Medical Assistant Program. MA Student Handbook

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Medical Assistant Program

MA Student Handbook

Revised: July 2015

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Seattle Vocational Institute

Medical Assistant Program

Dear Student,

Welcome to Seattle Vocational Institute and the Medical Assistant Program. Medical Assisting is a dynamic, challenging and rewarding profession. As stated by the American Association of Medical Assistants, we are at the “Heart of Health Care”.

This handbook will familiarize you with the Medical Assistant program. The information will answer your questions, direct you to the resources that are available to you on our campus, and outline your responsibilities as a student. Please read the handbook in its entirety, retain it for future reference and submit all required forms as soon as possible.

Our program will provide you with learning experiences, which allow applications of scientific concepts and principles, as well as technical and professional skills required to perform effectively and competently in the healthcare industry.

We are excited that you have chosen Seattle Vocational Institute and we wish you much success in your studies and as a future practitioner of Medical Assisting.

Sincerely,

Richard St. Clare

Richard St. Clare, RMA, CAHI, BSHHS, MBA Medical Programs Director

Medical Assistant Faculty and Staff

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Student Success Services Resource List

Admissions 934-4950 Financial Aid 934-4977 Registration 934-4970 SVI Reception 934-4950 Medical Programs Director 934-4910 Dental Clinic 934-4973 Bright Futures 934-4962 Job Resource Center 934-4935 Salon Services 934-5477 Counseling Center 934-4950

Student Advisor 934-4963

MA Program Age Requirement

Students must reach the age of 18 years prior to enrolling in clinical classes. Washington State Legislative Requirements for State Level Certification

• Pass a National examination • Apply for state level certification

• Proficiency in reading, writing and communicating effectively in English to perform required skills and techniques in a professional medical setting

Medical Assistant (MA) Working Conditions

MA’s work in clinical environments, interact with patients and fellow professionals, and manage multiple responsibilities at the same time. Work schedules include full-time, part-time and

occasionally evenings or weekends. MA’s must be able to respond to patient needs and execute instructions with accuracy under minimal supervision. They must respect the confidential nature of medical information.

MA’s spend a large portion of their workday walking and standing, and must be able to manipulate equipment, read fine print, listen accurately, and lift/move objects. The Medical Assistant also spends a great deal of time interpreting and responding to verbal and non-verbal communication, gathering information, and processing data.

Physical Demands Placed On the Medical Assistant

It is common to lift 10-25 pounds throughout daily duties. Lifting 40-50 pounds may occasionally be required. Sufficient visual acuity, auditory acuity, and manual dexterity is required.

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Accreditation

The Seattle Vocational Institute Medical Assistant certificate program is accredited by the Commission on Accreditation of Allied Health Education Programs (www.caahep.org) upon the recommendation of the Medical Assisting Education Review Board (MAERB).

Commission on Accreditation of Allied Health Education Programs 1361 Park Street, Clearwater, FL 33756

727-210-2350

Seattle Vocational Institute Medical Assistant program graduates are eligible to sit for a National certification examination. Upon successful completion of a national examination students are eligible to apply for Washington state level certification. The national and state level certifications are

required to be eligible for employment as a Medical Assistant in the state of Washington.

Seattle Vocational Institute Mission Statement

Seattle Vocational Institute provides basic skills, vocational and workforce-training opportunities through competency-based, open-entry, short-term programs that lead to jobs with a future, personal achievements and educational advancement. The college collaborates with other campuses in the Seattle Community Colleges District and with business, labor, government and community groups.

Diversity Statement

Diversity, in its many forms, is a valued component of student learning, success and fulfillment.

Seattle Vocational Institute supports students, our campus and our community by acknowledging and incorporating the diversity of all persons. In valuing all persons, Seattle Vocational Institute does not discriminate or tolerate discrimination based on:

• Marital status • color • creed •national origin •gender

•race •age •religion •disability •sexual orientation

Americans with Disabilities Act

Students with disabilities may seek assistance through the office of Disability Support Services at Seattle Central College. Please contact Seattle Central College at 206.934.4169 for further information.

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Medical Assistant Program Mission Statement

The Medical Assistant program mission is to prepare students with the business and clinical skills necessary to gain employment as an MA. Emphasis is placed on patient relations, anatomy and physiology, medical terminology, interpersonal communication skills, patient care, clinical and lab procedures, administrative front office procedures and computer use.

This fully accredited program provides the mechanism for graduates to take a national examination to become a certified Medical Assistant.

The MA program is designed in collaboration with local health care providers to prepare graduates for positions in clinics, offices and ambulatory care settings. The student is cross-trained in multiple clinical and laboratory procedures, ensuring maximum flexibility in employment. Students complete the program with practicum experience in a medical clinic.

Uniforms

Uniforms (scrubs) in the MA program color of royal blue must be worn every day to all classes, both clinical and non-clinical. SVI students can purchase and receive a discount at all Life Uniform locations.

Estimated costs:

1. Uniforms – 2 sets of uniform scrubs ($50 - $70) 2. Stethoscope and blood pressure cuff– ($35 - $55) 3. Name tag – ($10 - $20)

4. Watch with second hand – ($20-$40) 5. Comfortable shoes – ($30-$70)

Uniform and equipment cost are estimates only. Costs may vary.

Grading Policies - Satisfactory Progress – Academic Competency

• Refer to the Standard Attendance Policy section of the 2014-2016 Seattle Colleges Catalog for a complete explanation of the attendance policy.

• Receiving a failing grade may have a negative impact on academic progress and a student’s eligibility to qualify for financial aid benefits.

• 100% of all competencies in all classes in the Medical Assistant program must be successfully completed to qualify for practicum.

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• The MA program requires a cumulative GPA of 2.9 or above to qualify for the practicum portion of the program.

• Students must pass classes with a minimum grade of 2.0 with the exception of clinical, Pharmacology and Anatomy & Physiology classes.

Clinical I, Clinical II, Clinical III Clinical IV, Pharmacology, and Practicum/Externship require a minimum grade of 2.9.

Anatomy & Physiology classes require a minimum grade of 2.5.

• Grading formulas for individual classes are provided in each class syllabus.

Repetition of Courses/Readmission

Repeating a course may require an academic contract to assist the student in achieving their academic goals. A student cannot repeat a class after a second failure.

Separation/Withdrawal from the Medical Assistant Program

If for any reason, a student separates/withdrawals from the program and upon or after a period of six months the student will be required to take and pass previous clinical competency tests in order to advance to the next level of study. In the event that a student is not able to pass all clinical

competencies he/she will need to repeat the appropriate clinical class or classes.

Attendance

It is essential that students arrive on time and ready for class each day. Attendance is critical in the MA program, if absences occur it is the student’s responsibility to contact the instructor. Instructors are available to discuss course work, academic concerns and/or absences. Refer to the instructor’s syllabus to obtain contact information.

Students can locate a full explanation of college attendance requirements in the Seattle Colleges Catalog.

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Program Requirements

1) Physical Exam and Immunizations Requirements

All students are required to meet the health requirements of health care industry employers. A

physical exam and immunizations are required for all students. A current (within six months) negative tuberculin skin test or negative tuberculin screening chest x-ray is also required.

The physical examination/ immunization form is to be completed by the student’s physician, ARNP or PA. Students are responsible for delivering this form to the Program Director’s Accreditation office (room 303, east end of the third floor) before practicum eligibility.

2) Student Health Insurance Responsibility

Students are responsible for their medical expenses. If it is necessary for the student to receive

medical care of any kind, including emergency room care, the student is responsible for all expenses. A student health insurance policy is available through the college and may be purchased at the time of registration. Malpractice coverage is provided during the externship/practicum portion of the program. Be aware that this is not student health insurance.

3) Age and High School Diploma (or GED) Requirement

A high school transcript or GED completion document is required as a prerequisite to being accepted into the Medical Assistant program. Students must achieve 18 years of age prior to enrolling in clinical classes.

4) Criminal Background Check

A criminal background check is performed during the admission process. Any evidence of a student’s

criminal history can result in the denial of entry to a practicum site, and jeopardize the successful completion of the program. Practicum sites reserve the right to request a national background check.

The national background check fee must be paid by the MA student.

Student Responsibilities

Instructors will provide students with a course syllabus and schedule that explains how course content will be presented and how performance of course requirements will be measured. Students are expected to comply with the instructions contained within the course syllabus, the SVI Student Handbook and the MA Student Handbook. General responsibilities are as follows;

1. Attend and participate in all classes. If an emergency arises, notify the instructor as soon as possible. Each quarter is highly concentrated; missing even one day affects learning outcomes. 2. Books and supplies are required for successful completion of each course, therefore required

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class daily. Failure to purchase necessary equipment is a direct deterrent to a student’s opportunity to participate in class. A student’s grade is partially dependent upon evaluation of the student’s willingness and ability to participate fully in class.

3. Read in preparation for class. Successful participation in courses are partially dependent upon preparatory knowledge acquired through reading prior to class.

4. Organize any course materials. If an instructor has specific requirements for this process, follow them. Organization is a key to success.

5. Be sure that the work submitted in class is not copied or plagiarized. Plagiarism is a violation of the student conduct code at SVI as outlined in the student handbook. If an instructor discovers that work has been plagiarized, the work will be rejected and disciplinary action will be taken. 6. A meeting with an instructor may be arranged if a student has questions or concerns about a

class.

7. Be courteous toward instructors and classmates. If disagreements arise, apply respectful conflict resolution techniques or seek advice from Student Services or the Counseling Center staff.

8. Arrive on time and stay in class through the scheduled period. In an emergency, if a student must leave early let the instructor know and exit quietly.

9. Food and drink are not permitted in the classrooms or laboratories. 10. Children and/or adult visitors are not permitted in classes.

11. Provide services for fellow students as assigned by the instructor regardless of race, creed, gender, national origin, sexual orientation, or preference.

12. Cell phone use is not permitted within the classrooms and laboratories. Please turn your cell phone to vibrate before class starts. Regular breaks are scheduled and cell phones may be used during that time. If a student anticipates an emergency call, please alert the instructor before class begins.

Dress Code for the Medical Assistant Program

All students attending the SVI MA program are subject to the following dress-code standards. Remember that the distinctive uniform identifies students as members of the MA training program at SVI. Students are required to report to every class wearing the required uniform.

The medical field is a conservative profession. If a student refuses to comply with the dress code guidelines below, the student may be excused from class for the day and/or not be able to be

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placed in a practicum and therefore will not pass the course. The guidelines listed below apply to all classrooms and practicum sites.

1. Uniform scrubs are required and students will be expected to appear ‘ready to work’ in all classrooms daily. Sweats or form fitting pants are not acceptable. The MA program color of royal blue is acceptable for scrub tops, pants and skirts. A white turtleneck or cotton shirt may be worn under the scrub top. A white or royal blue lab jacket is optional.

2. For health and safety reasons, scrubs are the only clothing allowed in Clinical classes. Do not wear expensive garments because accidents with lab materials may stain clothing permanently. 3. If a skirt is worn it must be a uniform type skirt, in the MA program color of royal blue only. 4. In the interest of safety, no open toe footwear, open heels or heels are permitted. Due to

possible needle-stick injury, Crocs or similar footwear with holes are not acceptable for students.

5. Be aware that perfumes and scented creams/lotions are prohibited. 6. Good oral hygiene is essential.

7. Chewing gum is not permitted relative to safety/health concerns.

8. Hair should be neat, clean and if long or loose, tied back, to prevent cross contamination. 9. Color-appropriate headscarves may be worn. No other headwear is permitted.

10. The use of hand jewelry is discouraged due to the potential for cross contamination. 11. Large hoop or dangling earrings may not be worn as injury can occur if items such as

stethoscopes and telephone headsets may be caught in them. 12. For safety reasons gaping sleeves are not permitted.

13. Pants or skirts must not touch the ground in order to prevent cross contamination. 14. The SVI student identification badge and name tag must be worn at all times.

15. No obvious tattoos or facial rings. Facial rings and tattoos are generally unacceptable in the health care industry. Be prepared to cover tattoos and remove facial rings during the practicum portion of the program.

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16. Fingernails should be clean and well-groomed. Artificial nails are often unacceptable in the healthcare industry. Be prepared to remove artificial nails during second quarter, do not wear artificial nails for the remainder of the program including the practicum.

17. If make-up is worn, it should be lightly applied.

18. To maintain a professional image it is important to wear clean clothes without tears or holes and non-visible undergarments.

Practicum

The practicum (externship) course is designed to allow students to demonstrate the skills and technical abilities acquired throughout the MA program. The practicum is a non-paid, supervised position in a contracted medical facility.

Students will have the opportunity to explore the different responsibilities that are required of an MA. Emphasis will be placed on demonstration of professionalism, ability to write, spell and communicate in English, use appropriate medical terminology, spelling, and the ability to perform basic entry-level administrative and clinical skills.

The Practicum Coordinator communicates regularly with the staff of the practicum facility. The practicum site proctor, Practicum Coordinator, and/or Program Director will evaluate students, both formally and informally, throughout the practicum.

1) Unsatisfactory completion of the practicum portion of the program will result in a failing grade, preventing the student from receiving a Certificate of Completion.

2) Only the Practicum Coordinator will arrange practicum placement. Faculty are not responsible for, nor do they have the authority to place students in a practicum position.

3) Any student who fails the practicum portion of the program or is released from their practicum site may need to repeat the Clinical IV class (AHL 190). Further, the student must submit a request, in writing, to be considered for a second practicum placement. The written request for a repeat practicum will be reviewed by a committee that includes the MA Program Director and is not a guarantee of placement. All first-time practicum students will be given placement priority over students repeating the practicum.

4) The placement portion of the practicum is an interview opportunity which may or may not result in acceptance to practicum. It is the student’s responsibility to prepare for all interviews. The

outcome of interviews rests with the student and the interviewing site and not with SVI. 5) The Practicum portion of the Medical Assistant program at SVI is a part of the programs

educational process. Students are not to be utilized to supplement vacant positions at the

practicum site. Students must be supervised at all times. Successful placement at an externship site in no way implies an opportunity for employment.

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6) Any student who refuses to participate in the interview process of a designated practicum site or refuses to accept placement without just cause will forfeit the practicum opportunity and will be required to submit a letter of explanation before further placement consideration.

7) On occasion, students request permission to secure a practicum site. The following is the set standard for students who wish to establish a practicum site for the MA program:

• All sites must be contracted with SVI. If a site is not currently contracted with the college the process of executing a contract can result in a delay of the practicum starting date.

• No student will begin the practicum experience until the contract process is complete and the Practicum Coordinator has given the student permission to start.

• Students who wish to procure their own practicum site must do so no later than eight weeks before the end of the Clinical Review class (AHL 190.) No student procured site will be considered after that time.

7) Students will be referred to a practicum interview only after they have met all curricular

requirements, completed all physical examination and immunization processes and provided all relative documentation from their provider.

8) Any student owing makeup hours or with a failing or incomplete grade will not be considered for practicum interviews until satisfactory course work is completed.

9) Any student who has not successfully completed 100% of all competencies in all classes in the Medical Assistant program will not be eligible for practicum or graduation.

10) The medical field is a conservative one. Practicum sites maintain the right to decline the student based on a negative criminal history. SVI is not responsible for the practicum site’s decision to not accept any student.

11) Practicum sites require a background check and may require a national background check. The additional cost of a national background check is the student’s responsibility. The Practicum Coordinator will notify students of the necessity for a national background check prior to their interview.

Practicum Site Dress Code

Students are required to abide by the MA program uniform regulations while attending the practicum portion of the program.

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Occupational Safety and Health Administration (OSHA) / Washington Industrial

Safety and Health Act (WISHA) Training

Students receive training throughout the MA program regarding the occupational risk of blood-borne pathogens and other healthcare related pathogens. Topics may include, but are not limited to, transmission of pathogens, exposure control plans, work practice controls, engineering controls, hazard communications, personal protective equipment, record keeping, methods of compliance, and regulated waste handling and management.

HIV/AIDS Training

Students will be provided a seven-hour HIV training class that meets the State of Washington criteria (WAC 246-12 and 246-826-230). Students must complete the entire seven hours of training.

Practicum eligibility is contingent upon successful completion of the 7-hour HIV class as mandated by Washington state law. Documentation must be provided prior to practicum eligibility. Failure to

complete this training prior to practicum will delay eligibility for practicum until training is completed.

TB Test Requirement

Under Washington State law, all health care professionals must have a current (within 6 months of practicum) TB test. Since a student will be providing care for patients during the practicum

experience, documentation of a current negative TB test result or current negative TB screening chest x-ray is required.

Documented proof of a current negative TB test or negative chest x-ray report must be provided prior to the start of the practicum portion of the program. Students will not be able to begin practicum until acceptable TB documentation is submitted. If current results from another job or program are available, a copy of the results should be deposited in the mailbox outside of the Program Director’s office (room 303.)

The TB skin test is first placed and then read 48–72 hours later. The student will need to return to the clinic to have the result read. A positive result does not necessarily mean an active case of

tuberculosis, only exposure to the bacteria. If a positive result is detected a chest X-ray is required. If there is evidence of active TB infection the student will not be able to continue in the class due to legal and medical restrictions.

Hepatitis B

Hepatitis B virus (HBV) infection is the major infectious occupational hazard for health care workers. The risks of acquiring HBV infection are from occupational exposures to blood or blood products. Health care workers who handle blood or blood products are at risk for HBV exposure. Students may experience exposure to blood and/or contaminated body fluids in clinical classes therefore vaccination is advised for all students.

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Risks among health care professionals vary but are highest during the training period therefore it is required that the student either receive the Hepatitis B vaccine series or sign the

Hepatitis B vaccine waiver. Students receiving the vaccine must have completed the second vaccine of the Hepatitis B series before assignment to a practicum site.

Competency Completion

The following table lists eleven groups of Psychomotor and Affective competencies that will be required for program completion. All competencies must be completed for the student to be eligible to receive a passing grade.

100% of all competencies must be successfully completed prior to the end of the

corresponding course. Students who do not complete 100% of all competencies will receive a failing grade in that course and are not eligible for the practicum portion of the Medical

Assistant program.

I. Anatomy & Physiology 1. Obtain vital signs

2. Perform Venipuncture 3. Perform capillary puncture

4. Perform pulmonary function testing 5. Perform electrocardiography

6. Perform patient screening using established protocols 7. Select proper sites for administering parenteral medication 8. Administer oral medications

9. Administer parenteral (excluding IV) medications 10. Assist physician with patient care

11. Perform quality control measures

12. Perform CLIA-Waived hematology testing

13. Perform CLIA-Waived chemistry testing 14. Perform CLIA-Waived urinalysis

15. Perform CLIA-Waived immunology testing

16. Screen test results

17. Apply critical thinking skills in performing patient assessment and care 18. Use language/verbal skills that enable patients’ understanding

19. Demonstrate respect for diversity in approaching patients and families

II. Applied Mathematics

1. Prepare proper dosages of medication for administration 2. Maintain laboratory test results using flow sheets

3. Maintain growth charts

4. Verify ordered doses/dosages prior to administration 5. Distinguish between normal and abnormal test results

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III. Applied Microbiology/Infection Control 1. Participate in training on Standard Precautions 2. Practice Standard Precautions

3. Select appropriate barrier/personal protective equipment (PPE) for potentially infectious situations 4. Perform hand washing

5. Prepare items for autoclaving 6. Perform sterilization procedures

7. Obtain specimens for microbiological testing 8. Perform CLIA waived microbiology testing

9. Display sensitivity to patient rights and feelings in collecting specimens 10. Explain the rationale for performance of a procedure to the patient

11. Show awareness of patients’ concerns regarding their perceptions related to procedure performed

IV. Concepts of Effective Communication

1. Use reflection, restatement and clarification techniques to obtain a patient history 2. Report relevant information to others succinctly and accurately

3. Use medical terminology, pronouncing medical terms correctly, to communicate information, patient history, data and observations

4. Explain general office policies

5. Instruct patients according to their needs to promote health maintenance and disease prevention 6. Prepare a patient for procedures and/or treatments

7. Demonstrate telephone techniques 8. Document patient care

9. Document patient education

10. Compose professional/business letters

11. Respond to nonverbal communication

12. Develop and maintain a current list of community resources related to patients’ healthcare needs 13. Advocate on behalf of patients

14. Demonstrate empathy in communicating with patients, family and staff 15. Apply active listening skills

16. Use appropriate body language and other nonverbal skills in communicating with patients, family and

staff

17. Demonstrate awareness of the territorial boundaries of the person with whom communicating 18. Demonstrate sensitivity appropriate to the message being delivered

19. Demonstrate awareness of how an individual’s personal appearance affects anticipated

responses

20. Demonstrate recognition of the patient’s level of understanding in communications 21. Analyze communications in providing appropriate responses/ feedback

22. Recognize and protect personal boundaries in communicating with others

23. Demonstrate respect for individual diversity, incorporating awareness of one’s own biases in areas including gender, race, religion, age and economic status

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1. Manage appointment schedule, using established priorities 2. Schedule patient admissions and/or procedures

3. Organize a patient’s medical record 4. File medical records

5. Execute data management using electronic healthcare records such as the EMR

6. Use office hardware and software to maintain office systems 7. Use internet to access information related to the medical office 8. Maintain organization by filing

9. Perform routine maintenance of office equipment with documentation 10. Perform an office inventory

11. Consider staff needs and limitations in establishment of a filing system 12. Implement time management principles to maintain effective office function

VI. Basic Practice Finances cont.

1. Prepare a bank deposit

2. Perform accounts receivable procedures, including: a. Post entries on a day sheet

b. Perform billing procedures c. Perform collection procedures d. Post adjustments

e. Process a credit balance f. Process refunds

g. Post non-sufficient fund (NSF) checks h. Post collection agency payments 3. Utilize computerized office billing systems

4. Demonstrate sensitivity and professionalism in handling accounts receivable activities with clients

VII. Managed Care/Insurance

1. Apply both managed care policies and procedures 2. Apply third party guidelines

3. Complete insurance claim forms

4. Obtain precertification, including documentation 5. Obtain preauthorization, including documentation 6. Verify eligibility for managed care services

7. Demonstrate assertive communication with managed care and/or insurance providers

8. Demonstrate sensitivity in communicating with both providers and patients

9. Communicate in language the patient can understand regarding managed care and insurance plans

VIII. Procedural and Diagnostic Coding

1. Perform procedural coding 2. Perform diagnostic coding

3. Work with physician to achieve the maximum reimbursement

IX. Legal Implications

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2. Perform within scope of practice

3. Apply HIPAA rules in regard to privacy/release of information 4. Practice within the standard of care for a medical assistant

5. Incorporate the Patient’s Bill of Rights into personal practice and medical office policies and procedures 6. Complete an incident report

7. Document accurately in the patient record

8. Apply local, state & federal health care legislation and regulation appropriate to the MA practice setting 9. Demonstrate sensitivity to patient rights

10. Demonstrate awareness of the consequences of not working within the legal scope of practice 11. Recognize the importance of local, state and federal legislation and regulations in the practice

setting

X. Ethical Considerations

1. Report illegal and/or unsafe activities and behaviors that affect health, safety and welfare of others to proper authorities

2. Develop a plan for separation of personal and professional ethics

3. Apply ethical behaviors, including honesty/integrity in performance of medical assisting practice 4. Examine the impact personal ethics and morals may have on the individual’s practice

5. Demonstrate awareness of diversity in providing patient care

XI. Protective Practices

1. Comply with safety signs, symbols and labels

2. Evaluate the work environment to identify safe vs. unsafe working conditions 3. Develop a personal (patient and employee) safety plan

4. Develop an environmental safety plan

5. Demonstrate proper use of the following equipment: a. Eyewash

b. Fire extinguishers

c. Sharps disposal containers

6. Participate in a mock environmental exposure event with documentation of steps taken 7. Explain an evacuation plan for a physician’s office

8. Demonstrate methods of fire prevention in the healthcare setting 9. Maintain provider/professional level CPR certification

10. Perform first aid procedures

11. Use proper body mechanics

12. Maintain a current list of community resources for emergency preparedness 13. Recognize the effects of stress on all persons involved in emergency situations 14. Demonstrate self-awareness in responding to emergency situations

Documentation

The following forms, with the exception of the Physical and Immunization Form, must be

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After completion by your physician, the Physical and Immunization Form and any accompanying

documentation, must be deposited in the mailbox outside of the Program Director’s office (room 303.) 1. Verification of Receiving the MA Handbook

2. Hepatitis B Waiver (if applicable)

3. Consent for Injections/Blood Draws/Clinical Activities

4. Student Health Insurance Validation OR Health Insurance Waiver 5. Pregnancy and Invasive Clinical Procedures

6. Program Confidentiality Statement 7. Pregnancy and Practicum/Externship 8. Separation / Withdrawal from Program 9. Age and High School Diploma/GED

10. Student Contact and Emergency Contact Information

11. TB, Immunizations, and Physical Exam Requirement Acknowledgement 12. Physical and Immunization Form

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

“Verification of Receiving the MA Handbook”

I (Print student name), ___________________________________________ have received and agree to abide

by the requirements and policies of the Seattle Vocational Institute MA program as defined in the MA Student Handbook.

• I understand that I will be informed in writing of any change in policy that occurs prior to the next scheduled Handbook revision.

• I understand that I may address any questions/concerns regarding the SVI MA Program Student Handbook to the MA Program Director.

_______________________________________________________________

Print Student Name

_______________________________________________________________

Student Signature Date

Note: This disclaimer must be turned in to the Program Director. This Disclaimer will remain in your MA student file.

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

“Hepatitis B Immunization Waiver”

I

(Print student name), ____________________________________________________

have received information

regarding Hepatitis B and the Hepatitis B vaccine provided in the MA

Handbook.

After careful consideration of the risks, I do not wish to receive

the vaccine.

________________________________________________________________

Print Student Name

________________________________________________________________

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

“Consent for Participation in Injections, Blood Draws and Other Clinical Activities”

To develop expertise in the administration of injections, blood draws and other clinical less invasive procedures, it is necessary that those skills be performed in the college skills clinic and lab setting.

The skills acquired in the practice setting will prepare you for patient care in the clinical area. To facilitate this learning you are required to be the subject as well as the provider of subcutaneous, intramuscular, intradermal injections, blood draws and the other clinical procedures in the clinic and laboratory setting, under the supervision of the instructional staff.

• In consideration of being afforded the opportunity to administer

subcutaneous, intramuscular, intradermal injections and blood draws, as

well as other less invasive procedures to other students, I

(Print student

name),____________________________________ agree to participate in this

learning experience by serving as a subject for other students.

• I

(Print student name), _____________________________________________ acknowledge

that risks to my person, including but not limited to bruising, swelling and

pain may be involved in the injections and blood draws.

• I

(Print student name), _______________________________________________agree to hold

SVI, my instructors and fellow students harmless from any damages I may

suffer as a result of said procedures.

• I

(Print student name), ____________________________________________further agree

that I will thoroughly familiarize myself with the techniques prior to

performing any of said procedures on another individual.

________________________________________________________________

Print Student Name

________________________________________________________________

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

“Student Health Insurance Responsibility”

I (Print student name),____________________________________ understand that I will be responsible for my

own health care coverage and expenses incurred by me while a student in the MA Program at SVI.

• I further understand that if it is necessary for me to receive medical care, including Emergency Room treatment, I will be responsible for any charges incurred.

• Additionally, if my insurance status changes I will inform SVI and complete a replacement Student Health Insurance Responsibility Disclaimer or a Student Health Insurance Waiver Disclaimer.

• I have health insurance through_____________________________________.

________________________________________________________________

Print Student Name

________________________________________________________________

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

“Student Health Insurance Waiver”

I (Print student name), _ ________________________________________________ understand the importance

of health insurance coverage. However, I do not have a valid health insurance and purchasing such a policy would place undue hardship on me.

• I do not and will not hold the school or any affiliated institution liable for any

illness, injury or accident that may be directly related to being a MA

student at SVI, and I will be responsible for any medical fees incurred as a

result.

________________________________________________________________

Print Student Name

________________________________________________________________

Medical Health Insurance is available to any student by virtue of being enrolled at SVI and the Seattle Community College District VI. The cost is minimal. If you are interested in health insurance please inquire at the Registration Desk.

Note: This waiver must be turned in to the Program Director. It will remain in your MA student file.

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

“Pregnancy and Invasive Clinical Procedures”

I (Print student name), _________________________________________________ understand that if I am or

become pregnant while I am enrolled in MA classes at SVI, in consideration for being given the opportunity to administer subcutaneous, intramuscular, intradermal injections and blood draws, as well as other less invasive procedures to other students, I agree to participate in this learning experience by serving as a subject for other beginning students.

• I acknowledge that risks to my person, including but not limited to bruising, swelling and pain maybe involved in the injections and blood draws. I agree to hold SVI, my instructors and fellow students harmless from any damages I may suffer as a result of said procedures.

• I understand that SVI has no financial obligation to me for any costs that I may incur if I am required to repeat any courses due to my separation from the MA program.

________________________________________________________________

Print Student Name

________________________________________________________________

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

“SVI MA Program Confidentiality Statement”

I (Print student name), _ _ understand that in the course of the MA Program I will encounter information that is of a sensitive and personal nature. I acknowledge that information shared in the classroom environment and in the observation of clinical activities must be kept confidential and private.

• In the classroom students are encouraged to participate openly and may choose to share personal information. I understand the shared information is to be held in confidence. I understand that I may

not discuss any information about any student with anyone in or outside of the classroom.

• During the clinical practicum portion of my program I will be involved in various aspects of patient care. I acknowledge that I may have access to information that, by law, must not be shared or discussed with anyone other than the patient’s medical providers. I further agree to comply with any additional

confidentiality requirements that my clinical site may require of me.

In accordance with current federal and state mandates designed to “develop security standards to prevent unauthorized use or disclosure of any health information that is electronically maintained or used in electronic transmission,” I also acknowledge that any access I have to written or electronic medical charting is strictly confidential. I further acknowledge that should I have access to such record maintenance systems, I will not attempt to review confidential material in any regard other than

by direct order from a supervisor, physician or other health care provider. Additionally, I

acknowledge that I must comply with any confidentiality and regulatory compliance standards that may be imposed upon me during any of my clinical activities.

I acknowledge that should I break this statement of confidentiality, I may face consequences

that may prevent me from completing this program, or other consequences yet to be determined.

________________________________________________________________

Print Student Name

________________________________________________________________

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

Note: This disclaimer must be turned in to the Program Director. It will remain in your MA student file.

“Pregnancy and Practicum (Externship)”

I (Print student name), ____________________________________understand that SVI does not

discriminate in any course; however, if I should become pregnant during my program of study, my pregnancy may effect practicum eligibility.

• I understand that it is decision of the Practicum Site Supervisor whether or not I will be allowed to remain on site. If I am asked to leave the site because of pregnancy, it is my responsibility to immediately inform the SVI Practicum coordinator.

• If I am receiving Financial Aid at the time I am released from my Practicum, I understand this may jeopardize my eligibility for future Financial Aid. Furthermore, I may be

required to pay back the Financial Aid award I received for the quarter I was serving the Practicum.

________________________________________________________________

Print Student Name

________________________________________________________________

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

Note: This disclaimer must be turned in to the Program Director. It will remain in your MA student

file.

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

“Separation/withdrawal from the program.”

I (Print student name). _____________________________________understand that in the event of

separation or withdrawal from the program, I will be required to take and pass competency test(s) to advance to the next level of study:

• If after successfully completing Quarter II of the MA Program and after an absence of six (6) months or more, I will be expected to take and pass the competency test for Clinical I.

• If after successfully completing Quarter III of the MA Program and after an absence of six (6) months or more, I will be expected to take and pass the competency tests for Clinical I, Clinical II and Pharmacology.

• If after successfully completing Quarter III and all course work of Quarter IV except for the Practicum of the and after an absence of six (6) months or more, I will be expected to take and pass the competency tests for Clinical I, Clinical II and Pharmacology. Additionally, I will be required to repeat Clinical Review.

________________________________________________________________

Print Student Name

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

“Statement of Understanding - High School Diploma / GED”

I (Print student name), ____________________________________________, understand that I must

have a high school diploma or GED to register in the MA Program.

Further, I understand that I must achieve 18 years of age prior to the first day of second quarter.

• If an official high school or GED transcript showing evidence of completion is not on file at SVI I will not be permitted to enroll in or attend classes in the program.

• If I do not achieve 18 years of age prior to the first day of second quarter I understand that I will not be permitted to attend classes in the MA program until age 18.

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Print Student Name

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SVI MA Program Student Information / Emergency Data Sheet

STUDENT ID# (if known) ____ ____ ____ -____ ____ -____ ____ ____ ____

NAME (Print)

ADDRESS Street

City, State, zip code

Phone(s)

E-mail

EMERGENCY CONTACT INFORMATION

NAME RELATIONSHIP TO STUDENT ________________________________ ADDRESS PHONE NUMBER(S) _________________________________________________

IS THERE ANY MEDICAL CONDITION YOU WISH TO SHARE WITH YOUR FACULTY MEMBERS?

________YES ________NO IF YES PLEASE EXPLAIN _________________________________________________________________________ ________________________________________________________________ Print Student Name

________________________________________________________________ Date__________________________________ Student Signature

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DISCLAIMER FOR MEDICAL ASSISTANT STUDENTS

“Statement of Understanding – TB, Immunization and Physical Exam Requirement”

I (Print student name), ____________________________________________, understand that I am

required to have a licensed health care provider complete the information on the Physical

Examination Form, including documentation of a current negative TB test or negative chest x-ray for active TB screening.

Further, I agree to provide documentation from a licensed health care provider indicating all required immunizations, as listed on the Physical Examination Form have been received.

• If the Physical Examination Form and all required documentation is not submitted prior to practicum eligibility I understand that I will not be permitted to attend and/or participate in the MA program practicum until required documentation is submitted.

________________________________________________________________

Print Student Name

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Seattle Vocational Institute Medical Assistant Program Physical

Examination

To be completed by a Licensed Physician, Nurse Practitioner or PAC

Student Name ______________________________________________________

Last First Middle

Address ___________________________________________________________

Street City State Zip Code

Date of Exam ___________Age____Height_____Weight____ DOB ___________

Allergies/drug reactions ____________________________________________________________

HISTORY OF APPLICANT - to be completed by provider (not student)

Diabetes _______________________________________________________________________ Tuberculosis/respiratory problems ___________________________________________________ Epilepsy/convulsions/fainting _______________________________________________________ Back problems __________________________________________________________________ Tremors _______________________________________________________________________ Mental health care _______________________________________________________________ Medication taken routinely__________________________________________________________ _______________________________________________________________________________ Other physical limitations ___________________________________________________________

_______________________________________________________________________________

PHYSICAL EXAMINATION NOTES

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

REQUIRED VISION EXAMINATION

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A current one-step TB test or TB screening chest x-ray is required. The test or x-ray is considered current if obtained within the past six months. If not current a new TB test

or TB screening chest x-ray is required.

Result _______mm Positive  or Negative  Date Results read __________

If the TB test result is positive, a chest x-ray is required and official documentation

of

results that indicate a negative TB status must be submitted.

In your opinion, is there any physical, medical, or psychological issue or concern that might

prevent this person from participating in the Medical Assistant program?________________

_________________________________________________________________________ _________________________________________________________________________

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DOCUMENTATION OF REQUIRED IMMUNIZATIONS

1) a. Diphtheria-Tetanus immunization date (must be within past 10 years) _________

2) a. MMR immunization dates

___________________________________________ or b. MMR titer with lab results attached

3) a. Varicella immunization dates ________________________________________ or

b. History of disease?  YES or c. Varicella titer with lab result attached

4) a. Hepatitis B immunization dates 1st_{__________ 2}nd_{__________ 3}rd

_________ or

b. Hepatitis B titer with lab result attached

Signature __________________________________________________________

(Licensed Health Care Provider)

Printed Name _______________________________________________________ Clinic Name ________________________________________________________ Phone Number ______________________________________________________ Clinic Address _______________________________________________________ ____________________________________________________________ ____________________________________________________________

PLEASE RETURN THIS FORM TO: Seattle Vocational Institute

Medical Assistant Program 2120 South Jackson Street

Seattle, WA 98144