sequence and any additional information which may be pertinent.
6. The incident report will be maintained in a confidential file stored in the Office of the Assistant Dean.

Unsafe Practice
Unsafe practice is defined as behavior which threatens, or has the potential to threaten, the safety of a client, a family member, another student, a faculty member, or other health care provider in the clinical placement.

Unsafe Practice Procedures

1. A request for investigation of a Conway School of Nursing student's fitness for the practice of nursing may be instigated by any person. This request is submitted to the Assistant Dean for the involved clinical program. Removal of a student from clinical due to immediate or imminent concerns about unsafe practice automatically warrants further investigation.
2. The Assistant Dean will review the request and supportive evidence. If the request is based on actual behavior or observations and is of sufficient concern, the Assistant Dean will either (a) recommend direct administrative action to the Dean of the Conway School of Nursing or (b) request a review for Fitness for Practice. The purpose of the review is to provide additional information to guide the administrative decision regarding student placement and progression in the clinical setting.
   
   Until a decision is made by either of these two routes, the student will not be allowed to attend the clinical practicum or experience.
3. In the event of a review for fitness for practice, the Assistant Dean will constitute a Review Committee chaired by the Assistant Dean, and comprised of two additional faculty members plus one alternate. Typically, the additional committee members are drawn from the Conway School of Nursing Committee on Admissions, Progression and Graduation.
4. The Review Committee will receive all available information about the report; this typically includes a written report of the practice concern, specifically the name of the student, the behavior that allegedly affects the respondent's fitness for practice, and the name of the individual submitting the request.
5. The Review Committee, through its chairperson, shall notify the respondent by mail, certified, return receipt requested, within five business days of receipt of the complaint.
   
   Such notification shall contain:
   -the practice concern as articulated in the investigation request and a copy of the "Unsafe Practice: Procedures for Addressing Potential Concerns"
   -The date, time and place of the Review Committee deliberations and names of Committee members
   -The right of both the complainant and the student to address the Review Committee and to present witnesses and documentation to support their position
   -a statement specifying the respondent's right to bring an advisor who may not speak on behalf of the respondent; the right to ask questions regarding the complaint and documentation; and the right to a closed and confidential hearing
   -the right to submit a written request for an extension of time in appearing before the Review Committee no later that 48 hours prior to the scheduled deliberations.
   -a statement specifying the student's right to follow Catholic University procedures for appealing academic sanctions.
   -a statement that the proceedings will be audio-taped
6. The Review Hearing will obtain any additional information which they deem important either prior to the hearing or after the hearing.
7. Upon completion of the hearing and collection and analysis of all pertinent information, the Review Committee will present the Dean with a written analysis of the available information and a recommendation regarding the disposition of the complaint.
8. The timeline for this recommendation may vary depending on such factors as the need for additional information and the time in the semester; however, the written report should be as close to 5 business days as possible.
9. The Dean will then make a decision regarding the disposition of the complaint and notify the student in writing of the outcome.
10. The student has the right to follow the published University procedures in the event of course failure or program dismissal.

HIPAA Adherence
All students are expected to comply with the requirements of the Health Insurance Portability and Accountability Act (HIPAA) as applied to clinical education.

Failure to adhere to these expectations may result in immediate removal from a clinical setting and additional academic sanctions including course failure and dismissal.

Specifically, it is expected that all students in the School of Nursing complete training on HIPAA prior to participating in clinical practica or rotations; HIPAA training is provided in class with web supports suggested at the time. The Catholic University HIPAA policies are noted here.

Students are expected to maintain the privacy of individually identifiable health information (IIHI ).

Electronic communications and HIPAA rules
Nursing students may not post any material that could potentially violate patient confidentiality or professional behavior guidelines on any online sites.  Students are expected to observe professional standards for communication in all interactions.

Students may be subject to disciplinary action by the school and the clinical agency for comments that are either unprofessional or violate patient privacy. HIPAA regulations apply to comments made on social media sites and Blackboard or other online tools, and violators are subject to the same prosecution as with other HIPAA violations.

Guidelines:

1. Social media includes but are not limited to blogs, podcasts, discussion forums, online collaborative information, and publishing systems that are accessible to internal and external audiences (e.g., Wikis) through RSS feeds, video sharing, and any social media sites or channels.
2. Postings on social networking sites are subject to the same professional standards as any other personal interactions. The permanence, worldwide access, and written and visual nature of these postings make them even more subject to scrutiny than most other forms of communication.
3. Restricted postings include but are not limited to protected health information –individually identifiable information (oral, written, or electronic) about a patient’s physical or mental health, the receipt of health care, or payment for that care.
4. Online postings or discussions of specific patients should be avoided, even if all identifying information is excluded. It is possible that someone could recognize the patient to which you are referring based on the context. Remember, if you would not want YOUR own health information being posted to the Internet, do not post that of anyone else.
5. Under no circumstances should photos or videos of patients or photos depicting the body parts of patients be taken or displayed online.
6. Statements made by you within online networks will be treated as if you verbally made the statement in a public place.

Frequently Asked Questions
Q. Will I be covered under HIPAA once I begin my clinical practice upon graduation?
A. Nurses will in most instances be working for covered entities that are required to comply with HIPAA

Q. Am I covered by HIPAA now as a student?
A. Students, while not covered per se under HIPAA, are bound by state law on the confidentiality of medical records. In addition, the terms of certain affiliation agreement bind the School of Nursing by contract to advise students that the medical record privacy policy of the clinical placement site must be respected.

Students are also bound by moral and ethical obligations to maintain confidentiality.

Protection of IIHI is a core component of caring for patients. Patients who fear that personal information will be shared are less likely to share it. This can lead to ineffective care, or even worse, care which may harm the patient.

Q. What about case notes written after a case management meeting, or a discharge planning meeting? Is this IIHI?
A. This would be covered under the broad definition of individually identifiable health information under HIPAA. If you have any doubts about whether information is covered under HIPAA, treat it as covered information. Psychotherapy notes are accorded special privacy protections under HIPAA. Ordinarily, written client consent is required before psychotherapy notes can be disclosed to anyone.

Psychotherapy notes are defined in the regulation as "notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual's medical record." Excluded from the definition of psychotherapy notes are medication prescription and monitoring, counseling session start and stop times, modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: diagnosis, functional status, treatment plan, symptoms, prognosis, and progress to date.

Transportation to Agencies
The student is expected to assume responsibility for transportation in connection with the clinical practice, community health practice, and field trips. Public transportation is often available at these sites. 
Insurance
All students in clinical programs are required to carry malpractice insurance, which is covered under their student enrollment fees. This insurance applies only to clinical practice while the student is enrolled in University courses. It does not cover students involved in personal employment. (See Fees and Expenses in the General Information section of the current Undergraduate Student Announcements).