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					                                Clemson University Clinical Faculty Guide
                                      Greenville Hospital System

      Table of contents

 I.      GHS Faculty Requirements and Timelines                                  p. 1
         A. Setting up rotations
         B. Required Documents and timelines

 II.     Policies                                                                p. 2

         A.   Process for Badges
         B.   Faculty dress code
         C.   Student dress code
         D.   Co-Signatures on documentation
         E.   Supervision of medication administration
         F.   Assignment form
         G.   Post-conference rooms
         H.   No observation
         I.   Parking policies
         J.   Use of cell phones and other portable communication devices
         K.   Social media and social networking

III.     Clinical Documentation Systems                                          p. 6
         A. Access to Clinical Documentation (ClinDoc)
         B. MAC and Clin Doc Registration Guidelines
         C. Instructions for Clinical Documentation and MAC Class Registration
         D. Omnicell Medication Automation Password Verification
         E. Optiflex
         F. IBEX
         G. Troubleshooting
         H. Access to intra/internet

IV.      Appendices
          Appendix A: Student assignment sheet                                  p. 10
          Appendix B: Stellar Service Standards                                 p. 11
          Appendix C: Instructions for ScrubEx and requrest form                p. 12
          Appendix D: Omnicell password request                                 p. 14
          Appendix E: Skills students can and cannot perform                    p. 15
I. GHS Faculty Requirements and Timelines
    A. Setting up clinical rotations
         All rotations should be orientated to the units to which they will be assigned,
         Clinical instructors should set up time to meet manager and/or clinical nurse educator or CNS
           for their units
         Each manager should have clinical instructor’s contact information.
    B. Required Documentation and Timeline
        6 weeks ahead:
           Instructor contact information and student rosters with a calendar specifying where the
           students will be on each clinical day: They want rosters showing the names of the students,
           the date and time of their clinical rotation and where each student will be on each clinical day.
           They “need to be able to track where students are at all times”. Any changes in scheduled
           clinical times – no matter how minor- must be approved by the education coordinator ahead of
           time.
        4 weeks ahead:
           Each student and a faculty member must complete the following requirements at least 4
           weeks prior to the educational and/or research opportunity:
           o Mandatory orientation –on HealthStream
           o Student/Faculty Information/Orientation Form – copy to educational coordinator
           o Signed Confidentiality Agreement Form - copy to educational coordinator
           o Copies of the background checks: The original back ground check will be valid for the
                duration of the program unless the student has a 12 month break in registration in the
                program.
           The orientation materials and other documents are on HealthStream, however, they still want
           hard copies of the Confidentiality Forms, the background checks, and the Student/Faculty
           Information/ Orientation Form.
        1 week ahead:
           Mandatory requirement summary sheet (below): Separate summary sheet for each clinical
           group with the instructors contact information at the bottom. Complete contact information for
           each clinical instructor along with the roster of students. Per the affiliation agreement, Names
           of students and faculty must be forwarded at least one (1) week prior to the student’s clinical
           assignment
        Beginning of semester:
           o Syllabus: can be sent electronically to educational coordinator (SMejia@ghs.org)
           o Instructors’ CV/resume and license number or come by and show copy of RN license




                                                                                                           1
II. Policies
  A. Process for badges: Badges will be signed out to the instructor, who will keep them for successive
     semesters. The instructor is responsible for the badges and should have the students sign them out
     in order to maintain an accurate record. A $10.00 replacement fee will be charged for each lost
     badge. Please do not send students to sign out individual badges.
  B. Faculty Dress Code: Faculty members who are with students in clinical areas must wear white uniform
     with white lab coat with the school logo on it. Faculty members may also wear professional business
     attire street clothes, but with a white lab coat. All faculty members must wear school photo identification
     badges and GHS “Faculty” badges, preferably at the upper left part of the blouse, coat, dress, shirt or uniform.
     Faculty members who do not have identification badges will not be permitted to remain in the clinical area.
     Temporary methods of identification will not be accepted.
         Clinical instructors who are also GHS employees are not to wear blue scrubs as they are not in
          an employee role. Employee codes are not to be used while in the role of a clinical instructor.
          Each clinical instructor should request access codes as a clinical instructor for their school.
       Faculty members assigned to Pediatric ICU, Neonatal ICU, Pediatric ER, acute care Pediatrics and
        Mom/Baby units may wear children’s print tops with white lab coat.
       Faculty members in clinical areas where scrub attire is provided for GHS personnel should contact the
        Education Consultant/Nursing Student Liaison for access to the automated scrub dispensing system.
 C. Student Dress Code:. Clemson nursing students must wear purple Clemson scrub top and white bottoms.
    Students must have Clemson ID and GHS Student ID badges visible at all times. Students on OB and OR
    rotation will wear hospital-issued scrubs. Please see Scrub-Ex instructions Appendix C. Students must wear
    Clemson uniform to and from the hospital, even if scrubs will be worn during clinical. Students who go to the
    hospital for pre-planning must be in official Clemson uniform with proper ID badges. Students who do not
    have their identification badge will not be allowed to remain in the clinical area. Temporary methods of
    identification will not be accepted. GHS “Student” badges must be worn at all times, along with the school
    photo identification badges. Footwear must conform to GHS guidelines.
     Nursing students on clinical assignment at Marshall I. Pickens Hospital must be dressed in a manner that
        would be considered conservative, neat and professional. A white lab coat may be worn. Students are not
        expected to wear the uniform that is associated with their School of Nursing.
     Student nurses in Pediatric ICU, Neonatal ICU, Pediatric ER, Acute Care Pediatrics and Mom/Baby Units
        must wear their School of Nursing uniform. It is not acceptable to wear children’s print tops or seasonal
        scrub jackets.
     Students in clinical areas where scrub attire is provided for GHS personnel should follow the guidance of the
        nursing management in those areas as to the appropriate dress attire.
 D. Co-Signatures on Documentation: Basic student nurses, refresher student nurses, LPN-to-RN student
    nurses and non-employee degree completion RN student nurses (RN-to-BS; Masters) must have their
    documentation co-signed or validated electronically (for online documentation) by a Registered Nurse who is a
    credentialed school of nursing faculty member, GHS RN preceptor or other GHS Registered Nurse involved in
    the care of the patient. The co-signature must be immediately obtained for any documentation in the medical
    record done by the student at the time of the documentation entry.
 E. Supervision of Medication Administration: Student nurses can administer medications, per GHS policies
    and guidelines, only under the direct supervision of a Registered Nurse who is a credentialed school of nursing
    faculty member, GHS RN preceptor or other GHS Registered Nurse involved in the care of the patient. The
    Registered Nurse who supervised the administration of the medication by the student nurse must co-sign on
    the Medication Administration Record and any documentation related to that medication administration. The co-
    signature of the medication administration must be done immediately upon administration of that medication
    and each medication entry must be co-signed. If a Registered Nurse is not immediately available to supervise
    the entire medication administration, the student/refresher nurse may not administer that medication.
F. Assignment form: Use required assignment form Appendix A
                                                                                                                    2
 G. Post-conference: Reservations for a room for post-conference can be made through Dan Pitts
    (dpitts@ghs.org)
 H. No observation experiences at all (with the exception of accompanying a patient to a procedure). This
    prohibits students from being assigned to observe in endoscopy, cath lab, radiology, etc.
 I. Parking Policy: All students and faculty members are required to park in Parking Lot 9C on the 5th level. Levels
    1-4 of Lot C are reserved for GHS employees only. Students who park in unauthorized areas may be asked to
    move their vehicles and/or will be ticketed. Faculty members will receive notification of any issues involving
    unauthorized parking of students.
    It is recommended that valuables such as purses, computers, phones, etc., be locked in the trunk or dash of
    vehicles and not left inside vehicles in visible view. Any problems related to vehicles while parked in the 9C
    parking lot should be reported to security. The parking deck is equipped with cameras that monitor activity on
    all levels. In case of emergency, there are call boxes throughout the deck and walkway to the hospital. If at any
    time a faculty member or student need escort assistance for any reason please call security at 455-7931.

J. Use of Cell Phones and Other Portable Communication Devices:
    I. Policy Statement. In an effort to maintain a safe environment for patients,visitors, and employees by
    minimizing unnecessary distractions, it is the policy of the Greenville Hospital System to limit the use of
    personal cell phones and other portable communication devices during worked time. Cell phones and other
    portable communication devices should never be used in any way that would distract from patient care or
    customer service.This policy applies to any portable device that makes or receives phone calls, leaves
    messages, texts messages, accesses the Internet or allows for the reading of and responding to email.
    II. Guidelines. A. Personal Cell Phones or Similar Devices. During work time, employees are expected to
    exercise the same discretion with the use of personal communication devices as is expected with the use of any
    business phone. Personal phone calls (including text messaging) during the work day, regardless of the phone
    or device used, are not appropriate and can interfere with productivity and be distracting to others. Employees
    are expected to make personal calls on non-worked time and to inform family and friends of the policy.
    Generally, personal cell phones should not be kept in work areas. However, decisions to allow employees to
    keep phones and/or answer personal cell calls and/or messages will be made at the department level based on
    department needs. If department managers allow employees to have cell phones during work time, the sound
    should be turned off. Calls should generally be returned during break time or with supervisory approval. B.
    GHS-issued cell phones or similar devices. When business needs demand immediate access to an employee,
    GHS may issue a cell phone or similar device for work-related communications. C. Orders, Consult Requests
    and Critical Values/Information: Orders, consult requests and critical values/information require personal voice
    conversation. Information that needs to be communicated immediately should not be texted or left on voice
    mail. If a physician is paged regarding an order, a consult request and/or critical information but does not
    respond within a reasonable timeframe, a second request should be made through the GHS Call Center at 455-
    8760. D. Cell phone cameras: Use of cell phone cameras is included in the intent of Policy S-50-03, “Releasing
    Information to the Media” and other policies that specify that patients may only be photographed for officially
    approved uses and must provide written consent before being photographed.
    III. Responsibility. A. Employees are responsible for understanding and following all aspects of this policy. B.
    Management staff is expected to serve as role models for proper compliance and to ensure that employees
    understand and follow the expectations related to cell phones and other portable communication devices.

K. Social Media and Social Networking:
    DATE: October 1, 2009
    I. Policy Statement. With the rise of new media and next generation communications tools, the way in
    which GHS employees can communicate internally and externally continues to evolve. While this
    creates new opportunities for communication and collaboration, it also creates new responsibilities for
    GHS employees.This policy applies to employees who use the following:
  Multi-media and social networking websites such as MySpace, Facebook,
  Yahoo! Groups and YouTube
                                                                                                                   3
   Blogs (Both external to GHS and GHS blogs)
   Wikis such as Wikipedia and any other site where text can be posted
    All of these activities including multi-media, social networking sites, blogs, photo sharing, video
    sharing, microblogging, podcasts, and posted comments are referred to as "Internet postings" in this
    Policy GHS reserves the right to suspend, modify, or withdraw this Internet Postings Policy, and you
    are responsible for regularly reviewing the terms of this Internet Postings Policy.Violation of this policy
    may result in disciplinary action up to and including termination.
    II. Guidelines. Common sense is the best guide should employees decide to post information in any
    way relating to GHS. Employees should contact their supervisor, Human Resources, or the Office of
    Corporate Integrity if they are unsure about any particular posting. For instance, if you are writing
    about GHS operations where you have responsibility, you should make sure your supervisor is
    comfortable with your taking that action.
    A. External Internet Postings 1. Internet postings should not disclose any information that is
    confidential or proprietary to GHS or to any third party that has disclosed information to GHS.
    Employees are prohibited from posting any patient information which may include, but is not limited to,
    name, photograph, social security number, address, diagnosis or prognosis, treatment, date of
    admission or discharge, or any other identifying information which may be protected by HIPAA. 2. An
    employee who comments on any aspect of the hospital system’s operations or any policy issue in
    which GHS is involved and in which the employee has responsibility must clearly identify himself or
    herself as a GHS employee in postings or blog site(s) and include a disclaimer that the views are his
    or her own and not those of GHS. In addition, a GHS employee should not circulate postings he or she
    knows are written by other GHS employees without informing the recipient that the author of the
    posting is a GHS employee. 3. An employee’s Internet posting should reflect the employee’s personal
    point of view, not necessarily the point of view of GHS. Because an employee is legally responsible for
    his or her postings, the employee may be subject to liability if his or her posts are found defamatory,
    harassing, or in violation of any other applicable law. An employee may also be liable if he or she
    makes postings which include confidential or copyrighted information (music, videos, text, etc.)
    belonging to third parties. All of the above mentioned postings are prohibited under this policy.4. When
    an employee posts his or her own point of view, the employee should neither claim nor imply he or she
    is speaking on GHS’s behalf, unless the employee is authorized in writing by GHS to do so. 5. An
    employee who identifies himself as a GHS employee on any Internet posting, refers to the work done
    by GHS or provides a link on a GHS website is required to include the following or a similar disclaimer
    in a reasonably prominent place: “The posts on this site,including but not limited to images, links, and
    comments left by readers, are my own and don’t necessarily represent my employer’s position,
    strategies or opinions.” 6. Internet postings should not include GHS’s logo or trademarks, and should
    respect copyright, privacy, fair use, financial disclosure, and other applicable laws.
    B. GHS Blogs.1. GHS reserves the right to create blogs which require corporate approval in which
    employees may blog about GHS and the healthcare industry. Only GHS blogs may include the
    company’s logo. GHS blogs may also include links back to GHS web destinations. All GHS blogs must
    include a legal disclaimer stating that all posts by the author, guest author and visitors reflect personal
    thoughts and opinions which are not necessarily those of the company. 2. GHS may request
    employees to avoid certain subjects or withdraw certain posts from a GHS blog if it believes that doing
    so will help ensure compliance with applicable laws, including securities regulations.3. GHS reserves
    the right to remove any posted comment on GHS blog site(s) that is not appropriate for the topic
    discussed or uses inappropriate language. GHS also reserves the right to post particular
    communications on a GHS blog.
    III. Responsibility. A. Supervisors shall ensure each of their employees is familiar with the contents of
    this policy and shall investigate reported violations of same. B. Employees who are contacted by a
                                                                                                             4
member of the news media or a blog site about an Internet posting that concerns the operations of
GHS are required to refer that person to GHS public relations. C. Employees’ Internet postings shall
not violate any other applicable policy of GHS, including those set forth in the employee handbook, the
Code of Business Conduct policy, and the Inappropriate Conduct and Behavior policy. D. Employees
who engage in social media or social networking Internet postings must agree that GHS shall not be
liable, under any circumstances, for any errors, omissions, loss or damages claimed or incurred due to
any of their Internet postings.




                                                                                                      5
  Clinical Documentation Systems
A. Access to Clinical Documentation (ClinDoc)
   A GHS Confidentiality Agreement must be signed prior to requesting a user id to access electronic
   applications (Faculty and Students). Signed confidentiality agreements are to be submitted to the
   GHS, Education Consultant prior to a clinical rotation in GHS facilities.

   A spread sheet of faculty and students that have signed confidentiality agreements is maintained by
   the Education Consultant. Electronic access will only be given when all faculty and students for a
   specific clinical assignment have confidentiality agreements signed and in the office of the Education
   Consultant. Electronic access will only be given to faculty and students assigned to areas that are
   using electronic applications.

   Request for student and faculty sign-ons must be submitted via e-mail to the GHS Information
   Services Security Department by the Faculty Coordinator for the clinical assignment.
   (pmartin@ghs.org) Names of students and faculty must be forwarded at least 1 week prior to the
   students’ clinical assignment. The students’ full name and school id number (or last four numbers of
   social security) must be included in the request for a userid. Dates for the clinical rotation must be
   included with the request. The I/S Security Department will verify that a signed confidentiality
   agreement is on file for faculty and students prior to issuing access.

         He needs the names of the students and all three initials to create a userid – if he receives
         only first and last name, “N” for nurse will be used as the middle initial. The student names can
         be printed from the Clemson webpage. Click on the internet browser and go to
         www.clemson.edu. Click on faculty & staff (left top) and then CRSM (right top). Click on
         CRSMweb Section information. You will be prompted to log on with your Clemson userid and
         password. Click on “select” button next to the NURS 303 section and scroll down to the
         bottom. You will see a radio button “View roster/photo gallery”. Click on “submit” and the
         names and e-mail addresses will appear. You can cut and paste this table onto a word
         document to send to Phil. He will send you the same table back with the userids. The first time
         a student logs on, the student will use the userid in both the block for the userid AND in the
         block for the password. At that point, the student will be prompted to change the password.

   Faculty and student user IDs will be in effect for the duration of each clinical rotation. User IDs will be
   deactivated at the completion of each rotation and must be reactivated with each clinical rotation.
   Schools of nursing must notify the Education Consultant of any student who withdraws from a
   nursing program prior to completion of a clinical rotation.

B. MAC and Clin Doc Registration Guidelines for Clinical Instructors
   1. When submitting the packet of required documents for new clinical instructors, the School of
      Nursing (SON) will also notify Sheree Mejia (Nursing Student Liaisons) that the clinical instructor
      needs Clin Doc and MAC training. The notification should include the instructor’s name, email
      address and a phone number where the instructor can be reached easily. Nursing faculty members
      who are assigned to clinical areas at GHS are given a MAC sign-on only upon the completion of
      the MAC training class that is 3-4 hours long. New faculty members have to fill out a form and go
      down to the pharmacy and show their faculty ID to get an access code. Schedule this through
      Sheree Mejia at Mejia@ghs.org.


                                                                                                            6
   2. Students are not given a MAC sign-on. Students administering medication on MAC units will
      administer medications accompanied by the nursing faculty using the faculty user ID. Senior
      Practicum students will not receive a MAC sign-on.
   3. If the SON is utilizing Healthstream, the instructor must register for classes in Healthstream. The
      Nursing Student Liaison must be notified of the date(s) for which the instructor has registered. If
      the SON is not utilizing Healthstream, the instructor will be registered for the class by the Nursing
      Student Liaison.
   4. The Nursing Student Liaison will obtain a UserID and MAC access for the instructor and will send
      this important information through email directly to the instructor. Instructors must bring this UserID
      with them to class.
   5. Nursing Orientation (NO) staff will hold two slots in each scheduled class. If additional slots are
      needed, the Nursing Student Liaison will notify NO staff to see if additional slots are available for
      instructors.
   6. Deadline for instructors registering in Healthstream will be 1:00 PM Wednesday prior to the
      start date of Nursing Orientation (dates provided in another document). If an instructor cancels
      after the deadline, no substitutions will be permitted to fill that slot as there is not sufficient time for
      a UserID to be obtained for any instructor who registers after the deadline. There can be NO
      EXCEPTIONS to the deadline.
   7. If a scheduled participant is more than ten minutes late to a class he/she will not be admitted and
      must reschedule for another class.
   8. Class dates and times are subject to change to meet the needs of NO. If dates/times are changed,
      the registered instructor will be notified via email or phone.
   9. The MAC study guide is available in Healthstream for the participant to review prior to attending the
      MAC class.
   NOTE: Instructions for registering in Healthstream are included in this document.

C. Instructions for Clinical Documentation and MAC Class Registration for Faculty
   You may register using the following instructions:
    Login to HealthStream as a student
    Click the Catalog tab.
    Type clinical documentation or MAC in the search field depending on which class you are trying to
     register for.
    Select the course you wish to enroll in, either Clinical Documentation or Medication Administration
     Check (MAC).
    Click “Enroll in this Course”.
    Click the course title for the class you wish to register, either Clinical Documentation or Medication
     Administration Check (MAC), under learning activity.
    Select “Register” for the specific date and time for which you wish to register. If your registration is
     complete you will receive a “Registrations Successful” green bar at the top of your page. You will
     also see this class under Upcoming Classes. If you should need to remove yourself from that class
     click on the “Drop” option and select another date using the “Register” option
     Note: You will find the location under the Class Details link. Deadline for Registration is 1pm the
     Wednesday before the Nursing Orientation start date. The register option will not be available if it is
     past the deadline or the class is full.

D. Omnicell Medication Automation Password Verification


                                                                                                                7
   Nursing faculty members who are assigned to clinical areas at GHS will be issued an Omnicell
   access code through the main pharmacy at each hospital. An Ominicell Medication Automation
   Password Verification Form (see below) should be completed. A picture Id and a school name
   badge must be presented to the Pharmacy along with the completed form when requesting an
   Omnicell sign-on. A signature of the manager of the unit faculty is assigned to is required. This
   process must be completed at the beginning of each semester and the access is valid for the
   semester.

   Each School of Nursing is required to submit a faculty roster listing the name of the each faculty
   member that is assigned to clinical areas at GHS along with contact information. The roster must be
   submitted to the Education Consultant Sheree Mejia at Mejia@ghs.org.

   Students will not be given Omnicell access. Faculty or the assigned registered nurse for senior
   practicum students will use their Omnicell sign-on with the student to remove medications from the
   Omnicell. All controlled medications must be within the possession of the person who removed the
   medication. Any medication that is removed from the Omnicell under the Blind Count function is a
   controlled substance.

   Discrepancies must be resolved prior to the end of the shift or prior to the students and faculty
   leaving the unit. Unresolved discrepancy must be reported to the Nurse Manager immediately.
   Medications that must be removed using the override function must be removed by the registered
   nurse assigned to the patient.

E. Optiflex

   Optiflex is the system where patient supplies are stocked – nurses/students must enter a code to get
   into the system and get supplies out. Instructors and students are to use the codes that is specific to
   Clemson: cuedu. Please only use this code in clinical and not a work code or a staff member’s.
   GHS needs to keep the students’ codes separate just like with clin/doc and MAC.

F. IBEX
    IBEX is the Clinical Documentation System that is used by the Emergency Department and
    Children’s Emergency Center. To receive sign-on codes, the faculty must submit the student’s full
    name to include the middle initial to the Education Consultant and/or the Clinical Nurse Educator of
    the ETC. Access will not be given to students who have not completed requirements for clinical
    placement.

G. TROUBLESHOOTING
   Problems with sign-on codes should be reported to the Help-Desk. Go to GHS Net under Problem
   Reporting Online Help Desk and follow directions. Please indicate your problem, leave your name,
   indicate that you are faculty (or student) and leave a number where someone can reach you (unit
   number or cell phone number).

H. Access to Intra/Internet
   Faculty and students can access the GHS intranet nursing webpage. Any GHS computer will have an
   icon to access the internal GHS site. On Left, click “Departments” and then click “Nursing” which will
   open the Nursing Webpage. There is key information available on this site and in particular, there is

                                                                                                           8
a heading for “Student Resources” with a drop down of available documents for faculty and students
reference.

Students can get access to the internet by using a weekly password that will be issued by Information
Services. This password will be provided weekly to faculty. The user ID is “academics”.
No lab tech codes will be issued to nursing faculty, paramedic clinical instructors, or students.




                                                                                                     9
                                                 Appendix A

                           GREENVILLE HOSPITAL SYSTEM
                      STUDENT NURSE PATIENT ASSIGNMENT SHEET
Unit:                                                     Date:
Nursing School: (circle
one)                        GTC        CU          BJU                USCU            TCTC
Student(s) will only be observing and not providing direct
care.
Student Level                            Patient Care Hours
Instructor:                               Contact Number:
(The contact number will be used in the event of questions regarding patient care that need clarification
after the instructor has left the unit.) NOTE: The patient should be informed and consent to having a
student involved in their care.

Please indicate the type of direct care activities that the student will be performing.
                                      Bath,                                               Treatments (only those
 Room                                             Physical    IV’s and   p.o. Meds,
                Student Name        Bed, Vital                                             permitted by GHS
Number                                           Assessment    IVPB’s    IM & s.q.
                                      Signs                                                      policy)




During a clinical rotation on a unit with faculty responsible for supervising the learning experience, the
faculty should be supervising the student performing procedures and co-validating documentation.
For Senior Practicums in which arrangements have been made for student to work with a designated GHS
RN preceptor, that preceptor must co-validate student documentation. The faculty member must be
immediately available by cell phone or beeper and able to be present in the clinical setting within 30
minutes. Faculty are expected to be regularly checking on the learning experience for their students and
meeting with the preceptors during that practicum.

Preceptors must refer to the GHS Preceptor Handbook (available on nursing web page) regarding
supervision of students and what procedures students may perform.

PLEASE LEAVE THIS SHEET POSTED FOR A COMPLETE DAY SO THAT PATIENTS
WILL NOT BE ASSIGNED TO A SECOND NURSING STUDENT IN THE SAME DAY.




                                                                                                               10
Appendix B Stellar Standards




                               11
                                              Appendix C
                                Instructions for using ScrubEx


All faculty members whose students need scrubs will be required to submit a roster with the
names of students requiring scrubs along with their GHS student badge number to the
Education Consultant/Nursing Student Liaison Sheree Mejia. The faculty will receive a card
number and a PIN number for each student. Each student will be responsible to keep up with
their card number and PIN number. Students will be responsible for returning the scrubs each
day after their clinical rotation is finished. Faculty will be sent instructions to assist students with
any problems.

To obtain a set of scrubs:

    1. Enter the card number and PIN number. Please enter the card number first, then the pin
       number.
    2. Select option F (“New Size”) and enter the size of scrubs that you will need.
    3. Enter the card number and PIN number again and select “Collect” and follow the rest of
       the instructions to retrieve the selected scrubs (you should be able to select the size that
       you entered in the previous transaction (step # 2).

To return a set of scrubs:
    1. Enter the card number and PIN number
    2. Select option “Deposit”
    3. Return scrubs in the machine as specified (top goes in one bin and the bottom goes in
       another)

    ****IMPORTANT*****

    Students should return all scrubs each day the end of their clinicals. Under no
    circumstances should scrubs be taken home. If scrubs are not returned, the students will not
    be able to get another set. If there are any scrubs missing at the end of the clinical rotation,
    the material service department will be able to track the badge number and student name.




                                                                                                      12
                             ScrubEx Request Form

    Must be completed in order to receive access to the ScrubEx system. The badge
    number refers to the number on the back of the GHS faculty or student badge.
    Email completed form to Sheree Mejia at Mejia@ghs.org.



Name of School:


                              List the GHS
    Student Name or
                           Student or Faculty     Access Code        Pin Number
     Faculty Name
                            Badge Number




                                                                                13
14
                         Appendix E Student Skills and Procedures
                  Skills/Procedures that student nurse MAY NOT perform

SKILL/PROCEDURE                                       No         Yes         Comments              GHSPolicy/Procedure
                                                   May NOT May perform                                      #
                                                   perform or but specific
                                                   administer precautions
Blood or blood products including                      X                     Includes all blood,       Blood Pro 3, 4, 5, 6
immunoglobulins and monoclonal antibodies                                    blood products,
                                                                             FFP,
                                                                             Cryoprecipitate,
                                                                             Platelets
Blood: Autotransfusion                                 X                     RNs and MDs only              Blood Pro 2
Cardiovascular: management of intra-aortic             X                     RNs with
balloon and any lABP procedure: Ventricular                                  demonstrated
Assist Device or other external heart support                                competency only
device/pump
Cardiovascular: Temporary pacing: external or          X                     RNs with
internal; adjustment in settings of pacemaker;                               demonstrated
changing dressings on external site, changing                                competency only
batteries on temporary pacer, removal or
manipulation of external wires
Cardiovascular: arterial lines of any type:                                  May only observe
   Flushing                                           X                     RN
   Interpretation of waveforms                        X
   Withdrawal of blood specimens                      X
   Removal of                                         X
Cardiovascular: Interpretation and treatment of        X                     RNs with
ECG rhythms                                                                  demonstrated
                                                                             competency only
Cardiovascular: Pulmonary artery catheters:                                  Student may
 assisting with insertion of                          X                     observe RN only
 flushing                                             X
 interpretation of waveforms,                         X
 withdrawal of blood specimens                        X
 cardiac output measurements,                         X
 obtaining PCWP                                       X
                                                       X
 removal or any manipulation of the catheter
Cardiovascular: Removal of arterial sheath post        X                     RN only. Student
interventional procedure                                                     may observe only.

Codes: Defibrillation and/or Cardioversion             X                     RNs only who have     Code 14
                                                                             completed
                                                                             competency
                                                                             requirements
Diagnostics: Bedside blood glucose finger sticks       x                     Students & faculty    Lab policy
                                                                             do not complete
                                                                             this competency to
                                                                             meet lab regulatory
                                                                             requirements.




                                                                                                                              15
SKILL/PROCEDURE                                              No        Yes         Comments                      GHSPolicy/Proced
                                                         May NOT May perform                                         ure #
                                                         perform or but specific
                                                         administer precautions
Document: Documentation on flowsheets, progress                      Note:         Basic generic student         Document 1
notes., forms, medication administration record.                     Must be       nurses and refresher          Document 4
                                                                     co-           nurses, who do not have a     Document 16
                                                                     signed        valid active South
                                                                     by            Carolina RN license must
                                                                     faculty       have or validated
                                                                     or GHS        electronically (for online
                                                                     RN            documentation) by a
                                                                                   Registered Nurse, This
                                                                                   documentation includes
                                                                                   any documentation in the
                                                                                   medicaI record that is
                                                                                   normally documented only
                                                                                   by a licensed nurse and
                                                                                   does not include
                                                                                   documentation normally
                                                                                   done by unlicensed
                                                                                   assistive personnel. The
                                                                                   Registered Nurse who
                                                                                   supervised the
                                                                                   administration of the
                                                                                   medication by the student,
                                                                                   must co-sign on the
                                                                                   medication Administration
                                                                                   Record -and any
                                                                                   documentation related to
                                                                                   that medication
                                                                                   administration.
GI: Removal of fecal impaction                                           X         Under direct supervision      GI Tract 6
                                                                                   RNs only. May cause
                                                                                   stimulation of vagus nerve;
                                                                                   contraindicated in specific
                                                                                   conditions
GI: Insertion of fecal rnanagement system                                X         Under direct supervision of
                                                                                   RN
                                                                         X         Under direct supervision of
Gl: JP drain removal
                                                                                   RN
                                                             X                     MDs only can perform          GI Tract 14
GI: Insertion of MiIler-Abbott tube; Sengstaten-
                                                                                   insertion. Student may
Blakemore
                                                                                   assist MD if supervised by
Tube
                                                                                   RN.
GU/Dialysis Peritoneal Dialysis, set up, infusion of &       X
monitoring of
GU Dialysis: Arteriovenous Fistula/Bovine Graft:             X                                                   GU- Dialysis 1
                                                                                   RN only.
Patient Care
GU/Dialysis: Continuous bladder irrigation using 3           X                                                   GU- Dialysis 3
way                                                                                RN only.
Foley catheter
GU/Dialysis: Bladder retraining                              X                     RN only.                      GU- Dialysis 4



                                                                                                                                  16
SKILL/PROCEDURE                                                No        Yes         Comments                      GHSPolicy/Proced
                                                           May NOT May perform                                         ure #
                                                           perform or but specific
                                                           administer precautions
GU Dialysis: Catheter Irrigation, manual                       X                     RN only.
GU/Dialysis: Suprapubic catheter removal/reinsertion/          X
balloon type
IV: Changing centra! line dressings                                        X         Student must review policy.   IV Device 2
                                                                                     Student who has had
                                                                                     theoretical instruction.,
                                                                                     under direct supervision of
                                                                                     RN, may perform sterile
                                                                                     dressing change only.
IV: Withdrawal of blood from vascular access devices           X                     RNs and LPNs only who         IV Device 16
(central lines, implanted vascular devices, PICC lines)                              have completed competen.
Discontinue any central, epidural, PICC or other               X                     RNs only with completed       IV Device 2
surgically or percutaneously inserted central line                                   competency training.
                                                                                     PICC trained RNs only for
                                                                                     PICC lines.
IV: Initial access to and manipulation of Portacaths,          X                     Must be done by RN. PICC      IV Device 3
surgically or percutaneous                                                           trained RNs only for PICC     IV Device
inserted central lines, peritoneal catheters or dialysis                             lines.
catheters (including accessing dialysis fistulas)                                                                  Med Drugs 9
[Groshongs, Hickmans, PICC, Quintons,]
Declotting of anv IV line
IV: Initiate and manage PCA or Epidural infusions;             X                     Only by RN or CRNA. RN        IV Device 5
discontinue. (includes changing any setting at any                                   with documented
time)                                                                                competency may remove
                                                                                     epidural catheters. Student
                                                                                     can only observe
Culturing peripheral intravenous catheter                      X
IV: Hang or make changes in IV pump settings on any                                  Student & preceptor/faculty   IV Device 4-4A
medication drips: and/or program any medication                                      must have completed
pump containing excluded meds such as heparin,                                       module and skills training
insulin, vasoactive meds, antiarrhythmics, magnesiurn                                on Alaris Pumps. Student
Sulfate, etc.                                                                        should be able to show
                                                                                     how to calculate a rate or
                                                                                     make a change on the
                                                                                     pump.
                                                                                     Can only be done under
                                                                                     direct supervision of RN
IV: Assisting with venous cutdown                              X                     RN only. Student may          IV Device 17
                                                                                     observe
IV: Insertion of peripherally inserted central catheters       X                     Physicians and Registered     IV Device 18
(PICC)                                                                               Nurses who have               IV Device 22
                                                                                     successfully completed an
                                                                                     educational program on
                                                                                     PICC insertion and have
                                                                                     demon-strated competency
                                                                                     may insert a PICC
IV: Maintenance and care of PICC lines                         X                     Registered Nurses who         IV Device 19
                                                                                     have completed required
                                                                                     training and have
                                                                                     demonstrated competency



                                                                                                                                    17
                                                                No        Yes         Comments                       GHSPolicy/Proced
                                                            May NOT May perform                                          ure #
SKILL/PROCEDURE                                             perform or but specific
                                                            administer precautions
IV: Flushing of central lines or peripheral central lines       X                     RN only.                       IV Device 20
IV: Therapeutic phlebotomy via peripheral                       X                     Registered Nurses who          IV Device 21
venipuncture or                                                                       have completed required
Port access                                                                           training and have
                                                                                      demonstrated competency
Medication Administration Activase Administration               X                     RN only.                       Med Drugs 9
IV/ Medication Administration: Hypodermoclysis                  X                     RN only.                       IV Device 9
administration
Medication Administration: Student must review                              X         Student must be observed       Must review: Med Proc
carefully policies and procedures involving:                                          during the entire procedure    1, Med Proc 2, & Med
medication administration                                                             of medication                  Proc 12
                                                                                      administration. RN must
                                                                                      co-sign for all medications.
                                                                                      Medications removed from
                                                                                      the Pyxis, med cart or other
                                                                                      medication storage areas
                                                                                      must be kept in the
                                                                                      possession of the student
                                                                                      nurse until the medication
                                                                                      is administered. Medication
                                                                                      must be pulled from the
                                                                                      Pyxis just prior to
                                                                                      administration. Meds must
                                                                                      be given at prescribed
                                                                                      times per policy.
                                                                X                     RNs only. Can cause            Med Drugs 2
Medication Administration: Administration of IV                                       severe vascular
Dilantin                                                                              complications; must have
(Phenytoin)                                                                           patent IV site and be
                                                                                      administered slowly.
                                                                            X         Student to review policy,      Med Drugs 5
                                                                                      Two licensed RNs must
Medication Administration: Insulin injection ~ SQ                                     initial and sign insulin
                                                                                      administration
                                                                                      record
Medication Administration: Preparation &                        X                     Compounded sterile             Med Drugs 4
administration of                                                                     products (CSP's) will be
compounded sterile products (Admixtures)                                              prepared at all GHS
Medication Administration: Administration of an                 X                     RN only.                       Med Drugs 10
investigational (non FDA) approved drug to
patient in clinical trial.
 Medication Administration: IV push through IV                  X                     RN only.                       Med Drugs 10
 tubing or lock
 Medication Administration: Administration of                   X                     RN only who has completed      S 50-29 Found in
 moderate or deep sedation related to a                                               specific competency and        GHS
 procedure                                                                            knowledge of sedation          Manual of Policy
                                                                                      protocol and can manage        Directives. {GHS system
                                                                                      appropriate monitoring         policy]




                                                                                                                                         18
                                                          No        Yes         Comments                       GHSPolicy/Proced
                                                      May NOT May perform                                          ure #
SKILL/PROCEDURE                                       perform or but specific
                                                      administer precautions
Medication: Intraosseous administration 'Of               X                     By RN Transport Team           PICU policy
medications/ fluids                                                             only
Medication: Intrathecal medic:a.t1on administration       X                     By RN or MD only
Medication Administration: Parenteral                     X                     May not check, initiate or     Med Drugs 7
Nutrition for Adults or Pediatrics (TPN, PN)                                    hang existing PN fluids on
                                                                                any age patient. No
                                                                                initiation or monitoring of
                                                                                PN solutions; student may
                                                                                observe RN only.
Medication Administration: RhoGam                         X                     RN only.
Medication Administration: Student nurses                                       RN only.                       See Med Drugs 13 A-
cannot administer IV drip medications that                                                                     D for details
require, titration or IVP medications that require
special monitoring
 Reopro, Alteplase, Aminophylline, Arnicar,              None                   Students are not to give       Med Drugs 11
 Amiodarone, Argatroban, Bivalirudin, Burnex,                                   these drugs                    Med Drugs 14
 Cisatracurium, Cyclosporine, Diltiazem,                                                                       Med Drugs 15
 Dobutamine, Dopamine, Drotrepln alpha,
 Epinepherine, Eptifibatide, Esmolol,
 Fentanyl, Furosemide IV, Heparin, Ibutillide,
 Inamrinone, Insulin IV, Isoproterenol,
 Labetalol, Lepirudin, Lidocaine, Mannitol,
 Methopredlsone
 Midaxolum, Mirinone, Morphine, Nalozone,
 Nesiritide, Nicardipine, Nitroglycerin IV,
 Nitroprusside, Norepinenphrine, Octreotide,
 Oxytocin, Pantroprazole, Pentobarbital,
 Pehnephine, Potassium Chloride,
 Procainamide, Propofol, Rnidtiden,
 Vasopressin, Vecuronium
Medication Administration: Chemotherapy                   X                     Chemotherapy will be           Oncology 1
                                                                                administered only by
Note: students need to be aware of extra                                        Registered Nurses who are
precautions when handling urine of                                              designated to do so by
patients receiving chemotherapy. Students                                       demonstrating the
may not perfrm urine dipsticks at point of                                      necessary knowledge and
care.                                                                           competencies, according to
                                                                                Greenvillle
                                                                                Hospital System
                                                                                requirements. Applies to all
                                                                                chemotherapeutic
                                                                                meditations.
Medication Administration: Controlled                     X                     Students will not have         Med Proc 15
Substances                                                                      Pyxis access. Two licensed
                                                                                personnel must witness
                                                                                wasting of controlled
                                                                                substances.




                                                                                                                                19
                                                     No          Yes         Comments                           GHSPolicy/
                                                 May NOT      May perform                                       Procedure #
SKILL/PROCEDURE                                  perform or   but specific
                                                 administer   precautions
Musculoskeletal: Administer medicinal Leech           X                      RN only. Medicinal leech          Muscosk 1
Therapy                                                                      therapy has shown to be
                                                                             effective in treating venous-
                                                                             congestion/venous outflow
                                                                             obstruction following
                                                                             microvascular surgery and
                                                                             salvaging vascularly
                                                                             compromised flaps and replants
NEONATAL ICU:
  Trach care                                         X
  PICC care                                          X
  Umbilical IV Lines                                 X
  Ventilator care                                    X
  Closed trach suctioning                            X
  Chest tubes                                        X
  Exchange transfusions                              X
                                                      x
  Tracheal intubation
Newborns: Heel sticks involving glucose PKU           X                      RN only.
Newborns: Transcutaneous bilirubin monitoring;        X
Neurologic: External Cerebrospinal fluid              X                      CSF drainage devices and
Drainage                                                                     procedures may only be
                                                                             monitored & procedures
                                                                             performed by RN only with
                                                                             competency training
Nursing Care: Care of patient in acute alcohol        X                      Care involves use of protocol
withdrawal and acutely agitated                                              with specific assessment skins
                                                                             and medication dosage
                                                                             calculations
Nursing Care: Monitoring and care of patient          X                      RN only.
with femoral vein catheter used for dialysis
etc.. or PA catheter
                                                      X                      Student may observe but cannot
                                                                             apply or reapply the restraint
Nursing Care: Restraints, application of or
                                                                             device. May participate with RN
reapplication of, monitoring checks
                                                                             in monitoring but must be
                                                                             directly supervised
Nursing Care: Care of patient on home                 X                      RNs only. Students can observe
ventilator                                                                   only
Obstetrics: ·                                                                RN only with competency
  Assessment of labor in non obstetrical             X                                                        OB GYN 1
     area                                             X
  Initiation of and changes in IV pump                                      Student may observe with RN in    OB GYN 1
     settings for administration of oxytocin          X                      attendance and with patient's
  Vaginal examinations or assisting with             X                      consent.
     pelvic exams                                     X
  removal of vaginal packing                         X                      Student must be directly
  administration of Magnesium                        X                      observed with RN present
  application of fetal monitoring                                           Student must be directly
  assist with amniotomy                                                     observed with RN present


                                                                                                                           20
                                                         No         Yes         Comments                        GHSPolicy/Pr
                                                      May NOT May perform                                        ocedure #
SKILL/PROCEDURE                                       perform or but specific
                                                      administer precautions
                                                          X                     OnIy licensed or registered     Document 13
Policies/ Patient Care: Phone or verbal orders
                                                                                specific personnel can take
from MD
                                                                                verbal or phone orders
Policies/ Patient Care: Signing off on                    X                     Only RN may sign off on         Document 13
physicians' orders                                                              physician's orders
SKILL/PROCEDURE                                          No         Yes         Comments                        GHSPolicy/Pr
                                                      May NOT May perform                                        ocedure #
                                                      perform or but specific
                                                      administer precautions
Respiratory: Tracheostomy care                                      See   Student Registered Nurses,            Review Respirat 6
                                                                  comment student Practical Nurses and
                                                                     s    student Respiratory Care
                                                                          Practitioners may perform
                                                                          tracheostomy care
                                                                          ONLY on patients with a well-
                                                                          established
                                                                          <greater than 48 hours old) after
                                                                          adequate instruction and
                                                                          demonstrated competency and
                                                                          with their instructor, RN or RRT
                                                                          in direct supervision at the
                                                                          bedside. Student Registered
                                                                          Nurses, student Practical Nurses
                                                                          and student Respiratory Care
                                                                          Practitioners are not to change
                                                                          any tracheostomy securing
                                                                          device.
Respiratory: Nasotracheal suctioning                      x               RNs and RespIratory Therapists        Respirat 5
                                                                          only. Student Registered
                                                                          Nurses, Student Practical
                                                                          Nurses, and Student Respiratory
                                                                          Care Practitioners are not to
                                                                          perform nasa tracheal suctioning
                                                                          in any area of the Greenville
                                                                          Hospital System, including the
                                                                          Children's Hospital
                                                          x               RNs or Respiratory Therapists
Respiratory: Changing of tracheostomy ties
                                                                          only
Respiratory: Assisting with extubation                    x               RNs or Respiratory Therapists
                                                                          only
Respiratory: Chest tube insertion, assisting the MD       x               Students may assist the MD with       Respirat 1
                                                                          insertion of chest tube if RN is in
                                                                          attendance for direct
                                                                          supervision..
Respiratory: Chest tubes, removal of                      x               MDs only.
Respiratory: Chest suction and drainage                   x               RNs only                              Respirat 2
Respiratory: Endotracheal tube &tracheostomy tube         x               Student may only observe              Respirat 7
suctioning; ET tube care
Respiratory: Obtaining nasopharyngeal culture or          x                     RNs only                        Respirat 3
throat culture



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