Practice learning environments are appropriate for student learning and support the achievement of student learning and program outcomes; current written agreements

specify expectations for all parties and ensure the protection of students.

4.8.1 Student clinical experiences reflect current best practices and nationally established patient health and safety goals.

Clinical agencies are selected based upon factors such as location, type of facility, availability of appropriate clients, and quality of the clinical experience. The program enjoys positive working relationships with our affiliating organizations. The agency resources support sufficient student numbers and a variety of experiences. Our standard contract is shared with the agency

representative for approval. Once approval is obtained, SUNY issues a certificate of liability to the agency. An example of our agency contract, a list of agency contracts, and actual contracts are available in the Document Reading Room.

Evaluation of clinical facilities is obtained through written evaluation by students, faculty evaluation (meeting minutes), and end-of-the-semester meetings between faculty and clinical agencies. Evaluation data are the basis for decisions regarding continued use of the facility. For example, in fall 2009, Countryside Care Center, despite its close proximity to campus, was eliminated from our sites for freshman clinical. The financial challenges experienced by the

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facility translated into deficiencies in care provided to the residents, such that our freshman student experiences were compromised. In addition, students evaluated their experience poorly, and commented that they did not feel welcomed by the staff.

Given the rural location of SUNY Delhi and its surrounding communities, the Nursing program is most fortunate to have established contractual arrangements with a variety of sites. A list of agencies we have contractual arrangements is located in Appendix I. Consistent with our

curriculum that builds in complexity, freshman students begin clinical rotations during their first semester primarily at skilled nursing facilities with a brief transition to acute care. The second semester of the freshman year includes acute care, and OB/peds experiences at A.O. Fox (Oneonta), O’Connor (Delhi), and Delaware Valley Hospitals (Walton). Students will begin a new psychiatric rotation at Creekside Social Club in Walton NY in fall 2011. This experience will offer students an opportunity to observe and interact with various stabilized mentally ill clients in the community setting. Freshman students are scheduled for two 6-hour clinical days the fall semester, and one 12-hour clinical day the spring semester.

Senior students are placed at Bassett Medical Center in Cooperstown, New York, for all clinical experiences with the exception of community rotations, which are completed at the Delaware County Public Health Department, Delhi, NY, and At-Home Care in Oneonta, NY. Bassett Medical Center is a 180-bed acute care teaching hospital that offers 24-hour emergency and trauma care, comprehensive cancer and heart care, dialysis, medical and surgical specialties, obstetrics, pediatrics, and psychiatry. Senior students are scheduled for one 12-hour clinical day for both fall and spring semester.

The clinical nursing courses are designed and planned to promote student success in meeting course objectives. Pre- and post-conferences are a component of each clinical experience, which allow faculty to assess student performance, and stimulate the students to engage and participate in a professional, problem-solving dialogue among their peers.

Additional learning experiences include specialty rotations such as the OR, cardiac

catheterization lab, crisis center and ECT, and dialysis. Other experiences include pairing

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students with a professional in a variety of areas such as wound care, IV and respiratory therapy.

Faculty also arrange for guest speakers to present to students on topics such as case management, nutrition, pastoral care, relationship-based care, and infection control. Other conference topics include nursing process workshops, strategies to strengthen decision-making, delegation, and prioritization abilities.

One of the cornerstones of our program is awareness of national patient safety trends, as identified and defined by The Joint Commission in their “National Patient Safety Goals,”

updated in 2011 (http://www.jointcommission.org/standards_information/npsgs.aspx). The language of safety goals is embedded throughout the curriculum; goals are referred to in units of instruction and are covered in each course. We also stress to students that these goals are revised annually based on new evidence. Examples of courses where this content is addressed include:

 Preventing infection is introduced in:

o NURS 110 theory/lab with lecture content that includes proper hand hygiene and asepsis throughout skill evaluations.

o Reinforced in NURS 120 and 125 in evaluating the students for maintenance of these standards.

o Infection prevention, again is threaded throughout NURS 200, 210, 230, and 240.

Identifying clients at risk is a focus at the second year level that is incorporated into clinical and the clinical paperwork.

 In NURS 125, students are required to address at least one of the safety goals in weekly clinical paperwork in which they discuss how they maintained this standard.

 SBAR (situation-background-assessment-recommendation)is emphasized in NURS 125 to develop communication skills. SBAR communication is heavily emphasized in the NURS 230 and 240 (clinical courses) and is part of the student evaluation.

 Medication administration begins in NURS 110 and then is threaded throughout the clinical courses. Emphasis is place on safe medication administration, five rights, and the importance of properly identifying client.

 Safety goals are threaded throughout NURS 200, 210, 230, and 240. Clinical expectations at the second year level mandate patients are identified prior to every

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medication administration as well as identifying potential and actual medication side effects.

 Suicide risk is addressed in NURS 101 and 220.

For nursing education units engaged in distance education, the additional criterion is applicable:

4.9 Learning activities, instructional materials, and evaluation methods are appropriate