Undergraduate (BSN) Nursing Practicum Manual:

Section 4: Identification of Preceptor and Site

 It is critical to students’ successful practicum experiences that they thoroughly and completely review the Walden University College of Nursing Practicum Manual designated for their program and specialty area in their first term and throughout their program. Walden provides guidelines for identifying an appropriate preceptor and practicum site, and the manuals outline the practicum application submittal resources necessary in order to begin the practicum process. 

Preparing early will be critical to practicum success. It is highly recommended that students work with the Office of Field Experience to start the search process for a practicum site and preceptor early in the program, as it can take a significant amount of time to identify a preceptor and practicum site and complete the application process. Eligible students who would like to partner with a Field Placement Coordinator to be matched with a preceptor and practicum site through the Practicum Pledge™ service must begin the process early in their program to complete the registration requirements by the deadline. 

Walden’s program directors, director of field placement, experience, specialization coordinators, field experience coordinators, field placement coordinators, practicum course faculty instructors are committed to working collaboratively with students and preceptors to support the successful completion of practicum experiences. 

• The process of selecting a site for placement begins with the student identifying a practicum site and initiating contact with a potential preceptor who meets the knowledge, education, skill, and certification qualifications necessary to support the outcomes as outlined in each field experience (i.e., practicum) course. Because Walden students are located around the world, students have the flexibility to identify sites and nominate preceptors based on their region or location. 
•  Most students should have their first preceptor nominee and a practicum site identified by the middle of their second term. 
•  A completed practicum application must be submitted via Meditrek® by the practicum application deadline date for each term. 
•  Walden’s policy on practicum sites and preceptors is aligned with the Commission on Collegiate Nursing Education’s (CCNE) Key Element II-B Standard (2018), which states that “the program is responsible for ensuring adequate physical resources and clinical sites. Clinical sites are sufficient, appropriate, and available to achieve the program’s mission, goals, and expected outcomes.” Further, it is Walden’s policy to ensure adequate physical resources and practicum sites by collaborating with students, preceptors, and administrators to support the successful completion of each student’s program of study, including the field experience and practicum placements. 

Reference: 

Commission on Collegiate Nursing Education. (2018). Standards for accreditation of baccalaureate and graduate nursing programs: Key element II-B standard. CCNE. 

Students should read this manual and refer to the practicum application resources on the Office of Field Experience website to begin the practicum process. Walden provides guidelines for how to identify preceptors and practicum sites. Because Walden students are located around the world, they have the flexibility to identify sites based on their region/location. To begin the process, students identify a practicum site and initiate contact with a potential preceptor who meets the qualifications and may be interested in working with them. 

Students are encouraged to start the search to identify practicum sites and possible preceptors at least three terms before the beginning of their practicum courses, as it takes time for Walden to negotiate Affiliation Agreements with sites and to review qualifications of potential preceptors. Students should notify the Office of Field Experience of their identified preceptor nominees and practicum sites early in their specialization.  

Students are strongly encouraged to identify alternative practicum sites and preceptor nominees as back-ups and submit their application prior to application deadline in order to increase their opportunity for placement during the students’ desired term and to avoid practicum and academic delay. A completed application must be submitted via Meditrek® by the practicum application deadline date. Students must submit the application in Meditrek® for the application to be reviewed and processed. Incomplete applications will not be reviewed and may delay practicum placement and academic progress. 

“Identifying” a practicum site and a preceptor means that the student has received confirmation from a site and preceptor that the site is willing to host the practicum and the preceptor is willing to advise the student in the practicum during a specific term. 

The role of the preceptor is to provide interaction, guidance, and professional role modeling for students, as well as assisting the student in exploring either a health issue in the community or a quality/safety issue at the site. The preceptor does not track your hours or grade this experience. A preceptor is a trusted advisor and coach. A preceptor is a professional with experience and knowledge who will help guide a student in exploring ideas and identify resources to help the student develop a project during the practicum courses. 

Students must identify a potential preceptor for each practicum course and determine if the individual is interested in working with them. If so, students must find out whether this individual meets the qualifications to serve as a preceptor. Tips on how to identify a preceptor are provided below under the “Preceptor Requirements” heading. 

Students should contact the nursing field experience coordinators as soon as they identify a possible preceptor, and no later than the start of their second term, to nominate the individual to serve as their preceptor. Students should evaluate potential preceptors early by emailing nursingfield@mail.waldenu.edu to obtain feedback about whether the nominee is an acceptable preceptor candidate. 

Preceptor Requirements

• Preceptor must hold a bachelor’s degree (or higher) in a field related to the role.
• RN preceptors must hold an active, unencumbered license to practice professional nursing in the state where the practicum will occur.
• Preceptor must have a minimum of one year of experience and a current job role that is relevant to the project.
• The one year of experience is based upon the original date of licensure for licensed practitioners.
• Preceptor is able and willing to commit to the preceptor role for the duration of the practicum.
• Preceptor is employed at the practicum site where the practicum takes place.
• Preceptor cannot be the student’s relative, family member, fiancé, roommate, significant other, personal friend, or primary care provider, and does not have any other relationship that would create an actual or perceived conflict of interest. 
• The preceptor is not the student's direct or immediate supervisor and does not report directly to the student.
• Preceptor cannot be another BSN student.

Important Note: If it is found that a student’s preceptor is a relative, family member, fiancé, roommate, significant, personal friend, or primary care provider of the student, the practicum hours will be rejected and not counted toward the practicum hour requirement. If a student utilizes a preceptor inappropriately as noted above, this may lead to an academic integrity violation that could result in a sanction up to and including dismissal from the university. Students are responsible for nominating preceptors that fully meet all requirements for preceptors.

 

Note: Please refer to the “Course Specific Requirements” section for more course-specific requirements for preceptors.

Tips to Identify a Preceptor

1. Connect with colleagues at your place of employment as a resource.
2. Use your professional and personal networks to make connections, contacts, and referrals.
3. Grow your professional network through events at work, professional associations, or even social functions.
4. Develop a profile on professional networking sites to network, such as LinkedIn.
5. Connect with colleagues, friends, classmates, and alumni of Walden for contacts and referrals.
6. Connect with professional nursing-related groups in your local area.
7. Contact your state board of nursing to see if they have a list of available preceptors or resources.
8. Explore professional nursing associations, organizations, and networks to find preceptor resources.
9. Conduct an internet search of possible sites of interest, and then conduct cold calls and face-to-face visits.
10. Connect with your own healthcare provider for contacts and referrals.

The practicum is project-based, which involves a Faculty supervised experience with a preceptor outside of the classroom setting. Students must identify a preceptor and a site for the practicum course.

“Identifying” a practicum setting and a preceptor means that the student has received confirmation from a site and preceptor that the site is willing to host the practicum and the preceptor is willing to advise the student in the practicum during a specific term.

Students should follow the appropriate procedure at the practicum site to secure a practicum and to understand the practicum site requirements prior to beginning the practicum.

Students who wish to conduct their practicum at their place of employment should be aware that the loss of employment during their practicum may interfere with their ability to complete their required practicum hours and experiences.

Students may need additional preceptors in order to meet all the requirements for the course including logging all the required hours and/or requirements. If students need to precept with multiple preceptors to meet the course requirements, then they have an option to nominate another person as their supplemental preceptor, provided the supplemental preceptor nominee fulfills the requirements. When students complete their practicum application, they must provide a fully completed application for both their preceptor nominee and their supplemental preceptor nominee. Applications for supplemental preceptor nominees must be submitted by the application deadline. If students need to submit a supplemental application for a supplemental preceptor after the application deadline or during the term, they must go through the waitlist to submit a waitlist application.  Applications for supplemental preceptors go through the same review process as other applications and the same policies and requirements apply.  

Note: Practicum hours completed under a preceptor other than the preceptor who was identified in a practicum application—submitted by the student and approved in Meditrek®—will be rejected, and students will be required to repeat the hours. Failure to notify the Office of Field Experience, as stated above, will result in a Code of Conduct inquiry and may result in disciplinary action, including course failure and permanent dismissal from the university. For more information about the Code of Conduct, please refer to the Walden University Student Handbook: Code of Conduct.

NURS 4300/4301: BSN Capstone

The Capstone course provides students an opportunity to apply previously learned knowledge and skills with their baccalaureate education in the identification and implementation of a scholarly nursing project. Students will complete 100 hours in a practice setting and develop an evidence-based, patient-centered nursing project focused on a health care environment. This course will culminate with a presentation of their project to peers and others in the practice and academic community.  

Course Outcomes

1. Analyze practice problems to improve patient or population health outcomes.
2. Demonstrate effective communication skills in a manner that facilitates a partnership approach to quality care delivery.
3. Use leadership skills to develop a quality and safety or population health evidence-based project to improve healthcare outcomes.
4. Utilize information systems to support evidence-based decision-making and disseminate information to improve health care delivery.
5. Apply quality and safety or population health data to propose a change plan to improve health care outcomes in an organization or population.
6. Evaluate strategies for improving health equity and cost in population health or quality and safety to promote positive social change within healthcare.
7. Collaborate with health professionals to assess, plan, implement, and evaluate an improvement in practice related to quality and safety or population health.

Purpose of Practicum

Capstone is the culminating practicum course in the RN to BSN program. Students have an opportunity to apply previously learned knowledge and skills.  Students will collaborate with their preceptors to assess, plan, implement, and evaluate an improvement in practice through implementing a practice change plan.  

This course is formatted in five modules where students interact with preceptors throughout the course.  

Module 1: Students focus on Interprofessional Communication. In this assessment, students complete an interview to develop interprofessional skills. In addition, they use the 5 Whys to analyze an issue.  
Module 2: Students Evaluate data and evidence-based research to plan practice change.  
Module 3:  Apply leadership strategies in the collaboration process to develop a practice change to improve health outcomes.  
Module 4: Implement practice change to improve healthcare outcomes.  
Module 5: Evaluate practice change to improve healthcare outcomes. 

Appropriate Preceptor

Preceptors must be a BSN prepared nurse with an unincumbered license. Examples include chief nursing officer, director of nursing, nurse managers, quality improvement nurses, nurse managers of a patient care unit, manager of quality improvement, nursing educators, infection prevention nurses, charge nurses, public health nurses, school nurses, diabetes nurse educators, nutritional nurse, wound care nurse, etc.  

NURS 4210/4211: Role of the Nurse Leader in Population Health

The practicum is an active learning experience that provides students with the opportunity to apply their nursing knowledge in a community or public health setting. With the support from a preceptor, as well as guidance from the Faculty, students will apply the concepts and skills they are acquiring in the Role of the Nurse Leader in Population Health course to health problems in their own practice or in the community setting. The Faculty and practicum preceptor will provide feedback on student projects as they are developed during the course in weekly group Discussion. The practicum requires a minimum of 72 hours.

Practicum Learning Objectives:

• Identify a health issue for a specific population at risk. Health issues should be supported by an objective from Healthy People 2030.
• Analyze data pertaining to a specific community health issue for a specific population.
• Evaluate current evidence-based practices for your selected population and evidence-based strategies to address the identified health issue.
• Analyze evidence-based programs aimed at solving health problems.
• Develop a potential intervention plan in collaboration with other professionals that addresses a specific population. Take into account determinants of health, available resources, and activities that contribute to health and the prevention of illness or injury.
• Present practicum presentation to preceptor and other stakeholders.

Purpose for Practicum

The purpose of the practicum is to allow students the opportunity to develop a potential population-based solution to a recurring health problem in their community through evaluation of available and relevant data; a focused community assessment; and development of culturally appropriate intervention strategies designed to mitigate the problem, and to reduce incidence and prevalence among a selected population demographic.

Students develop a potential project to improve the health of a specific population of interest or a population at risk. This practicum is designed to help students develop as scholar-practitioners and health leaders to promote positive social change in their own community. In this practicum, students will focus on primary prevention of a health problem in their community.

Students already possess the knowledge and skills to help those who are acutely ill, so this practicum experience will help students learn how to prevent a health problem in a specific population at risk at the community and system level of care. Consequently, because students are well aware of how to care for individuals, they will now develop leadership and advocacy skills to improve the health of the community.

Collaborating with a preceptor and with other professionals and community members in the community will be the key to a successful practicum and project. Students collaborate with each other in the Discussions; with their Instructor, preceptor, and healthcare professionals (nurses and other disciplines); with local and state departments of health; and, most importantly, with the population they hope to help. As advocates, students will promote positive social change through collaboration with families, communities, and professionals in the healthcare system. They will develop a culturally relevant proposal that could improve health outcomes for a specific population group at risk in their community, which will be accomplished through the following:

• Interaction with public health professional preceptors who represent a public health or community agency
• Evaluation of health data on public health and other government websites
• Conduction of a community assessment through a windshield survey and available community resources (published community assessments, news reports, or other pertinent documentation)
• Development of an evidence-based public health intervention

Project Overview: Population-Based Nursing Care

Develop a potential project to improve the health of a specific population of interest. This practicum is designed to help students develop as scholar-practitioners and health leaders to promote positive social change in their own community. In this practicum, students will focus on primary prevention of a health problem in a specific population at risk at the community and system level of care.

Students are asked to collaborate with a preceptor, Faculty, and other students in the online Discussion Group. Students are also asked to collaborate with the population at risk, if possible. As an advocate, students will promote positive social change through collaboration with families, communities, and professionals in the healthcare system. Students will also develop a culturally relevant proposal that could improve health outcomes for a specific population at risk in their communities.

The purpose of the Population-Based Nursing Care Project is for students to design and present a nursing care plan for a specific population group; the plan focuses on primary prevention with system-level and population-based interventions. Community-based project examples include related to Healthy People 2030 include:

• Prevention of STIs in teens (STI–01): Increase the proportion of sexually active female adolescents and young women who get screened for chlamydia.
• Prevention of cervical cancer in women (C–09): Increase the proportion of females who get screened for cervical cancer.
• Prevention of childhood obesity (NWS–04): Reduce the number of children and adolescents with obesity.
• Prevention of diabetes in Hispanics (D–01): Reduce the number of diabetes cases diagnosed annually.
• Prevention of HIV (HIV–01): Reduce the number of new HIV cases.
• Prevention of maternal mortality (MICH–04): Reduce the number of maternal deaths.
• Prevention of opioid misuse (IVP–21): Reduce opioid deaths involving natural and semisynthetic opioids.

Practicum Assignments Overview

• Identification of a Population in Your Community
• Define Your Population and Selected Problem Using Health Data for Your City or County
• Cultural Considerations for Specific Populations
• Evidence-Based Practice Project
• Present PowerPoint Presentation to Community Preceptor and Other Members
• Presentation Finalized and Submitted to Faculty
• Students in Practicum Experience Discussions

Activities Leading Up to the Final Practicum Project

Students will:

• Investigate a health problem or concern supported by an objective of Healthy People 2030 that they believe exists in their community, and then confirm its existence through comparison of available health data on public health websites and through conversations with public health professionals.
• Select a population with a high-risk probability for development of this condition or injury.
• Evaluate the social determinants of health of the community.
• Evaluate available community resources that are designed to mitigate the problem.
• Consider gaps in services, and then develop culturally-, ethnically-, and age-appropriate interventions to address this condition or injury.
• Consider public health evidence-based interventions, such as those found in the Community Guide.
• Present the results of their investigations and proposed solution to their preceptor and other interested professionals.

Final Proposed Practicum Project: After soliciting feedback from the initial presentation to their preceptor and other interested professionals, students will submit their Final Practicum Project.

Appropriate Preceptors: It is preferred that the preceptor be a nurse. If a nurse is not available, other qualified interdisciplinary professionals with a role in population health or public health would qualify. Examples of preceptors could include public health nurses, infectious disease nurses/physicians, public health staff, school nurses, nutritionists, health educators, diabetes educators, or other qualified interdisciplinary preceptors related to population health or public health. Note: The preceptor generally should not be employed in a hospital or clinic setting.

NURS 4220/4221: Leadership Competencies in Nursing and Healthcare

The practicum is an active learning experience that provides students with the opportunity to apply nursing knowledge and skills that students acquire in NURS 4220/4211 to experiences in a healthcare setting. The practicum comprises selected practice experiences. Throughout their practicum, students will collaborate with leaders and other colleagues in their work or other practicum site; fellow students in practicum Discussion Groups; their preceptor; and their Faculty. Each week of the course outlines specific activities or reflections students will engage in during their practicum as they complete their proposed Practicum Quality and Safety Project. (Note: The practice problem must be related to patient outcomes, and staffing cannot be the main practice problem for the completion of the capstone project.) A complete description is presented on the practicum Discussion page of each week and is included below. 

Students are asked to collaborate with a preceptor, Faculty-Preceptor, and other students in the online Discussion Group. Students are also encouraged to interact and collaborate with other professionals in the agency about quality improvement. Students will develop a quality improvement plan in their setting, and then present this project via a storyboard to their preceptor and other interested professionals onsite. 

Practicum Learning Objectives 

1. Develop an evidence-based quality improvement plan 
2. Apply definition of quality to work setting 
3. Identify a quality improvement practice problem 
4. Perform a literature review to identify measurement standards for a problem identified in healthcare 
5. Summarize the purpose, methods, and findings from the evidence-based literature that relate to a practice problem 
6. Apply a process improvement model to a practice problem 
7. Apply a quality improvement process to an improvement plan 
8. Recommend strategies to reduce the cost of care 
9. Develop a quality improvement storyboard to address a practice problem 

Purpose for Practicum 

The purpose of the Practicum Quality and Safety Project is for students to design an evidence-based quality improvement plan that improves a quality and safety problem that is specific to their practice setting, which may be implemented once the course is over and once approved by management at the practice site. 

This evidence-based quality improvement plan will be accomplished through the following: 

• Interaction and collaboration with the nurse preceptor, healthcare leaders, colleagues, other professionals involved with quality and safety improvement efforts 
• Identification of the practice problem using readily available data that supports a problem exists 
• Utilization of an appropriate quality improvement tool 
• Application of a process improvement method 
• Development of an evidence-based quality improvement plan 

Project Overview: Quality and Safety 

Develop a quality improvement plan, which—if implemented—will improve patient outcomes at their facility. Students are asked to collaborate with a preceptor, Faculty-Preceptor, and other students in the online Discussion Group. Students are also encouraged to interact and collaborate with other professionals in the agency about quality improvement. 

Students are expected to be prepared to interact in a professional, respectful manner with their nurse preceptor and other professionals in the practice setting. Students are also asked to present a storyboard presentation. 

• Improve CAUTI (catheter-associated urinary tract infection), CLABSI (central line bloodstream infection), HAPI (hospital-acquired pressure injury), and HAPU (hospital-acquired pressure ulcers) rates. 
• Improve patient fall rates. 
• Improve medication error rates and bar code scanning compliance. 
• Improve patient satisfaction scores. 
• Improve documentation of pain reassessment. 
• Improve vaccination rates in the practice setting. 

Practicum Assignments Overview

• Apply definition of quality to practice setting. 
• Identify data in the practice setting that suggests a quality improvement problem exists. 
• Perform a literature review to identify best practices for a problem identified in practice setting. 
• Summarize the purpose, methods, and findings from the evidence-based literature that identifies solutions or interventions to a practice problem. 
• Apply a quality improvement model to a practice problem. 
• Identify quality improvement tools to share project data. 
• Develop and present a quality improvement storyboard. 

Appropriate Preceptors: The preceptor must be a nurse with at minimum a bachelor's degree. Examples of preceptors include chief nursing officer, directors, nurse managers, quality improvement nurses, nurse managers of a patient care unit, manager of quality improvement, nursing educators, infection control practitioners, charge nurses, unit managers, or other qualified nursing leaders.