Clinical Placement
Guidelines
2014
Contact Numbers
Mt Helen
Clinical Office: (03) 5327 9635 or 53279835
Clinical Coordinator: (03) 5327 9669 After hours - 0428 172 866
Table of Contents:
Section 1: Introduction ... 3
1.1 Clinical Learning Program ... 3
1.2 Clinical Placement Allocation Process ... 5
1.2.1 Clinical Placement Allocation Consideration ... 5
1.2.2 Rosters ... 6
1.2.3 Cancelled Placements ... 6
1.2.4 Change of Address/Telephone Number ... 6
1.2.5 Paid Employment during Clinical Placement ... 6
1.2.6 Missed Placement days ... 6
1.2.7 Problems Arising During Clinical Experience ... 6
Section 2: Clinical Placement Requirements ... 7
2.1 Mandatory Documentation ... 7
2.1.1 Police Check ... 7
2.1.2 Working with Children Check ... 8
2.1.3 Immunisation and Consent Form ... 8
2.2 Student Responsibilities: Clinical Placement & Attendance ... 9
2.3 Uniforms and Professional Presentation ... 10
2.4 Professional Behaviour ... 11
2.4.1 Alcohol/Drugs ... 12
2.4.2 Confidentiality ... 12
2.4.3 Telephone calls while on placement ... 12
2.4.4 Responsibility as a Member of the Health Care Team ... 12
2.4.5 Standard infection control precautions ... 12
2.4.6 Manual Handling ... 12
2.4.7 Clinical Care Documentation ... 13
2.4.8 Transfer of patients/clients/residents/consumers ... 13
2.4.9 Medication Administration ... 13
Section 3: Clinical Placement ... 13
3.1 Clinical Supervision Models ... 14
3.2 Modes/Types of Clinical Placement ... 15
3.3 Clinical Placement Requirements……….15
3.4 Communication with Clinical Assessors……… ………….16
3.5 Assessment of Clinical Competence ... 16
3.6 Clinical Appraisal Tool booklet (Appendix A) ... 16
3.7 Completion of Clinical Placement Responsibilities …..……….16
3.8 Students at Risk ... 18
3.9 Reporting Incidents (Appendices F & G) ... 18
3.10 Non Medical Emergencies ... 19
Appendices: Appendix A: Clinical Placement Appraisal Tool ... 20
Appendix B: Minimum Competency Level... ... ...29
Appendix C: Absentee Record... ... ...31
Appendix D: Learning and Teaching Plan for At Risk Students... ... ...33
Appendix E: Clinical ‘At Risk’ Report... ... ...35
Appendix F: Injury Report... ... ...38
Appendix G: Sharps/Needlestick/Splash Injury Report ... .41
Section 1: Introduction
1.1
Clinical Learning Program
Clinical placement is an important component of your program of study, providing you with the opportunity to develop skills and integrate theoretical knowledge within nursing practice. Completion of the theoretical and clinical learning requirements of your program is essential to be eligible for registration with the Nursing and Midwifery Board Australia, Australian Health Practitioner Regulation Agency (AHPRA).
This information outlines the Clinical Placement Guidelines for the Bachelor of Nursing program. It is important that you familiarise yourself with this information which should be read in conjunction with the Faculty and University handbooks. While it is expected that attendance at clinical placements will require you to reorganise some aspects of your personal life it is anticipated that you will find this component of the program most rewarding as it provides you with a range of experiences and opportunities. Clinical Placements occur throughout the calendar year including semester breaks, school and public holidays. Therefore you are advised not to organise personal commitments until final clinical allocations for your particular clinical course have been published by the Clinical Office. Clinical placement dates are published at the beginning of each academic year.
Clinical placements and allocations are managed according to University and Health agency contractual agreements. Therefore, you are not to contact or organise your own clinical placements with external health agencies.
Clinical placements are determined by processes and availability within Regional, Metropolitan Victoria and Interstate agencies. As the University is situated in the Grampians region the majority of clinical placements occur throughout this region. Clinical placements and venues are subject to change. You will be expected to travel to achieve the clinical objectives of the program. This includes travel, parking and any associated accommodation costs related to clinical placement attendance. The Clinical Office will maintain a record of your clinical placement hours. Non-attendance at an allocated clinical
placement could result in a fail grade for the course. The clinical office will notify you of the days you are required to make up and supporting evidence, Medical/Health certificates for absences should be forwarded to the clinical office.
Details of rosters and attendance requirements specific to your allocated placement will be made available to you following publication of allocations. You are expected to attend all rostered shifts including morning, afternoon, night duty, weekend shifts and public holidays. A clinical week is from Monday to Sunday for all year levels. First year students are not permitted to do night shifts. It is your responsibility to fulfil the requirements of the allocated clinical placement and to familiarise yourself with health agency policies.
The following points may assist you to prepare for clinical placement:
• Be available for clinical placement dates
You need to be available for clinical placements as indicated by the Clinical Office. If you are allocated to attend clinical placement and have booked holidays, this will not be considered as a reason not to attend placement. You may have an opportunity to swap with other students.
• Apply early for the mandatory documents required for clinical placement
If you do not have the required mandatory clinical placement documents you will not be able to attend clinical placement and this will jeopardise your progression in the program.
• Make sure your contact details are current
It is your responsibility to ensure that your contact details are up to date at all times. Correspondence will be via your student email address only.
• Visit the Clinical Education websites frequently http://federation.edu.au/faculties-and-schools/faculty-of-health/school-of-health/student-resources/clinical-education/forms-and-guidelines
Comprehensive information regarding every aspect of your studies is available at this site. Check the site regularly and always on the Friday before going out on clinical placement. All useful and essential information about clinical placement will be there.
• Accommodation (Greater Green Triangle)
Accommodation is available at low cost at most Grampians health agencies outside Ballarat, however you do need to book early. Accommodation, travel and any related costs are your responsibility. Accommodation is also available through the Greater Green Triangle Network. Information relating to this is available on the Faculty of Health – Nursing website:
http://federation.edu.au/faculties-and-schools/faculty-of-health/school-of-health/student-resources
• Check Student Email Frequently
UB recommends all students check their UB email accounts at least twice weekly. Information about clinical placement will often be sent to your student email.
• Communication with Clinical Office
You can contact the Clinical Office via phone on 03 5327 9635 or 03 5327 9835 during office hours. When leaving a messageplease speak clearly and slowly leaving relevant contact details. You should only email the Clinical Office from your student email account and include your student ID, year level, and precise information about your concern and return contact information so the relevant staff member can contact you.
• Agency Details
Check that you know the address of the health agency, arrange appropriate transportation, and allow adequate travel time to arrive early. Parking can be a problem at some health agencies. Ensure you check which campus you are to attend if the health agency has multiple campuses. Confirm the starting time and meeting place for the first day.
Little Tips … For First Day of Placement.
Arrive early as parking may be an issue Take food, snacks and drinks
1.2 Clinical Placement Allocation Process
Allocation to a health care agency for clinical placement is determined by the objectives of your clinical course, and year level. The Clinical Office allocates appropriate placements that enable you to experience work-integrated learning and meet the objectives of the course. You will be emailed notification of your placement allocation approximately five weeks prior to commencement of your placement.
Following publication of allocations, you will have one working week (5 days) to swap your allocation with another student provided that:
• The one working week (5 day) timeframe is observed.
• Both students are enrolled in the same course, year level and program
• Both students agree to the change
• A Change of Allocation form is completed and signed by both students.
https://www.federation.edu.au/__data/assets/pdf_file/0018/52515/Placement-Swap-Form.pdf • Both students present to the Clinical Office with the completed form. Changes will not be
approved if one student only presents to the Clinical Office.
• The Clinical Office confirms the change as appropriate for each student’s clinical learning program.
A request to change your allocation does not guarantee approval. If you have difficulties arranging a change of allocation, please contact the Clinical Office as early as possible to discuss options.
1.2.1 Clinical Placement Allocation Consideration
You can apply for clinical placement consideration in extraordinarycircumstances. If you have extraordinary circumstances that may affect your ability to participate in a clinical placement you will need to complete the clinical placement consideration form stating your specific circumstances and attach supporting documentary evidence to your letter. This needs to be completed at least 10 weeks prior to clinical placement commencing. This is to be submitted to the clinical office.
http://www.federation.edu.au/__data/assets/pdf_file/0004/52492/Clinical-Placement-Consideration-Form.pdf
Extraordinary Circumstances include:
• Essential surgery (a medical certificate will be required)
• Medical conditions (a medical certificate will be required)
• Obligations to the armed forces or CFA or similar (Documentary evidence required)
• Requirements of Legal proceedings – supported with documentation
• Bereavement – supported by documentation
Extraordinary Circumstances do not include:
• Individual work commitments• Any kind of recreational leave, absence or holiday
Voluntary work commitments that are not university organised (other than army reserve or CFA or similar)
Clinical Placement Allocations cannot be:
• Split or delayed• Based upon individual shift requests
• Sourced by individual students
1.2.2 Rosters
Not all health agencies provide rosters prior to clinical placement commencing, many agencies negotiate rosters on your first day of placement. Rosters that are available will be emailed to you prior to placement commencing. As changes to rosters often occur, amended rosters will also be emailed to you. It is your responsibility to check your email regularly.
Whilst on placement, you may be able to negotiate shift changes. But please note that changes in the roster need to occur in a timely manner and the health agency must approve the swap and be
notified if any other changes occur.
1.2.3 Cancelled Placements
There are instances where clinical placements are unavoidably cancelled by health agencies. Where the cancellation is at short notice, an alternative clinical placement will be found for you, but it may be that you will be allocated to a different clinical venue at another time. Under these circumstances, you will need to communicate regularly with the Clinical Office.
1.2.4 Change of Address/Telephone Number
If your address and/or telephone number changes during the year it is essential that you notify the Clinical Office and Student Administration. It is your responsibility to ensure that your contact details are keep up to date at all times. Email correspondence will be via your student email address only.
1.2.5 Paid Employment during Clinical Placement
While we understand the pressures faced by students in relation to clinical placement, it is a
compulsory component of your course and needs to take precedent in your planning. We are unable to arrange clinical placements around individual work and family commitments. The quality of learning whilst on placement will be greatly enhanced if you are able to organise yourself in advance to ensure full attendance.
1.2.6 Missed Days / Non-completion of Required Clinical Placement Hours
The Australian Health Practitioner Regulation Agency (AHPRA) mandate the clinical hours required for registration as a Division 1 Nurse. You are required to complete all allocated clinical placements hours for each placement in order to gain your registration at the completion of the program. You are required to submit supporting documentation for missed clinical time at the end of the placement. Medical certificates, statutory declarations, and receipts of appointments should be forwarded to the clinical office. This evidence is filed and supports the allocation of additional placement hours (make up time) which you will be required to attend.
Makeup clinical placement time is not automatically available for students who, due to illness or other reasons, are not able to complete the hours required for any one clinical placement. Makeup time is dependent upon the health agency availability. You may be required to complete additional clinical placement hours either out of semester or in the next calendar year when it becomes available.
1.2.7 Problems Arising During Clinical Placement
If you have a problem whilst on clinical placement, clarification about the situation should be sought from the person(s) responsible. If the problem is related to a clinical situation you should consult your clinical educator and or health agency staff immediately. The Faculty process for problem resolution involves the following steps:
If the problem is related to:
• The course, the Course Coordinator should be contacted.
• The clinical placement, the Clinical Coordinator should be contacted. • The program, the BN Program Coordinator should be contacted.
The clinical office can be contacted during office hours Mon – Fri from 0900-1700. After hours or weekends a message can be left or email sent to the clinical office:
[email protected] or the clinical coordinator [email protected] and you will be contacted within 48hrs. In an emergency after hour situation only the clinical coordinator can be contacted on 0428 172 866.
Section 2: Clinical Placement Requirements
2.1 Mandatory Documentation
Health agencies mandate that you provide the following documents at the commencement of your clinical placement:
• National Police Check
• Working with Children clearance
• Immunisation Status clearance
• Consent form
These documents must be original, current and legible.
If you are not able to present the documents as required to the clinical office or to the health agency you will be not be permitted to attend placement. This will jeopardise your ability to complete your course and hinder your program progression and completion timeframes.
2.1.1 Police Check
http://www.police.vic.gov.au/content.asp?Document_ID=274Federal and State government legislation has made it mandatory for organisations providing services, such as child care, nursing and midwifery services, teaching and paramedic support to require
remunerated employees (staff) and non-remunerated employees (students) to provide a satisfactory Police Check to the employer. You must present your Police Check to health agency staff on your first day of placement and whenever requested.
You are required to provide a Police Check every calendar year to the clinical office. This is due at the end of week 1 of the academic calendar every year. For midyear intake students this is due week 1 entering the program in 2nd semester.
The process to obtain a police check can take up to ten (10) weeks. You are advised to apply the first week of January every year of your course. If the forms are not completed correctly they will be sent back to you, so please check them carefully before submission.
In the event that you have a disclosure on a Police Check, it is your responsibility to ensure that any disclosure is discussed with an appropriate agency representative prior to commencement of clinical
representatives. These matters are managed sensitively and with discretion. A disclosure on the certificate does not mean you will be prevented from attending a placement.
Procedure for a Lost or Destroyed Police Check
• Inform the Clinical Office immediately• Apply for a new Police Check immediately.
• Complete a statutory declaration form, detailing the circumstances of the loss of the document, steps which have been taken to obtain a replacement, including a precise timeframe, and have the document signed by a person authorised to sign such documents.
• Bring the statutory declaration to the Clinical Office.
• The Clinical Office will contact the health agency regarding your clinical placement.
• If a health agency refuses your attendance for clinical placement, the Clinical Office will approach another health agency regarding your clinical placement, but there is no guarantee of acceptance.
2.1.2 Working with Children Check (WWC)
http://www.justice.vic.gov.au/workingwithchildren/You are required to provide a WWC to the clinical office at the commencement of your BN program. The WWC is valid for 5 years so you only need to do this once. There is no cost for this check but it can take up to 10 weeks to arrive so please allow for processing time.
If you do not obtain a WCC or fail to present the WCC for sighting by the Clinical Office you will not be able to attend clinical placement.
2.1.3 Immunisations and Consent Form
You are required to comply with the Health Departments Immunisation guidelines to enable you to meet health agency requirements. It is your responsibility to ensure immunisations are current. You will be required to present documentation to individual health agencies or sign statutory declarations regarding your immunisation status.
Vaccinations required for the Bachelor of Nursing program are:
• Hepatitis B
• Measles, Mumps and Rubella (MMR)
• Diphtheria, Polio, Tetanus and Pertussis (ADT)
• Varicella (Chicken Pox)
• Annual Influenza vaccine is highly recommended, and is compulsory for some placements. You can obtain evidence of immunisation status by attending your General Practitioner or Federation University Health Clinic. You should ensure that you obtain a letter /certificate of immunisation status.
Consent
Form https://www.federation.edu.au/Schools/School-of-health/student-resources/clinical-education/forms-and-guidelines/Clinical-Placement-Consent-Form.pdfA consent form is to be completed by all students commencing the BN program. The consent form must be signed and submitted to the clinical office at the end of week one of your commencing semester. This form is available on the Faculty of Health Website. This is to be submitted with your National police clearance and your working with children’s check.
that patient safety may be compromised, you may be refused access to the health agency and this may jeopardise your progress in the program.
2.2. Student Responsibilities: Clinical Placement
Clinical Attendance
You are required to complete all the clinical hours / days outlined in your course descriptor.
Clinical educators will monitor your attendance and will communicate with the Clinical Office regarding absences. They are also required to submit an absentee record (Appendix C) at the end of each placement to the clinical office.
Following completion of a clinical placement, it is your responsibility to scan the original completed clinical appraisal tool and submit via Moodle (see page 17 for details). You should ensure this document has been signed by appropriate health agency staff.
It is very important that you submit sick certificates or proof of missed days such as statutory declarations, and receipts of appointments at the end of your placement. Original copies must be submitted directly to the clinical office. See p. 7
Shifts
You are expected to attend all shifts rostered to you including morning, afternoon, night duty,
weekend shifts and public holidays. A clinical week is from Monday to Sunday for all year levels. First year students are not permitted to do night shifts. It is your responsibility to fulfil the requirements of the allocated clinical placement and to familiarise yourself with health agency policies.
In some instances you may be rostered for either longer or shorter days. If so, this will be clearly specified. It is your responsibility to check your start and finish times. Night duty is not required by first year students.
Illness
If you become ill during the course of a shift, and have worked four or more hours, this may at the discretion of the clinical educator and/or course co-ordinator, be counted as a full day. You will need to provide evidence of illness if any further time is missed.
Absence: Required Notification Process
If you are unable to attend a clinical placement you must notify the clinical educator or health agency staff in a timely manner. If you have difficulty contacting the relevant person, you must contact the Clinical Office. This can be via phone or email. The clinical office will then notify the health care agency. Please contact the health agency in the first instance as they do get concerned about your wellbeing.
If you are unable attend an allocated shift, those hours will be recorded as absent. Failure to provide evidence to support an absence and or any prolonged absence will result in you having to make up the time missed or repeating the placement.
If you are aware that you will be away from your clinical placement for a prolonged period, the Clinical Office should be notified as soon as possible. You should also consider contacting the BN program coordinator to discuss special consideration options.
Post Clinical Debriefing
Debriefing is an opportunity to reflect in a constructive way on the positive and sometimes challenging issues or experiences you may have encountered during your day/week whilst on clinical placement. It is also an opportunity to support other students, ask questions and to prepare for the next day. Attendance at post clinical debriefings is compulsory. If you are having issues on placement or require further support it is advisable to contact your clinical educator as soon as possible. Also your course coordinator is available to discuss your concerns.
Punctuality/ Lateness
You are expected to present punctually to clinical placement. If unable to attend or if you are running late you must notify the health agency immediately. Punctuality is part of professional practice and is integral to your clinical learning experience.
2.3 Uniforms and Professional Presentation
Personal presentation, whilst on placement should be reflective of a student representing the Faculty of Health and the University. Professional appearance and behaviour is to be maintained at all times. The uniform is available at the UBuy shop Mt Helen Campus.
Your official uniform and name badge clearly identifies that you are a student of Federation University and must be worn to and from clinical placement unless otherwise directed. Improper attire may result in being asked to leave the venue and recorded as absent for that shift unless it is a designated “non-uniform” placement
If you are attending clinical placements which stipulate ‘non – uniform’ – for example mental health agencies – you may be requested to alternatively wear neat, clean professional clothes with closed-toe shoes, as approved by the health agency. Inappropriate attire such as jeans and tracksuits will not be tolerated. In the event that your professional appearance is inappropriate you will be sent home and this will be counted as a missed placement day.
It is recommended you purchase at least two uniforms. The uniform should be freshly laundered, ironed, stain free, in good repair and appropriately sized. Footwear must be closed-toe with non-slip sole. Hair must be clean. Long hair must be styled neatly and tied up off the collar so that it does not come into contact with either the client/patient, equipment or other items. Beards should be trimmed and tidy. Fingernails should be clean, short and free of nail polish. Ornamental jewellery is not to be worn, with the exception of a wedding ring, plain earrings, sleepers or small studs or a fob watch with a second hand. Any jewellery associated with body piercing should be removed or covered. Wrist watches and bracelets are not to be worn whilst on clinical placement.
The Faculty approved Bachelor of Nursing uniform is: FEMALE: Navy trousers or knee length skirt
Federation University shirt
Navy cardigan, and/or Navy V-Neck long sleeved jumper Tights - natural or navy colour – optional
Socks – Navy or Black
Socks - navy or black
Shoes - navy/black lace-up duty shoes
NOTE: Cardigans or jumpers must only be worn to and from placements.
2.4
Professional Behaviour
As a student, your role is to participate fully in the clinical placement. Your clinical placement
experience is designed to provide you with opportunities to develop and extend your knowledge, apply skills and appreciate values whilst participating, observing and performing as a student in a variety of professional nursing practice settings. The relationship between patient/client/resident/consumer and health care professional should always be safe, helpful and therapeutic and within the ethical and professional boundaries determined by the nurses professional code of conduct.
Whilst on clinical placement, you are expected to:
• Be punctual
• Dress professionally at all times
• Clearly wear student identification
• Introduce yourself as a student
• Maintain confidentiality of information
• Accept responsibility for all relevant aspects of nursing care within the limitations of your role as determined by the clinical preceptor/educator/supervisor
• Behave in a respectful manner to colleagues, supervisors, patients/clients/residents/consumers, carers and their families;
• Not use electronic communication devices such as mobile phone whilst rostered on clinical shifts – meal breaks excepted;
• Acknowledge and respond respectfully to individual patient, client, resident or consumer needs
• Respond professionally to the requests of the health agency and its staff
• Present and complete each shift as rostered
• Comply and be familiar with health agency policies and procedures
• Notify the relevant person if you are unable to attend rostered shift/s.
Whilst you are on placement you are accountable for your conduct to your clinical educator and health agency staff. The clinical coordinator and course coordinator are ultimately responsible for the
management of clinical placement performance issues, in conjunction with the relevant clinical assessor/s and health agency staff.
Behaviour in the clinical setting, which jeopardises other people’s safety, will result in immediate withdrawal from the clinical setting and automatic failure of that course.
Conduct, whilst on placement or in accommodation, that brings the Discipline of Nursing and/or the University into disrepute will result in immediate withdrawal from the clinical placement and automatic failure of that course. A disciplinary hearing may be held as set out in the University Handbook under Statute 6.1 Student Discipline.
In the event that you have been negligent, the University insurance policy does not protect you from either the health agency and/or the patient/client/resident/consumer taking legal action against you.
2.4.1 Alcohol/Drugs
It is expected that you will not present for clinical placement under the influence of alcohol and or drugs. These substances have the potential to effect performance which may jeopardise your ability to complete your course and hinder your program progression and completion timeframes.
2.4.2 Confidentiality
You will have access to identifying information about the people for whom you provide care. Therefore you need to be familiar with, and understand, the relevant requirements of maintaining confidentiality and privacy of information. You are expected to maintain the privacy of information relating to the people for whom you care.
You must sign the Faculty of Health Confidentiality Agreement in your Clinical Placement Appraisal Tool (Appendix A) prior to going on placement. An academic within the Discipline of Nursing must countersign the agreement. If for some reason you have not signed your confidentiality form prior to attending placement it can be signed on day one of your placement by your clinical educator. Some agencies may refuse to accept you for placement if you fail to produce a signed confidentiality agreement when requested.
Discussion and/ or photographs relating patients, clients, staff or agencies via electronic technology including Facebook or mobile phones, or in public spaces must not occur. This behaviour not only compromises the individual's security, but litigation may result. This is an issue which is taken very seriously and failure to observe appropriate professional conduct may result in instant termination of your clinical placement and a subsequent disciplinary hearing.
2.4.3 Telephone calls while on placement
Mobile phones must be turned off/silent/vibrate during each shift and must be placed in your bag. You are not permitted to carry a phone while in the clinical setting or working with clients. Please note that in some clinical settings you may be required to leave your mobile phone deposited in a secure area.
2.4.4 Responsibility as a Member of the Health Care Team
While on placement you are regarded as a member of a health care team. You are to follow the directions of your clinical educator/preceptor and health agency staff. If you are uncertain or unclear of a given direction, please seek clarification before commencing the activity. You may choose not to participate in a clinical activity if you do not feel adequately prepared or competent; however you should discuss this with your clinical educator.
2.4.5 Standard infection control precautions
You are required to be familiar with, and abide by, the health agencies written policies regarding the handling of bodily fluids, standard precautions and isolation. Standard infection control precautions are work practices required for the basic level of infection control. These are available from your clinical educator. They include good hygiene practices, particularly use of hand hygiene products, washing and drying hands before and after patient contact, the use of protective barriers (which may include gloves, gowns, plastic aprons, masks, eye shields or goggles), appropriate handling and disposal of sharps and other contaminated or infectious waste, and use of aseptic techniques.
2.4.6 Manual Handling
and year of study. It is your responsibility to ensure that you are competent at using safe manual handling techniques and manual handling equipment to protect yourself and your colleagues from injury. You will be working under the supervision of a registered nurse / midwife. It is important that you always assess patients prior to moving them to identify the correct safe manual handling
technique. This is required to move each client safely and prevent injuries to your colleagues and yourself.
2.4.7 Clinical Care Documentation
At all times, you must comply with health agency policies and standards for documentation of clinical care. All students are expected to complete documentation and handover of their clients with the supervision of their clinical educator or preceptor. All written notes are to be checked and counter signed by the clinical educator or preceptor.
2.4.8 Transfer of clients/residents/consumers
You will need to follow health agency policy regarding transfer procedures and be accompanied by a clinical educator or health agency staff. If you are transferring clients to and from the peri-operative area, or on life-support/monitoring systems, or to other agencies, you must be accompanied by a registered nurse division one. You may accompany clients for investigative procedures if the person would not normally be accompanied by a member of staff and consents to you being an observer. You may accompany clients in non-acute settings on external activities, such as a walk, or outings with the consent of health agency staff.
2.4.9 Medication Administration
You are permitted to administer topical, oral, IM, IV and sub cut medications during clinical placement as per the guidelines of your course descriptor and clinical objectives book. You can only perform these skills in accordance with the health agency policies and procedures, and under the supervision of a Division 1 registered nurse or registered midwife. The protocol of the health care venue must be always followed with respect to checking, administering and documenting of medications.
Under no circumstances should you administer a medication without direct supervision of a registered division one nurse.
Section 3: Clinical Placement
During your clinical placement, your clinical educator or preceptor should be a registered division one nurse or midwife. In some instances you may also be supported on your placement by an enrolled nurse, particularly in aged care and sub-acute placements; however it is the responsibility of your clinical educator or preceptor to assess your overall competence against the ANMC competency standards and sign your clinical books. It is your responsibility to present these documents to your clinical educator/ preceptor every day you attend placement. Also it is your responsibility to have and be familiar with the current clinical guidelines and clinical books of your course. It is not the
responsibility of the clinical venue to be printing your clinical books. If the assessment for another course in which you are enrolled is linked to the clinical placement, you should also present this document.
The clinical agencies are sent details of who is attending placement a month before you attend. They are also sent a copy of the clinical placement guidelines, the clinical appraisal tool and the clinical objectives book.
3.1 Clinical Supervision Models
There are generally two models of clinical supervision: Clinical Educators (CE) or Clinical Preceptors. Both have similar functions to provide support and supervision for students while on clinical
placement. They are also responsible for assessing your progress and signing off your clinical books at the end of placement. Ultimately the final grade for your clinical placement is the responsibility of your course coordinator and the University.
Clinical Educators
Responsibilities of a Clinical Educator include negotiating with hospital staff to ensure that you are allocated a workload that is commensurate with your progress and level of competence within the program, and enables you to meet relevant course objectives. The clinical educator may have a group of students to supervise at any one time and you will be allocated to work with another registered nurse or preceptor. The clinical educator will oversee your placement and may provide debriefings and work with you individually throughout the course of the day. Your clinical educator will liaise with the clinical staff in relation to your progress on clinical placement. They are also
responsible for assessing your progress and signing off your clinical books at the end of placement.
Preceptors
A preceptor is a qualified experienced practitioner who is formally assigned to provide individual support to students. The role is very similar to that of the clinical educator except that preceptors generally work with one student per shift. Overall they may have a number of students they are supporting in a set clinical environment. They are also responsible for assessing your progress and signing off your clinical books at the end of each shift. In most instances you will have more than one preceptor on your placement. Health venues have various processes in place to ensure that students’ progress is monitored to ensure continuity of assessment and a final grade at the end of placement.
Clinical Liaison Nurses
Clinical liaison nurses are currently working in the Grampians region to support and provide education to health agency staff in the region about your program of nursing study. . They are a liaison person between Federation University and the health care agency; they assist in sourcing new learning opportunities for students, and assist the role of the clinical coordinator in working with health agency staff to support students while on placement.
3.2 Modes / Types of Clinical Placement
There are currently two modes of clinical placement at Federation University. Block Placement and Flexible (Flexi) Placement.
Block Placement:
Clinical Placements occur throughout the calendar year including semester breaks, School and public holidays. Clinical placement dates are published at the beginning of each academic year.
Block placement occurs in first, second and third year. The length of clinical blocks varies from year to year, however most are 4 weeks in duration except in third year.
Many of the Grampians health services provide low cost accommodation and some support with meals.
Flexible Placement: (Currently third year students only)
Flexible clinical placement is simply “part time” placement. The placements occur over the entire academic year. They vary in length with the different health care agencies. In semester 1 the flexible placement can be anything from 10 - 14 weeks long. In semester 2 the flexible placement can range from 20 -24 weeks. A flexible placement allows you to manage your studies, work and family
commitments around your placement roster.
Students on this type of placement are able to self-roster 1 to 3 shifts per week (Mon – Sun) within a determined roster set by the nurse unit manager or clinical educator. There needs to be equity with the allocation of shifts on placement and there will be times when the roster that you request will not be met in order to ensure all students have a fair and workable roster. The shifts include AM, PM and ND, but please note you are not permitted to work only weekend or night duty shifts. The clinical hours of flexible placement are the same as those of block placement but are completed over a longer time frame. Students on this type of placement are not permitted to work more than 3 shifts per week. In semester one students are required to work no more than 2 shifts per week to facilitate the
scheduling of lectures/ tutorials or laboratories with clinical placement.
Students need to arrange their rosters to allow for lecture and tutorial attendance. Most classes will be flexible with course content made available online. There may be some mandatory class attendance. You will need to negotiate the possibility of your absence from course content with your course coordinators. Please check the requirements of class attendance in your course descriptor prior to organising your roster. Flexible placement also means that if you are unwell over placement you will also be able to make up the time during your placement. You will also be able to work around Graduate Year interviews that occur in semester 2.
3.3 Clinical Placement Requirements
It is a requirement that you will bring items with you to clinical placement that will assist your transition into clinical practice.
What to Bring the First Day of Placement
• Victorian Police Check• Working with Children’s Card
• Immunization Record
What to Bring Every Day of Placement
• All your clinical books and course descriptor in a folder
• Blue/black pen
• Watch with a second hand or digital face
• Pair of scissors, 15cm blunt/sharp
• University name badge
• Writing paper
First Day /Orientation
• You will meet your clinical educator/ preceptor at an allocated time and location. This information is sent to you prior to attending placement. Please read it carefully
• You will need to present your Police Check, Immunisation record, and Working with Children Card.
• Your clinical educator/ preceptor will conduct an orientation to the health agency, including Basic Life Support and Occupational Health and Safety.
• Orientation may take a half or full day and is a mandatory requirement of your placement
• In some agencies this may be the time that your roster is organised.
3.4 Communication with Clinical Education Staff
In some health agencies, your clinical education staff may have a variety of means of communicating with you, including pagers or mobile phones. You need to ask for relevant contact details. If you have consistent trouble finding your clinical assessor over more than one day, please contact the Clinical Office.
3.5 Assessment of Clinical Competence
You are required to meet the Nursing and Midwifery Board Australia (NMBA) competencies for the registered nurse as described in the Clinical Appraisal Tool booklet (Appendix A & H). Further detail concerning this assessment will be found in the clinical course descriptor for your course of study. The requirements to pass clinical placement advance each year so please make sure you are aware of the clinical requirements of your course prior to attending your placement. Your final summative assessment while on placement is to be conducted by a division one registered nurse only. However the final grade that you will be allocated for clinical placement is managed by your course coordinator and the university. This is a requirement of NMBA.
It is your responsibility to ensure that all course assessments are completed and submitted by the assigned date and time to your course coordinator. The date and time for this will be in your course descriptor. Students who submit incomplete and unsigned clinical books will be required to resubmit their books once they have been completed.
3.6 Clinical Appraisal Tool (Appendix A)
This can be accessed via the Faculty Clinical Education website and on Moodle under the relevant course of enrolment. It is your responsibility to take your booklet to each clinical placement. You will be assessed at the mid- and end- points of each clinical placement in your program of study. During your clinical placement, it is your responsibility to ensure that you are given regular feedback about your performance, the two formal assessments are to be completed by a division one registered nurse and you are to complete the student sections in your clinical appraisal tool.
3.7 Completion of Clinical Placement Responsibilities
It is your responsibility to scan and submit the original signed copy of your clinical appraisal tool.
A Scanned PDF file should be uploaded onto Moodle by the date detailed in the relevant course descriptor. You are advised to keep an electronic copy of the original document for your own records as you may require this evidence for future graduate employment.
It is advised that you use the library facilities for scanning and uploading of the appraisal tool due to the large size of the document.
Students are not required to submit documentation in support of clinical absence to Course Coordinators. Such documentation is to be handed directly to the Clinical office.
3.8 Students at Risk
Unsatisfactory Clinical Performance
If you’re clinical performance is considered to be of concern or unsatisfactory, the following procedure applies:
1. In the first instance, the clinical educator/ preceptor or health agency staff will informally approach you and confidentially investigate the areas of concern/risk.
2. This does not mean you will fail the placement but it will be an opportunity to discuss any concerns or issues both you and your educator may have about your placement/performance. 3. In this instance your clinical educator will contact the clinical office and speak to the clinical
coordinator. The educator will also develop learning objectives for you to achieve. These are to be written in your clinical appraisal tool
4. In the event that you are deemed ‘at risk’, the area of unsatisfactory practice will be documented and you will receive appropriate counselling.
5. If the educator/ preceptor remains concerned with your performance then the Clinical at Risk Report (Appendix E) will need to be completed. You are required to counter sign the Clinical at Risk Report with your clinical educator and this is forwarded to the University and Clinical Coordinator.
6. If required the clinical coordinator and course coordinator may attend this meeting or phone in or video link for the meeting. Alternatively a clinical liaison nurse may attend the meeting on behalf of the university.
7. At this time the Learning and Teaching Plan for at Risk Student (Appendix E) will be completed to enable you and your clinical assessor to identify areas for improvement,
determine appropriate strategies and establish timeframes. You are responsible for all aspects of learning and must demonstrate professionalism at all times
8. The Clinical at Risk Report and the subsequent learning and teaching plan are aimed to highlight areas of concern with your nursing practice and also support you in your learning while on placement.
9. A Clinical at Risk Report does not mean that you will automatically fail your placement but offers you an opportunity to demonstrate an improvement in your learning to a satisfactory standard in a supportive nursing environment.
Unsafe practice and unprofessional conduct
If you demonstrate unsafe and or unprofessional conduct at any time during the clinical placement, the following procedure applies:
• You will be immediately contacted by your clinical educator / preceptor and counselled about your professional practice or conduct
You may be removed from the clinical area until the university has been contacted.
• The Clinical Coordinator will be advised as soon as practical. If the incident occurs overnight it will be the next day.
• A Clinical At Risk Report (Appendix E) will be completed so as to clearly identify those areas in which you have been deemed unsafe and or unprofessional will be completed by the clinical assessor and forwarded to the Clinical Coordinator.
• The issue will be fully investigated and documented. Your course coordinator and the BN program coordinator will be informed.
• You will not be permitted to return to the clinical area until authorised by the health care agency, your clinical educator or the clinical office.
•
Depending on the decision made by the health care agency and the university, the BN program coordinator, clinical coordinator and course coordinator will meet with you to determine your progression in the course and the program.3.9 Reporting Incidents (Appendices G & H)
It is important that you engage in work practices designed to eliminate or minimise reportable incidents. The reporting of incidents and near misses is a part of the accreditation process by all health care facilities in accordance to the Occupational Health and Safety Act Victoria. The reporting of any incident or near miss is essential. If you identify an incident or near miss while you are on placement you must report it immediately to your clinical educator who will follow the relevant health agency occupational health and safety procedures and notify the clinical office.
Reportable incidents will fall into two broad categories:
Incidents reportable according to health agency policy
The form supplied by the health agency must be completed and signed by all appropriate staff members before the end of that clinical shift. The Clinical Office must be notified and a copy of the incident report forwarded as soon as possible.
Incidents involving injury to Federation University students or clinical educators:
Federation University “Notification of Injury” form (Appendix F) must be completed and returned to the Clinical Office with a copy of the relevant medical certificate. In addition, a health agency incident form must be completed. Where appropriate, a Federation University Sharps/Needle stick/Splashes Injury
(Appendix G) form should be completed. If you are exposed to contaminated or uncontaminated injury involving sharps, needle sticks or splashes, the Sharps, Needle Stick and Splash Injury Guidelines
found on the Clinical Website should be followed. Ifthe injury warrants medical attention, you should seek medical assistance from the nearest appropriate Emergency Department.
3.10 Non Medical Emergencies
You are expected to familiarise yourself with emergency procedure protocols in your allocated health agency, including exits, internal evacuation or safe areas, fire extinguishers, emergency chimes and colour codes of specific emergencies. In the event of an emergency, you will be directed by the designated area warden. These directions must be followed accurately and promptly.
Faculty of Health - Nursing
Clinical Placement
Appraisal Tool
Appendix A:
APPENDIX AThis appraisal tool is based upon the Nursing and Midwifery Board Australia Competency Standards for the Registered Nurse in four domains:
1. Professional Practice, 2. Critical thinking & Analysis, 3. Provision & Coordination of Care, 4. Collaborative & Therapeutic practice
The Bondy Scale is used for assessment of performance in all clinical c ourses in the Bachelor of Nursing. Five levels are used and are descriptively labelled: Independent (I), Supervised (S),
Assisted (A), Marginal (M) and Dependent (D). Each level is defined by the description of
characteristics in three areas: Professional standard, Quality of performance and Assistance required. To successfully complete clinical placement, the student must achieve the required levels as
described in the relevant clinical placement course descriptor.
Following completion of a clinical placement, it is your responsibility to: submit a copy of your clinical appraisal tool via Moodle as per the relevant course descriptor and documentation to support any absence such as Medical Certificates should be handed in at the Clinical office (see page 17 for details).
Student Name (Please print clearly) Student ID Number Course Code Course Coordinator Health Agency Placement Dates Completed Days/Hours Assessment Result (please circle) Satisfactory/ Unsatisfactory Clinical Assessor/s* (name, signature, date)
*A Clinical Educator/ Preceptor must be a Nursing and Midwifery Board Australia (NMBA), Australian Health Practitioner Regulation Agency (AHPRA), registered division one nurse or midwife.
Confidentiality Agreement
BETWEEN: The FACULTY OF HEALTH at Federation University, of University Drive, Mt Helen, Victoria (“the University”) and
The Student... (“the Student”)
(Print Name)
RECITALS:
A. The Student is a student of the University who is undertaking external clinical placement that will form part of their course work with the University.
B. To protect Confidential Information which may be disclosed to the Student in relation to the clinical placement, the Student has agreed to the following terms and conditions.
AGREEMENT:
Definitions:
1. “Agency” means the external Hospital or Health Care Centre where the clinical placement is being conducted; “Confidential Information” means any information whether written or oral provided by one party to another party on or after the date of this agreement in connection with the clinical placement including without limitation any clinical information on patients and of other information concerning the Agency which is deemed confidential.
2. All information submitted by the Agency to the Student, shall be kept confidential and shall not be disclosed to any other party without the prior written consent of the Agency.
3. The Student agrees to comply with any terms and conditions under which the clinical
placement is conducted particularly relating to their duty of confidentiality under Section 141 of the Health Services Act.
4. In the event the Student requires access to current and archival patient medical records for the purposes of formal research the Student will seek approval from Agency’s Ethics Committee before commencing such research.
5. This agreement shall be governed by and construed in accordance with the laws of the State of Victoria.
EXECUTED AS AN AGREEMENT
Dated this ... day of ... 201..
Signed by the Student (Print Name)...Signature...
In the presence of: (Print Name)...Signature………... (Name of SON Staff Member)
Clinical Learning Plan
Prior to the commencement of your clinical placement you need to identify your clinical learning objectives and write these in the space provided below. On the first day of placement, you will need to discuss your objectives with your clinical assessor and document how you will achieve these
objectives.
Student Learning Objectives:
Teaching / Learning Strategies
Student Name & Signature Date
Clinical Assessor Name & Signature
Mid-Point Assessment (Formative):
To be completed by midway through the placement
Domain 1: Professional Practice
Relates to the professional. Legal and ethical responsibilities which require demonstration of a satisfactory knowledge base, accountability for practice, functioning in accordance with legislation affecting nursing and health care, and the protection of individual and group rights.
Student self-appraisal*
Clinical assessor appraisal*
I S A M D I S A M D
Practises in accordance with legislation affecting nursing
practice and health care
Practises within a professional and ethical nursing framework
Domain 2: Critical Thinking and Analysis Relates to self-appraisal, professional development and the value of evidence and research from practice. Reflecting on practice, feelings and beliefs and the consequences of these for individual groups is an important professional benchmark Student self-appraisal* Clinical Assessor appraisal* I S A M D I S A M D
Practises within an evidence-based framework
Participates in the on-going professional development of self
and others
Domain 3: Provision & coordination of care
Relates to the coordination, organisation and provision of nursing care that includes the assessment of individuals/ groups, planning, implementation and evaluation of care
Student self-appraisal*
Clinical Assessor appraisal*
I S A M D I S A M D
Conducts a comprehensive and systematic nursing
assessment
Plans nursing care in consultation with individuals or groups,
significant others and the interdisciplinary health care team Provides comprehensive, safe and effective evidence-based
nursing care to achieve identified individual or groups health
outcomes
Evaluates progress towards expected individual/group health outcomes in consultation with individuals/groups, significant
others and interdisciplinary health care team
Domain 4: Collaborative & therapeutic practice Relates to establishing, sustaining and concluding professional relationships with individuals/groups. This also contains those
competencies that relate to the nurse understanding their contribution to the interdisciplinary health care team
Student self-appraisal*
Clinical Assessor appraisal*
I S A M D I S A M D
Establishes, maintains and appropriately concludes
therapeutic relationships
Collaborates with the interdisciplinary health care team to provide comprehensive nursing care
Mid-Point (Formative) Feedback Summary
Clinical Assessor: additional comments and strategies for improvement
(Please make general comment on the four main areas of the appraisal tool – professional practice, critical thinking & analysis, provision & coordination of care, collaborative & therapeutic practice)
Clinical Assessor Name: Signature: Date:
Student: Revised learning outcomes
Clinical Assessor Name: Signature: Date
Student Name: Signature Date
Final Clinical Placement Assessment (Summative)
To be completed by the end of the placement.
Domain 1: Professional Practice
Relates to the professional. Legal and ethical responsibilities which require demonstration of a satisfactory knowledge base, accountability for practice, functioning in accordance with legislation affecting nursing and health care, and the protection of individual and group rights.
Student self-appraisal*
Clinical assessor appraisal*
I S A M D I S A M D
Practises in accordance with legislation affecting nursing
practice and health care
Practises within a professional and ethical nursing
framework
Domain 2: Critical Thinking and Analysis Relates to self-appraisal, professional development and the value of evidence and research from practice. Reflecting on practice, feelings and beliefs and the consequences of these for individual groups is an important professional benchmark Student self-appraisal* Clinical assessor appraisal* I S A M D I S A M D
Practises within an evidence-based framework
Participates in the on-going professional development of
self and others
Domain 3: Provision & coordination of care
Relates to the coordination, organisation and provision of nursing care that includes the assessment of individuals/ groups, planning, implementation and evaluation of care
Student self-appraisal*
Clinical Assessor appraisal*
I S A M D I S A M D
Conducts a comprehensive and systematic nursing
assessment
Plans nursing care in consultation with individuals or groups,
significant others and the interdisciplinary health care team Provides comprehensive, safe and effective evidence-based
nursing care to achieve identified individual or groups health
outcomes
Evaluates progress towards expected individual/group health outcomes in consultation with individuals/groups, significant
others and interdisciplinary health care team
Domain 4: Collaborative & therapeutic practice Relates to establishing, sustaining and concluding professional relationships with individuals/groups. This also contains those
competencies that relate to the nurse understanding their contribution to the interdisciplinary health care team
Student self-appraisal*
Clinical Assessor appraisal*
I S A M D I S A M D
Establishes, maintains and appropriately concludes
therapeutic relationships
Collaborates with the interdisciplinary health care team to provide comprehensive nursing care
Final (Summative) Feedback Summary
Clinical Assessor: additional comments and strategies for improvement
(Please make general comment on the four main areas of the appraisal tool – professional practice, critical thinking & analysis, provision & coordination of care, collaborative & therapeutic practice)
Clinical Assessor Name:
Signature: Date
Student Comments
Clinical Assessor Name: Signature: Date
Appendix 1: Bondy Scale
The Bondy Scale* is used for assessment of performance in all clinical c o u r s e s in the Bachelor of Nursing. Five levels are used and are descriptively labelled: Independent (I), Supervised (S), Assisted (A), Marginal (M) and Dependent (D). Each level is defined by the description of characteristics in three areas; these being,
Professional standard, Quality of performance and Assistance required.
It is important to remember that students are not master practitioners. The aim is to prepare them to be beginning level practitioners. Differing levels of skills are to be expected.
SCALE PROFESSIONAL STANDARD QUALITY OF PERFORMANCE ASSISTANCE REQUIRED
INDEPENDENT (I) Safe; accurate; achieves the
intended purpose each time; performs in an appropriate manner each time
Proficient; coordinated; confident; occasional expenditure of excess energy; performs within an expedient time period
Without supporting cues
SUPERVISED (S) Safe; accurate; achieves the
intended purpose each time; performs in an appropriate manner each time
Efficient; coordinated; confident; occasional expenditure of excess energy; performs within an reasonable time period
Occasional supportive cues (e.g. comments such as ‘that’s right’, ‘keep going’ are supportive cues)
ASSISTED (A)
Safe; accurate; achieves the intended purpose most of the time; performs in an appropriate manner most of the time
Skilful in parts of the behaviour; inefficient and un-coordinated; expends excess energy; performs within a delayed time period
Frequent verbal and occasional physical directive cues (in an attempt to correct activity or indicate what is required next) in addition to supportive ones.
MARGINAL (M) Safe, but not alone,
performs at risk; not always accurate: Occasionally achieves the intended purpose; Occasionally performs in an appropriate manner
Unskilled; inefficient, considerable expenditure of excess energy; performs within a prolonged time period
Continuous verbal directive, and frequent physical directive cues
DEPENDENT (D) Unsafe; unable to
demonstrate intended behaviour
Unable to demonstrate procedure or behaviour; lacks confidence; lacks coordination, lacks efficiency
The cues are so
directive and continuous that it is as if the
supervisor is performing the behaviour or skill * This criterion - referenced rating scale was constructed and validated by K.N. Bondy (1983, 1984). It has also been utilised and validated by Hawly & Lee (1991) and Tower & Majowski (1987). The scale has been adapted for use in the Bachelor of Nursing program at Federation University
APPENDIX B
Faculty of Health - Nursing
Minimum Competency
Levels
APPENDIX C
Faculty of Health - Nursing
Absentee Record
To be completed and submitted by the Clinical Educator only to Federation University at the end of each placement
Hospital/Agency: Ward/Unit:
Circle Year of Student: 1st Year 2nd Year 3rd Year
Student Name Date(s) Absent Evidence (eg Medical Certificate)
MAKE UP TIME
Please indicate in the table below if the student has made up completed any absent days
Student Name Make up time completed in lieu of absent days
Clinical Educator Name & Signature Date
This
Absentee Record
is to be faxed, scanned or posted to the Clinical Office by the Clinical
Educator at the end of placement.
Scan/Email: [email protected]
Fax: 5327 9240
Faculty of Health - Nursing
Learning and Teaching
Plan for ‘At Risk’
Learning and Teaching Plan for At Risk Students
Student Name:
Student ID
DUE DATE OF FINAL COMPLETION:
I have read and understood the requirements outlined above. I am aware that if I do not satisfactorily meet the requirements of the Plan within the stated time frame this outcome will be referred to the Clinical Coordinator and relevant course coordinator. This may result in a fail grade being awarded for this course which will jeopardise my program progression and completion timeframes.
Student Name & Signature
Clinical Educator Name & Signature
Date: Date:
Goals / Objectives
Strategies to assist student Due Date Evidence of satisfactory completion by student
Completed Sign & Date
APPENDIX E
Faculty of Health - Nursing
Clinical ‘At Risk’ Report
SECTION 1: STUDENT DETAIL (Please COMPLETE ALL AREAS in Section 1 & 2) SURNAME:
FIRST NAME:
STUDENT NO:
CE/PR/RN LOCATION: (Hospital & Ward) DATE OCCURED: TIME:
DAY & DATE WHEN STUDENT NOTIFIED OF BEING ‘AT RISK’: Day: Date: / / Section 2: CE/PR INSTRUCTIONS: Identify reason for unsatisfactory rating -relate to the ANMC (2006) Competency Domains, action taken and outcome.
Performance Criterion and Domain U/S
Reason (specific example/s must be provided)
Action taken and Outcome to be documented below:
Action taken and Outcome
Supporting documentation attached? Please outline type:
Clinical Assessor Name: Signature: Date: / /
Student Name: Signature: Date: / /
Attach additional pages and/or supporting information and forward to the Course Co-ordinator
APPENDIX F
Faculty of Health - Nursing
Appendix G: Injury Report
This form must be used in accordance with the OHS Procedure -Incident ReportingPart 1 (Injured Person to Complete if Possible) Office Use
Incident No: __________
Incident (Events that led to Injury)
Date of Incident Time of Incident Campus
AM/PM Ararat Camp Street Horsham Mt Helen SMB Stawell
Incident Reported to Date and Time of Report
Description of Events
Precise Location of Events
Personal Details of Injured Person (Strictly Confidential)
Surname Given Names
Home Address
City, Town or Suburb Postcode Telephone
Status Faculty/Section or Company Name
Academic/Teaching General Staff
UoB Student Contractor/Subcontractor
Visitor/Customer Other Specify (right)
Injury
Exact Body Location of Injury Left/Right
Nature of Injury/Illness (e.g. cut, acute stress response,
Name(s) of Witness(es) Phone
1. 2. Treatment
First Aider*(see below) Campus Health Centre Doctor*/Hospital*
(see below) Ambulance
*Name of First Aider/Doctor/Hospital
Outcome (University Employees Only)
Remained Ceased work on (date): at (time): AM/PM