2019-2020 Clinical Policies

Samuel Merritt University provides an educational environment which seeks to foster respect for human dignity and to promote professional responsibility. Students and faculty follow the standards of professionalism and ethical practice in accordance with the respective professional codes of ethics when dealing with issues of infectious illness. The University is committed to supporting the rights of all people to receive high quality healthcare, regardless of social and economic status, personal attributes, or the nature of their health problems.  

Assignment of students to care for clients with an infectious illness

Because it is the policy of most healthcare agencies that employees will treat clients without discrimination, and since students are being educated to work in a variety of healthcare delivery settings, it is essential that they learn to care for a variety of clients with infectious illnesses. When proper precautions are practiced, the chances of a healthcare worker becoming infected are minimized. The student will be assigned to a client with an infectious illness only after being educated on the epidemiology, precautions and practices to be taken to prevent transmission of these illnesses. Prior to such assignments, the student will also have satisfactorily demonstrated skill in application of infection precautions.  

Exemption of students under special circumstances

  • Immunocompromised students: Students with diagnosed immunological deficiencies are at an increased risk for developing opportunistic infections. The decision to exempt such a student from caring for a client with an infectious illness will be made on a case-by-case basis by the faculty responsible for the clinical course in consultation with the student’s physician and appropriate University faculty/administrators. Current CDC guidelines recommend that asymptomatic healthcare workers with HIV infection not be restricted from employment. Based on this information, students who are positive for HIV and who are asymptomatic need not be restricted from clinical agencies or from attending class. Students should be advised that HIV infection may cause immunosuppression, and therefore increase the student’s susceptibility to infections acquired from client-student interaction.

  • Pregnant students: Any limitations regarding clinical experience should be outlined in writing by the student’s physician. The student is responsible for contacting the Student Health Services family nurse practitioner for counseling regarding safety in the clinical setting. A pregnant student should also consult with her academic advisor regarding her schedule and possible adjustments to her degree plan. When assigning a student with confirmed pregnancy, faculty will follow the established policy of the institution where the clinical experience is based.

  • Students with infectious illness: Any students exhibiting signs and symptoms of an infectious illness that places at risk the health of those with whom they have contact will not attend class or clinical.

  • Student refusal of clinical assignment: Any student who refuses a clinical assignment because of the nature of the client’s illness may be subject to disciplinary action.

Exposure of students to an infectious illness:  

Prevention: There is an immunization prerequisite for clinical courses. Infectious illness history and an immunization record are obtained at the time of admission into the University and are updated periodically to conform with the required practices of Student Health Services. Students who have not filed the University medical history and physical examination form or who are not current with immunizations will be prohibited from clinical experience until they are in compliance.

Suspected or confirmed exposure of a student to an infectious illness: The suspected or confirmed exposure of a student while in a clinical agency is treated in a manner similar to any exposure occurring within the agency. The student is expected to immediately notify the clinical faculty, who will then notify the supervisor of the healthcare facility where the exposure occurred. A formal report of such exposure should be filed at the agency as directed by agency policy before the end of the clinical day. The forms designated in the SMU Clinical Injury/Exposure Procedure must be submitted to Samuel Merritt University Human Resources as soon as possible after injury or exposure. Subsequently, agency and University policies should be followed for reporting and follow-up surveillance and/or treatment. Any exposure to an infection during clinical rotation at Alta Bates Summit Medical Center must be evaluated by Employee Health and Infection Control. If necessary, medical referral will be provided. Exposures at other agencies should be followed up with the appropriate departments where the exposure occurred. Follow-up for exposures to infectious disease from other clinical settings will be provided if the healthcare agency where exposure occurred refuses to follow up (and documentation of the exposure is given to Sutter @ Work). Any exposure to an infectious disease outside of clinical rotation may be evaluated by Student Health Services for follow-up treatment as needed and according to policy. The clinical faculty is expected to notify the program or department Clinical Coordinator and department chair or program director of student exposure to an infectious illness.

Background Check Policy

Incoming students must complete a background check before they are eligible to enroll at the University.  Continuing students who return from any type of leave of absence or who are readmitted to the University must complete a new background check prior to enrolling.  Continuing students may also need to complete additional background checks in order to meet the requirements of a clinical agency to which the student is assigned for a clinical experience.  Incoming students and continuing students pay for the cost of the background check.  

 

SMU transmits the summary results of the background check to the clinical agencies in advance of a student beginning a clinical experience.  Those summary results indicate only whether or not there were findings on the background check, not the specifics of the findings.  The full results are released to the clinical agency only with the student’s consent and only when requested by the clinical agency.  A clinical agency may refuse to accept a student on a clinical experience based on the background check results.  

 

Incoming students with a background check result that may compromise the ability to find clinical placements receive notification to that effect.  These incoming students are also notified that the ability to obtain a license may be affected by the findings from the background check and that the University cannot guarantee that the student will be able to obtain a license after graduation.  It is the students’ responsibility to take all necessary actions as it is related to their ability to obtain a license upon completion of their degree requirements.  The University retains the right to defer the offer of admission to a different term or to rescind an offer of admission based on the results of a background check.  Continuing students who are unable to obtain a clinical placement due to the results of a background check may need to take a leave of absence or withdraw from Samuel Merritt University.  Continuing and incoming students have the opportunity to correct or clarify the items identified on the background check with the appropriate agency before the University makes a final decision about continuing matriculation or admission.  

Applicability:  

  1. All incoming students who are admitted to Samuel Merritt University with exceptions noted below.   

  2. Continuing students who return from any type of Leave of Absence or who are readmitted to the University

  3. Continuing students when required by a clinical agency to which the student is assigned for a clinical experience.  

Exceptions:  

  1. Incoming Doctor of Nursing Practice students unless they have a clinical experience at a clinical agency where they are not currently employed.  

  2. Special status students may be exempt from this policy requirement and will be notified if they must complete a background check.

All students and faculty will, as appropriate, receive instruction in the utilization of standard precautions and infection control procedures for the prevention of the transmission of blood-borne diseases.

 

Faculty or students will obtain agreement from potential subjects before subjects participate in activities or assignments related to a specific course of instruction.  Potential subjects include individuals in the community or individuals from within the University who are not registered in the specific course.  Activities or assignments are those designed or provided by an instructor for students in a specific course, and may include physical examination or treatment procedures in the classroom, elsewhere on campus, or in the community. 

Participation in Course Activities

For all courses in which they are registered, students are expected to participate in course activities as designed by their course faculty.  Such course activities could include, but are not limited to, invasive, manipulative procedures/techniques or demonstrations (i.e. venous blood draws, and intravenous needle insertions or injections, intramuscular or subcutaneous) or other non-invasive procedures.  Faculty must inform students of the reasonable risks of any procedure/s required in the course.  

Students are expected to both act as provider and recipient of these procedures.  The student must notify the Instructor of Record of any condition or circumstance that would prevent them from acting as provider or recipient as soon as possible.  In those cases, the faculty and student must identify alternative learning activities that would satisfy course requirements.  In all cases, the student must be able to fulfill regular or alternative course activities in order to successfully complete the course.

 

Before students can begin clinical rotations, they must complete and be up to date with the following requirements for the duration of their enrollment at the University. There may be additional requirements for an individual clinical agency or for a particular program that students need to comply with.

  • Enrolled in a Medical Insurance Plan
  • Completion of a Drug Screen and/or a Background Check
  • Certified in CPR, Basic Life Support (BLS) level
  • Up to Date in Immunizations

Due to both the variations in clinical sites and agency personnel and departmental faculty roles, each University department will publish a specific procedure for handling student injuries and exposures to potentially hazardous materials.  Students will be provided with thorough orientation to that procedure with their first clinical assignment. Students and faculty will clarify the protocol for handling clinical injuries and exposures with each subsequent clinical rotation.  

Clinical injuries are covered under the University’s worker’s compensation insurance. Treatment will be available from a Sutter Health @ Work facility, during regular business hours, and from the Emergency Department during non-business hours (see procedures for specific hours). These sites should also be used for students injured during work/study employment, as well as students injured during clinical assignments.  In addition to receiving evaluation and treatment, students will, as soon after the injury or exposure as possible, notify the appropriate University representative designated within their department (i.e. clinical faculty member for nursing, clinical coordinator for PT and OT), and within 24 hours notify the Samuel Merritt University Office of Human Resources (510.879.9260) of any injury or occupational hazard exposure and be assured of support in decision making regarding correct procedure for treatment and follow-up.

In order to avoid incurring financial and legal liability, it is critical for injured or exposed students and their clinical faculty to follow the procedure provided by their department.

Students are required to carry the University’s health insurance (or have an approved plan that meets University requirements) to cover treatment of illnesses not directly related to classroom and clinical work. For more information about the Clinical Injury Procedure, please contact your department representative.

 

Any student may be required to go out of the immediate area of campus and/or their home for at least one of their clinical rotations.  The student will be responsible for their own transportation and housing. 

Incoming and continuing students at Samuel Merritt University (SMU) are required to complete a drug screen when they receive notice from the University that such a drug screen is required.  These students must pay for the cost of the drug screen.  These students must comply with all directions they are given regarding the drug screen, including the designated vendor they are to use.  All students with an abnormal or dilute report are required to retest at their own expense.  The University retains the right to defer the offer of admission to a different term or to rescind an offer of admission based on the results of a background check.  Continuing students with a positive drug screen are referred to the Office of the Vice President of Enrollment and Student Services.  The Vice President of Enrollment and Student Services may require a continuing student with a positive drug screen to repeat the drug test, may require a second medical review officer (MRO) evaluation of the results, may place the student on a leave of absence or may dismiss the student.  Students have the right to dispute the findings of the drug screen report under Section 61s of the Federal Fair Credit Reporting Act (FCRA) free of charge.  All student drug screen reports are confidential.  

 

Applicability:  Students admitted to the pre-licensure nursing programs (BSN, ABSN, ELMSN, and RN to BSN) and newly admitted post professional graduate MSN nursing students (CRNA, FNP, CM) are required to complete a drug screen upon receipt of the offer of admission and before they are eligible to enroll in courses.  Continuing nursing students who return from any type of Leave of Absence or who are readmitted to the University, students in the other programs (DNP, DPM, DPT, MOT, OTD, MPA, MSN-online) and special status students are only required to complete a drug screen when they receive notice that a drug screening is required by a clinical agency to which they are assigned for a clinical experience.

 

All Samuel Merritt University students must have an annual flu vaccine prior to entering a clinical setting.  Students who decline a flu vaccine must wear an N95 mask when they are in clinicals.  Students are informed that if they refuse to get their annual flu vaccine, it may affect their ability to practice in a clinical location and prevent a student from progressing in their academic program.

 

Before registration, all entering students must provide the following to the Student Health and Counseling Center.  All required health information and supporting documents must be uploaded and entered on the Student Health Portal (SHP).  Documents submitted by mail, email, fax, or hand delivered will NOT be accepted and documents will not be returned.

  1. Tuberculosis Screening (PPD): 2-Step PPD must be completed within 6 months prior to the University entrance date, and will need to be updated annually. Tuberculin (PPD) conversions will be evaluated and referred for follow-up care by the appropriate agency. Students who are exposed to a patient with tuberculosis will be screened according to Employee Health Services tuberculosis exposure policy.  If there is a history of a positive PPD, students will need proof of a negative chest x-ray within 12 months prior to University entrance, date of positive PPD test, and an annual TB survey.  

  2. Measles (Rubeola), Mumps, and Rubella:  Students born in 1957 or later: documentation of receipt of two doses of MMR or positive titres for rubeola, rubella, and mumps.  Students born before 1957: documentation of receipt of one dose of MMR or positive titres for rubeola, rubella, and mumps.

  3. Varicella: Documentation of positive varicella titre or of two varicella vaccines received regardless of prior history of chickenpox.

  4. Hepatitis B: Documented proof of the Hepatitis B vaccination series (3 doses over a period of 6 months) or positive titre.

  5. Tetanus: Verification of a Tdap (Tetanus, Diphtheria, Pertussis) within the last 10 years.  

  6. Flu Vaccine: Documented proof of the annual influenza vaccination or signed declination (mask required).

  7. Medical Insurance (see Student Health Insurance section)

  8. There may be additional requirements from your academic program or clinical placement, including (but not limited to) vaccine titers, color vision testing, and physical exam.  Please check with your clinical coordinator.

The above health documents should be submitted to Student Health and Counseling Center as soon as you have confirmed your acceptance to the University, but no later than thirty days before your program start date.

Each department may have additional requirements.  Any student who does not comply with the above examination and immunization policy will be prohibited from class attendance and clinical experience until she or he is in compliance. Registration for succeeding terms may be held until students provide the above documentation

 

Samuel Merritt University provides professional liability coverage for faculty and students which pertains to educational experiences required by the University. The acquisition of additional coverage for faculty and students is an individual decision based on individual circumstances.

Samuel Merritt University complies with all professional requirements for licensure.  These include criteria for denial of licensure for crimes or acts which are substantially related to professional qualifications, functions, or duties.  Felony convictions or a history of substance abuse may lead to a denial of licensure/certification.  Specific policies may be obtained from the regulatory agency or from the appropriate licensing or credentialing agency.  Felony convictions may prevent licensure by the profession’s regulatory agency.

  1. At the beginning of each course, students are given procedures for requesting excused absences from clinical, course activities, and examinations for reasons which include, but are not limited to, illnesses and accidents.

  2. Students notify or leave messages for their instructors at least one hour before the beginning of the clinical experience.

  3. Students notify the appropriate agency supervisor as established by protocol in each agency, or by the clinical coordinator, at least one hour before the beginning of the clinical experience.

 

Faculty members have the right to deny students access to the clinical area if, in their opinion, the student is too ill or unsafe to care for patients. In instances where a faculty member is unable to make this decision, the student will be referred to Health Services for clearance. The Student Health Services nurse practitioner is available as a resource person to the faculty, as needed. If a student is hospitalized, the student and/or family will notify the Assistant Vice President of Enrollment and Student Services and the Student Health Services Department at the earliest possible time.  If the Student Health Services Department is closed at the time of the student’s illness or accident (see Clinical Injury for injuries occurring on clinical rotation), the department supervisor at Alta Bates Summit Medical Center will notify Health Services and the Assistant Vice President of Enrollment and Student Services.

 

Referrals  

Faculty may refer students with suspected functional, organic, or emotional problems to the Assistant Vice President of Enrollment and Student Services, or in his/her absence the Vice President of Enrollment & Student Services, for evaluation. The Assistant Vice President of Enrollment and Student Services will evaluate and refer to specialists when necessary (at student’s own expense).

Policy 

A student whose pattern of behavior is found to be unsafe and/or unprofessional may be excluded from a clinical practicum at any time and could receive a failing grade in the course. The student is referred to the program director/department chair and may be subject to further disciplinary action.

Guidelines  

The student will demonstrate patterns of health care professional behavior which follow the legal and ethical professional codes; promote the well being of clients, health care workers, and self in the biological, psychological, sociological, and cultural realms; demonstrate accountability in preparation, documentation and continuity of care; and show respect for the human rights of individuals.

Indicators to be used as guidelines for evaluating safe and professional practice are:

Regulatory 

The student practices within the boundaries of the applicable State Practice Act, the guidelines and objectives of the department, and the rules and regulations of the health care agencies. Examples of safe and/or professional practice include, but are not limited to the following:

  1. notifying the agency and/or instructor of clinical absence.
  2. adhering to the dress code.
  3. presenting for clinical practicum free from the influence of unprescribed psychoactive drugs, including alcohol.
  4. demonstrating accountability by making up missed clinical experiences, as designated by faculty member.
  5. arriving promptly for clinical assignments.
  6. meeting obligations in a timely manner.

Ethical

The student practices according to the relevant professional association’s Code of Ethics, Standards of Practice, and the State Practice Acts.  Examples of safe and/or professional practice include, but are not limited to the following:

  1. accepting assignments in keeping with the University’s policy of non-discrimination.
  2. appropriately performing any activity related to clinical practice.
  3. reporting unethical behavior of other health care providers, including other students.
  4. demonstrating honesty in all aspects of clinical practice.

Biological, Psychological, Social, and Cultural Realms 

The student’s practice meets the needs of the human from a biological, psychological, sociological and cultural standpoint.  Examples of safe and/or professional practice include, but are not limited to the following:

  1. displaying stable mental, emotional and physical behavior.
  2. following through on referrals or interventions to correct own areas of deficiency in clinical practice which, if ignored, may result in harm to others.
  3. building interpersonal relationships with agency staff, coworkers, peers and/or faculty that result in clear, constructive communication, promoting quality client care and/or unit functioning.
  4. being physically capable of carrying out essential procedures.

Accountability

The student’s practice demonstrates accountability in the responsible preparation, documentation and promotion of continuity in the care of clients.  Examples of safe and/or professional practice include, but are not limited to the following:

  1. communicating concisely both orally and in writing.
  2. documenting client behavior accurately and comprehensively.
  3. reporting questionable professional practices.
  4. undertaking activities with adequate orientation, theoretical preparation and appropriate assistance.
  5. demonstrating honesty in all aspects of practice.

Human Rights

The student’s conduct shows respect for the individual, client, health team member, faculty and self, including, but not limited to the inherent  legal, ethical and cultural realms. Examples of safe and/or professional practice include, but are not limited to the following:

  1. maintaining confidentiality of interactions.
  2. maintaining confidentiality of records.
  3. demonstrating honesty in relationships.
  4. using individual assessments which support quality patient care.
  5. recognizing and promoting patient’s rights.

Dress Code 

The purpose of the dress code is to establish standards which are consistent with the professional image and provide for patient safety while allowing for some individuality.  Students are required to comply with the dress code policy of each affiliating clinical agency and adhere to faculty directive(s) regarding dress. 

 

In order to comply with clinical requirements and accrediting obligations, SMU requires all students to obtain and maintain continuous coverage in a domestic medical insurance plan that is compliant with the Affordable Care Act (ACA).  The minimum level of coverage for waiving enrollment in the student health insurance plan includes an ACA-compliant level medical plan, urgent and non-urgent care, mental health benefits, and prescription coverage.  Students who have their own qualified plan must submit an online waiver form; students who need coverage must enroll in the University plan(s) by submitting an online enrollment form.  Any questions regarding the University’s responsibility for medical care should be referred to the Coordinator of Student Health and Counseling Center.  Information on student insurance plans can be found at https://app.hsac.com/smu.

 

New students, at least thirty days prior to their program start date, are required to submit an online Student Health Insurance Form indicating that:

  1. you would like to enroll in the SMU health insurance plan, or

  2. you would like to waive the SMU health insurance plan and will provide proof of an approved group health insurance plan by submitting the policy information as requested by the Student Health Insurance Form.

See website:  https://app.hsac.com/smu

Students who fail to submit an online enrollment form by the start of their first term in their program will be automatically enrolled and charged for the full term.

Students enrolled in the University’s plan will be re-billed each term while they are enrolled at SMU, unless and until a new online enrollment form is completed and submitted in advance of the next term’s billing cycle to the Office of Health & Counseling Services.

All students are required to notify the Servicing Administrator for SMU - HSA Consulting, Inc. (HSAC) - of any change in their health insurance status while enrolled at SMU via submitting a new online Student Health Insurance Enrollment Form.

All charges for the University’s Health Insurance will be billed to your University student account.

Students who take an official leave of absence or suspended, are eligible to keep their insurance for the duration of their leave, provided that they make a payment in advance for every six months of coverage. 

There are no adjustments or refunds available for payments made for health insurance continuation during a leave of absence or suspension.

Students who withdraw from Samuel Merritt University will have their SMU health insurance terminated as of their withdrawal date, unless they elect to keep their insurance through the end of the period for which they last paid.

Students must complete the withdraw process, as outlined in the Academic Policies section, prior to having their insurance charges adjusted.  Students must provide the Office of Health & Counseling Services with a copy of the completed withdrawal form.