Clinical Agency Information Form - DOC

							                                 San Joaquin Valley Nursing Education Consortium
                                                           Clinical Agency Information Form
Information on this form will assist nursing schools in requesting clinical placements at your facility.

Hospital: Kaiser Permanente, Fresno                       # of Beds: 169 Date: January 2011

Contact Person: Kathie Deitz, RN (Medical Center Educator)

Phone: 559-448-4961                     Fax: 559-448-5960               e-mail: Kathie.L.Deitz@kp.org

                                                                                                                                                     Preceptorship
                                Agency-Specific    Average    Shift Times    Type of student
Unit Option   Focus/Specialty                                                                        Other information             Primary   Float    (Sr Focus)
                                  Grouping         Census     (8hr, 12hr)      suitable*
3E/3W         General           Orthopedic           37       8 hours Days    Beginning to      eMR training attestation prior
              Med/Surg          Bariatrics                    or Evenings       Advanced         to 1st clinical
                                                                                                                                     X                    X
                                Oncology                        (M-Sun)       RN (ADN or
                                                                               BSN), LVN
4E/4W         Telemetry         Telemetry            32       8 hours Days      Advanced        eMR training attestation prior
                                                              or Evenings     RN (ADN or         to 1st clinical                     X                    X
                                                                (M-Sun)           BSN)
LDRP          Perinatal         Labor, Delivery,   SCN 2      8 hours Days      Maternity       eMR training attestation prior
              Services          Post Partum and    L&D 7      or Evenings        Rotation        to 1st clinical
                                                                                                                                     X                    X
                                Special Care                     (M-F)        RN (ADN or        SCN one student per group
                                Nursery                                        BSN), LVN         per day
CCU           Intensive Care    Medical and          7        8 hours Days      Advanced        eMR training attestation prior
              (CCU)             Surgical                      or Evenings     RN (ADN, or        to 1st clinical
                                combination.                    (M-Sun)      BSN) and LVN       This area for Advanced
                                                                                                                                              X           X
                                                                             for observation     students as a specialty day and
                                                                                  only           not full rotation. (one student
                                                                                                 per day)
ED            Basic             All areas of       80-100     8 hours Days   Intermediate to    eMR training attestation prior
              Emergency         interest,                     or Evenings       Advanced         to 1st clinical
              Services          predominantly                                 RN (ADN, or       One Student per day
                                                                                                                                              X           X
                                medical                                      BSN) and LVN
                                                                             for observation
                                                                                  only


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Perioperative   Perioperative     Pre-Op Holding,           8 hours Days   Intermediate to    eMR training attestation prior
Services        Services          OR                        or Evenings       Advanced         to 1st clinical for preceptorship
                                  PACU                         (M-F)        RN (ADN, or       OR requires special prep
                                                                                BSN)           work. Call 448-2501 or page
                                                                                                                                       X   X
                                                                                               265-8600 afternoon prior to
                                                                                               clinical.
                                                                                              One student per day in OR and
                                                                                               Pre-Op/PACU
Respiratory     Respiratory       All ages                    Days and     Beginning to       One student for ½ day
Therapy         Therapy                                       Evenings      Advanced
                                                                                                                                       X
                Services                                       (M-F)       RN (ADN, or
                                                                              BSN)
Physical        Physical          Adult                            Days    Beginning to       One student for ½ day
Therapy         Therapy                                           (M-F)     Advanced
                                                                                                                                       X
                Services                                                   RN (ADN, or
                                                                              BSN)
Discharge       Hospital and      Adult                           Days     Beginning to       One student per day. ½ day
Planning        Emergency                                         (M-F)     Advanced           Discharge Planning/Social
                                                                                                                                       X
Medical         Department                                                 RN (ADN, or         Work, ½ day RT
Social Work                                                                   BSN)
Pediatric       Pediatric         Pediatrics                       Days    Beginning to       Manager approval required.
Clinic          Services                                          (M-F)     Advanced           One Student per day.
                                                                                                                                       X
                                                                           RN (ADN, or
                                                                              BSN)
Diabetic        Diabetic Care     Adults                           Days    Beginning to       Manager approval required.
Clinic                                                            (M-F)     Advanced           One Student per day.
                                                                                                                                       X
                                                                           RN (ADN, or
                                                                              BSN)
Infusion        Rheum. Disease,   Adolescent and                   Days    Beginning to       Manager approval required.
Clinic          Anemia, Home      Adult                           (M-F)     Advanced          One Student per day.
                Antibiotic                                                 RN (ADN, or
                                                                                                                                       X
                Teaching, PICC                                                BSN)
                & Port
                Insertions/Care
                FNP/PNP           Clinic Physicians                Days     Beginning to      eMR training attestation prior
                                  and NP’s                        (M-F)    Advanced FNP        to 1st clinical.                    X
                                                                              or PNP          Manager approval required
                Leadership        CNS                              Days    Masters Level      eMR training based on role
                                  Educator                        (M-F)                       Manager or Service Director
                                                                                                                                   X
                                  Management                                                   approval required.
                                  Administration
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*Types of students: CNA, MA, PCAT, LVN, LVN-RN, R/R (Refresher/Reentry) ADN, BSN, MSN, AP (advanced practice), Pre (Preceptorship)




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