Doctor of Nursing Practice (DNP) Practicum Manual:

Section 7. Practicum Policies

This manual contains only select policy information. All Walden students agree to abide by all university policies and procedures as a condition of acceptance and continued enrollment. Students should consult the Walden University Student Handbook for complete information about university policies and procedures.

Walden manages the practicum application processes in a nearly paperless environment, which permits verifiable electronic signatures, as regulated by the Uniform Electronic Transactions Act. Legally, an electronic signature can be the person’s typed name, email address, or any other identifying marker. An electronic signature is just as valid as a written signature as long as both parties have agreed to conduct the transaction electronically.

As outlined in the Student Handbook, students, faculty, and staff must use their WaldenU email address to communicate with one another regarding university business.  Students are required to check their Walden email account regularly to ensure they are receiving and/or responding to all communications.  The Office of Field Experience communicates with student about the practicum process and application process through their Walden email account.  Therefore, it is imperative that students check their Walden email account frequently, read each message in its entirety, and follow all instructions outlined in emails.

Students in Walden University nursing programs are required to comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as well as all field experience site-specific policies and procedures related to privacy and security of health-related information. Students enrolling in graduate field experience courses are required to complete annual HIPAA training and to have a certificate of completion on file in CastleBranch prior to being approved for practicum.

It is important to note that Walden University is not a “Covered Entity” or a “Business Associate” (as those terms are defined under HIPAA). Therefore, students must refrain from disclosing protected health information (PHI) to Walden University, since any disclosure of PHI to Walden University would constitute a HIPAA violation. The College of Nursing Faculty develop teaching/learning materials carefully so that these materials (e.g., assignments and logs), do not inadvertently lead students to share HIPAA identifiers or PHI.

Walden University is fully committed to creating and maintaining a safe environment and academic community for all students, Faculty, and staff. View “Walden University’s Notice of Nondiscrimination and Procedures for Students, Faculty, and Staff Reporting of Sexual Misconduct, Sexual Discrimination, or Other Related Reports” on the Student Safety/Title IX page.

Refer to Section 3: Student Expectations and Responsibilities, of the Walden University Student Handbook, for detailed policy information including the Code of Conduct.

Professional Competence

Refer to the Walden University Student Handbook for the Student Professional Competence Policy, reflecting academic standing, problem behaviors, inappropriate and/or unprofessional conduct, and critical behaviors.

Nondiscrimination and Sexual Harassment Policies

The Code of Conduct includes Walden’s nondiscrimination and non-harassment policies. Additional policy information regarding sexual misconduct, sexual discrimination, or other related reports is available from Walden’s Student Safety/Title IX page.

Students will abide by the nondiscrimination and non-harassment policies of the site and Walden University. If no such written policy exists, then the Walden policies must be adopted by the site.

All students in the College of Nursing participating in graduate practicum courses commencing on and after November 27, 2017, will be required to successfully complete specific onboarding requirements in order to be approved to complete field experience. Onboarding requirements must be obtained or completed through Walden’s designated provider, CastleBranch. Information about CastleBranch can be found on the Office of Field Experience website under Application Requirements.

Students who do not satisfactorily complete onboarding requirements prior to term start will not be permitted to begin their field experience. In situations such as this, failure to meet the requirements prior to term start may result in delay of practicum and academic progress.

Further information regarding onboarding requirements and the process can be found on the field experience website for Onboarding Requirements. 

Technical Standards and Professional Skills & Competencies Necessary for the Successful Completion of College of Nursing Programs

Walden University’s College of Nursing programs are designed to educate nurses for today’s professional environment by developing the skills of reflection, independent learning, and enhanced critical thinking. These standards will enable students to graduate from Walden’s programs and better equip them to fulfill their roles, develop leadership skills, and stay current in their field throughout their career. All students must be able to consistently demonstrate, with or without accommodation, the ability and fitness to perform nursing skills and professional behaviors in a manner to not jeopardize well-being and safety for patients, field sites, or themselves.  

Establishing professional relationships is a requirement for student success as well as professional practice. Students enrolled in the College of Nursing's programs must demonstrate positive professional relationships and complete active physical tasks both within and outside the classroom setting. This is especially important when working with other practitioners and patients in a professional setting during field experience Therefore, the following list of technical standards is provided to clearly establish the level of capability required to successfully complete College of Nursing programs of study and to encourage current and prospective students to self-assess their qualifications for the program.  

Walden University is committed to providing equal access to qualified students with disabilities. A qualified student is a student with a disability who, with or without reasonable accommodation, meets the technical standard requirements for participation in College of Nursing programs and activities. A reasonable accommodation is a modification or adjustment to an instructional activity, equipment, facility, program, or service that enables a qualified student with a disability to have an equal opportunity to fulfill the requirements necessary for graduation from the nursing program. College of Nursing applicants and students who require disability-related accommodations to meet program requirements are encouraged to contact the Office of Student Disability Services at disability@mail.waldenu.edu or 855-229-0848 at the earliest opportunity to receive support. 

A student in the College of Nursing must meet technical standard requirements, with or without accommodation, in the areas outlined below (examples are not all-inclusive).  Students must master the outlined essential and technical skills, produce positive academic outcomes, and conduct themselves within the guidelines of the Walden University Code of Conduct and in compliance with applicable professional practicum regulation.  Students who are not able to meet the technical standard requirements, produce positive academic outcomes, and socialize in the value structure of the profession, with or without accommodation, are encouraged to speak to their student success advisors regarding a potential educational path where such technical standard requirements and professional standards are not essential to patient safety and care. 

Students are advised that their success in their chosen program may be dependent on an ability to meet these technical standards. 

Motor and Mobility Function

Students must be able to perform the following functions:

• Observe patient condition and responses to health and illness.  
• Coordinate both gross and fine motor muscular movements, maintain equilibrium, and functionally use the senses of touch and vision.  
• Maintain stamina and physical ability required to participate in classes and activities that are part of the curriculum and practicum settings. 
• Execute movements sufficient to communicate effectively in a written format. 
• Obtain and interpret data from assessment techniques such as observation, palpation of anatomical structures, percussion, noting surface characteristics, assessment of tone, temperature, depth, and other diagnostic procedures. 
• Travel to and from practicum sites independently. 
• Push, pull, stoop, kneel, bend, carry equipment, lift, and operate assessing medical equipment as required for individual practicum experiences to achieve learning outcomes. 

Behavioral/Emotional Function

Students must be able to perform the following functions:

• Maintain mental acuity and professional demeanor in stressful environments or during impending deadlines.  
• Maintain mental acuity and professional demeanor sufficient to complete timed written and/or oral examinations and laboratory practical assessments within established time limits, especially when speed of performance or speed of decision making is a critical component.  
• Maintain emotional and physical endurance in a high-stress, fast-paced setting.   
• Respond to challenging situations in a respectful and professional manner, accept responsibility and accountability for one’s own actions, and act in a manner that minimizes any disturbance which might impact patient care and / or the academic learning process.  
• Tolerate physically – and mentally-taxing workloads, and function effectively under stress without exhibiting disruptive behavior in patient care and academic settings.   
• Provide self-care and manage personal stress to effectively care for patients in keeping with academic and professional practicum guidelines.

Critical-Thinking and Cognition Skills

Students must be able to perform the following functions:

• Analyze and synthesize data from a variety of sources.
• Put research findings into practice.  
• Exhibit a positive, interactive response to feedback.  
• Use sound judgment and apply safety precautions as appropriate.  
• Refrain from allowing the use of behavior- or mind-altering substances to impede professional functioning, includes prescribed or illicit substances.  
• Critically think through complex problem solving for positive patient outcomes.  
• Demonstrate higher-level cognitive abilities, which include:  
  • Rational thought
  • Measurement
  • Calculation
  • Conceptualization
  • Analysis
  • Synthesis
  • Organization
  • Memory
  • Application
  • Clinical reasoning
  • Ethical reasoning
  • Sound judgment

Interpersonal and Professional Skills

Students must be able to perform the following functions:

• Demonstrate respectful, mature, and professional relationships with individuals and groups from a variety of social, cultural, and intellectual backgrounds.  
• Recognize and problem-solve challenging professional relationships in a respectful manner, with ability to know when to seek out assistance prior to escalation.  
• Actively participate and contribute to group projects. 
• Consistently display integrity, honesty, empathy, caring, fairness, respect for self and others, diligence, and dedication  
• Promptly and accurately complete all assignments and responsibilities by provided due dates.  
• Develop mature, sensitive, and effective relationships, not only with patients but with all members of the university community and other healthcare teams.  
• Tolerate emotionally and mentally demanding workloads. 
• Identify potentially violent or abusive situations with patients in order to safely withdraw from the interaction.  
• Function effectively under stress, and proactively make use of available resources to help maintain both physical and mental health.  
• Adapt to changing environments, display flexibility, and be able to learn in the face of uncertainty.  
• Take responsibility for themselves and their behaviors.  
• Demonstrate awareness of ethical actions always as published by the University and professional nursing standards.  
• Respect the privacy and confidentiality needs of others.  
• Prioritize the welfare of patients, preceptor schedule, and academic schedule over self-interest when providing professional services.  
• Maintain flexible and open attitude towards change, new ideas, and new ways of learning. Accept constructive feedback openly and professionally.  
• Fulfill obligations promptly, consistently, reliably, and according to expectations of program faculty, academic leadership, and preceptors.  
• Maintain a professional appearance (including hygiene and attire) appropriate for the setting where you are representing Walden University as a student. 

Communication Skills

Students must be able to perform the following functions:

• Communicate accurately and effectively in any applicable setting including communications with university Faculty and staff, other students, and other healthcare professionals.  
• Elicit, convey, and clarify information in a timely manner.  
• Complete written work at a professional level in a timely manner  
• Document patient/client assessment/evaluation, intervention plans, and progress notations succinctly and in a time frame similar to clinical constraints.  
• Achieve basic technical competency and accuracy required to function in the classroom and professional setting, including functionality in word processing, email, and use of the internet.  
• Describe, effectively, perceived changes and perceive nonverbal communication.  
• Ability to speak, hear, and observe to elicit information from patients and team, describe changes in the patient, and perceive nonverbal communications.   
• Demonstrate verbal language capabilities sufficient to communicate effectively and sensitively with patients, patient families, and teams regarding plan of care.   
• Demonstrate sufficient writing and reading capabilities for record keeping, professional health care team interactions, and patient/family interactions.  
• Respect the autonomy and beliefs of others and refrain from imposing one’s own personal beliefs on others.  
• Act with an awareness of how personal actions affect others.  
• Communicate information truthfully and accurately.   

The Office of Field Experience abides by all practicum policies outlined in the Practicum Manuals to confirm the practicum policies and requirements are upheld to ensure all practicum experiences meet the required academic, accreditation, regulatory, legal, and compliance requirements.  Students must review the Practicum Manual to ensure they are meeting all policies and requirements for practicum. 

All exceptions to College of Nursing practicum policies must be formally appealed through the appeal process in Meditrek®.   To appeal a practicum policy, students must send an email to the Office of Field Experience at nursingfield@mail.waldenu.edu to initiate the appeal process and follow all directions to complete the appeal process through Meditrek®.   Supporting document must accompany all appeals at the time the appeal is submitted in Meditrek® in order for the appeal to be considered.  Students bear the responsibility to submit all relevant and required documentation supporting the appeal.      

Once the appeal is submitted in Meditrek®, the Office of Field Experience staff will review and verify the submitted documentation. If the required documentation is not submitted with the appeal, the appeal will be returned to the student and be provided the opportunity to resubmit the appeal within a specific period of time.  The initial review of the appeal will be completed within 7 business days.  Once the initial review has been completed, the appeal may be assigned to the Field Experience Supervisor, Director, Program Coordinator, or Program Director.  Final appeal decisions may take up to 30 days.  Students will be notified via email of the decision.   Students have an option to appeal the decision by submitting a second appeal, which are reviewed by the Associate Dean of the student’s program and considered the final decision.  

During their practicum, students may be vulnerable to any number of difficulties that can pose barriers to a successful learning experience. By the time students reach the end of the program, they are entering the work setting and should demonstrate effective problem-solving skills in many difficult situations. However, students are not expected to resolve practicum problems alone.

With Practicum Site Personnel

If a problem develops between students and their practicum preceptor (or other site personnel), they should consult the practicum course Faculty Member, and then, if needed, they may consult the specialization coordinator.

Significant problems that arise in the practicum setting should be addressed using the process available to employees at the site and as officially documented in the site Affiliation Agreement signed for the practicum experience. The appropriate Walden Faculty or staff member will assist students in preparing any necessary documentation and will closely monitor the progress of the problem resolution, including any grievance process.

The specialization coordinator and/or program director should inform the dean of the College of Nursing about any unresolved issues and must formally document the efforts to resolve the issues presented. The dean will review the efforts to resolve the problem and inform students of other possible recourse options.

With Walden Faculty or Staff Members

Consistent with ethical guidelines, in nearly all situations, students should initially address any concerns directly with the Faculty or staff member involved (e.g., practicum course Faculty Member, specialization coordinator) and attempt to resolve the issue at an informal level, before proceeding to a request for intervention (e.g., from the program director or dean). Failure to address the problem at the program level may delay resolution, as the problem will likely be referred back to the program level.

There shall be no retaliation against any student who identifies a problem or seeks assistance in resolving a conflict involving practicum site personnel, including those students who choose to file a formal grievance. We encourage students to notify Walden as soon as possible to allow for intervention and resolution, if possible.

1. Consult the Appropriate Specialization Coordinator

If a problem develops between students and their practicum course Faculty Member (or other Faculty or staff member), the specialization coordinator will help students determine the appropriate strategy to resolve the problem in an informal manner. The Faculty or staff member and/or the coordinator should fully inform the program director associate dean about any unresolved issues and document all attempts to resolve the issues students have presented. All parties should receive copies of documents memorializing resolution of and attempts to resolve the issues, after such documentation is submitted to and approved by the appropriate dean.

2. Consult the Program Director

If students are not able to resolve the problem with the support and intervention of the program coordinator, they should approach the program director to seek guidance and/or intervention. The program director should already have copies of all the documentation of the problem and resolution efforts. The program director will initiate further investigation of the concern. Students may be offered counseling or other support at the program director’s discretion.

3. Consult the Dean

If students are not able to resolve the problem with the support and intervention of the program director, they should approach the dean to seek guidance and/or intervention. The dean should already have copies of all the documentation of the problem and resolution efforts. The dean will initiate further investigation of the concern. Students may be offered counseling or other support at the dean’s discretion.

4. Consider Filing a Grievance

If the dean is unable to facilitate resolution of the problem, students may consider filing an appeal or grievance following Walden University’s grievance procedure. Students should consult the Walden University Student Handbook: Process for Petitions, Appeals, Grievances, and Complaints for guidance on the process of submitting an appeal or grievance.

Note: Filing a grievance may initiate reassignment of one or more of the involved parties for a reasonable period to allow for an appropriate investigation of the situation. The right to confidentiality, both of the complainant and of the accused, will be respected to the extent possible insofar as it does not interfere with the institution’s legal obligation or ability to investigate allegations of misconduct brought to the university’s attention or to take corrective action when it is found that misconduct has occurred.

Scope

The College of Nursing is committed to providing a safe and healthy environment for our students. Protecting nursing students from exposures is a critical component of the practicum education environment. Practicum situations present the possibility for contact with blood, body fluids, and other potentially infectious materials that pose infectious disease risk.

The purpose of this plan and protocol is to provide procedures to be used by students, Practicum Instructors/Faculty, field experience staff, and academic program leadership when a student experiences an exposure to blood, bodily fluids, or other potentially infectious or hazardous materials while participating in a field experience activity while enrolled in a practicum course in the College of Nursing at Walden University. Walden University cannot identify and protect against the specific exposure risks present at the various sites where its students participate in their field experiences and, therefore, expects students to adhere to the exposure policies and protocols maintained at their practicum site.

Note: This plan and protocol are intended to supplement the policies and protocols maintained at the practicum site and shall not be interpreted to conflict with or replace practicum site polices and protocols.

Overview

All students enrolled in a practicum course in the College of Nursing must practice universal precautions, which, according to the Occupational Safety and Health Administration (OSHA), means that all human blood and human bodily fluid is treated as if known to be infectious for HIV, HBV, and other bloodborne pathogens. While OSHA’s bloodborne pathogen standards apply to employers and employees, Walden expects students in the College of Nursing to adhere to OSHA standards and guidance to protect against the risks of exposure to bloodborne pathogens.

Training

In order to minimize risk posed to students and/or patients by persons infected with blood borne pathogens, bodily fluids, or potentially hazardous materials, as identified by the Centers for Disease Control and Prevention (CDC) and OSHA, students enrolling in graduate practicum courses are required to complete annual training and have a certificate of completion on file in CastleBranch prior to being approved for practicum. Training includes information on hazard recognition, bloodborne pathogens, exposure prevention, universal precautions, standard precautions, use of personal protective equipment (PPE), workplace safety, and post-exposure procedures.

Students are required to adhere to all practicum site policies and protocols, as well as applicable OSHA standards, to prevent contact with human bodily fluids or other potentially infectious and hazardous materials. Students must routinely use appropriate PPE tailored to the risks present at the field experience site.

Health Insurance

The College of Nursing strongly advises all nursing students to have personal health insurance, or join a healthcare plan, to cover the expenses of their healthcare treatments in case of exposure, injury, and/or care for a catastrophic illness or serious chronic condition within or outside the clinical setting during their practicum experience.

Students are responsible for all costs and bills incurred during the practicum experience if not covered by health insurance. Walden University does not pay for costs related to healthcare for students during practicum courses.

Protocol for Exposure

1. Clean it: Students exposed to blood borne pathogens or human body fluids should take immediate first aid including the following:

• Wash the exposed area immediately with soap and water.
• Wash wounds and skin with soap and water.
• Flush splashes to the nose, mouth, or skin with water.
• Irrigate eyes with clean water, saline or sterile irrigates.

2. Get treatment: Students who are possibly exposed to blood borne pathogens or human body fluids, during practicum, should follow this process:

• For exposures in a setting with a policy covering possible exposure to bloodborne pathogens and human body fluids, the policy and protocols of the facility must be followed. If the facility does not have a policy or protocols for laboratory tests, the student should either report immediately to their personal healthcare provider or to the nearest emergency room. The student should identify themselves as a nursing practicum student and request laboratory tests as recommended by the CDC. Students must follow all post-exposure directions provided by the healthcare provider or the emergency room and required follow-up instructions. Students are responsible for the cost of testing if health insurance does not cover the costs.
• For exposures in a setting where there is no policy on possible exposure to bloodborne pathogens and human body fluids, the student should either report immediately to their personal healthcare provider or to the nearest emergency room. The student should identify themselves as a nursing practicum student and request laboratory tests as recommended by the CDC. Students must follow all post-exposure directions provided by the healthcare provider or the emergency room and required follow-up instructions. Students are responsible for the cost of testing if health insurance does not cover the costs.

3. Report it:

• Students: Students who are possibly exposed to blood borne pathogens or human body fluids during practicum, must report the exposure as follows:
  • Report to their preceptor at the Practicum  site immediately upon exposure. Students must follow all protocols as required by their Practicum site.
  • Report to their practicum Course Instructor or Faculty Member as soon as possible.
• Practicum Course Instructors and Faculty Members:
  • Practicum Course Instructors and course Faculty Members will keep a record of the incident, circumstances of the incident, steps taken, and the communication with the student.
  • Practicum Course Instructors or course Faculty Member will send a copy of the record to the following individuals:
    • Students’ program director and program coordinator
    • NP program clinical coordinator
    • Director of field experience
    • Note: The director will review site’s Affiliation Agreement to ensure all site policies and protocols are being followed.

Students With Disabilities

The College of Nursing at Walden will not discriminate on the basis of disability and is committed to providing all qualified students with disabilities equal access to its programs, services, and activities in accordance with the Americans with Disabilities Act and Section 504 of the Rehabilitation Act of 1973.

In postsecondary education, it is the students’ responsibility to self-identify disability status and register with the Office of Disability Services prior to requesting accommodations. To register, students should submit documentation of disability along with Walden’s Accommodation Request Form to disability@mail.waldenu.edu.

The process and form are available from the Office of Disability Services. Students with disabilities requesting accommodations to access field experiences, such as a practicum and/or internship, should register with the Office of Disability Services prior to registering for those field experiences and clarify their specific accommodation needs. In most cases, field experience sites have their own systems for ensuring equal access for employees/interns with disabilities. The Office of Disability Services will help address any gaps in those systems.