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Welcome to the New Student Documentation Orientation

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Speakers

Gerianne Babbo ~

Professor, Associate Dean of

Nursing

Bethany Mauden ~ Office

Support Supervisor

(Presenter)

Chere Perrone ~ Clinical

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Nursing Programs Administrative

Office

 Office Hours (subject to change)

Monday: 7:30-8:30, 12:00-12:45, 4:00-5:30pm Tuesday: 8:00-5:30pm

Wednesday: 7:30-8:30, 12:00-12:45, 4:00-5:30pm Thursday: 8:00-5:30 pm

Friday: 7:30-8:30, 12:00-12:45, 4:00-4:30pm Saturday thru Sunday: Closed

(4)

PN Documentation FAQ Page

Questions?

1.

Review your materials

2.

Visit the Documentation FAQ page located at

www.olympic.edu/nursing

◦ Click on the Practical Nursing Certificate of Specialization page

◦ Then click Documentation FAQ page for your answer.

3.

After completing the first two steps then email

nursing@Olympic.edu

with a list of questions.

(5)

Documentation Packets

We will review each document and

requirement within the packets

Packet 1: General Information Packet

(return today)

Packet 2: Documentation Packet

(return by

December 28, 4:00pm

)

Packet 3: Harrison Medical Center – Student

Nurse Information Packet

(6)

Documentation Packet Submission

Turn in ORIGINALS of your signed forms.

Keep a copy of all documentation for your

records. We do NOT make copies.

Incomplete packets will not be accepted

.

Turn in your

documentation packet in a Sheet protector. It really will fit!

(7)

Due date

Complete documentation packet is due

into:

1.

CertifiedBackground.com/Medical

Document Manager

Prior to

December 28, 2015, 4:00 PM

.

&

2.

Nursing Programs Administrative office

(8)

Olympic College

Nursing Programs

General Documentation Packet

(Green)

Includes:

1.

Documentation Acknowledgement

2.

Documentation Release Form (for clinical

partners)

3.

Student Information and Address Consent

Form

(9)

What will happen if I miss the

deadline?

Failure to turn in your complete documentation

packet

by

December 28, 2015

4:00pm

Provisional acceptance will be

forfeited

and slot

will be offered to another student.

No exceptions will be made.

Documentation Acknowledgement Form

(included with general packet)

Please review, sign and date.

(10)

Documentation Release Form

Allows release of information to clinical

agencies.

• Immunization Status; • Personal Health & Liability Insurance; • CPR (Health Care

Professional Level);

• Malpractice Insurance;

• Background Check; • Modules.

 What do I do?

1. Complete and return the documentation release TODAY.

2. Complete your background check on CertifiedBackground.com at

home.

3. Print a copy of your completed background check and turn in with your

packet to the Nursing Programs office.

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Student Information &

Address Consent Form

 Complete entire document regardless of address

permissions. No blanks.

This is the ONLY address and phone information the

Nursing Programs receives.

Please update any name, phone, and address changes with the Nursing

Programs office as well as Registration & Records.

 Permissions area is for the Nursing Students Directory.

 Nametag Order: required for clinical.*

$8.15 each.You will be given instructions regarding payment at the

orientation, December 9th, 8:00-12:00pm

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OC Nursing Programs

Packet #2: Documentation ~

Blue color

1. Student Health & Safety Requirement Checklist (CertifiedBackground/Medical Document

Manager )

2. Demographic Form

3. Student Mailbox Consent Form 4. Permission to Use Student Work

5. Naval Hospital Bremerton Agreement

6. Group Health Student Checklist for HIPAA; Confidentiality and Security Agreement

7. Harrison Medical Center Acknowledgement 8. Photo/Video Release

(13)

Certified Background.com

& Medical Document Manager

Service order will include:

Background Check:

 Nationwide Sex Offender, Washington Statewide Criminal Search, Nationwide Federal Criminal Search, Residency History

Medical Document Manager

 Proof of Immunity for Immunizations: TB Skin Test, Hep B, MMR, Varicella, Tdap, Influenza

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Certified Background.com

Ordering Instructions

1. Go to www.CertifiedBackground.com and

click on "Students."

2. In the Package Code box, enter the package

code:

OL32PN

– Background Check +

Annual Medical Document Manager

$87.75

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Submitting Documents to Medical

Document Manager

Submit your documents to

CertifiedBackground.com/Document

Manager via:

1.

Upload (similar to Facebook)

Accepts JPG or PDF.

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What do I provide to OC from

Certified Background.com

& Medical Document Manager ?

1.

A “To-Do-List Summary

Report” from Certified

Background/Medical

Document Manager

(instructions to download the report are in the packet)

2.

Completed background

check.

Please do not give us a copy of documents submitted to your

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Medical Document Manager

Student Health & Safety Requirement Checklist

(Clinical Passport)

This document includes all requirements that are to be submitted to CertifiedBackground.com/Medical Document

Manager.

Immunizations (TB Skin Test, Hep B, MMR, Varicella, Tdap, Influenza)

 Proof of Immunity is Required (By Titer or Vaccination Record)

Note: HEP B Requires vaccination record &/or titer  CPR Card

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**Proof of immunity required**

Proof of immunity:

Proof of immunity by titer. (blood test)

or

Proof of immunity by immunization/vaccination

record.

Note: HEP B Requires vaccination record & titer

Documentation MUST meet requirements at all times

during the program. It is your responsibility to keep all

documentation up to date (example HEP B Series).

(19)

Medical Document Manager:

Required Immunizations –

TB Skin Test

 If no previous records or more than 12 months since

last TST → 2 step TST.

(2-step TB Skin tests require 4 visits to provider)

1. 1st step: Injection, return to read.

2. 2nd step: repeat injection, return to read, otherwise 1

step TST.

(typically within one week of 1st step completion, some

providers prefer a month between injections) OR

 All TB Skin Tests results must cover the duration of the

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TB Skin test…

Q: I had a skin test for TB last year, what is required for me?

 You will need to complete a 1-step TB Skin test only in

December.

 You will also need to provide proof of your TST from last year.

Note: If it was longer than 12 months since your last TST you will be required to get a two step TB skin test.

---Q: I tested positive what do I do?

1. You will need to provide documentation of:  A negative chest x-ray showing no symptoms.  TB health questionnaire.

 And a signed note from your PCP approving clinical

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Medical Document Manager:

Required Immunizations –

Hepatitis B

 Series of 3 vaccines completed at appropriate time intervals

and post vaccination titer at 6-8 weeks after series completion.

o You must show evidence of beginning the series (first two immunization)

at least prior to the December 28th.

o You must continue to get the series and submit proof to Certified

Background while in the program. Series must be complete by end of spring quarter OR

 Provide documentation of positive titer (anti-HBs) OR

 If negative titer, then repeat series and repeat titer 6-8 weeks

after #6 dose – you will be allowed in fieldwork while undergoing this process.

Note: Specific healthcare institutions may require vaccination without exception.

 Considered a non-responder to vaccination after 2 complete vaccine series and a

negative titer.

 Signed waiver for students who decline vaccination. (must meet with Associate

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Hepatitis B…

Not immunized yet?

Get your first immunization ASAP.

Series must be complete by the end of spring

quarter!

Immunization Timeline:

1

st

immunization

~ Early November

2

nd

immunization

~ 1 month later (early December)

3

rd

immunization

~ 6 months from the 1

st

(early

May)

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Medical Document Manager:

Required Immunizations

MMR & Varicella

MMR (Measles, Mumps, Rubella)

 Proof of vaccination (2 doses)

OR

 Proof of rubella, rubeola, and mumps immunity by titer.

Titer must show all sections of the MMR to be accepted.

***

Varicella (Chicken Pox)

 Proof of vaccination (2 doses)

OR

 Proof of immunity by titer.

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Medical Document Manager:

Required Immunizations –

Tdap & Flu

Tetanus, Diphtheria & Pertussis

 Vaccination must cover the duration of the program.

(from December to December 2016)

 Td is not accepted.

***

Influenza

Both H1N1 & Seasonal immunizations are

required. Typically combined.

 Proof of vaccination is required.

Note: In Fall 2016 – you will be required to update your

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Medical Document Manager:

Additional Items–

CPR

CPR (Healthcare Provider Level)

Cards must read: Healthcare Provider & be from the American Heart

Association and cover entire duration of the program (December – December 2016). Red Cross CPR is not accepted.

Due to our clinical affiliation agreements CPR needs to be done

yearly by all students (even though it is issued for two years).

 Your card must be signed and look like the card below.

 The 1st year of the card is accepted only. Cards whose start dates are prior

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CPR Suggestions

Note: You may find other organizations on your own that also provide certification for American Heart Association, be sure to check that the card issued will be from AHA.

*You may check our Nursing News webpage,

(27)

Medical Document Manager:

Additional Items –

Insurance

Insurance

 Proof of Personal health insurance.

Suggestions:

 Summit America Insurance Services

Malpractice Insurance (from Olympic College Cashier) must be dated for winter quarter. $19.85 One time payment.

Liability Insurance (from Olympic College Cashier) must be dated for winter all quarter. $2.50 One time payment.

(28)

Medical Document Manager:

Additional Items –

Modules

Instructions to Access PowerPoint Training Modules

All training modules are required: Infective Medical Waste, Standard

Precautions, Compliance (HIPAA), Emergency Response Procedure, Bloodborne Pathogens & Workplace Safety

 Test score results are required for all modules.

*Pop-up blocker must be disabled*

1) Type, http://cpnorthwest.org

Select - Student login: Username: s0uthStud3nt

Password: s0uthnurs3!

2) Learning Modules will appear 3) Begin your learning modules

4) Print or take a screenshot of the results with your name printed for submission with your documentation to Certified Background.

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Modules…

Example of Compliance module screenshot

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Forms to be submitted to Nursing

Office

1.

Demographic Form

2.

Student Mailbox Consent Form

3.

Permission to Use Student Work

4.

Naval Hospital Bremerton Agreement

6.

Group Health Student Checklist for

HIPAA; Confidentiality and Security

Agreement

7.

Harrison Medical Center

Acknowledgement

8.

Photo/Video Release

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D

OCUMENTATION

F

ORMS

-Demographic Form

Completion of the items with an asterisk

* is required for

Navy Security

.

Complete ALL areas of this form.

It is a part of the ongoing evaluation process

of the Nursing Programs and provides

valuable information for accreditation.

(33)

D

OCUMENTATION

F

ORMS

P

ERMISSION TO

U

SE

S

TUDENT

W

ORK

& S

TUDENT

M

AILBOX

C

ONSENT

P

ERMISSION TO

U

SE

S

TUDENT

W

ORK

Used for accreditation purposes.

S

TUDENT

M

AILBOX

C

ONSENT

Gives permission for faculty and staff to return

(34)

D

OCUMENTATION

F

ORMS

-

Naval

Hospital Bremerton Agreement & Harrison

Medical Center Student Acknowledgement

Navy Hospital Bremerton Agreement

 Navy Civilian Trainee Agreement  Fill out and return.

 You will be going to Naval Hospital Bremerton for clinical

experiences. They require completion of this form.

Note: to apply for Navy Access all US citizens are required to present official

identification at Pass/ID (Valid US Passport, Enhanced Drivers License, or Certified Birth Certificate). You do not need to submit them to the Nursing Office.

***

Harrison Medical Center - Student Acknowledgement

(35)

D

OCUMENTATION

F

ORMS

-

Group

Health HIPAA & Video/Photo Release

Group Health HIPAA

1. Complete “Compliance” module.

2. Complete both sides of the HIPAA form.

3. Leave dates of clinical experience and instructor blank as these do change throughout the program.

4. Return with documentation packet to the Nursing Administrative office. We will send them to Group Health in bulk.

***

Video/Photo Release

Primary use: Video’s during simulation practice, etc.  Please review, sign and date.

(36)

D

OCUMENTATION

F

ORMS

-

DSHS

Background Authorization

Print clearly with black ink.

 Read each question carefully.

You MUST fill in ALL boxes on this form as

instructed. READ the instructions for each Section & each box.

You MUST put an answer in the box. You can put

NO, NOT APPLICABLE (N/A), OR NONE– except BOX number 3

DO NOT answer any question by putting

(37)

Packet # 3 -

Harrison Packet

(Blue)

Harrison Medical Center (HMC) requires the packet to be completed in preparation for clinical experiences at HMC. Please fill out

completely and clearly so it can be entered into HMC’s database.

The pages that need to be filled are:

 Student Nurse Information Sheet

Make sure to answer the following questions:

Is there a Student Acknowledgement form to be signed? Yes / No Are you a current Harrison Employee? Yes / No

Were you a former Harrison Employee? Yes / No

Leave department, title, and dates blank

Review documents and initial the Harrison Checklist

 Census Data

 HMC Child and Adult Abuse Disclosure Statements  Confidentiality Agreement

 HIPPA Regulations (Read manual and return ONLY the Attestation)  Service Standards (Sign & Date on the bottom of the form)

 Student Acknowledgement form (attachment A)

(38)

Further Questions??

***** Due date

Can you submit the documents prior to the deadline of

December 28th?

Absolutely!

(39)

Take Away’s

Turn in TODAY

1. Documentation Acknowledgement

2. Documentation Release Form

3. Student Information and Address Consent Form

***

Turn into CertifiedBackground.com/Medical Document Manager

1. Proof of immunity for all immunizations

2. Background Check information

3. CPR card

4. Insurance (Malpractice, Liability, Health)

(40)

Take Away's….

Turn into Nursing Programs Administrative Office 1. Background Check Results from Certified

Background.com

2. To-Do-List Summary Document or Screenshot from Medical Document Manager showing approval for all documents submitted

3. Demographic Form

4. Permission to Use Student Work 5. Student Mailbox Consent Form 6. Naval Hospital Agreement

7. Group Health Student Checklist for HIPAA and Confidentiality and Security Agreement

8. DSHS Background Authorization

9. Harrison Medical Center Acknowledgement

(41)

PN Documentation FAQ Page

Questions?

1.

Review your materials

2.

Visit the Documentation FAQ page located at

www.olympic.edu/nursing

◦ Click on the Practical Nursing Certificate of Specialization page

◦ Then click Documentation FAQ page for your answer.

3.

After completing the first two steps then email

nursing@Olympic.edu

with a list of questions.

(42)

Hints:

Keep copies for your records.

*Remember we do not make copies.

Please do not register until your

registration letter has arrived, you may

inadvertently register for the incorrect

item numbers.

(43)

References

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