Background Check and Drug Screening Guidelines for Valencia
Allied Health and Nursing Programs
Valencia does not have an official policy regarding student background checks or drug screening. However, all students entering the Nursing and Allied Health programs are required to submit to a criminal background check and drug testing because these programs include clinical rotations in a variety of external affiliate health care facilities, which have policies that we must respect pursuant to our contracts with them.
Our affiliates’ policies require that students serving in a clinical rotation be free of specific offenses that would disqualify them for a student clinical and have their civil rights intact. In addition, our affiliates require that students return negative drug screening results based on a list of specified substances. These guidelines are derived from the requirements specified by our affiliates, and are subject to change upon any modification to our affiliates’ policies.
PROCEDURES:
Our affiliates require Level 1 and 2 criminal background checks and 10-panel drug testing of all students. This screening must be completed utilizing the Allied Health and Nursing Divisions’ process, including use of its designated vendor(s). The results of background checks and drug testing from other facilities or entities will not be acceptable for admission to Valencia’s Allied Health and Nursing programs. The clinical portions of the programs are required for program completion and students cannot fulfill the program requirements if they cannot participate in the clinical experience.
Incoming students:
Background Checks
• Valencia’s healthcare affiliates require Level 1 criminal background checks for all students who participate in clinical experiences in their facilities.
• The Agency for Healthcare Administration, which governs our affiliates, requires Level 2 background checks/ FDLE finger printing for students whose clinical program places them with vulnerable populations.
• Due to additional requirements from some of our clinical affiliates, employment verifications are included in the background effective February 2014.
Valencia’s health care affiliates have provided the administration with a comprehensive list of offenses that they deem unacceptable for students entering their facilities. This list is compiled solely by the affiliate, without any input from Valencia. When Valencia receives the results of each background check, those results are compared with the list provided by the affiliate to determine if a listed offense has been discovered. Valencia does not make any determination of the suitability of a student to serve in a clinical rotation or subjectively interpret any results; it merely determines whether an offense listed on a background check report is present on the affiliate’s list of unacceptable offenses and advise the affiliate of that fact.
The student may meet with the appropriate Academic Dean for consultation regarding the results of background checks; however, the Dean will advise the student only based upon clearly
Background Check and Drug Screening Guidelines for Valencia
Allied Health and Nursing Programs
defined offenses provided by the affiliates. The Dean does reserve the right to consider the student for program entry at a later date; if the disposition of an offense is changed in the student’s favor; he/shall may be reconsidered for entry to a program.
Drug Testing
• 10 panel drug testing must be negative for all substances.
• Dilute negative specimens will not require retesting, unless required by specific health care agency.
Valencia’s health care affiliates have provided the college administration with a comprehensive list of substances that they deem unacceptable for students entering their facilities. This list is compiled solely by the affiliate, without any input from Valencia. When Valencia receives the results of each drug screening, those results are compared with the list provided by the affiliate to determine if the presence of a listed substance has been discovered. Valencia does not make any determination of the suitability of a student to serve in a clinical rotation or subjectively interpret any results; we merely determine whether a substance found through a drug screening is present on the affiliate’s list of unacceptable substances and advise the affiliate of that fact. Positive results for any substance must have a viable medical explanation and the student shall have been prescribed treatment by a licensed health care professional. Where positive results do not have a medical explanation, students may be denied admission and may re-apply to the program at a later time.
Incumbent students:
• If a student incurs a record as a result of an arrest or encounter with the law, he/she is required to disclose the incident to the Office of Clinical Compliance immediately. Depending on the circumstances, failure to self-disclose or the offense itself may result in withdrawal from the program. Clinical affiliates may perform a separate background check and, if an offense is discovered, may affect the student’s clinical access.
• Random drug testing will be required at the student’s expense in the event of o A previous positive result
o Suspicion of substance use/abuse o Affiliate policy change
• A positive result upon random drug testing will result in withdrawal from the clinical assignment with commensurate inability to meet the completion requirements of the program.
CLINICAL COMPLIANCE: STUDENTS AND FACULTY
Valencia College Allied Health and Nursing Programs
Background Check Summary
• Patriot Act
• Residency History
• Criminal Records
• Sex Offender Index
• Nationwide Healthcare Fraud and Abuse Scan
• Employment Verification
• FDLE/Florida Fingerprinting (Required by AHCA)
Drug Test: 10-Panel
• Amphetamines
• Barbiturates
• Benzodiazepines
• Cocaine
• Methadone
• Methaqualone
• Opiates
• Phencyclidine
• Propoxyphene
• Marijuana
Immunizations and Other Requirements:
• Physical Exam/Provider Signature verifying good health status for program)
• TST (tuberculosis skin test) annually
• Chest X-Ray Results/Report (if positive TST)
• TB Screen/Symptom Sheet (annually if positive TST/negative chest X-Ray)
• MMR
• MMR
• Varicella (Chicken Pox)
• Tetanus: Tdap one time, T/D thereafter every 10 years
• Hepatitis B Series
• AHA BLS Healthcare Provider
• Certificate of FIT Test N95
AHA Basic Life Support for Healthcare Providers
All students enrolled in programs in Valencia’s Divisions of Nursing or Allied Health shall be required
to obtain and maintain the American Heart Association Basic Life Support (BLS) for Health Care
Providers certification. For the purpose of Valencia student clinical rotations, ONLY American Heart
Association certification is acceptable per our hospital affiliates. For students required by their
respective program to have advanced certification (ACLS and/or PALS), only American Heart
Association certification is acceptable.
Students will upload a copy of their current American Heart Association card to their Certified
Background tracker. It is the student’s responsibility to maintain all certifications required by the
program in which he/she is enrolled and to present documentation of updated certifications during the
duration of their enrollment.
Health Care Provider (CPR) Classes Available
Valencia College is an American Heart Association Training Site
• Offers certification and re-certification classes at least once a month on the West
Campus. The fee includes the student manual. You may register online with a credit
card at
http://valenciacollege.edu/cehealth
. Sections are identified for Valencia degree
students. You must have your V# to register in these special sections to obtain student
pricing:
o Certification $40.00
o Re-Certification of an unexpired AHA BLS card $20.00
• For more information or to pay by check or cash, contact the
Office of Continuing Education and Clinical Compliance
Location: West Campus, HSB 200
Phone: 407.582.1793 or 407.582.1870
Email:
cehealthinfo@valenciacollege.edu
Other Student-Friendly American Heart Association Providers
• CPR for Citizens: (Rick McGarrity)
For schedule, pricing and/or register for classes, call 407.629.5183
Provider accepts only cash or check, no credit cards
• All Care Health Services
www.allcarecpr.com/student
407.432.4756
Present current Valencia I.D.
To locate other approved American Heart Association providers, go to
www.heart.org/HEARTORG/CPRAndECC/FindaCPRClass
s:\health sciences-common\west campus\division of health sciences\compliance\orientations\orientation_5-2014\compliance documents\individualcompliance docs\cpr bls certification requirement.doc
Page 1 Valencia College Divisions of Allied Health and Nursing
HEALTH AND PHYSICAL FORM Revised: October 2013
TO BE COMPLETED BY STUDENT:
Name: VID #:
Street Address: DOB:
City/State/Zip Phone #:
TO BE COMPLETED BY STUDENT'S HEALTH CARE PROVIDER:
PHYSICAL EXAMINATION: indicate ability to perform standards described below LIMITATIONS: Mobility: Physical abilities sufficient to move from room to room and maneuver small
spaces; move freely to observe and assess patients and perform emergency care to include full manual dexterity of upper extremities,including neck and shoulders, unrestricted movement of lower extremities, back, hips,in order to assist in all aspects of care. Ability to touch floor to remove environmental hazards and to include nursing procedures as applying restraints bladder catheterization and injections.
Motor Skills: Gross and file motor abilities sufficient to provide safe and effective care
Hearing: Auditory abilities sufficient to monitor and assess patient needs and to provide a
safe environment
Visual: Visual ability sufficient for observation and assessment necessary in the operation of
equipment and care of patients
Tactile: Tactile ability sufficient for patient assessment and operation of equipment
Cognitive: abilities to include calculating medication dosages, interpreting and carrying out provider orders, read and comprehend course materials,patient care documents and facility policies and procedures
PERSONAL HISTORY
HEALTHCARE PROVIDER SIGNATURE AND/OR STAMP
Signature and/or Stamp of Healthcare Provider (MD,DO, PA, ARNP) Date:
Provider Printed Name: Phone:
Health Science Program: Circle your program
Describe any conditions (including allergies to substances normally found in a clinical setting) that could potentially impact the student's attendance and/or performance. if a student should present with any physical or cognitive limitation, each case will be reviewed on an individual basis. Reasonable accommodations will be made as determined by the Office for Students with Disabilities.
Following the performance of a physical exam and utilizing history and immunization information provided to me by the student, I verify the above information to be true.
AVS CVT Dental Hygiene EMT Generic Nursing Paramedic Respiratory Radiography MRI CT Sonography Medical Information Technology RN Refresher
Page 2 Valencia College Divisions of Alied Health and Nursing
HEALTH AND PHYSICAL FORM Revised: February 2014
Student Name: VID #:
IMMUNIZATION INFORMATION DATE RESULTS
TUBERCULOSIS
TST (tuberculosis skin test/PPD) Date Placed: / / Date Read: / / Positive Negative
CHEST X-RAY RESULTS/REPORT (if positive TST/PPD) Positive Negative TB SCREEN/TB symptom sheet to be done annually if positive TST/PPD
HEALTHCARE PROVIDER SIGNATURE:
MEASLES, MUMPS, RUBELLA DATE
Two MMR vaccines with dates or individual titers for each satisfy the requirement for Measles (Rubeola), Rubella (German Measles)
RESULTS MMR VACCINES (given after 1st birthday)
Vaccine #1
Vaccine #2 (not required if born before 1957) TITERS
Rubeola Titer Positive Negative
Rubella Titer Positive Negative
HEALTHCARE PROVIDER SIGNATURE:
VARICELLA (CHICKENPOX)
Two Varicella vaccines with dates, or a positive titer, or history of having chickenpox disease satisfy this requirement
DATE RESULTS
Documentation of Disease N/A
Varicella #1 Varicella #2
Titer Positive Negative
HEALTHCARE PROVIDER SIGNATURE:
TETANUS/DIPTHERIA One time Tdap, then TD every 10 Years DATE Tetanus/Diptheria
Tdap
HEALTHCARE PROVIDER SIGNATURE:
SEASONAL FLU VACCINE DATE
HEALTHCARE PROVIDER SIGNATURE:
HEPATITIS B (strongly recommended for healthcare workers) DATE RESULTS
Vaccine #1 Vaccine #2 Vaccine #3
Titer Positive Negative
HEALTHCARE PROVIDER SIGNATURE:
STUDENT'S PRINTED NAME: DATE
STUDENT'S SIGNATURE:
I understand that, due to my exposure to blood or other potentially infectious materials, I may be at risk for acquiring the hepatitis B (HBV) infection. I have been informed of the recommendation that all healthcare workers be vaccinated with hepatitis B vaccine. However, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I could be at risk of acquiring hepatitis B, a serious disease.
Rev. 1/20/2012
SEASONAL INFLUENZA VACCINE DECLINATION
Influenza vaccine is strongly recommended for healthcare workers, not only to protect themselves, but also to reduce the chance of spreading influenza to patients, their families, and to the community. Influenza infection can lead to serious complications and can be fatal, especially in elderly or sick persons, including those who are hospitalized. In the U.S. approximately 200,000 people are hospitalized and 36,000 persons die from influenza each year. The influenza vaccine is highly effective in PREVENTING infection. Valencia’ Divisions of Nursing and Allied Health are committed to the health and well-being of students, faculty, and patients and we consider influenza vaccination a PATIENT SAFETY priority.
PLEASE HELP PREVENT THE TRANSMISSION OF INFLUENZA BY RECEIVING THE ANNUAL INFLUENZA VACCINE.
If you choose to decline the vaccination, please complete this form and upload it to your immunization tracker and/or provide it on demand in your clinical setting.
PRINT NAME: First ____________________ MI __ Last ________________________________ VALENCIA PROGRAM (circle one):
Nursing Paramedic EMT CVT Respiratory Radiography Dental Hygiene Sonography Answer the following questions:
1. YES NO Have you ever had a severe allergic reaction to chicken eggs?
2. YES NO Have you previously had a severe reaction to an influenza vaccination OR other vaccinations?
3. YES NO Do you have an allergy to any preservatives used in vaccines?
4. YES NO Have you ever developed Guillian-Barre syndrome following influenza vaccination?
DECLINATION OF VACCINE: I have read the above statement regarding seasonal influenza vaccine. I fully
understand that my declination will necessitate my wearing a mask during the entire shift in some clinical settings as required by the facility. I am choosing not to take the vaccine for the following reason(s):
____ Answered “yes” to the questions above (1-4)
____Dislike of needles ____Concern for side effects ____Don’t think vaccines work ____Never get flu ____Fear of getting influenza from vaccine ____Other:____________________ Signature: _______________________________________ Date:_________________________
Valencia Community College
Division of Health Sciences
Tuberculosis Symptom Screening Sheet
Form Revision Date: May 2010
Student Name (Print)
SYMPTOM YES NO Productive cough Night sweats Shortness of breath Loss of appetite Unusual tireness
Unintentional weight loss Fever
Swollen or tender lymph nodes
QUESTION YES NO DATE
Have you ever been exposed to TB? If yes, when? Have you ever had a positive TB skin test? If yes, when? Have you ever taken BCG vaccine? If yes, when? Are you currently taking medication(s) for TB? Have you ever taken medication(s) for TB?
Please answer the following questions and comment on positive answers
Do you currently have, or have you had in the past two months, any of the following: PRINTED NAME:
VID #
FORM TO BE COMPLETED BY STUDENT
DATE:
STUDENT SIGNATURE:
This form is required annually ONLY if the student has a positive TB skin test (TST or PPD) followed by a normal chest x-ray or has received BCG and has had a normal chest x-ray.
Centra Care, Florida Hospital Urgent Care & Valencia College Division of Health
Sciences are excited to be Health Partners providing you an opportunity to receive
your required Immunizations at a discounted rate at a Centra Care, Florida Hospital
Urgent Care location, or Centra Care Onsite services.
Immunizations Description Cost
Hepatitis B Vaccination # 1 $50.00 Hepatitis B Vaccination # 2 $50.00 Hepatitis B Vaccination # 3 $50.00
MMR Vaccination (No Pregnancy) $65.00 (at South Orange, Colonial Town, Waterford, Altamonte & Sanford only)
Varicella Vaccination (No Pregnancy) $95.00 (at Sanford & South Orange only )
Td Vaccination $25.00
TDAP $45.00
Influenza Vaccination $21.00
Lab Work:
Hepatitis B Titer (HBSAB) $50.00
Rubella Titer (RUBLG) $50.00
Varicella Titer (VARIGP) $50.00 PPD / TB:
PPD (Step One Only – No Pregnancy) $20.00
History of + PPD N/C
Health Review Form (HRF) N/C
