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KPSA Student Handbook 1

Kaiser Permanente School of Anesthesia Student Handbook

TABLE OF CONTENTS

1. INTRODUCTION .............................................................................................................. 5 PROGRAM GENERAL CONTACT INFORMATION ...............................................................................5 POLICY CHANGES AND DISCLAIMER ................................................................................................8

POLICY ON POLICY DEVELOPMENT AND CHANGE ........................................................................ 8 ACCREDITATION .............................................................................................................................8 NON-DISCRIMINATION ...................................................................................................................8 PROGRAM MISSION AND PHILOSOPHY ...........................................................................................8 TERMINAL OBJECTIVES ................................................................................................................. 10

2. ETHICS .......................................................................................................................... 13 ADMISSIONS ................................................................................................................................ 13

CATEGORIES OF ADMISSION ............................................................................................................... 13 ADMISSION REQUIREMENTS .............................................................................................................. 13 REQUIREMENTS FOR ADMISSION TO THE UNIVERSITY ...................................................................... 14 DEADLINES .......................................................................................................................................... 15 TECHNICAL STANDARDS...................................................................................................................... 15 CRIMINAL BACKGROUND CHECK, HEALTH AND DRUG SCREENING ................................................... 16 INFORMATION SHARING AND PRIVACY POLICY ................................................................................. 17 SPECIAL ACCOMMODATIONS ............................................................................................................. 17

RIGHTS AND RESPONSIBILITIES ..................................................................................................... 18 APPLICANTS ......................................................................................................................................... 18 STUDENTS ........................................................................................................................................... 19 INSTITUTIONAL RESPONSIBILITES AND EXPECTATIONS ..................................................................... 19 COUNCIL ON ACCREDITATION ............................................................................................................ 21

3. PROFESSIONALISM AND INTEGRITY .............................................................................. 21 PRACTICE AND PROFESSIONAL ETHICS .......................................................................................... 21 PROFESSIONAL DECORUM ............................................................................................................ 23

GUIDELINES FOR CLINICAL CONDUCT ................................................................................................. 23 DRESS CODE ........................................................................................................................................ 23 CLINICAL SETTING ............................................................................................................................... 24 SIMULATION POLICY ........................................................................................................................... 25

CONFIDENTIALITY OF MEDICAL RECORDS AND HEALTH INFORMATION (HIPAA) ............................. 25 TITLE AND IDENTIFICATION ................................................................................................................ 26 MOBILE PHONES AND MOBILE DEVICES ............................................................................................. 27

4. CURRICULUM, FACULTY AND COURSE DESCRIPTIONS ................................................... 27 KPSA EDUCATIONAL MATRIX ........................................................................................................ 28 KPSA FACULTY .............................................................................................................................. 35


COURSE DESCRIPTIONS ................................................................................................................ 35

5. ACADEMIC POLICIES ..................................................................................................... 35 REGISTRATION ............................................................................................................................. 35 ATTENDANCE POLICIES ................................................................................................................. 35 COURSE POLICIES ......................................................................................................................... 36

EXAMINATIONS ................................................................................................................................... 36 KPSA GRADING SCALE ......................................................................................................................... 38

ACADEMIC MISCONDUCT ............................................................................................................ 39 KPSA ACADEMIC INTEGRITY POLICY ................................................................................................... 39

FRATERNIZATION ......................................................................................................................... 40 GRADUATION ............................................................................................................................... 40 CLINICAL SUPERVISION OF STUDENTS ........................................................................................... 41

6. ACADEMIC AND CLINICAL SCHEDULING......................................................................... 41 TIME COMMITMENT .................................................................................................................... 41 ACADEMIC INSTRUCTION ............................................................................................................. 41 HOLIDAYS .................................................................................................................................... 42 CLINICAL SCHEDULING .................................................................................................................. 42 CLINICAL ABSENCE ....................................................................................................................... 42

CLINICAL ROTATION REQUIREMENTS ................................................................................................. 43 SELF EVALUATION EXAMINATION (SEE) ............................................................................................. 43 REQUIRED CONFERENCES AND MEETINGS ......................................................................................... 43 MATERNITY LEAVE .............................................................................................................................. 44 LEAVE OF ABSENCE ............................................................................................................................. 44

7. FINANCIAL CONSIDERATIONS ....................................................................................... 45 FINANCIAL ASSISTANCE ................................................................................................................ 45 PROGRAM EXPENSES AND TECHNOLOGY REQUIREMENTS ............................................................ 45 HEALTH INSURANCE ..................................................................................................................... 47 LIABILITY INSURANCE ................................................................................................................... 47 REQUIRED TEXTBOOKS ................................................................................................................. 47

8. STUDENT RESPONSIBILITIES IN THE CLINICAL AREA ....................................................... 47 CASE RECORDING ......................................................................................................................... 47 CARE PLANS ................................................................................................................................. 48 CLINICAL TIME .............................................................................................................................. 48

CLINICAL ORIENTATION ...................................................................................................................... 49 CLINICAL ROTATION ACCOMODATIONS ............................................................................................. 49 COMMUNICATION AND DISTRACTIONS (CLASS, CLINICAL AND PROF. MEETINGS) ........................... 50

LICENSURE ................................................................................................................................... 50 MEDICATION SAFETY .................................................................................................................... 51

9. ENVIRONMENTAL AND CHEMICAL HAZARDS ................................................................. 51


ENVIRONMENTAL HAZARDS ......................................................................................................... 51 CHEMICAL DEPENDENCY .............................................................................................................. 52

10. CLINICAL AFFILIATIONS .............................................................................................. 56 DUTIES OF CLINICAL COORDINATORS AT CLINICAL SITES ............................................................... 56

11. LIBRARY AND COMPUTER RESOURCES ....................................................................... 56

12. EVALUATION PLAN .................................................................................................... 57 OVERVIEW ................................................................................................................................... 57 EVALUATION OF STUDENTS .......................................................................................................... 57

ACADEMIC EVALUATION ..................................................................................................................... 57 CLINICAL EVALUATION ........................................................................................................................ 58

EVALUATION OF FACULTY ............................................................................................................ 59 EVALUATION OF PROGRAM .......................................................................................................... 60 SUMMARY OF EVALUATION METHODS AND PROCESS................................................................... 60

13. ACADEMIC PROGRESSION ......................................................................................... 63 GUIDELINES FOR CLINICAL PROBATION ......................................................................................... 63 GUIDELINES FOR ACADEMIC PROBATION ...................................................................................... 64 DISMISSAL ................................................................................................................................... 65

CLINICAL AND ACADEMIC REASONS FOR DISMISSAL ......................................................................... 66 WITHDRAWAL .............................................................................................................................. 66

14. COMMITTEES, MEETINGS, GRIEVANCE AND APPEALS ................................................ 67 CURRICULUM AND EVALUATION COMMITTEE .............................................................................. 67 ADMISSIONS COMMITTEE ............................................................................................................ 67 KPSA FACULTYMEETING ............................................................................................................... 67 CSUF COMMUNITY OUTREACH MEETING ...................................................................................... 67 CLINICAL COORDINATOR MEETING ............................................................................................... 68 GRIEVANCE AND APPEALS ............................................................................................................ 68

ACADEMIC APPEALS ............................................................................................................................ 68

15. CLINICAL PERFORMANCE OBJECTIVES ........................................................................ 68 TERMINAL CLINICAL OBJECTIVES ................................................................................................... 68 CLINICAL OBJECTIVES FOR SPECIALTY ROTATIONS ......................................................................... 70

CARDIAC SURGERY ROTATION ............................................................................................................ 71 PEDIATRIC ROTATION ......................................................................................................................... 72 NEUROSURGICAL ROTATION .............................................................................................................. 73 OBSTETRIC ROTATION ......................................................................................................................... 75 REGIONAL ROTATION .......................................................................................................................... 76

16. IMPORTANT CONTACT INFORMATION ....................................................................... 78 DAILY CLINICAL EVALUATION TOOL .............................................................................................. 79 PHOTOGRAPHIC AND VIDEOTAPING AGREEMENT & RELEASE FORM ............................................. 81


STUDENT NURSE ANESTHETIST STATEMENT .................................................................................. 82


1. INTRODUCTION

Welcome to the Kaiser Permanente School of Anesthesia (KPSA). This Student Handbook is intended to be used as a reference for questions regarding policy, procedure or any other matters related to our nurse anesthesia program. It should be referred to on an ongoing basis as questions arise. In addition to the policies in this handbook, students are expected to adhere to all policies in the

• California State University School of Nursing Graduate Handbook http://nursing.fullerton.edu/_resources/msn/2014_2015%20Graduate%20Nursing%20Handbook.pdf

• California State University Graduate Catalog http://www.fullerton.edu/catalog/

• California State University Graduate Student Guide http://www.fullerton.edu/graduate/currentstudents/graduateforms.asp

• AANA documents: Scope of Practice, Code of Ethics, etc. (requires login) http://www.aana.com

PROGRAM GENERAL CONTACT INFORMATION

Kaiser Permanente School of Anesthesia 100 South Los Robles, Suite 501 Pasadena, CA 91188 626-564-3000 Fax: 626-564-3099 www.kpsan.org

Office hours: 0700-1700 Monday- Friday

Revision history: This document was reviewed May 2016

http://nursing.fullerton.edu/_resources/msn/2014_2015%20Graduate%20Nursing%20Handbook.pdf


http://www.fullerton.edu/catalog/

http://www.fullerton.edu/graduate/currentstudents/graduateforms.asp

http://www.aana.com/

http://www.kpsan.org/


Kaiser Permanente School of Anesthesia & Southern California Medical Group Relationship

Edward Ellison, MD Medical Director

Todd Sachs, MD Medical Director Operations

Annie Russell Chief Operating Officer

Paul Minardi, MD Medical Director Business

Management

Sylvia Everroad, RN, MSN Regional Chief

Administrative Officer

Alex Chin, MD Kaiser Permanente

School of Anesthesia Medical Advisor

John Nagelhout, CRNA, Ph. D Kaiser Permanente

School of Anesthesia Director

Sass Elisha, CRNA, Ed. D Kaiser Permanente

School of Anesthesia Assistant Director

Michael Boytim, CRNA, Ed. D Kaiser Permanente

School of Anesthesia Assistant Director


Kaiser Permanente School of Anesthesia Organizational Structure

John Nagelhout, CRNA, Ph.D., F.A.A.N. Director

Sass Elisha, CRNA, Ed. D. Assistant Director

Michael Boytim, CRNA, Ed. D. Assistant Director

Edward Waters, CRNA, DNP Instructor

Sandra Bordi, CRNA, DNP Instructor

Jeremy Heiner, CRNA, Ed. D. Instructor

Jennifer Thompson, CRNA, DNP Instructor

Bryun Sakaye, BA Web Developer

Retta Smith Administrative Specialist III

Sandra Hinkson Administrative Specialist III


POLICY CHANGES AND DISCLAIMER

The Program reserves the right to make policy changes as the needs of its administration, faculty, students and conducting or affiliating institutions change. These changes may occur without prior notification. To assure that you have the most current information available, please contact the Program administrators.

POLICY ON POLICY DEVELOPMENT AND CHANGE

Procedure Suggested new or revised policies and procedures will be presented to the faculty for a first reading and discussion. The faculty will decide on whether to adopt the policies and procedures at their next regular meeting. The faculty will determine the implementation date of new policies as part of their review. All faculty and students will be notified by E-mail before substantive change(s) to policies or procedures are implemented. The Handbook will be published online.

ACCREDITATION

The Kaiser Permanente School of Anesthesia is accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), 222 S. Prospect Ave., Park Ridge, IL, 60068; (847) 655-1160; Email [email protected]; Web http://home.coa.us.com The program's next accreditation review by the COA is scheduled for 2017. Outcomes of interest (attrition, certification exam performance, and employment) are published at http://www.kpsan.org/about-the-school/program-statistics California State University Fullerton is accredited by the Commission on Collegiate Nursing Education (CCNE), One Dupont Circle, NW Suite 530, Washington, DC 20036; (202) 887-6791, the Western Association of Schools and Colleges (WASC), 985 Atlantic Avenue, Suite 100, Alameda, CA 94501; (510) 748-9001 and the California Board of Registered Nursing, PO Box 944210, Sacramento, CA 94244-2100; (916) 322-3350.

NON-DISCRIMINATION

Applicants, students and faculty will not be discriminated against on the basis of race, color, religion, sex (including pregnancy), gender identity, national origin, age, physical or mental disability, veteran status, sexual orientation, genetic information or other status protected by applicable federal, state or local laws or by corporate policy.

Kaiser Permanente School of Anesthesia (KPSA) abides by the nondiscriminatory admissions/hiring policies of California State University, Fullerton (CSUF) and Kaiser Permanente (KP).

PROGRAM MISSION AND PHILOSOPHY

Our Mission Statement The Kaiser Permanente School of Anesthesia exists to provide affordable, high-quality anesthesia care services and to improve the health of the communities we serve. Our Vision Statement Our commitment is to be an innovative leader and the model for excellence in nurse

http://home.coa.us.com/

http://www.kpsan.org/about-the-school/program-statistics


anesthesia education and community service. Our Core Values

1. Student Development - our primary goal is to empower our students to achieve their full potential.

2. Community Service - our commitment to social responsibility and diversity is reflected in our service to the community.

3. Respecting Partners – we excel through our strategic alliances with dedicated, professional colleagues.

4. Innovative Learning – we foster an environment, which values adult education, self-motivation, critical thinking, and lifelong learning.

5. Patient Focused – our program is grounded in promoting anesthesia excellence in the care of the individual.

6. Team Commitment – the success of our team is based on interdependent growth and mutual respect.

The programs mission exists as an extension of the mission and vision of Kaiser Permanente, California State University Fullerton, and California State University Fullerton School of Nursing.

• Kaiser Permanente mission statement, aspiration and promise http://insidekp.kp.org/insidekp/communicate/kppromise/index.html

• California State University Fullerton mission and goals http://www.fullerton.edu/aboutcsuf/mission.asp

• California State University Fullerton School of Nursing mission and goals http://nursing.fullerton.edu/aboutus/missiongoals.asp o Mission - The School of Nursing (SON) is committed to providing quality

undergraduate and graduate nursing programs, which are accessible to a diverse student population. In doing so, we strive to be a center of excellence in nursing education. We endeavor to be proactive in meeting societal health imperatives related to an increasingly diverse population of potential patients or clients. We are committed to promoting the health of individuals and communities through innovative educational partnerships, faculty and student scholarship, and service; and to the preparation of competent graduates who share these values and who demonstrate their commitment to professional practice throughout their nursing careers.

o Goals – To provide quality nursing programs which are accessible to a diverse

student population. To prepare graduates who can provide culturally competent care within a

framework of scientific and professional accountability and function independently in a variety of settings.

To prepare graduates with the necessary foundation for further education and specialization within their chosen career path.

To encourage our learners to commit to lifelong learning for personal and professional growth.

To establish and maintain innovative educational partnerships to promote health and meet societal imperatives.

http://insidekp.kp.org/insidekp/communicate/kppromise/index.html

http://www.fullerton.edu/aboutcsuf/mission.asp

http://nursing.fullerton.edu/aboutus/missiongoals.asp


To be recognized as a center of excellence in nursing education • California State University Fullerton School of Nursing learning outcomes, philosophy,

and practice model http://nursing.fullerton.edu/aboutus/learningoutcomes.asp

TERMINAL OBJECTIVES

Upon successful graduation from KPSA, a graduate will have the knowledge and ability to fulfill these key objectives. Patient Safety

Maintain vigilance and patient safety throughout the perianesthetic continuum.

Protect patients from iatrogenic complications, and utilizes appropriate precautions in infection control.

Position or supervise the positioning of patients to prevent injury.

Utilize standard precautions and appropriate infection control measures.

Utilize emerging health technologies.

Conduct a comprehensive and appropriate equipment check.

Individualized Perianesthetic Management

Provide care throughout the perianesthetic continuum.

Use a variety of current anesthesia techniques, agents, adjunctive drugs, and equipment while providing anesthesia

Provide anesthesia services to patients of all ages and physical conditions for a variety of surgical and medically related procedures, including trauma and emergency cases.

Perform a pre-anesthetic assessment and formulates an anesthesia care plan for patient to whom he/she is assigned to administer anesthesia.

Administer and manage a variety of regional anesthetics.

Function collaboratively with a multi-disciplinary team to affect patient outcomes.

Deliver culturally competent perianesthetic care throughout the anesthesia experience.

Function as a resource person for airway and ventilator management of patients.

Serve as a leader or member of cardiopulmonary resuscitation team and possess current ACLS, BLS, and PALS certifications.

Critical Thinking

Apply theory to practice in decision-making and problem solving.

http://nursing.fullerton.edu/aboutus/learningoutcomes.asp


Provide nurse anesthesia care based on sound principles and research evidence.

Perform a preanesthetic assessment and formulate an anesthesia care plan for patients to whom they are assigned to administer anesthesia.

Identify and take appropriate action when confronted with anesthetic equipment-related malfunctions.

Interpret and utilize data obtained from noninvasive and invasive monitoring modalities.

Calculate, initiate, and manage fluid and blood component therapy.

Recognize and appropriately respond to anesthetic complications that occur during the perianesthetic period.

Critique and integrate scholarly research in order to improve anesthesia care.

Communication Skills

Effectively communicate with all individuals influencing patient care.

Utilize appropriate verbal, nonverbal, and written communication in the delivery of perianesthetic care.

Demonstrate the ability to deliver a clear and organized public presentation.

Professional Role

Demonstrate personal and professional integrity.

Demonstrates respect for human dignity to patients, peers, and organizations.

Teach others.

Continue commitment to lifelong learning of anesthesia through professional development.

Function as an advocate for patients, families and communities.

Positively influence health care policy decision and participate in activities which influence advanced nursing roles and improve patient care.

Understands sound principles of anesthesia risk management to include preventive and procedural strategies.

Function as a registered professional nurse within appropriate professional standards, ethical and legal requirements and to accept responsibility and accountability in the delivery of patient care.

Participate in quality management activities and operate with budget restraints and cost effectiveness.

The expected Master of Science in Nursing Student Learning Outcomes of the California State


University Fullerton School of Nursing program are derived from the School of Nursing admission, goals, philosophy, and practice model; program goals; and, professional nursing standards and guidelines.

• Ethics: Evaluate ethical decision making from a personal and organizational perspective, develop an understanding of how these two perspectives may create conflict of interest, and act to resolve them.

• Professional Practice: Integrate a wide range of theories and knowledge from nursing and other disciplines to develop a comprehensive and holistic approach, implement advanced roles, and continue life-long learning.

• Evidence Based Practice: Access, analyze, and interpret information (theoretical, research, other) at the individual/family and community level to provide high quality health care, initiate change, and improve nursing practice and health care outcomes.

• Critical Thinking: Use a systematic approach to identify, analyze and diagnose real or potential problems with a variety of health care settings, and develop, evaluate and test possible solutions based upon highest level of evidence available, allowing for innovative solutions to the problem.

• Communication: Manage communication, including the uses of informatics, with clients, colleagues, and diverse groups to foster effective collaboration to promote optimal health outcomes in individuals/families/communities.

The nurse anesthesia faculty believes that care, competence, scientific inquiry, and integrity are the heart of the profession of nurse anesthesia. Care denotes the respect for and advocacy that we provide for patients as a unique individual. Care values guiding practice include respect, integrity, compassion, and excellence. These values will facilitate maintaining or promoting beneficial health or well being of patients and the communities we live and work in. Competence refers to the skill, knowledge of relevant scientific disciplines, and vigilance that we exercise. Scientific inquiry is necessary for recognition and to advance the nursing profession and its advanced specialties. Integrity is vital. The faculty expects that students are absolutely honest. This includes admitting mistakes; forthrightness with patients, families, and other team members; and a thorough standard of accountability with respect to controlled substances and other medications. The Program seeks to educate students at a higher level of learning. It is necessary to synthesize concepts and theory and apply these in the production of a plan relevant to safe patient care in specialty nursing practice. Students are taught to analyze relationships that connect various phenomena. The student is expected to exercise a high level of judgment in the classroom and clinical area. The graduate program prepares students beyond the certification and Master's level of education in that the graduate can evaluate clinical practice utilizing statistical analysis and research skills. The Program meets and frequently exceeds the minimum standards for programs of nurse anesthesia as dictated by the COA. Faculty expectations of students are carefully enumerated in course syllabi and clinical objectives; however, in addition to these, program faculty have additional expectations. We expect that students are intellectually curious and are sensitive of the need to study independently and in depth; to return to physiology and pharmacology, nursing science and other basic courses, to make inferences, draw upon past experience and integrate them with the


present, develop concepts, think through processes and to ask questions of oneself and others. We expect that each student's concern and respect for their classmates will be as great as their concern and respect for themselves; if a student comes unprepared for class or clinical assignments, they will require a disproportionate amount of the instructor's time and deprive other students of their rightful share of the learning experience. Graduate education in the field of nurse anesthesiology will prepare Certified Registered Nurse Anesthetists to contribute to the body of knowledge in the specialty of nurse anesthesiology and improve patient care through describing, explaining, predicting and controlling anesthesia related phenomena. Student interest and commitment to research are inextricably related to a learning climate in which scholarly inquiry is valued. Throughout the program, the student is encouraged to use knowledge and creativity, independent study and increased self-awareness. In addition, the student must readily accept responsibility for his/her actions, actively support the goals of the profession and the Program, and display the knowledge and skill needed to act independently, as well as the flexibility to be a good team member. 2. ETHICS

Programs of nurse anesthesia shall be conducted within the ethical and moral standards defined by those professional groups (organizations, institutions, agencies, government boards or other entities) having an impact on the individual program and on nurse anesthesia in general.

ADMISSIONS

CATEGORIES OF ADMISSION

The KPSA program recognizes only "regular" and "contingent" admission as described below. 1. Regular admission is selectively afforded to applicants who satisfy all admission

requirements of CSUF and KPSA. 2. Contingent admission is afforded to applicants who appear qualified for regular

admission but have not documented completion of all requirements. When the admission requirement has been completed, the faculty will make a decision about regular admission. Students admitted on a contingent basis, must resolve the incomplete requirement prior to registering for classes.

ADMISSION REQUIREMENTS

Applicants must meet both CSUF University and SON graduate admission requirements as follows:

• Active, unrestricted Registered Nurse (RN) license with no disciplinary action pending (if licensed outside of California, must be qualified to become licensed by the state of California prior to starting the program in August).


• Baccalaureate Degree in Nursing (BSN) or Master's Degree in Nursing (MSN) from a regionally accredited institution.

• Minimum degree GPA of 3.2 on a 4.0 scale in the highest nursing degree earned (BSN or MSN).

• Prerequisite Course: Upper Division Statistics with a grade of C or better (can be pending or in progress at the time of application but must be completed prior to starting the program in August). For more information about this prerequisite, visit the SON Prerequisites web page.

• Minimum of one year of current, full-time clinical RN experience in Adult ICU. The Adult ICU requirement can be satisfied by working in any kind of Adult ICU environment, such as a Medical ICU, Surgical ICU, Coronary Care Unit, Trauma ICU, Cardiovascular ICU, Neuro ICU, Burn ICU, and CT ICU. The following experience is NOT considered adult critical care: emergency room, post anesthesia care unit, step down unit, cath lab.

REQUIREMENTS FOR ADMISSION TO THE UNIVERSITY

All applicants to the MSN Nurse Anesthesia program must have earned a Baccalaureate degree in Nursing (BSN) or a Master's Degree in Nursing (MSN) from a regionally accredited college/university.

• Regional accrediting organizations include MSCHE, NEASC, NCA-HLC, SACS and WASC. Regional accreditation is granted to the university, not the nursing program. To verify the accreditation of your baccalaureate and master's degree granting university/college(s), visit the institution's website and/or search for the school on the regional accrediting organizations' websites.

• National accreditation alone is not sufficient.

Foreign degrees: If you completed your Baccalaureate and/or Master's degree outside of the United States, to verify if you meet the degree requirements for admission to the program prior to applying, you must have your transcripts/degree evaluated by a foreign transcript evaluation agency for equivalency to a Baccalaureate degree in the US, and for the conversion of your Grade Point Average (GPA) to a 4.0 scale.

TOEFL Requirement: All applicants, regardless of citizenship, whose native language is not English and whose preparatory education was principally in a language other than English, must demonstrate competence in English. Those who do not possess a bachelor's degree from a postsecondary institution where English is the principal language of instruction must receive a minimum score of 550 (paper) or 80 (Internet-based text, iBT) on the Test of English as a Foreign Language (TOEFL). Computer-based TOEFL scores are not accepted. For IELTS language test, a minimally acceptable score for graduate nursing applicants is a 7.0.

If invited, applicants must also complete an in-person interview.

http://nursing.fullerson.edu/prospectiveStudent/msnCRNA/prerequisites.asp

http://nursing.fullerson.edu/prospectiveStudent/msnCRNA/prerequisites.asp


In order to be a competitive candidate for admission the following are suggested:

• BSN or MSN GPA 3.5 or greater • 2-3 years of current Adult ICU experience • A's in all undergraduate/graduate science courses • Additional nursing experience in leadership (i.e. committee), education, or research • Completion of advanced nursing certifications (i.e. CCRN, TNCC) • Community Service

DEADLINES

1. KPSA shall publish deadlines for application, and shall review all applications that are completed by the deadline (“completed” applications include all required supporting documents).

2. Students who have withdrawn, or been dismissed from KPSA or another nurse anesthesia educational program may reapply. They will be considered for admission on a competitive basis, with all other applicants who complete applications and submit all required documents before the deadline.

TECHNICAL STANDARDS

The skills and abilities that applicants and students must demonstrate are listed in these technical standards. A graduate of the KPSA program must be able to fulfill the job description and duties of a Certified Registered Nurse Anesthetist. A candidate for the KPSA program must have abilities and skills in five categories: observation, communication, motor, intellectual, and behavioral/social. Reasonable accommodation for persons with documented disabilities will be considered on an individual basis, but a candidate must be able to perform in an independent manner that ensures patient safety Fitness for duty- Students are required to update KPSA on changes in their health status (including medications) which may impact vigilance, alertness, or patient safety. The following skills are required, with or without accommodation:

1. Observation: Candidates must have sufficient sensory capacity to observe in the lecture hall, the simulation laboratory, the clinical setting, and the patient's bedside. Sensory skills adequate to perform a comprehensive physical examination are required. Functional vision, hearing and tactile sensation must be adequate to observe a patient's condition and to elicit information from computerized monitors, and through procedures regularly required in a physical examination, such as inspection, auscultation and palpation.

2. Communication: Candidates must be able to communicate effectively in both academic and health care settings. Candidates must show evidence of effective written and verbal communication skills, and the ability to work in teams.


3. Motor: The ability to participate in basic diagnostic and therapeutic maneuvers and procedures (e.g. palpation, auscultation, drawing blood or starting intravenous lines) is required. Candidates must have sufficient motor function to execute movements reasonably required to provide care to patients, including the ability to help move or lift them. Candidates must be able to negotiate patient care environments and must be able adequately perform in various settings, such as clinic, classroom building, and hospital. Physical stamina sufficient to complete the rigorous course of didactic and clinical study is required. Long periods of sitting, standing, or moving are required in classroom, laboratory, and clinical experiences.

4. Intellectual: Candidates must be able to measure, calculate, reason, analyze and synthesize, both in quiet environments and in areas where distractions, noise, and other stressors are present. Problem solving, one of the critical skills demanded of CRNAs, requires all of these intellectual abilities. In addition, candidates should be able to comprehend graphic displays of physiologic data, distinguish artifact on monitor displays, and understand three-dimensional relationships and the spatial relationships of structures. Candidates must be able to read and understand medical and nursing literature. In order to complete the degree, candidates must be able to demonstrate mastery of these skills and the ability to use them together in a timely and often critical fashion in problem-solving and patient care.

5. Behavioral and social attributes: Candidates must possess the emotional health required for full utilization of their intellectual abilities, the exercise of good judgment, and the prompt completion of all academic and patient care responsibilities. The development of mature, sensitive and effective relationships with patients and other members of the health care team are essential. The ability to effectively function in the face of uncertainties inherent in clinical practice, flexibility, compassion, integrity, motivation, interpersonal skills, and concern for others are all required. Candidates must be willing and able to follow program and practice guidelines. They must practice ethically and within legal and regulatory authority.

CRIMINAL BACKGROUND CHECK, HEALTH AND DRUG SCREENING

Kaiser Permanente (KP) is committed to providing comprehensive employment screening and verification on all applicants receiving conditional offers of employment or education and to conducting screening of current employees/learners pursuant to applicable laws and standards. In addition, applicants and students who are convicted of any crimes prior to or during the anesthesia program must immediately notify KPSA administrators in accordance with this policy. Kaiser Permanente requires that students meet the same criteria as a perspective employee for hiring at KP. Applicants must pass a criminal background check (California BRN and FBI) and a drug screening as a condition of becoming a student at KPSA. Nurse anesthesia students must have a health screening, a negative drug screen, and satisfactorily pass a federal and CA BRN criminal and background check completed as a condition of admission and matriculation. They must also be vaccinated for influenza yearly. Some of the non-Kaiser Permanente clinical sites have additional requirements/paperwork that must be satisfied before students are permitted to provide patient care.


KP policies and procedures for criminal background check, health screening and drug screening. http://npl.kp.org/pl/do/public/record?rgid=1040&subcatid=3389&VIEW=M&rid=10882601

INFORMATION SHARING AND PRIVACY POLICY

Reporting Requirements Students must report past arrests during the background check, whether convicted or under charge. Once enrolled, students are required to promptly report events that might impact their ability to continue to hold a California RN license. Students may be placed on probation or immediately dismissed if the events have implications for patient safety or hinder their ability to continue to deliver professional nursing care. A referral may be made to the California State Board of Nursing if required by law. Failure to notify KPSA will result in disciplinary action up to and including dismissal, regardless if a criminal conviction occurs. Fitness for duty- Students are required to update the program on changes in their health status (including medications) which may impact vigilance, alertness, or patient safety. Students are required to have a current copy of their health record, RN license and ACLS, PALS, and BLS certifications available during all clinical rotations. Sharing of student information Violation of legal requirements pertaining to Registered Nurses (California Board of Registered Nursing Code) will be reported to the appropriate authorities to include Kaiser Permanente, California State University Fullerton and the California BRN. Students contact information will be shared with clinical site coordinators (name, phone number and E-mail address only). Student personal health status may be shared with clinical site coordinators or human resources for credentialing on a need to know basis for patient safety reasons (e.g. if a student has diabetes, seizures, or other disorders). Admission, withdrawal, and dismissal (with reasons) will be reported to the NBCRNA and the AANA.

SPECIAL ACCOMMODATIONS

Disability Support Services and Accommodations: It is very important for students to be proactive with regard to requesting disability accommodations. While it is never required that a student disclose a disability to KPSA faculty, all students at KPSA are encouraged to talk to their professors to discuss their concerns. Faculty cannot provide disability accommodations without official notification from the student. If a student needs special accommodations because of a disability, has emergency medical information to share, or is need of special arrangements in case the building must be evacuated, please contact the KPSA administrative faculty as soon as possible.

1. Applicants, students and faculty will not be discriminated against on the basis of race, color, religion, sex (including pregnancy), gender identity, national origin, age, physical or mental disability, veteran status, sexual orientation, genetic information or other status protected by applicable federal, state or local laws or by corporate policy.

2. KPSA strives to provide an environment that is free of harassment and will not tolerate

http://npl.kp.org/pl/do/public/record?rgid=1040&subcatid=3389&VIEW=M&rid=10882601


any kind of unlawful or otherwise prohibited harassment, including sexual harassment, of employees or applicants. (See NATL.HR.005, Commitment to a Harassment-Free Work Environment) http://npl.kp.org/pl/download/attachment_44612.pdf?docid=44612&subcatid=5697&rid=30087&name=attachment_44612.pdf

3. KPSA provides reasonable accommodations to qualified applicants and students with disabilities unless it would cause undue hardship for KPSA. KPSA also provides reasonable accommodations for an applicant's or student’s religious observance or practice unless it would cause undue hardship for KPSA or any of our affiliate hospitals. (See Job Accommodation, NATL.HR.027).

4. This policy applies to all terms, conditions and privileges as an applicant or student including, but not limited to: recruitment, and termination. Any violation of this policy may result in corrective/disciplinary action up to and including termination from KPSA.

a. KPSA policy, as well as applicable federal and state laws, prohibit retaliation, intimidation or reprisal against applicants and students who file complaints and/or who cooperate with or participate in any procedures or investigations related to complaints of discrimination and/or harassment.

5. Procedure: This policy applies to all applicants, students and faculty. a. The complainant will voice their concerns to KPSA program administrators. b. Any complaint that meets the criteria above and is conveyed to the KPSA program

director will be communicated to Kaiser Permanente’s human resource department. c. KP’s human resource department will hear the complaint and decide on a course of

action per KP policy and procedure.

RIGHTS AND RESPONSIBILITIES

APPLICANTS

Applicants have a right to:

• be treated in a respectful manner. • be communicated with in a truthful and timely fashion. • have their application considered with the same degree of consideration as any other

applicant. • be notified when their application is incomplete and be advised on the documents needed

to complete their application. Applicants have a responsibility to:

• inform KPSA of changes in contact information (address, email, phone). • review all admission requirements as described by CSUF and KPSA. Information can be

found at the following websites: o CSUF: http://nursing.fullerton.edu/prospectivestudent/msncrna/admissionsreq.asp o KPSA: http://kpsan.org/student-selection/admission-requirements

• complete their application and send in all supporting documentation before the deadline. • be truthful and complete on the application and in all aspects of their communication.

http://npl.kp.org/pl/download/attachment_44612.pdf?docid=44612&subcatid=5697&rid=30087&name=attachment_44612.pdf

http://npl.kp.org/pl/download/attachment_44612.pdf?docid=44612&subcatid=5697&rid=30087&name=attachment_44612.pdf

http://nursing.fullerton.edu/prospectivestudent/msncrna/admissionsreq.asp

http://kpsan.org/student-selection/admission-requirements


• provide the information necessary to make decisions about their qualifications for admission into the KPSA program.

STUDENTS

Students have a right to expect that upon acceptance into an accredited program of nurse anesthesia, they will be provided that quality of education necessary to fulfill the objectives of the program to prepare competent nurse anesthetists capable of:

• integrating theory underlying the practice of anesthesia with the actual practice. • providing anesthesia management to all categories of patients for most or all varieties of

diagnostic or therapeutic intervention utilizing consultation as required. • functioning independently with supervision in all hospitals or agencies. • assuring patient comfort and safety within the confines of those aspects of care over

which a student has control or can influence through consultation, advice or other actions. • incorporating sound ethical and moral practices into their own personal value system.

Students have a right to expect that:

• they will not be exploited relative to time commitment for pay or profit of the conducting institution or its affiliates.

• enrollment in a program of nurse anesthesia grants certain rights and responsibilities to both the student and the program. These rights and responsibilities of each party should be fully understood and compliance is required.

• a student's failure to achieve the goal within the time frame expected should be based on valid, reliable data and information from evaluations, viewed objectively and fairly and reviewed as may be required. Appeals mechanisms are available when decisions are contested. Fair and accurate evaluations of their progress in the educational program will be made and they will be kept informed of their progress.

Students will be held accountable for:

• the quality of preparation, completion and performance on assignments. • complying with the policies and procedures pertaining to the program of nurse anesthesia

and all affiliate sites. All responsibilities connected with the program defined at the time of enrollment in the program or made part of the educational experience during the period of enrollment.

• their ethical and legal responsibilities for repayment of student loans from any source, public and private.

INSTITUTIONAL RESPONSIBILITES AND EXPECTATIONS

KPSA and/or affiliated clinical sites are responsible to: • provide didactic instruction. • coordinate and carry out application and admission procedures. • provide classroom and laboratory space as needed for didactic/simulation courses. • provide for academic counseling of nurse anesthesia students. • coordinate advertising and public relation efforts.


• provide for the clinical instruction and evaluation of nurse anesthesia students. • provide orientation to the clinical area. • evaluate students in the clinical area. • provide support for clinical research and studies. • provide the resources needed for effective operation of a high quality educational

program. • continually evaluate the program to ensure that it meets student needs and that graduates

attain the desired outcomes. • conduct the program in compliance with all legal and accreditation standards. • maintain accurate and comprehensive records that will be made available to on-site

accreditation reviewers. • the program will submit annual reports to the accrediting agency, and other submissions

as will be required from time to time. KPSA, as the conducting institution, has the right to expect that:

• academic and clinical faculty operate the program in accordance with the standards, policies, and procedures, of the accrediting agencies, University, affiliated clinical sites, and the program.

• the program represents itself with integrity and truthfulness in all communications. • students and faculty will be kept informed of program changes, accrediting agency

evaluations and standards, and trends affecting nurse anesthesia education. • applicants will be selected after review of their academic records, interview, and personal

references. • students will be aware of and follow department and institutional policies relative to

patient care, personal health care habits, and in all other matters addressed in relevant policies.

• students will communicate with clinical instructors relative to their ability to perform procedures, throughout the perioperative period, and apply knowledge in their clinical rotations.

• students will arrive prepared and on time for classes, seminars, conferences, and clinical rotations.

Faculty Faculty members are expected to conduct themselves in a fair and conscientious manner in accordance with ethical standards generally recognized within the academic community as well as those of the nursing and nurse anesthesia profession. Members of the faculty are expected to (except in cases of illness or other compelling circumstances):

• attend scheduled classes and appointments • be available at reasonable times for appointments with students • make appropriate preparation for classes and other meetings • perform grading duties in a fair and timely manner • counsel students and make them aware of academic/clinical deficiencies and notice of

probation. • describe to students in writing at the beginning of a course the content and objectives

along with the methods and standards of evaluation.


• base all academic/clinical evaluation upon good-faith and professional judgment. • not consider, in academic evaluations, factors such as race, color, religion, gender, gender

identity, age, national origin, handicap, political or cultural affiliation, lifestyle, activities or behavior outside the classroom unrelated to academic and professional achievement records. Faculty may release such information in connection with intra-Institutional or University business, including releasing information to clinical preceptors and affiliate faculty without student consent, or as may be required by law.

• not exploit professional relationships with students for private advantage; and refrain from soliciting the assistance of students for private purposes in a manner which infringes upon such students' freedom of choice.

• give appropriate recognition to contributions made by students in research, publication, service or other activities.

• refrain from any activity which involves risk to the health and safety of a student, except with the student's informed consent, and, where applicable, in accordance with the Institutional or University policies relating to the use of human subjects in experimentation.

• respect the dignity of each student individually and all students collectively in the classroom, laboratory, clinics, and other academic contexts.

• academic faculty (including guest lecturers) must: hold current certification or recertification as a CRNA by NBCRNA; and have at minimum a Master degree. If not a CRNA, they must have appropriate credentials and expertise in the subject matter.

COUNCIL ON ACCREDITATION

1. It is the responsibility of the Council on Accreditation (COA) of Nurse Anesthesia Programs to publish any and all applicable standards necessary for accreditation and successful re-accreditation, and to evaluate programs in their ability to meet the published standards.

2. It is the responsibility of the COA to identify any areas of noncompliance and to inform the program accordingly. The COA reserves the right to conduct periodic announced and unannounced site reviews to assess for compliance to published standards.

3. It is the responsibility of the Program to assist the COA in all requirements necessary to conduct a thorough evaluation. The Program is responsible to provide any required supportive documentation to demonstrate compliance. The Program has the duty to provide accurate and truthful statements and documents to the COA or its representatives.

4. The educational program is required to follow all current policies and procedures published by the COA.

3. PROFESSIONALISM AND INTEGRITY

Students shall conduct themselves in a professional and respectable manner during class time, clinical time and during professional meetings and seminars. All students should be dressed neatly and appropriately in business attire when at any medical center, California State University Fullerton, KPSA, professional meetings and during volunteer experiences.

PRACTICE AND PROFESSIONAL ETHICS


In the rapidly changing world of advanced nursing practice, established principles of professional action and standards of judgment allow our CRNA community to provide the highest level of holistic patient care. It is the task of ethics as a discipline to clarify the rules and standards implicit in our common professional judgments and preferences. Such clarification suggests possible revisions that might resolve the conflicts based in a changing practice arena with minimal shock to our common system of values. The goal of KPSA is to assist the student in gaining an inherent understanding and ability to apply the practical rules and standards of ethical decision-making in a just and responsible manner. Exemplar to the philosophy of our program, the practical applications of ethical responsibility are germane to the conduct of the student role. Upon admission to the anesthesia program the student has a right to expect the following that:

1. the didactic and clinical learning experience will be represented to students, patients and the public with honesty and integrity.

2. the responsibility for the maintenance of high ethical and moral standards is a jointly shared responsibility of the students and academic/clinical faculty.

3. the program will actively promote appropriate ethical attitudes relative to the practice of nurse anesthesia and support the faculty and conducting institutions in carrying out their duties as role models.

4. while in the student role, there will be no undue exploitation relative to time commitment or clinical responsibility as dictated by COA policy.

5. enrollment constitutes a contract between the student and the program such that the attainment of established educational goals will cooperatively be sought by each party.

6. the evaluation of educational progress will be consistent, fair, accurate and ongoing. 7. due process is available to the student for resolution of concerns and difficulties

during the period of enrollment. 8. access to transcripts, grades and written evaluations will be freely available upon

student request. 9. all clinical experiences will be supervised by a CRNA or an anesthesiologist with staff

privileges at that institution. 10. pertinent and detailed information regarding all facets of student life will be clearly

written and available to the student.

Additionally, students will be held accountable for: 1. timely and honest completion of all didactic assignments, clinical case records and

anesthesia care plans. 2. active participation in all assigned clinical rotations and activities. 3. compliance with the policies and procedures of the nurse anesthesia program and the

clinical facilities. 4. providing upon request proof of intent to meet the responsibilities for repayment of

financial assistance received from public or private sources. 5. provisions of direct patient care unencumbered by the presence of factors such as

alcohol, thought-impairing drugs, excessive fatigue or other incapacitating conditions. 6. appropriate representation of their student role to patients and faculty. 7. accurate recording and reporting of the patient’s condition and all interventions to the


supervising CRNA, anesthesiologist or surgeon. 8. participation in selected professional projects, meetings and seminars which are deemed

by the faculty to promote professional socialization. 9. continued licensure as a Registered Nurse in the State of California and certifications

(ACLS, PALS, BLS); and conduct themselves as a professional nurse in both clinical and academic settings.

10. respect of patient’s rights and all provisions for maintenance of patient confidentiality in accordance with Kaiser Permanente policy.

11. non-disclosure of information on any examination, testing material, or anesthesia simulation (written or verbal).

The program expects students to adopt and observe the AANA Code of Ethics. http://www.aana.com/resources2/professionalpractice/Documents/PPM%20Code%20of%20Ethics.pdf Violations of this ethical conduct standard will be regarded as professional and academic misconduct and failure to meet clinical performance objectives, and will be subject to probation and dismissal from the program.

PROFESSIONAL DECORUM

The Student registered nurse anesthetist (SRNA) is a representative of the nurse anesthesia profession, Kaiser Permanente, California State University Fullerton, and the clinical affiliates. The maintenance of a professional appearance and demeanor facilitates the acceptance of the profession and the individual by patients and other health care professionals. It is expected that students will assume the responsibility for observing the following guidelines of professional behavior and conduct.

GUIDELINES FOR CLINICAL CONDUCT

The student registered nurse anesthetist bears the responsibility of representing the profession to patients, the public, and other members of the health care team. The following guidelines are to be observed at all times:

• Consistently demonstrate your concern for the welfare of the patient. Treat patients with respect and dignity, both in your interactions with them, and in your patient related discussions with other professionals. Demonstrate your concern not only for the medical problem but also for the total patient.

• Conscientiously respect the rights of your colleagues. Characterize all of your

professional encounters with cooperation and consideration. Strive to assume an appropriate and equitable share of patient care duties.

• Approach your responsibilities with dedication. Be truthful in all professional

communications. When meeting multiple demands, establish patient-centered priorities to guide you in completion of such work.

DRESS CODE

http://www.aana.com/resources2/professionalpractice/Documents/PPM%20Code%20of%20Ethics.pdf

http://www.aana.com/resources2/professionalpractice/Documents/PPM%20Code%20of%20Ethics.pdf


The maintenance of a professional appearance and demeanor facilitates the acceptance of the profession and the individual by patients, administrators and other health professionals. All students are expected to maintain a neat, professional appearance and a high standard of personal cleanliness at all times. Students who fail to maintain professional attire will be counseled by the academic or clinical faculty. Students who continue to fail to meet these guidelines will be placed on probation, which can progress to dismissal. General guidelines While participating in any program or university related activity, students should present a professional appearance. Business casual attire is mandatory at all times including:

• Non classroom professional or academic activities held on campus • Professional related meetings • Visits to hospital facilities, including patient visits, use of the hospital library, etc.

The following attire is not considered appropriate attire for the KPSA classroom:

• Crop or halter tops • Sweat pants • Jogging suits • Ripped, torn or faded clothing • Explicit logos • Sleepwear • Backless dresses or clothing more appropriate for evening • Mini-skirts • As a general rule, revealing or tight fitting clothing is not considered professional

Additional guidelines

• Students are required to wear scrubs or a KPSA logo shirt with scrub pants during simulation.

• Cleanliness and personal hygiene is required. • Excessive cosmetics are not permitted. • Excessive cologne or other fragrances can present a health hazard to others and therefore

is not permitted. Cologne or fragrances of any kind are not permitted in clinical areas where patients may be exposed.

• Visible body piercing jewelry should not be worn during clinical. • Tattoos are to be covered during clinical. • Hairstyles and hair color must commensurate with professional appearance. • The hood of sweatshirt/sunglasses cannot be worn in class.

CLINICAL SETTING

The clinical training opportunities represent a privilege extended to the academic program. Students are reminded of their responsibility to dress and act in compliance with the guidelines of the institution where the rotation is conducted. Students will assume the dress codes of the


clinical site and it is the student's responsibility to determine the specifics of the guidelines in each new situation.

1. Scrubs are provided by the clinical sites. Scrubs are not to be brought into or worn outside of the clinical site.

2. Scrubs obtained at each clinical site must be returned at the end of each clinical day. 3. When leaving the OR suite, students are expected to wear a full-length lab coat or other

cover garments throughout the hospital with their identification tag exposed. 4. Program identification/name badge MUST be worn and visible while on the hospital

grounds, Kaiser Permanente School of Anesthesia and at all clinical training sites. The hospital issued identification badge must be worn at all times while the student is rotating through a clinical site. The student registered nurse anesthetist must be clearly and continuously identified as a student during clinical experiences.

SIMULATION POLICY

Our core belief at the KPSA Simulation Center is that everyone involved is intelligent, cares about doing their best, wants to learn, and desires to improve. At the KPSA Simulation Center you will observe and participate in activities of simulated medical events. You are asked and expected to maintain and hold confidential all information regarding the performance of the individuals you observe and the details of the scenarios you participate in. Appropriate attire includes scrubs with solid colors and no designs. A KPSA t-shirt or sweatshirt may be worn instead of a scrub top. This attire is expected during simulation scenarios and can be worn during simulation task training if desired.

CONFIDENTIALITY OF MEDICAL RECORDS AND HEALTH INFORMATION (HIPAA)

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 mandates Federal privacy protection for individually identifiable health information. Standards have been set for health care providers who transmit health care transactions electronically. All data gathered about a patient from his/her medical record, including all items within a patient's medical history, are privileged information. To ensure compliance with Kaiser Permanente’s HIPAA standards and COA policy, patient privacy and confidentiality must be secured. All students will be trained in procedures to protect patient confidentiality and privacy according to HIPAA standards to meet Kaiser Permanente compliance policies and procedures prior to starting their clinical rotations. While participating in clinical practice, the student will be expected to comply with all HIPAA requirements including:

• No discussion or presentation of a patient's record in a manner or situation which would violate the confidential nature of that record.

• Charts or contents, (e.g., lab reports, etc.) are not to be removed from the hospital or clinical setting under any circumstances.

• Securing patient records containing individually identifiable health information so that they are not readily available to those that who are not providing patient care.


• Use safeguards to prevent the use or disclosure of PHI (Protected Health Information). Do not:

• Photograph the OR schedule. • Take photographs of patients including their anatomy, incisions, wounds or other unusual

findings, even if the patient is not identifiable in the photograph. • Remove patient stickers from the chart for case recording purposes. • Access your own medical records, or the records of anyone except those individuals

whom you are caring for. • Access Health Connect from the school’s computers.

KP Health Connect Students will have Kaiser Permanente’s Health Connect electronic medical record access during the clinical program. All students attend KP Health Connect training prior to starting in clinical. Students will be issued an individual login and access code. Under no circumstances will a student share their access with any individual. Students must only access electronic records of patients that they are providing care. Students must shred or dispose of printed patient information in designated secure receptacles. These standards also apply to other non-KP electronic medical records. Students who have problems accessing health connect should contact Sandra Hinkson at 626-564-3016. Students who do not comply with these policies and procedures will be placed on probation or be immediate dismissed from the nurse anesthesia program. Students are to notify the clinical coordinator and administrative program faculty if any inappropriate use or disclosure of PHI that is contrary to your service and its purpose occurs. Failure to comply with Kaiser Permanente’s HIPPA policies and procedures will be cause for probation or immediate dismissal from the nurse anesthesia program. Student records of HIPAA compliance training and orientation to DCS policies and standard procedures will be kept on file at Kaiser Permanente School of Anesthesia. To view Kaiser Permanente’s policy on HIPPA requirements and safeguards to electronic record keeping go to: http://npl.kp.org/pl/do/public/record?rgid=900&subcatid=5002&VIEW=M&rid=112392601

TITLE AND IDENTIFICATION

Kaiser Permanente School of Anesthesia recognizes an obligation to assure the proper identification of nurse anesthesia students to patients, visitors and other professionals in the clinical setting. Clear recognition of the student’s status is necessary to increase the understanding and knowledge of others of the role and abilities of the student and to comply with COA policies and procedures.

• All students will use the following introduction: “I am Your Name, a registered nurse and a nurse anesthesia student, a student registered nurse anesthetist or a registered nurse anesthesia student. Today, I will be part of the anesthesia care team administering your



anesthesia.” Students shall not refer to themselves as anesthesia residents, certified registered nurse anesthetists, or medical doctors.

• Kaiser Permanente School of Anesthesia strictly forbids the employment of nurse anesthesia students as nurse anesthetists by title or function in accordance with ethical standards of practice and COA policy.

• Students are subject to probation and dismissal from the program for failure to observe any of these ethical guidelines.

MOBILE PHONES AND MOBILE DEVICES

The use of mobile devices in the clinical and classroom settings MUST comply with Kaiser Permanente and COA policy.

• Use of mobile phones and devices for voice or data communication (e.g. text messaging) in the clinical or classroom settings is strictly prohibited.

• Use of media recorders or players (or those functions) in the clinical settings is strictly prohibited.

• Ring tones must be turned off at all times in the classroom and clinical settings. • Use of media recorders and players (or those functions) in the classroom setting is

permitted with the consent of the instructor. • Use of mobile devices for medical reference purposes directly connected with patient

care is permitted with the consent of the supervising clinical faculty. • Use of mobile devices in the classroom for educational purposes (e.g. as a reference tool)

is permitted with the consent of the faculty. • While assigned to affiliated institutions the policies of the affiliated institution takes

precedence over KPSA policy if that standard is more restrictive than KPSA policy.

Students violating these policies will be subject to probation or immediate dismissal.

4. CURRICULUM, FACULTY AND COURSE DESCRIPTIONS

The curriculum leads to the degree Master of Science in Nursing in a 24-month full-time program.

• Fall I

o N501 Theoretical Perspectives for Nursing Practice 3 Units

o N542/L Advanced Health Assessment/Lab 3 Units

o N580 Advanced Pharmacology for Anesthesia I 3 Units

o N581 Anesthesia General Principles 3 Units

• Spring I


o N505A Nursing Research and Evaluation for Practice 3 Units

o N582 Anesthesia for Surgical Procedures and Special Populations 4 Units

o N584 Advanced Pharmacology for Anesthesia II 3 Units

o N585L Nurse Anesthesia Practicum I 2 Units

• Summer I

o N505B Seminar in Nursing Research 3 Units

o N586 Pediatric and Obstetric Anesthesia 3 Units

o N587L Nurse Anesthesia Practicum II 5 Units

• Fall II

o N588 Advanced Physiology/Pathophysiology for Anesthesia I 4 Units

o N589L Nurse Anesthesia Practicum III 7 Units

o N596A Comprehensive Exam 2 Units

• Spring II

o N590 Advanced Physiology / Pathophysiology for Anesthesia II 4 Units

o N591L Nurse Anesthesia Practicum IV 7 Units

o N596B Comprehensive Exam 2 Units

• Summer II

o N592 Professional Nurse Anesthesia Role 3 Units

o N593L Nurse Anesthesia Practicum V 7 Units Total units = 71

KPSA EDUCATIONAL MATRIX

Semester 1

• Anesthesia General Principles 1. Applied cardiac and respiratory physiology 2. Preoperative/postoperative evaluation


3. Airway/difficult airway management 4. Neuraxial anesthesia 5. Fluid, blood and blood component therapy 6. Anesthesia monitoring and biotechnology

a. Anesthesia machine b. Mechanical ventilation c. Arterial line d. Central line e. Pulse oximetry f. Electrocardiography g. Capnography/capnometry

7. Universal precautions 8. Anesthesia case management 9. Recognition and treatment of critical events

(eg. malignant hyperthermia) 10. Physics: Gas laws and physical principles 11. Principles of radiation

• Advanced Pharmacology and Anesthesia 1 1. Pharmacokinetics/pharmacodynamics 2. Uptake and distribution of inhalation agents 3. Induction agents 4. Inhalation anesthetics 5. Narcotics/Non-narcotics 6. Benzodiazepines 7. Structure and activity relationship 8. Biochemical effects of drugs 9. Drug solubility

• Advanced Health Assessment • Theoretical Perspectives for Nursing Practice

Clinical Practicum 1

• Observational

Simulated Activities

• Task Training-Basic airway management • Pharmacologic induction sequence • High fidelity induction/airway management • Spinal anesthesia task training • Machine check simulation day • In hospital-machine check, basic set up with faculty • Sterile technique practicum • High fidelity simulation examination


Evaluation-Semester 1

• Written examinations • Verbal examination • Simulation critique • Self-evaluation

Semester 2

• Advanced Human Physiology 1. Cellular biology 2. Neurologic system 3. Respiratory system 4. Cardiovascular system 5. Hepatic system 6. Renal system 7. Hematologic system

• Advanced Pharmacology and Anesthesia 2 1. Neuromuscular blocking drugs 2. Local anesthetics 3. Autonomic pharmacology 4. Cardiovascular pharmacology

• Anesthesia for Surgical Procedures and Special Populations 1. Anesthesia case management

(pharmacologic, physiologic, biotechnological basis for surgical cases) • Ear, nose, throat • Orthopedic • Gynecologic • Urologic • Laparoscopic/Robotic • Outpatient • Geriatric

2. Introduction to cardiac surgery 3. Introduction to regional anesthesia 4. Recognition and treatment of critical events

• Nursing Research and Evaluation for Practice


• Minimum 30 hours/week



• High fidelity simulation • Arterial/central line task training • Epidural anesthesia task training • Case study analysis and presentation


• Written examinations • Verbal examination • Daily, monthly and semester clinical • Simulation critique • Self-evaluation

Semester 3

1. Pediatric Anesthesia Principles • Psychological impact of anesthesia/surgery for the pediatric patient • Pediatric anatomy and physiology • Pediatric pharmacology • Pediatric anesthesia case management • Surgical procedures and anesthetic considerations • Pediatric cardiac surgery and anesthetic considerations • Recognition and treatment of critical events

2. Obstetric Anesthesia Principles • Obstetric physiology and pathophysiology • Obstetric pharmacology • Anesthetic management of the laboring parturient • Anesthetic management for obstetric surgeries • Recognition and treatment of critical events

3. Seminar in Nursing Research


• Minimum of 40 hours/week


• High fidelity simulation (pediatric/obstetric patient) • Epidural task training



• Written examinations • Verbal examination • Daily, monthly and semester clinical • Simulation critique • Self-evaluation • Self-Evaluation Examination (SEE)

Semester 4

1. Advanced Physiology/Pathophysiology for Anesthesia I Anesthesia Case Management

(pharmacologic, physiologic, biotechnological basis for surgical cases) • Respiratory

1. Tuberculosis 2. Pulmonary embolus 3. Pulmonary hypertension 4. COPD/Evaluation of lung disease-ventilation strategies 5. Thoracic surgery-One lung ventilation

• Cardiac 1. Valvular heart disease 2. Aortic surgery 3. Carotid surgery

• Regional Anesthesia 1. Principles of ultrasound guided regional anesthesia 2. Upper/lower extremity nerve blocks 3. Bier/ankle/eye blocks

• Principles of acute and chronic pain management • Recognition and treatment of critical events

2. Comprehensive Examination I • Weekly case management discussions on assigned anesthesia topics • Weekly examinations of assigned anesthesia topics • Critique and appraise scholarly research


• High fidelity simulation • Case studies • Advanced airway workshop

1. Supraglottic devices 2. Video laryngoscopy (eg. glidescope) 3. Fiberoptic 4. Cricothyroidotomy


• Ultrasound workshop




• Written examinations • Verbal examination • Daily, monthly and semester clinical • Simulation critique • Self-evaluation • Pain management project

Semester 5

1. Advanced Physiology/Pathophysiology for Anesthesia II Anesthesia Case Management (pharmacologic, physiologic, biotechnological basis for surgical cases)

• Endocrine disorders • Hepatobiliary disorders • Autoimmune diseases • Neurodegenerative diseases • Coagulation disorders • Renal disorders • Organ transplantation • Trauma/Burns • Neurosurgery • Advanced Pharmacology-adjunctive medications (eg. antibiotics,

steroids) • Recognition and treatment of critical events

2. Comprehensive Examination II • Weekly case management discussions on assigned anesthesia topics • Weekly examinations of assigned anesthesia topics • Critique and appraise scholarly research


• High fidelity simulation





• Written examinations • Verbal examination • Daily, monthly and semester clinical • Simulation critique • Self-evaluation • Case studies • Self-Evaluation Examination (SEE)

Semester 6

1. Professional Nurse Anesthesia Role • Professional organizations • Credentialing/Privileging • AANA ethics and standards • Legal issues • Quality assurance • Healthcare reform • Leadership • Healthcare policy & reimbursement • Wellness/Peer assistance • Adult education and mentorship



Evaluation-Semesters 6

• Written examinations • Daily, monthly and semester clinical • Self-evaluation • Weekly examinations on assigned anesthesia topics

*This educational matrix is a partial list of all topics and learning activities that are taught throughout the program and they are subject


KPSA FACULTY

Director John Nagelhout, CRNA, Ph.D. FAAN Assistant Directors Michael Boytim, CRNA, Ed.D - Academic Sass Elisha, CRNA, Ed.D - Clinical Instructors Sandra Bordi, CRNA, DNP Jeremy Heiner, CRNA, Ed.D Jennifer Thompson, CRNA, DNP Edward Waters, CRNA, DNP

COURSE DESCRIPTIONS

The authoritative version of nurse anesthesia course descriptions will be included in each course syllabus provided by the course instructor at the start of each semester.

5. ACADEMIC POLICIES

Policies in the CSUF Graduate Catalog apply unless they are superseded by the policies found here.

REGISTRATION

Prior to the beginning of each semester of attendance, students are required to register in accordance with CSUF procedures. Registration must be completed before the student can attend classes.

ATTENDANCE POLICIES

Classroom Attendance for lectures and exams is mandatory. Due to the large volume of classroom material, it is very difficult for students to make up missed class lectures. Due to the nature of the course of study, it is expected that professional courtesy be extended by students to each other as well as faculty. The student must notify the instructor by email if the student is unable to attend classes on a given day and the student must also call in their absence to the program office at 626-564-3000. Repeated class absences and tardiness to class will result in disciplinary action, up to and including dismissal from the program. Clinical


Students are expected to attend every scheduled clinical day. If a student is absent for a clinical day due to an illness, personal or family emergency, or any other circumstance, it will be up to the student to make up all absent days at the clinical site from which they were absent at the discretion of the clinical coordinator. Additionally, sending an email to Sass Elisha at [email protected] and contacting the clinical coordinator as a notification of any missed clinical time either before or at the time of the event. If a student encounters a personal illness, personal or family emergency, or other extenuating circumstance necessitating extended absences, then the student will need to discuss these issues with the program administration and the clinical coordinator at the rotating clinical site as far in advance as possible. A student who calls in as unavailable for clinical on the last day preceding, or the first day following, a scheduled block of days off must bring in a note (e.g. from a healthcare provider) documenting their illness. Failure to submit documentation of absence necessary for health or other reasons will result in probation. Consistent or patterned absence or tardiness to clinical causing disruption of staff and/or necessitating changes in clinical assignments (including changes in clinical rotations) will result in disciplinary action, up to and including dismissal from the program. Students are expected to attend certain required events that occur outside of class or clinical time (e.g. graduation, seminars and conferences) except when they are scheduled for clinical. Non-attendance (without prior approval) will be treated as grounds for probation. Students who are members of the armed forces of the United States who are called to active duty or required to meet reserve training obligations will be granted time off. Students must notify the program director of their military status and anticipated obligations upon enrollment in the program. Students will not be granted clinical release time to serve on medical mission experiences or board review courses.

COURSE POLICIES

A course syllabus is distributed to each student by the instructor at the beginning of each semester. This outline may include a course description, learning objectives, student obligations, required texts and a description of the evaluation process. The syllabus also contains a copy of the KPSA/CSUF Academic Misconduct policy.

EXAMINATIONS

During exams: The only materials allowed at student desks are pencils/pens and erasers. Purses, cell phones, backpacks and other personal items must be placed under the desk. Scrap paper, which may be distributed, will be collected at the end of the exam. Talking during exams, except when asking a question to the proctor will result in the student receiving a grade of zero for that exam. Cell phones must be turned off (or silenced) and placed under the desk with personal belongings.

mailto:[email protected]


Students agree that they will not participate in any form of cheating including: • Copying, communicating, photographing, recording, or sharing examination questions

or answers from, or with, another student whether current or future. • Using "cheat sheets" or hidden materials with possible test information during

an examination. • Using test breaks or bathroom breaks to research test answers or share information

with others. • Stealing, gaining access to, reproducing, distributing, or using unauthorized

information, material, or assistance related to examinations. • Participation in any activity that gives a student an unfair advantage over others.

Scoring- Results of scoring will be available for students to review. Student rebuttals to any question(s) will only be accepted if they are typed, include a text reference from a required or recommended text for the course, and are submitted within 24 hours of the review. The instructor shall have two weeks to respond.

Examination dates- Examination dates, times, and locations may be changed at the instructor's sole discretion. Make-up exams for those unable to take an exam on the scheduled day due to absence will be scheduled only on approval of the assistant director of academics and/or the instructor. It is expected that the student contact the course instructor 24 hours prior to missing an examination. If this notice is not received, make-up exams will only be given at the discretion of the course instructor. Make-up exams will be weighted the same as the missed exam, but will not contain the same items or be in the same format as the original exam. Scantron and Written Testing- Answer sheets must be completed in number 2 pencil when Scantron is used. The exam booklet must be turned in with the answer sheet. Credit will only be given for answers indicated on the answer sheet, not on the exam booklet. Exams must be kept flat on the desk (this means that you may not lift your exam booklet or answer sheet to a vertical position while reading questions). Exams will not be returned to students, however an opportunity will be provided after class, or in a subsequent class session, for the students to review their exam. The exams must be returned to the instructor after student review, otherwise the student will receive a zero for that exam. Computerized Testing- Several testing modalities may be used including computerized testing, Scantron, or pencil and paper. The exam may be scored immediately upon submission. If the computer loses connectivity or a student is unable to complete for any reason there are several options.

• The computer can be rebooted and the student may restart the test. The time allowed for the test will also restart. The instructor will enforce the time allotted for exams.

• The student may be given a written examination. • The student may be issued another computer to complete the exam. • The student may be rescheduled on a different time and date.

Computerized Testing Requirements- Each student is required to possess a laptop with specific requirements for EXAMsoft® upon admission to the KPSA program. Each student is required to possess a privacy screen for his/her laptop that must be utilized for all testing sessions.


It is the student’s responsibility to download quizzes/examinations when prompted to do so via email, prior to the time of the scheduled quiz/exam. Failure to download a quiz or exam prior to the time of the scheduled examination will result in a grade of “0” for that specific quiz/examination. It is the student’s responsibility to upload their quiz/examination immediately after completion of the quiz/examination, prior to the end of the scheduled exam/quiz allotted timeframe. Failure to upload quiz/examination will result in a grade of “0” for that specific quiz/examination. Any problems encountered with downloading quizzes/examinations must be addressed immediately, prior to the examination date, to the assigned faculty and to Bryun Sakaye at [email protected] or 626-564-5926. The computer exam/quiz is confidential. The student is prohibited from disclosing, publishing, reproducing, or transmitting this exam, in whole or in part, in any form or by any means, verbal or written, electronic or mechanical, for any purpose. Violation of this nondisclosure policy/procedure will be handled in accordance with CSUF policy on academic dishonesty. Off Site Computerized Testing-In addition to the aforementioned policies/procedures for computer testing in the classroom, off-site computer testing assumes the following policies/procedures:

• The video camera and the audio function must remain “on” at all times. • The student must sit within an acceptable range of the camera in order to allow full

visualization of face, hands and testing environment. • Scratch paper must be destroyed in the presence of the faculty member prior to leaving

the viewing area. • The student must report to the faculty that he/she has completed the examination/quiz and

has successfully uploaded it prior to leaving the viewing area. WARNING: The computer clock is not the source for timekeeping (the time limit kept by the server administering the exam, and the workstation where you take it, may differ by several minutes). You cannot therefore use the clock that appears on screen as anything more than an approximate guide to the time remaining. Students are responsible for determining how much time they have to take each exam and finishing within the time limit. WARNING: The score or percent correct displayed on screen at the end of a computer- administered exam, or in the course site grade book on Moodle is for your feedback only. These may differ slightly from your exact score due to rounding and other reasons.

KPSA GRADING SCALE

Each classroom instructor will review the course's exam schedule, grading scale and exam format at the beginning of the semester. This information will appear in the course syllabus.

• A 93-100% • A- 90-92% • B+ 87-89% • B 83-86%



Any grade in non-MSN courses <83% will result in dismissal from the program. The official CSUF GPA Requirement policy can be found in the University Catalog. A grade point average (grade points divided by units attempted) of at least 3.0 is required for graduation with a graduate degree. This grade point average applies to (1) all 400- , 500- and 600-level units attempted subsequent to admission to a degree program; and (2) all units required on the official graduate Study Plan including transfer courses. Each MSN core course must be completed with a grade of “C” (2.0) or better. The School of Nursing requires that concentration specific didactic courses must be completed with a grade of “B” (3.0) or better. For Nurse Anesthesia students, the MSN core courses include; N501, 505A and 505B. Appeals, Notifications The program administration is notified by the instructors of any student deficiencies during the semester. Students may access their grades in Moodle at any time after they are posted. The classroom instructor and program administration reserve the right to require additional course work of any student when that student's command of a particular subject is questionable or unsatisfactory at any time. Disputes involving examination grades or scoring, or course grades, should be presented first to the individual instructors. Course grade disagreements that cannot be resolved by the student and classroom instructor will be resolved by the policy in this Handbook (see chapter entitled Committees; Grievance and Appeals). Repeating Courses Except as otherwise determined by the program director, no student will be allowed to repeat any course.

ACADEMIC MISCONDUCT

KPSA ACADEMIC INTEGRITY POLICY

Academic dishonesty includes but is not limited to cheating on examinations or assignments, unauthorized collaboration, plagiarism, falsification/fabrication of university documents, any act designed to give unfair academic advantage to the student (such as, but not limited to, submission of essentially the same written assignment for two courses without the prior permission of the instructor), assisting or allowing any of these acts, or the attempt to commit such acts. Cheating is defined as the act of obtaining or attempting to obtain credit for work by the use of any dishonest, deceptive, fraudulent, or unauthorized means. Examples of cheating include, but are not limited to: using notes or aides (including electronic devices) or the help of other students on tests and examinations in ways other than those expressly permitted by the instructor, or any acts which defeat the intent of an examination, plagiarism as defined below,


and collaborating with others on any assignment where such collaboration is expressly forbidden by an instructor. Violation of this prohibition of collaboration shall be deemed an offense for the person or persons collaborating on the work, in addition to the person submitting the work. Documentary falsification includes forgery, altering of campus documents or records, tampering with grading procedures (including submitting altered work for re-grading), fabricating lab assignments, or altering or falsifying medical excuses or letters of recommendation. Plagiarism is defined as the act of taking the work (words, ideas, concepts, data, graphs, artistic creation) of another whether that work is paraphrased or copied in verbatim or near verbatim form and offering it as one’s own without giving credit to that source. When sources are used in a paper, acknowledgment of the original author or source must be made through appropriate citation/attribution and, if directly quoted, quotation marks or indentations must be used. Improper acknowledgment of sources in essays, papers, or presentations is prohibited. The consequence of cheating, plagiarism, or any act of academic dishonesty, may range from probation or immediate dismissal from the program. Academic dishonesty will be handled in accordance with the procedures established by the University. For full details see: CSUF policy statement UPS 300.021 http://www.fullerton.edu/senate/publications_policies_resolutions/ups/UPS%20300/UPS%20300.021.pdf

FRATERNIZATION

Faculty who have personal or business relationships with students beyond the normal faculty role will not directly supervise these students in classroom or clinical. Faculty will disclose outside relationships to the program director, who will excuse them from deliberations on that student’s academic progress.

GRADUATION

Criteria

To be eligible for graduation, all students must meet didactic and clinical requirements including completion and submission of all required classroom work. Specific criteria and performance objectives for the clinical curriculum, which cover affective, ethical, and behavioral aspects, are located in this Handbook. Expectations for didactic courses are listed in their respective syllabi. All of these must be met prior to graduation. All students are required to attend both the CSUF and KPSA graduation exercises.

Program requirements that must be completed:

1. All terminal objectives met • 2. Program and clinical property returned (locker keys, narcotic keys, parking passes) library

material returned (books, journals, etc.)

http://www.fullerton.edu/senate/publications_policies_resolutions/ups/UPS%20300/UPS%20300.021.pdf

http://www.fullerton.edu/senate/publications_policies_resolutions/ups/UPS%20300/UPS%20300.021.pdf


• 3. All financial obligations met • 4. Satisfactory completion of curriculum and culminating experience requirements • 5. Final case record totals submitted, showing completion of all requirements of the National

Board for Certification and Recertification of Nurse Anesthetists (NBCRNA), and the Council on Accreditation of Nurse Anesthesia Educational Programs (COA)

• 6. Final semester course evaluations completed • 7. Exit interview completed • 8. Satisfy the faculty with regard to:

• Safe anesthesia practice • Personal integrity and demonstrated responsibility • Clinical proficiency and sound judgment • Attendance • Effective communication in all academic and clinical coursework

9. Student must be in good standing and meet all requirements for graduation as stated by CSUF CSUF graduation Requirements, Policies and Procedures may be found at: http://nursing.fullerton.edu/_resources/msn/2014_2015%20Graduate%20Nursing%20Handbook.pdf

CLINICAL SUPERVISION OF STUDENTS

Clinical supervision of students is restricted to CRNAs and or Anesthesiologists with staff privileges that are immediately available to provide patient care in the clinical area. Clinical supervisor to student ratio must be no greater than 1:2. Graduate registered nurse anesthetists or anesthesiology residents/fellows can be assigned to work with SRNAs. However, a CRNA or Anesthesiologist with staff privileges must supervise SRNAs.

6. ACADEMIC AND CLINICAL SCHEDULING

TIME COMMITMENT

Successful completion of the program requires a substantial time commitment. This commitment will be no greater than 64 hours per week. This figure includes time spent in the classroom and clinical experiences.

ACADEMIC INSTRUCTION

Students will be scheduled in class based on instructor availability and University schedules. Subsequent academic instruction will occur weekly on the following days (except for academic breaks):

• Fall (semester 1): Monday through Friday • Spring (semester 2): Monday and Tuesday




• Summer (semester 3): Monday • Fall (semester 4): Monday • Spring (semester 5): Monday • Summer (semester 6): Monday

Special circumstances that require class time off must have prior approval of the director/assistant director of academics and the classroom instructor.

HOLIDAYS

Throughout the program, students may be scheduled on duty for variable shifts, including overnight and weekend experiences. Students will be granted six (6) holidays per year, New Year's Day, Memorial Day, July 4th, Labor Day, Thanksgiving, and Christmas Day. Hours are per week and are subject to change. Students will be required to arrive earlier than their scheduled start time in order to prepare, and to stay after their scheduled departure when good learning experiences are available.

CLINICAL SCHEDULING

Various clinical rotations require alternating schedules as dictated by the clinical coordinator. These will be scheduled by the site clinical coordinator and may be on days, afternoons, nights or weekends. Students will not be scheduled more than 24 hours, and will not be scheduled for a full 24 hours after completing a 24-hour shift. Students should not be scheduled more than 64 hours of committed time per week (clinical and academic time). Students are not allowed to provide anesthesia for more than 16 consecutive hours without relief. The student must notify the assistant director of clinical of any changes in, or variance from, these COA guidelines.

CLINICAL ABSENCE

Students are expected to attend every scheduled clinical day. If a student is absent for a clinical day due to an illness, personal or family emergency, or any other circumstance, it will be up to the student to make up all absent days at the clinical site from which they were absent at the discretion of the clinical coordinator. Additionally, sending an email to Sass Elisha at [email protected] and contacting the clinical coordinator a notification of any missed clinical time either before or at the time of the event. If a student encounters a personal illness, personal or family emergency, or other extenuating circumstance necessitating extended absences, then the student will need to discuss these issues with the program administration and the clinical coordinator at the rotating clinical site as far in advance as possible. A student who calls in as unavailable for clinical on the last day preceding, or the first day following, a scheduled block of days off must bring in a note (e.g. from a healthcare provider) documenting their illness. Failure to submit documentation of absence necessary for health or other reasons will result in probation. Consistent or patterned absence or tardiness to clinical causing disruption of staff and/or necessitating changes in clinical assignments (including changes in clinical rotations) will result in disciplinary action, up to and including dismissal from the program.



Students are expected to attend certain required events that occur outside of class or clinical time (e.g. graduation, seminars and conferences) except when they are scheduled for clinical. Non-attendance (without prior approval) will be treated as grounds for probation. Students who are members of the armed forces of the United States who are called to active duty or required to meet reserve training obligations will be granted time off. Students must notify the program director of their military status and anticipated obligations upon enrollment in the program. Students will not be granted clinical release time to serve on medical mission experiences or board review courses.

CLINICAL ROTATION REQUIREMENTS

Students must complete paperwork (application with supporting documentation) including health information (current TB test, immunizations, influenza vaccination). Students must have current California licensure as an RN, as well as ACLS, BLS, and PALS certifications, at all times in clinical (there is no grace period). Documentation that all paperwork has been completed must be submitted to the program offices before the first academic day of the first year of the program. Current information specific to requirements at each clinical site is posted on KPSA website. Students must initiate credentialing and other processes well ahead of time. If they do not, and clinical time is missed, then it is REQUIRED by the student to complete any clinical time missed.

SELF EVALUATION EXAMINATION (SEE)

Students are required to complete the Self Evaluation Examination offered by the NBCRNA at the end of their junior and senior years. Scheduling of these examinations must occur on non-clinical and academic days.

REQUIRED CONFERENCES AND MEETINGS

Attendance and participation is required at: 1. Annual KPSA graduation celebration in August (senior graduating class only) 2. CSU Fullerton graduation in May 3. California Association of Nurse Anesthetists (CANA) meetings held in the Southern

California area (one per year). 4. Annual Kaiser Permanente Anesthesia Symposium 5. Clinical case presentations, anesthesia conferences and department meetings at the

scheduled clinical site. 6. Morning clinical conferences - students scheduled for clinical at some of the clinical sites

are required to attend the weekly clinical conferences. Students should be prepared to


present their patients scheduled for surgery and review previous day's cases. Many other sites have similar conferences.

Special permission for an excused absence from any of the above must be requested prior to the required commitment from the director or designee. Absence from any of the above conferences or meetings will result possible disciplinary action including probation. Conference time may be granted to students to attend the American Association of Nurse Anesthetists (AANA) annual meeting, the Mid-year Assembly, Assembly of School Faculty, or other conferences on a per student basis. This is dependent on student’s overall academic and clinical performance and availability, and will be determined by the program’s administration.

MATERNITY LEAVE

All students who are pregnant while enrolled in the program may request maternity leave from clinical courses. Students will receive an “in-progress” grade for clinical courses. All clinical time from the clinical course from which the leave of absence was instituted will be made up prior to graduation from the program. Since academic courses are only offered one time per year, there will be no provision for prolonged academic absence. KPSA program administration will assist students with the matriculation process. Students will register for GS700 course at CSUF in order to continue enrollment until the completion of clinical time.

LEAVE OF ABSENCE

General leaves of absence will not be granted. Military leave will be granted on a case by case basis. In the case of illness or pregnancy that requires more than a two-week absence, or for other reasons, a personal leave of absence may be granted at the discretion of the program director. A leave of absence is designed to cover a short and unexpected illness or emergency. Due to the cumulative nature of the curriculum, in the case of longer illnesses or elective procedures it may be necessary for the student to resign and reapply to the program. Criteria for returning to the program after a leave of absence will be determined by the program director and the student's treating physician. However, the leave of absence shall extend no longer than one semester. A student will normally be readmitted to the program at the end of his/her leave of absence if the faculty believes the purpose of the leave of absence has been achieved. The student may be required to do preparatory work before reentry after a prolonged leave, or demonstrate current knowledge through examination or through other means upon re-entry. A leave of absence will require additional class and clinical days to meet graduation requirements. Therefore, the student may not graduate on time (with their original cohort) or participate in the celebration for the graduates. All missed academic and clinical time will be REQUIRED to be completed prior to graduation.


7. FINANCIAL CONSIDERATIONS

FINANCIAL ASSISTANCE

Financial Aid There are a variety of avenues to explore when seeking financial assistance. Each program has a separate application process and deadline. Students interested in obtaining Financial Aid to assist with school costs as well as living expenses must complete the Free Application for Federal Student Aid (FAFSA). The priority filing period for the FAFSA each year is January 1st - March 2nd. Complete the form online at fafsa.ed.gov. Have the information electronically sent to CSUF using our school code: 001137. You can complete this prior to admission. CSUF Financial Aid information can be found online at www.fullerton.edu/financialaid. Other programs include:

• Fastweb.com • Finaid.org • Discovernursing.com • Collegenet.com • Bigfuture.Collegeboard.org • Veterans Administration Education Benefits • Nurse Anesthesia Traineeship Grants

PROGRAM EXPENSES AND TECHNOLOGY REQUIREMENTS

Students are required to pay the following program fees and expenses: • CSUF Application Fee • CSUF Tuition/Fees • CSUF Graduation Fee • KPSA Program Fees • AANA Student Membership Fee • Self-Evaluation Examinations (first and second year) • National Certification Examination • Ear Piece Stethoscope • Medatrax case tracking system • Professional conferences (KP anesthesia, CANA, etc) • Books (varies) • CSUF Sigma Theta Tau (optional) • Clinical site parking

Miscellaneous Expenses

• Students are expected to provide their own housing during enrollment in the school of anesthesia.

• Clinical sites are widely dispersed throughout Southern California. Students are expected to supply their own transportation to these sites.

https://fafsa.ed.gov/

http://www.fullerton.edu/financialaid

http://www.fastweb.com/

http://www.finaid.org/

http://www.discovernursing.com/

http://www.collegenet.com/

http://bigfuture.collegeboard.org/

http://www.benefits.va.gov/gibill/

http://bhpr.hrsa.gov/nursing/grants/nat.html


• Transportation and lodging for anesthesia conferences.

Information Technology The student will be expected to possess a laptop computer, in good working order, with the following system requirements:

PC Requirements: • Operating System: 32-bit and 64-bit Versions of Windows Vista, Windows 7, and

Windows 8. • Windows 10 is NOT supported • Only genuine, U.S.-English, French, Portuguese, Swedish, and British versions of

Windows Operating Systems are supported. • ExamSoft does not support Tablet or Convertible devices other than Surface Pro 1, 2 &

3. See below for those Minimum System Requirements. • CPU Processor: 1.86Ghz Intel Core 2 Duo or greater • RAM: highest recommended for the operating system or 2GB • Hard Drive: highest recommended for the operating system or 1GB of available space. • Internet connection for SofTest Download, Registration, Exam Download and Upload. • Screen Resolution must be 1024x768 or higher. • Adobe Reader (Version 9 or 11) is required for exams containing PDF attachments. • Administrator level account permissions

Surface Pro Requirements:

• Surface Pro 1, 2 & 3 (Surface RT tablets are not supported). • External Keyboard (USB or Bluetooth) required. Bluetooth keyboards must be paired

prior to launching exam. • Hard Drive: Minimum of 10GB available space. • Adobe Reader XI is required for exams containing PDF attachments. • Internet connection for SofTest Download, Registration, Exam Download and Upload. • Screen Resolution must be 1920x1080. • Administrator level account permissions.

Mac Requirements

• Operating System: OS X 10.6 (Snow Leopard), OS X 10.7 (Lion), OS X 10.8 (Mountain Lion), 10.9 (Mavericks) and 10.10 (Yosemite). Only genuine versions of Mac Operating Systems are supported.

• CPU: Intel processor • RAM: 2GB • Hard Drive: 1GB or higher available memory • Server version of Mac OS X is not supported • Internet connection for SofTest Download, Registration, Exam download and upload. • Administrator level account permissions

For communication purposes, a valid email address is required throughout the duration of the program.


HEALTH INSURANCE

Students are required to maintain health insurance coverage during their enrollment at KPSA. Coverage by Kaiser Permanente will be provided for the student at no additional cost to the student throughout the duration of the program.

LIABILITY INSURANCE

Kaiser Permanente provides malpractice liability coverage to students engaged in clinical learning experiences and patient care.

REQUIRED TEXTBOOKS

Consult course syllabi for the required textbook lists.

8. STUDENT RESPONSIBILITIES IN THE CLINICAL AREA

CASE RECORDING

Each student will maintain a daily case record, via Medatrax, in which pertinent case information is recorded. Accuracy and completeness of records is essential and entirely the student's responsibility. The purpose of the “Clinical Case Record” of Medatrax is to ensure that each student receives a variety of clinical experiences, and meets the minimum number of hours/cases as set forth by the Council on Accreditation (COA). Each student is responsible for the accurate completion of the Medatrax “Clinical Case Record" as required by the COA. This computerized record will be checked monthly by the assistant director of clinical for completeness.

• If the student neglects to input clinical case information/hours, etc. into the Medatrax system for more than 14 days, the Medatrax system will lock them out. To reinstate the account, the student will need to contact the KPSA assistant director of clinical.

• The student will be responsible for renewing their nursing license and certifications (PALS, ACLS, BLS) before the dates of expiration. It is the student’s responsibility to keep these documents up to date.

• The student will be placed on probation if Medatrax case records are not consistently kept up to date.

As the student accumulates clinical experiences, it is the student’s responsibility to seek assignments that will result in fulfillment of all required case totals. To ensure nurse anesthesia students develop the knowledge, critical thinking, skills and abilities for entry into practice, students must participate in all phases of their clinical cases including preoperative, intraoperative and postoperative anesthesia care. While it may not be possible for students to participate in all phases of care on every case, a student can only take credit for a case where he/she personally provides anesthesia for critical portions of the case. A student


cannot take credit for an anesthetic case if he/she is not personally involved with the implementation and management of the anesthetic, or only observe another anesthesia provider manage a patient’s anesthetic care. A student may only count a procedure (e.g., CVP placement, regional block, etc.) that he or she actually performs.

CARE PLANS

Care plans are used to help students apply theoretical concepts learned in the classroom to individualized nurse anesthesia care in the clinical area. KPSA academic faculty does not require written care plans. However, they are highly suggested as it assists in providing direction in individualized anesthetic care. Any instructor is justified in requesting a written care plan from the student at any time in the student’s education, particularly if the case is one that the student has never done before or for the novice student. If a care plan is not completed, the responsibility lies on the student to be prepared in regards to developing a comprehensive anesthetic perioperative plan based on the patient health status and surgical procedure. For all students placed on clinical probation related to patient care, a care plan is mandated for each case.

CLINICAL TIME

Students will complete daily clinical assignments at the discretion of the clinical faculty. • Students should check with the clinical coordinator regarding reassignment whenever

cases are canceled, long breaks are scheduled in the room, or if the room finishes early. Students must also check with the clinical coordinator prior to leaving the operating room area for any reason.

• Students must comply with all department practices regarding time spent out of the department (e.g. 15 minute breaks, 30 minute lunches).

• It is expected that unassigned clinical time will be used for educational endeavors. • Students are expected to continue working towards their terminal objectives daily. • Students will not request to leave early except for illness or emergency situations. • Students are NOT to request clinical schedule changes with facilities at any time. • Students who violate these policies will be placed on probation.

Each student is expected to attend and actively participate in clinical conferences as required by each clinical site. There should be no textbooks or classroom reference notes brought into the operating room. It is against operating room infection control policies. Each student is expected to comply with the dress code and Department of Anesthesia policies of each affiliating institution. The student is informed of the policies at the time of orientation provided by each affiliating hospital. This includes Infection Control, Hazardous Chemical policies and attendance at department meetings. A preanesthetic assessment and evaluation, and a postoperative evaluation are standards of care in nurse anesthesia practice (AANA Standards of Nurse Anesthesia Practice, http://www.aana.com/resources2/professionalpractice/Pages/Standards-for-Nurse-Anesthesia-Practice.aspx). They ensure continuity of care for the surgical patient.

http://www.aana.com/resources2/professionalpractice/Pages/Standards-for-Nurse-Anesthesia-Practice.aspx

http://www.aana.com/resources2/professionalpractice/Pages/Standards-for-Nurse-Anesthesia-Practice.aspx


• Each student is required to make a pre-anesthetic visit, perform a pre-anesthetic assessment, and formulate a plan of care on all patients they are to anesthetize.

• Post-anesthetic rounds are to be made the day of surgery and/or on the first post-op day, (subject to scheduling and patient availability).

• Patients with post-anesthetic complications should be seen each day during the rotation until the complication is resolved (as schedule and institutional policy permits). The CRNA or MD will be notified and consulted to determine appropriate plan of care.

• Upon transfers of patient care, the student is responsible to hand over care and include comprehensive and pertinent patient information to a competent licensed provider (e.g. PACU RN, ICU RN, CRNA, anesthesiologist).

• Pre and post-operative visits will be recorded on the Medatrax.

CLINICAL ORIENTATION

Students will rotate through the assigned Kaiser Permanente and affiliated medical sites. Each student will rotate one week at the Los Angeles Braille Institute. A clinical rotation schedule will be given to each student prior to entering clinical rotations. Students scheduled for out of state rotations must provide an out of state RN license 6 months prior to scheduled rotation. Failure comply will result in being placed on probation. Clinical orientation information from the various anesthesia departments will be available online prior to clinical rotations. The student is responsible to review this manual prior to the 1st day at that facility. Students are required to contact the clinical coordinator by email a minimum of three weeks prior to their rotation. The clinical coordinator from each facility is responsible for new student orientations to the clinical area. Introduction to the members of the anesthesia team and operating room staff will be conducted by the clinical coordinator and/or staff.

CLINICAL ROTATION ACCOMODATIONS

The student will be provided housing at a hotel for clinical rotations located in Oceanside, San Diego, Palm Springs, and Bakersfield. The hotels are located near the clinical facilities.

• KPSA will secure all room reservations in advance of the clinical rotations. If a room is not needed, the student is responsible for canceling their reservations by 11:00 a.m. the day before. When canceling a reservation, it is mandatory that a cancellation number be acquired and given to the administrative assistant (Retta Smith or Sandra Hinkson).

• On occasion, dual occupancy may be necessary at the discretion of the administrative secretary. Only students of the same gender will be placed together.

• The hotel will charge the school if the student fails to cancel the room. If the student fails to cancel the room reservation, it will become the student’s responsibility to pay the cost of the room. Failure to pay for the non-cancelled room will result in the inability to graduate from the program until all hotel charges are paid in full.


Hotel Accommodations Bakersfield: Springhill Suites, Marriott 3601 Marriott Drive Bakersfield, CA 93308 Tel: (661) 324-6660

Oceanside: Courtyard by Marriott 3501 Seagate Way Oceanside, CA 92056 Tel: (760) 966-1000

Palm Springs: Courtyard by Marriott 1300 E. Tahquitz Canyon Way Palm Springs, CA 92262 Tel: (760) 322-6100

San Diego: Days Inn San Diego 543 Hotel Circle South San Diego, CA 92108 Tel: (619) 297-8800

COMMUNICATION AND DISTRACTIONS (CLASS, CLINICAL AND PROF. MEETINGS)

“Any inattentive behavior during a procedure, such as reading, texting, gaming or using mobile devices to access nonclinical content, should be considered a potential patient safety issue.” (2012, AANA Position Statement 2.18) No reading or writing of any materials except the patient chart is permitted in the OR. Unless specifically directed to do so, students should not bring mobile electronic devices or cell phones into patient care areas. Mobile phones are portable electronic devices used for communication over a network of cell sites. Mobile devices include, but are not limited to, devices such as; smart phones, mobile computer (e.g. PDAs, laptops), hand held game consoles, and media recorders and players.

• Use of mobile phones and devices for voice or data communication (e.g. text messaging) in the clinical settings is prohibited.

• Use of media recorders or players (or those functions) in the clinical setting is prohibited.

• Use of game consoles or functions in the clinical setting is prohibited. • Ring tones shall be turned off at all times while the student is in the clinical setting. • Use of mobile devices for medical reference purposes directly connected with patient

care is permitted with the consent of the supervising clinical faculty. While assigned to affiliated institutions, the policies of the affiliated institution takes precedence over KPSA policy if that standard is more restrictive than KPSA policy. Students who violate this will be subject to disciplinary action.

LICENSURE

Students are required to maintain continuous and uninterrupted licensure as a Registered Nurse in California, ACLS certification, BLS certification, and PALS certification, from enrollment through graduation. Students who do not possess a current California license, ACLS, BLS, or PALS will not be allowed to participate in clinical and will be placed on probation.


It is the students’ responsibility to have a personal copy and provide a copy of their updated and current California Registered Nurse license, ACLS, BLS, and PALS to the administrative assistant (Retta Smith) at KPSA.

MEDICATION SAFETY

It is critical for infection control that students adhere to single-use of syringes, IV tubing, and medication vials (“one and done”). Please refer to AANA Position Statement 2.13 Safe Needle and Syringe Use: http://www.aana.com/resources2/professionalpractice/Documents/PPM%20PS%202.13%20Sa fe%20Needle%20Syringe%20Use.pdf ). Also see http://www.oneandonlycampaign.org/

9. ENVIRONMENTAL AND CHEMICAL HAZARDS

ENVIRONMENTAL HAZARDS

Responsibility for accepting risks associated with this specialty rests with the individual who chooses to work within this environment, rather than with the institutions, which take reasonable precautions to minimize potential hazards. All safeguards to limit the exposure of operating room personnel to anesthetic gasses at each hospital are closely regulated.

Exposure to blood borne pathogens-All students are expected to strictly adhere to universal precautions whenever involved in patient care. Gloves, protective eye wear, gowns, and masks are available at each anesthetizing site and must be worn when indicated. Proper regard for and performance of aseptic technique is mandatory to protect both patients and anesthesia caregivers. All students must be vaccinated against Hepatitis B, and have other immunizations required by policy at the various clinical sites. When exposed to any blood or body fluids during the course of a clinical rotation at any facility, the student must:

• At the time of exposure, notify the clinical coordinator or department administrator and report for medical treatment.

• Contact the assistant director of clinical (Sass Elisha) and administrative secretary (Sandra Hinkson) at (626) 564-3016 to provide details related to the exposure.

• The administrative secretary will complete on-line documents that are submitted to Employee Health at Kaiser Permanente (626) 405-7176.

• Employee Health will contact the student for any additional information. Radiation Exposure Anesthesia personnel are also frequently exposed to x-rays during operative procedures. Lead aprons and thyroid shields are available at each anesthetizing site and must be worn during fluoroscopy or x-ray procedures. Radiology dosimeters to monitor the level of x-ray exposure are provided and must be worn in all anesthetizing locations. Dosimeters will be issued to each student must be returned to Sandra Hinkson at the end of each month.

Latex Exposure Kaiser Permanente and the School of Anesthesia cannot guarantee a latex-

http://www.aana.com/resources2/professionalpractice/Documents/PPM%20PS%202.13%20Safe%20Needle%20Syringe%20Use.pdf

http://www.aana.com/resources2/professionalpractice/Documents/PPM%20PS%202.13%20Safe%20Needle%20Syringe%20Use.pdf

http://www.oneandonlycampaign.org/


free environment in any clinical or academic facility. Students with a latex sensitivity or allergy must provide a written clearance to enter the clinical or simulation area from their physician. The student will inform the clinical coordinator the first day of each rotation of their sensitivity or allergy to latex.

CHEMICAL DEPENDENCY

The educational program for nurse anesthetists has a vital interest in maintaining a safe, healthy and efficient environment for its students and patients, an environment free from the misuse of drugs and alcohol. Recognizing that chemical dependency is both a disease and a professional hazard, the purpose of this policy is to provide guidelines for the prevention and management of substance abuse within the nurse anesthesia educational program. The policy is intended to provide a safe, fair working environment for all anesthesia practitioners and their patients. Students, like employees, are required to comply with all hospital policies regarding pre-employment drug and health screening. Nurse anesthesia students shall be required to submit to drug testing as a condition of enrollment. Failure of the drug test, or refusal to cooperate with any aspect of this policy, or any hospital policy on substance abuse, will result in disciplinary action up to and including; refusal of enrollment, dismissal and the reporting of use to the appropriate authorities. Because of the paramount concern for patient safety, these disciplinary actions may be imposed without the customary mechanisms of academic warning, and probation period. The KPSA director may, for cause, ask a student for a list of all prescription medications, including the name, address and phone number of the licensed practitioner prescribing the medication, the nature of the illness or medical condition, the type, strength, dosage, specific directions for the use of the medication and the expected duration of therapy. A person currently involved in substance abuse cannot safely learn or practice as a nurse anesthetist. If this process is not interrupted it may result in the death of the student. Students are therefore encouraged to self-report to the faculty, and seek help from peer assistance and the state diversion into treatment program (see below). Such disclosure to faculty, or the presence on a drug test of any intoxicant, non-prescribed narcotic, hallucinogen, marijuana or other prescribed or non-prescribed controlled substance in blood or urine will result in immediate placement of the student on leave of absence status from the clinical and classroom areas. The student will be dismissed from the program if the following situation are definitively proven;1) diversion; 2) inappropriate or excessive use of controlled substances, illegal drugs, prescribed drugs, or alcohol, or 3) any other condition which may threaten patient or student safety; particularly if any of these are resulting, or may potentially result in impairment. Dismissal followed by a report to the California Board of Registered Nursing. Concern of Faculty The faculty is committed to facilitating the success of the nurse anesthesia student and will make every effort to assist in maintaining optimal health in order to safely achieve academic and clinical performance objectives. Impaired health status, which includes physical problems, mental/emotional problems, and drug and alcohol use/abuse, affects academic and clinical performance. Substances which may impair student performance include legal drugs (prescription and over-the-counter), illegal drugs, alcohol, and other


chemicals. The impaired student is a danger to self and to others in his/her care. The faculty, out of concern for the impaired student, has developed the following policy that is consistent with the Board of Registered Nursing Guidelines and the Kaiser Permanente Drug Policy. Impaired Student Policy The KPSA/CSUF faculty members follow the guidelines established by the Board of Registered Nursing related to Impaired Nursing Students. The Board of Registered Nursing Statement regarding Impaired Nursing Students Guidelines for Schools of Nursing in Dealing with the Matter of Nursing Students Impaired by Alcoholism, Drug Abuse, and Emotional Illness is as follows: In the matter of nursing students impaired by alcoholism, drug abuse and emotional illness the California Board of Registered Nursing recognizes that:

• these are diseases and should be treated as such • personal and health problems involving these diseases can affect one's academic and

clinical performance and that the impaired nursing student is a danger to self and a grave danger to the patients in her or his care

• nursing students who develop these diseases can be helped to recover • it is the responsibility of the nursing student to voluntarily seek diagnosis and treatment

for any suspected illness • confidential handling of the diagnosis and treatment of these diseases is essential

Therefore, the Board of Registered Nursing expects schools of nursing with students impaired by these diseases to offer appropriate assistance, either directly or by referral. Furthermore, the Board expects that schools of nursing will ensure that instructors have the responsibility and authority to take immediate corrective action with regard to the student's conduct and performance in the clinical setting. It is outside of the Board's scope of function to endorse or recommend a particular course of therapy; however, it does wish to inform nursing students of the importance of seeking voluntary aid for conditions that could, if left unattended, lead to disciplinary action and may prevent them from being licensed [or losing their license] to practice nursing in the State of California. As a preventive measure, schools of nursing are asked to provide factual material to incoming students regarding school policy on drug or alcohol abuse and mental illness among nursing students. Assessment It is in violation of law, and of university regulations to obtain, possess, prescribe, administer to self or to another person any controlled substance or patient medications not prescribed by the physician. It is in violation of law, and of university regulations to falsify, alter, or misuse records for controlled substances. The student shall be removed from the classroom or clinical setting when the student's behaviors and performance pose a danger to the safety and well being of self or others. These behaviors may include:

• physical impairment • mental or emotional impairment • impaired judgment • disruptive actions • inconsistent behavior patterns


Procedure When a student, in the program administrators, academic faculty, clinical coordinators and or preceptor's opinion, is exhibiting any of the above behaviors, the following actions will be taken:

• The student shall be excluded from the classroom or clinical setting. • The preceptor shall immediately consult the chief of the department and /or the

department administrator • KPSA shall immediately be notified of the incident by the preceptor, chief or DA. • The student shall immediately report to KPSA for investigation pursuant to university

and KPSA regulations. • The student shall be referred for further professional assessment. • The student will be asked to provide breath, blood and/or urine specimens for testing

Drug testing When reasonable suspicion has been established to indicate a student is under the influence of alcohol or drugs, the student will be asked to provide breath, blood and/or urine specimens for testing. A student may be required to undergo a blood test or urinalysis under any of the following circumstances:

• When there is reasonable cause to believe, in the opinion of didactic or clinical personnel that they are under the influence of any intoxicant, non-prescribed narcotic, hallucinogen, marijuana or other prescribed or non-prescribed controlled substance. Reasonable cause might include, but is not limited to, specific observations of abnormal behavior, appearance, speech, breath odor, or lapse of performance that may be indicative of the misuse of, influence of, or impairment by, alcohol or any illegal or legal substances.

• In this case, the student will be immediately removed from the patient care area or the classroom and required to submit to a drug test per KP policy.

• After the occurrence of a reported work-related injury/illness, patient-care incident, or accident while on the facility property or during work hours.

• During any physical examination provided by the facility. Confidentiality - Testing and test results will be handled confidentially with disclosure of results provided only to appropriate faculty, management, and program administration. A student's refusal to submit to drug testing shall be considered as equivalent to a failed drug test, and will subject the student to dismissal from KPSA. Dismissal from the Program as an Impaired Student- If the student is believed to be acutely or chronically impaired, and therefore a danger to self or others, and refuses to submit to further professional assessment and testing, the student will be dismissed from KPSA. The student may also be subject to suspension or expulsion from other university programs in accordance with the university rules and regulations. If the student submits to further professional assessment and/or testing, and is found to be impaired, therefore a danger to self or others, the student will be dismissed from KPSA. Kaiser Permanente has a zero tolerance policy for drug and alcohol abuse. Therefore, a student will be dismissed from KPSA if there is definitive evidence of substance abuse.


Students may be counseled that voluntary redirection of their career choice may be in the best interest of their own health, considering the stresses and the access to controlled substances inherent to the nurse anesthesia educational program and career. Should the student wish to appeal the decision, they shall follow the procedure listed in this Handbook in the section on Committees; Grievance and Appeals. Controlled Substance Accountability

1. A written, consistent process of controlled substance accountability will be followed by all nurse anesthesia students.

2. All controlled substances will be kept under the control of the person who signed for them, that is, on their person or kept in a locked drawer.

3. Controlled substances will not be exchanged between department members or fellow students.

4. All unused portions of drugs will be returned to the locked compartment in the anesthesia workroom after hours, or to the OR Pharmacy satellite. All controlled substance wastage will follow Department of Pharmacy guidelines at the site, and requires a witness at the time of wastage.

5. Assays on unused portions of controlled substances, as well as audits of anesthesia and PACU records, may be conducted periodically and if suspicion warrants.

6. Random audits of written records or returned waste may be conducted as part of the QA process. This information will remain confidential until such time that intervention or discipline may be required.

When sufficient evidence exists that inappropriate controlled substance usage has occurred, a specific investigation will begin. Unusual trends, violations or errors will be documented and investigated by the Chief of Anesthesia and the Directors of Pharmacy, Anesthesia Services, and the School of Anesthesia, or their designees. Resources

• Kaiser Permanente Drug-Free Workplace Policy http://npl.kp.org/pl/do/public/record?rgid=1040&subcatid=3469&VIEW=M&rid=98042601

• Kaiser Permanente Drug and Alcohol Testing Policy http://npl.kp.org/pl/do/public/record?rgid=1040&subcatid=3469&VIEW=M&rid=114502601

• Kaiser Permanente Employee Assistance Program (EAP) https://epf.kp.org/wps/portal/hr/kpme/healthyworkforce/gethelp

• California State University Student Health and Counseling Center http://www.fullerton.edu/shcc/caps/staff.asp

• California Board of Registered Nursing Diversion Program http://www.rn.ca.gov/diversion/index.shtml

• AANA Student Wellness http://www.aana.com/resources2/health-wellness/Pages/Student-Wellness.aspx

• AANA Peer Assistance http://www.aana.com/resources2/peer- assistance/Pages/default.aspx Phone (800) 654-5167





https://epf.kp.org/wps/portal/hr/kpme/healthyworkforce/gethelp

http://www.fullerton.edu/shcc/caps/staff.asp

http://www.rn.ca.gov/diversion/index.shtml

http://www.aana.com/resources2/health-wellness/Pages/Student-Wellness.aspx

http://www.aana.com/resources2/health-wellness/Pages/Student-Wellness.aspx

http://www.aana.com/resources2/peer-%20%20assistance/Pages/default.aspx

http://www.aana.com/resources2/peer-%20%20assistance/Pages/default.aspx


10. CLINICAL AFFILIATIONS

Students rotate to various local hospitals where the program has clinical affiliations. Affiliations are designed to provide depth and breadth of clinical experience. Refer to the KPSA online clinical handbook for specifics related to clinical site rotations. Students are scheduled for clinical at least two months in advance based upon student and clinical site availability. Students will not complete the rotations in the same order or at the same times as their classmates.

DUTIES OF CLINICAL COORDINATORS AT CLINICAL SITES

Clinical coordinators are faculty of KPSA. They possess a minimum of a Master degree and are a CRNA or anesthesiologist. Their duties include:

• Encouraging preceptors to complete daily student evaluations. • Acting as a student advocate. • Conducting monthly evaluations of students. • Communicating with the assistant director of clinical if a student has

unsatisfactory clinical performance, or if there are questions about student performance, time keeping, or professionalism.

• Conveying suggestions from their site for program improvement or enrichment.

• Functioning as second-line problem resolution if disputes arise between students and clinical faculty.

A list of current clinical coordinators and their email addresses shall be made available to each student.

11. LIBRARY AND COMPUTER RESOURCES

KPSA Library-Students are encouraged to utilize the library at KPSA. A variety of text, journal, and online database references are available. The library is located on the 5th floor near the faculty offices. The program office hours including the library are Monday-Friday, 0700-1700. Students may be asked to leave the premises earlier if there are less than three aggregate students and/or staff present. Students are not permitted in the office at any other time unless specific arrangements are made with the faculty. All books must be signed out when taken out of the office. Books must be returned within two weeks. All library materials must be returned prior to the end of each grading period before grades will be released to CSUF. Library privileges may be revoked for failure to comply with library policies. Internet Access-Internet access is available at KPSA at several computers in the lobby and library, including Wi-Fi access throughout the KPSA building. Students can access the KPs clinical library via the KPSA intranet.


Clinical Sites/Hospital Library-Students are permitted to use the hospital libraries at most sites. The facility clinical coordinator will provide students with information/access as deemed necessary. CSUF Library-Students have full access to Pollak Library and must abide by the university rules and regulations regarding its use. http://library.fullerton.edu/

12. EVALUATION PLAN

OVERVIEW

Student orientation for all beginning students will include review of all program policies. This includes access to the Student Handbook acknowledged by signature.

The evaluation process is an integral part of the educational mechanism at KPSA. Evaluation is present during all phases of the educational program and encompasses all students, all clinical and didactic faculty, courses, the program itself, and graduates.

The assistant director of academics schedules evaluation activities, ensures they are completed confidentially, communicates the results, and monitors the adequacy of measures taken to address problems. The KPSA faculty and clinical faculty monitor student performance in classroom and clinical areas, and make recommendations on academic progression to the program director(s).

EVALUATION OF STUDENTS

Evaluation of students occurs in both the clinical and academic areas and the results of these processes are communicated to students, academic faculty and clinical faculty. The results from evaluations of students are used to:

• Assess the progress of students from novice to expert throughout their education. • Formulate a grade based on CSUF and KPSA policy. • Determine if particular students are not meeting academic and/or clinical objectives. • Counsel students regarding areas of achievement and opportunities for improvement. • Identify commonalities and trends to assess the overall effectiveness of the program. • Implement curricular change as necessary.

ACADEMIC EVALUATION

The assistant director of academics reviews student academic performance throughout the semester. Individual student progress is communicated monthly to the academic faculty. At the end of each semester, each student meets with an academic faculty member and reviews his/her semester academic and clinical performance. Prior to meeting with academic faculty, all students

http://library.fullerton.edu/


are required to complete a written semester academic and clinical self-evaluation. During their semester summative evaluation, the student's self-evaluation is reviewed. The student is encouraged to include written comments on their self-evaluation summary based on their exam scores and other academic learning exercises (eg. oral boards, case studies, simulation, and differential diagnosis, etc.). Student’s self-evaluations are completed each semester. All students’ end of semester self-evaluations are permanently archived.

Academic Assessment of Achievement

The most common method of academic evaluation is by on-line examination utilizing ExamSoft. Additionally, results from quizzes, presentations, written papers, and simulations are included in the evaluative process (See academic course content and graded assignments). Students who are not meeting semester academic objectives are counseled by the assistant director of academics or other faculty, who will meet with the student after each exam. Students who continually fail to meet semester academic objectives are subject to probation and dismissal (See policies-academic/clinical probation/dismissal).

CLINICAL EVALUATION

Student clinical evaluations are based upon the clinical objectives (See clinical objectives). The following is the procedure for clinical evaluation of students.

Daily evaluation-At the end of each clinical day, students will initiate the completion of the daily evaluation by their preceptor on their personal electronic device.* Preceptors will enter their name/secure facility code, complete the evaluation and the student will upload the evaluation to Medatrax. The daily evaluations will be available for review on-line by students and clinical educators after the assistant director of clinical reviews them within 7 business days after submission. All clinical educators are encouraged to verbally discuss their evaluation and observations of the student’s performance at the end of the day. For evaluations that consistently do not “meet or exceed” objectives, an individualized plan for improvement will be initiated by the clinical coordinator and the assistant director of clinical and be reviewed with the student (see evaluation tool below). The assistant director of clinical will carefully assess the student’s progress weekly. Students will be placed on probation or dismissed if clinical objectives are not consistently met or if the student’s clinical performance at any time jeopardizes patient safety.

It is not possible to evaluate clinical performance if clinical evaluations are not completed. Students must obtain evaluations for at least 60% of their assigned clinical days. It is the student’s responsibility to ask each clinical preceptor to complete the evaluation at the end of the day. It is the responsibility of the clinical instructor to complete the evaluation for each student.

If clinical preceptors refuse to complete the daily clinical evaluation, then the student should inform the clinical coordinator at the site and the KPSA clinical administrator.


*During the rotation to Children’s Hospital of Los Angeles (CHLA) (2 month rotation), students will be evaluated on-line via the CHLA resident anesthesiologist evaluation sheet by their attending pediatric anesthesiologists. A one-month summative evaluation will be distributed to the KPSA clinical program administrator and then to the student. A copy of the evaluation is kept in the student’s file.

*During the Cardiac anesthesia rotation (1 month rotation), students will be evaluated daily on a verbal feedback basis and at the end of the rotation via the Medatrax online evaluation system.

Falsification of clinical evaluations by a student constitutes unethical conduct and will result in immediate dismissal from the program.

Summative Semester Clinical Evaluations-During end of semester evaluations, each student will review their clinical evaluations with a member of the academic faculty. Strengths and areas of improvement will be identified and discussed.

Students who are not meeting clinical objectives at any point during the clinical semester will be identified. The clinical coordinator and the assistant director of clinical will implement a plan for improvement. Depending on the nature of the clinical performance issue, the assistant director of clinical may observe the student during clinical practice. If necessary, a student will be placed on probation or be dismissed from the program. (See probation/dismissal)

Medatrax Case Totals-The assistant director of clinical will review each student’s progress toward meeting the COA case/procedure mandated requirements. A copy of the COAs case counting policy is distributed to the students prior to starting clinical. Students will be counseled throughout the program to ensure that they are obtaining the necessary case requirements for graduation. Graduating senior total case/procedure numbers will be evaluated monthly and guide clinical programmatic change.

EVALUATION OF FACULTY

Faculty/clinical educators are evaluated in both the clinical and the classroom settings. Clinical Clinical coordinator evaluations of KPSA and overall student performance are completed annually at the clinical coordinators meeting. Surveys are completed online allowing for anonymity to all participants. The comments are immediately reviewed with the clinical coordinators. Students are required to evaluate each clinical site and a minimum of 3 clinical educators during each clinical rotation on-line via Medatrax. Freedom of expression is encouraged and confidentiality for each student is preserved. The data from the evaluations is reviewed by the assistant director of clinical and shared with the program faculty for strengths and areas of


improvement. The anonymous evaluations are then distributed to each clinical coordinator. Annual visits to each clinical site by KPSA faculty also serve as a form of evaluation of clinical educators/site.

Academic

Academic faculty are evaluated anonymously by the students at the end of each semester on-line via Moodle. The results of these evaluations are shared with each KPSA faculty. A designated time is specified for completing evaluation forms at the end of each semester. Since improvement of instructional quality depends in part on student feedback, the results are presented to the faculty each semester during the curriculum and evaluation committee meeting.

Students’ comments and ratings are summarized and compiled for use by the program to guide meaningful curricular change. Freedom of expression is encouraged and confidentiality of each student is preserved. Compiled comments and ratings will be reviewed by program administration and shared with KPSA faculty, communities of interest and University faculty members to guide professional development.

EVALUATION OF PROGRAM

Evaluation of the program will occur by reviewing data from a variety of sources (see KPSA evaluation matrix below). The program’s academic and clinical faculty, university faculty, communities of interest and students assess the program strengths and weaknesses to ensure continuous improvement and strategies for meaningful change. Policies and procedures for the program will be reviewed and updated annually or more frequently as needed.

Program administration will schedule exit interviews with all graduates during the end of their last semester prior to graduation. All graduates evaluate the program as a whole on-line and then discuss their opinions during the exit interview with the academic faculty. Freedom of expression is encouraged and confidentiality will be preserved. The results of this periodic review of evaluation data will be shared with communities of interest including students and academic/clinical faculty.

A postgraduate program evaluation form will be sent to graduates and their employers at one year and five years. The program administration will review the returned forms and summarize their findings on an annual basis. The results of this periodic review of policies will be shared with the community of interest including students and academic/clinical faculty.

SUMMARY OF EVALUATION METHODS AND PROCESS

Data for program evaluation includes but is not limited to: NCE results, 1st and 2nd year students SEE exam results, academic and clinical faculty evaluations of the program, and current student evaluations of the:

• Courses • Academic and clinical instructors • Clinical educators and clinical sites


• Curriculum and evaluation committee • Graduating student exit interviews • Graduate evaluations • Employer evaluations • Communities of interest evaluation (public member, university representatives, etc.) • Results of annual report/accreditation review

KPSA Evaluation Plan Matrix

Type of Evaluation

Evaluator Indicator Evaluation Tool

Frequency Intervention

Student Performance-

Academic

Academic Faculty

Exams scores and other learning experiences (eg. simulation) per course syllabi

Throughout the semester, End of each

semester

Verbal/written counseling/remediation/ probation/dismissal

Student Written semester self- evaluation tool

Each semester, More often as

needed

Request guidance/remedial instruction

Student Performance-

Clinical

Clinical Educator On-line Medatrax daily evaluations of clinical objectives

Daily Remedial instruction as indicated, formal plan of remediation as indicated by probation/dismissal

Clinical Coordinator

On-line monthly summative clinical evaluation-survey, student can access their on-line evaluations

Monthly Remedial instruction as indicated, formal plan of remediation as indicated by probation/dismissal

Academic Faculty

Verbal and on-line review of semesters clinical performance


needed

Successfully meeting clinical objectives mandatory to progress to next clinical semester

Student On-line semester self- evaluation tool


needed

Request guidance/remedial instruction

Assistant Director of

Clinical

Review of daily and monthly on-line evaluations

Monthly Remedial instruction as indicated, formal plan of remediation as indicated by probation/dismissal

Academic Course and Academic Educator

Performance

Student Electronic submission of anonymous course and academic educator evaluations-survey

Each semester for each

individual course

Data will be analyzed and utilized to recognize accomplishments and institute improvement

Academic Educator Self

Evaluation

Written self-evaluation, Reviewed by program director

Annually Academic educator will assess their own strengths and areas needing improvement

Program Performance Review Annually Data will be analyzed and utilized to


Director

of academic faculty recognize accomplishments and guide faculty development activities

Clinical Site and Clinical Instructor

Performance

Students Anonymous electronic submission of clinical site and clinical educator evaluations

Each clinical rotation (1 or 2

month duration)

Data will be analyzed each semester and utilized to recognize accomplishments and institute improvement

Assistant Director of

Clinical/ Academic

Faculty

Clinical Site Visits Annually /more often as needed

Data will be analyzed and utilized to recognize accomplishments and institute improvement

Complete Program

Effectiveness and

Continuous Improvement

Students Electronic submission of anonymous course and academic/clinical program evaluation

Each semester Data will be analyzed and utilized to recognize accomplishments and guide change for program improvements

KPSA Curriculum and Evaluation

Committee

Discussion with senior/junior students/public member and academic faculty

Each semester Data will be analyzed and utilized to recognize accomplishments and guide change for program improvements

KPSA/CSUF Evaluation Committee

Discussion of program effectiveness

Each month Data will be analyzed and utilized to recognize accomplishments and guide change for program improvements

Graduating Students

Electronic submission of anonymous survey-program effectiveness

Each year- exit interview

Data will be analyzed and utilized to recognize accomplishments and guide change for program improvements

CSUF Nursing Faculty/Nursing

Community


Continuously Data will be analyzed and utilized to recognize accomplishments and guide change for program improvements

Alumni Electronic submission of anonymous survey-program effectiveness

Annually Data will be analyzed and utilized to recognize accomplishments and guide change for program improvements

Academic Faculty


Each semester, more often as

needed


Clinical Coordinators

On-line yearly evaluation-clinical coordinators meeting

Annually, more often as needed



Employers of Graduates

On-line survey of 1 and 5 year graduates


Public of Interest

(public member, community partners)


Each semester Suggestions for improvement considered by academic faculty

External Reviewers

COA annual report/accreditation visit

Annually/per accreditation

cycle

Results of annual report/accreditation review

Outcome Indicators

SEE scores, NCE 1st time pass rate, student satisfaction, clinical case requirements, etc.


13. ACADEMIC PROGRESSION

GUIDELINES FOR CLINICAL PROBATION

Definition Probationary status shall be assigned when it is determined that a student is failing to make satisfactory progress toward meeting clinical objectives. Directing a student to seek appropriate counseling during probation is within the purview of the KPSA Academic faculty. A student may be placed on probation, or dismissed without probation at any time for violation of the expectations for professional decorum and unethical behavior which are expressed elsewhere in this handbook. A student can be assigned academic and clinical probation simultaneously. Guidelines A student's behavior must be safe in all areas of patient care, or the student is considered unsafe. Consideration for progress will be based on a review of written student evaluations, clinical coordinator observations, and communications with the assistant director of clinical. When students are having difficulty in the clinical area, they are counseled by program faculty/administration, goals and objectives are identified, and a plan is formulated with input from the student. If at any time, it is determined that the student is not consistently meeting clinical objectives, a probationary status will be instituted. If a student's satisfactory progression is questionable (for example, if a site clinical coordinator requests that the student be reassigned to a different site, or serious questions about performance are raised in written evaluations, or critical clinical incidents occur), the student will be placed on probation or dismissed from the program. Student performance is evaluated in relation to clinical objectives for their level. A recommendation for probation or dismissal will be determined by KPSA program administrators, and the academic faculty. The clinical grade of pass or fail will be recommended by the KPSA program administrators and academic faculty. KPSA


administration will assign clinical probation status based on input from clinical faculty, assistant director of clinical and the academic faculty at KPSA. Clinical Probation Probation is defined as a time frame of 30 days designated to evaluate the performance of a student who has not met clinical objectives. In addition, a student may be placed on probation as the initial disciplinary action if the faculty deems the infraction of a serious nature. A record of this act will be made on the “Probationary Action” form, including all specific unmet objective(s) and necessary actions to correct the problem(s). The student will be counseled and made aware of their deficiencies. Objectives and outcomes will be communicated with the student and documented. Continuous assessment by KPSA faculty, clinical faculty, and assistant director of clinical will occur throughout the probationary period. Students will meet with KPSA clinical administration at the end of the 30-day probationary period to review objectives and ensure satisfactory progression. At this time, if the student remains unable to meet the clinical objectives, the student will receive a “fail” grade for clinical and will be dismissed from KPSA and the Nurse Anesthesia concentration at CSUF. If the student meets the clinical objectives within the 30 day timeframe, the probationary period will end and the student will receive a “pass” grade for clinical upon completion of the semester. The student must successfully meet all clinical objectives in order to receive credit and matriculate in the curriculum. All students must attain a “pass” in clinical following all semesters.

GUIDELINES FOR ACADEMIC PROBATION

CSUF MSN core nursing courses All nurse anesthesia concentration MSN students are required to take the following Core course (9 units), which include:

• NURS 501 Theoretical Perspectives for Nursing Practice (3 units) • NURS 505A Nursing Research and Evaluation for Practice (3 units) • NURS 505B Seminar in Nursing Research (3 units)

A student can receive a “C” letter grade or better in any MSN core nursing course. However, a student must maintain a cumulative GPA of 3.0 or greater. In the event that the student fails to maintain a cumulative GPA of 3.0, they will be dismissed from KPSA. KPSA Academic Grades Acceptable graduate level nurse anesthesia course grades need to be a “B” or better (83% or above). A grade of less than 83% is not acceptable. Students will be dismissed from KPSA for any overall nurse anesthesia course grade of less than 83%. Students are advised when they are accepted in the program that they must complete courses on the timeline with their cohort. There is no opportunity for repeating any nurse anesthesia course within the curriculum. Students must maintain a cumulative GPA of 3.0 or greater.


Academic Probation Students will be placed on academic probation at the discretion of the KPSA faculty if they are not meeting academic objectives at any time during the semester. A record of this academic probation will be documented. The document of academic probation will include:

• All specific unmet academic objectives • Necessary actions to correct deficiencies

Students will be counseled and made aware of deficiencies and notice of academic probation. The student will have the opportunity to discuss and provide input into their progress. Continuous assessment by the KPSA faculty will occur throughout the probationary period. The length of the probationary period extends throughout the student’s current semester. If the student fails to maintain an 83% or greater in the course, or a cumulative GPA of 3.0 or greater at the end of the semester, they will be dismissed from KPSA. A student can be assigned academic and clinical probation simultaneously.

DISMISSAL

Dismissal from the program may be for academic, clinical, ethical, professional, or disciplinary reasons. Disciplinary reasons include violation of University rules and regulations and for unprofessional, unethical or illegal conduct related to professional practice. General guidelines for determining a violation of ethical or professional standards of conduct are found in the Standards for Accreditation of Nurse Anesthesia Education Programs (http://home.coa.us.com/accreditation/Pages/Accreditation-Policies,-Procedures-and- Standards.aspx ). Criteria for Immediate Dismissal: Although students are normally notified during the term that they are not meeting clinical and/or academic expectations, it should be understood that egregious deviations from standards of care, other actions jeopardizing patient safety, or unprofessional conduct will result in dismissal, even from a single incident in which no prior notification by faculty of student deficiencies is possible. Students may be dismissed from the academic/clinical program without prior verbal or written warning depending on the extent and seriousness of the infractions. 1. Clinical error affecting patient safety 2. Unethical or immoral conduct 3. Lack of respect or empathy for patients 4. Professional misconduct 5. Inability to cooperate with supervisors, peers, or hospital staff 6. Habitual malcontent 7. Physical or mental illness that interferes with safe clinical performance 8. Abuse of drugs or alcohol 9. Habitual tardiness or absenteeism 10. Disruptive, lewd, or indecent behavior in the clinical area or classroom

http://home.coa.us.com/accreditation/Pages/Accreditation-Policies%2C-Procedures-and-Standards.aspx




11. Noncompliance with departmental policies 12. Cheating, plagiarism, or theft of any nature 13. False or misleading information on application form or health form 14. Administering anesthesia outside the confines of the anesthesia program 15. Soliciting or assisting another to do any act that would subject a student to expulsion, suspension or probation pursuant to the stated criteria. 16. Any other reason, which in the professional judgment of the department reflects student

inability to master the didactic or clinical component, or breach of academic integrity. 17. Disclosure of any material and/or content of examinations and simulation (written or

verbal).

CLINICAL AND ACADEMIC REASONS FOR DISMISSAL

All students must continually meet standards of care and the requirements of state law that pertain to Registered Nurse practice. The program director will report violations of law to appropriate authorities. Notification of Dismissal

Dismissal of a student will be recommended to the program director by the KPSA Academic and/or clinical faculty. Such recommendations shall include documentation of the reason(s) for dismissal. The final decision for dismissal rests with the program director. Once the student is dismissed, they must return any KPSA, hospital or University property to the director. A summarization of the student's performance to date and a description of the circumstances of dismissal will be placed in the student's file. The Dean of the School of Nursing at California State University Fullerton, other University officials (Registrar, Financial Aid, etc.), the NBCRNA, the AANA, and various departments of the clinical site (public safety, the administrator of the anesthesia or other departments that are applicable) will also be notified of the dismissal. The NBCRNA and the AANA will be notified of the reason(s) for the dismissal.

WITHDRAWAL

Students contemplating withdrawal from the program are required to consult in person with the program director or designee prior to finalizing the decision and submitting a written resignation. At the time of resignation, the student must state their intentions in writing and return all KPSA, hospital or CSUF property. A student may resign during an academic or clinical probationary period, however, the resignation must be made prior to the point where the Academic faculty has made a final recommendation to the director to dismiss (in other words, students are not allowed to resign in lieu of dismissal). A summarization of the student's performance to date and a written description of the circumstances of resignation will be placed in the student's file. The hospital administrator, the Dean of the School of Nursing at CSUF, the AANA and the NBCRNA will also be notified of the resignation.


14. COMMITTEES, MEETINGS, GRIEVANCE AND APPEALS

CURRICULUM AND EVALUATION COMMITTEE

Charge: • Analyzes data from evaluations of all curricular functions. • Utilizes data from evaluations, student comments, and community partner(s) to make

strategic changes in all academic and clinical functions. Membership and meetings:

• Chair: Nurse Anesthesia faculty member • Members: Senior students (1-2) as needed, junior students (1-2) as needed, public

member, and all program administrative faculty • Meet at the end of every semester.

ADMISSIONS COMMITTEE

Charge: • Review candidate applications. • Interview candidates for entrance into KPSA nurse anesthesia program. • Selection of interviewed candidates for KPSA nurse anesthesia program.

Membership and meetings: • Chair: Nurse Anesthesia faculty member • Members: Program administrative faculty, junior and/or senior SRNAs, CRNA clinical

and/or classroom faculty, CRNA clinical faculty, CSUF faculty. • Meet quarterly.

KPSA FACULTYMEETING

Charge: • Monitor student performance in clinical and classroom, and make recommendations for

progression, probation, and dismissal. • Review of daily program processes (personnel functions, CSUF relations, simulation,

testing, etc.) Membership and meetings:

• Chair: Nurse Anesthesia faculty member • Attendees: All program faculty • Meet monthly.

CSUF COMMUNITY OUTREACH MEETING

Charge: • Discuss current and future trends in nursing education with community partners. • Allow KPSA to obtain feedback from the community of interest.

Membership and meetings: • Attendees: CSUF faculty, KPSA faculty, community partners


• Meets annually

CLINICAL COORDINATOR MEETING

Charge: • Communicate with and distribute information to clinical faculty. • Discuss current aspects of nurse anesthesia clinical education.

Membership and meetings: • Chair: Assistant director of clinical • Members: CSUF faculty, clinical coordinators • Meets annually

GRIEVANCE AND APPEALS

ACADEMIC APPEALS

If a dispute regarding academic dishonesty or regarding capricious or arbitrary assignment of a grade occurs, the program supports the following problem-solving and dispute resolution mechanisms to ensure the rights of all program participants to a fair hearing. Students shall utilize these mechanisms of problem resolution before seeking access to external mechanisms of problem resolution (such as contacting the Council on Accreditation). Because these are conflict resolution mechanisms and not judicial proceedings, students may not be represented by legal counsel in any hearing, or record the proceedings of any meeting by any means.

1. Informal Adjustment: Every effort should be made to resolve differences on an informal basis through a discussion of the problem between the student and the faculty. If the situation cannot be resolved with the instructor, the student should consult the program director. If the instructor is the program director, the student should consult one of the assistant directors and vice versa. The student should announce clearly that the purpose of this meeting is an attempt at "informal adjustment". Faculty will document the proceeding.

2. Formal Adjustment: If the matter remains unresolved after such efforts have been made, the student may request that it be reviewed by the CSUF Academic Appeals Committee. This request must be made on paper and signed, be directed to the program director, must state the reason for the appeal, and include any pertinent supportive documentation.

3. Academic appeals processes can be found in the CSUF catalog of university policies found at the following website:

a. CSUF Academic Appeals http://catalog.fullerton.edu/content.php?catoid=3&navoid=248#Academic Appeals

15. CLINICAL PERFORMANCE OBJECTIVES

TERMINAL CLINICAL OBJECTIVES

http://catalog.fullerton.edu/content.php?catoid=3&navoid=248%23Academic%20Appeals

http://catalog.fullerton.edu/content.php?catoid=3&navoid=248%23Academic%20Appeals


Upon successful graduation from KPSA, a graduate will have the knowledge and ability to fulfill these key objectives. Patient Safety

Maintain vigilance and patient safety throughout the perianesthetic continuum.

Protect patients from iatrogenic complications, and utilizes appropriate precautions in infection control.

Position or supervise the positioning of patients to prevent injury.

Utilize standard precautions and appropriate infection control measures.

Utilize emerging health technologies.

Conduct a comprehensive and appropriate equipment check.

Individualized Perianesthetic Management

Provide care throughout the perianesthetic continuum.

Use a variety of current anesthesia techniques, agents, adjunctive drugs, and equipment while providing anesthesia

Provide anesthesia services to patients of all ages and physical conditions for a variety of surgical and medically related procedures, including trauma and emergency cases.

Perform a pre-anesthetic assessment and formulates an anesthesia care plan for patient to whom he/she is assigned to administer anesthesia.

Administer and manage a variety of regional anesthetics.

Function collaboratively with a multi-disciplinary team to affect patient outcomes.

Deliver culturally competent perianesthetic care throughout the anesthesia experience.

Function as a resource person for airway and ventilator management of patients.

Serve as a leader or member of cardiopulmonary resuscitation team and possess current ACLS, BLS, and PALS certifications.

Critical Thinking

Apply theory to practice in decision-making and problem solving.

Provide nurse anesthesia care based on sound principles and research evidence.

Perform a preanesthetic assessment and formulate an anesthesia care plan for patients to whom they are assigned to administer anesthesia.


Identify and take appropriate action when confronted with anesthetic equipment-related malfunctions.

Interpret and utilize data obtained from noninvasive and invasive monitoring modalities.

Calculate, initiate, and manage fluid and blood component therapy.

Recognize and appropriately respond to anesthetic complications that occur during the perianesthetic period.

Critique and integrate scholarly research in order to improve anesthesia care.

Communication Skills

Effectively communicate with all individuals influencing patient care.

Utilize appropriate verbal, nonverbal, and written communication in the delivery of perianesthetic care.

Demonstrate the ability to deliver a clear and organized public presentation.

Professional Role

Demonstrate personal and professional integrity.

Demonstrates respect for human dignity to patients, peers, and organizations.

Teach others.

Continue commitment to lifelong learning of anesthesia through continuous professional development.

Function as an advocate for patients, families and communities.

Positively influence health care policy decision and participate in activities which influence advanced nursing roles and improve patient care.

Understands sound principles of anesthesia risk management to include preventive and procedural strategies.

Function as a registered professional nurse within appropriate professional standards, ethical and legal requirements and to accept responsibility and accountability in the delivery of patient care.

Participate in quality management activities and operate with budget restraints and cost effectiveness.

CLINICAL OBJECTIVES FOR SPECIALTY ROTATIONS

Purpose To clinically prepare nurse anesthesia students to understand anatomy/physiology, pathophysiology, monitoring modalities, pharmacology, and anesthetic techniques as it relates to


cardiac anesthesia, pediatric anesthesia, obstetric anesthesia, neurosurgical anesthesia, and regional anesthesia. A student cannot graduate without successful completion of each specialty clinical rotation. In addition to the general clinical guidelines, the following guidelines apply to each specialty rotation.

CARDIAC SURGERY ROTATION

Policy and Procedure

1. All students are required to complete the online cardiac anesthesia rotation module. In addition, students are required to review the list of pharmacologic agents used in cardiac anesthesia including the appropriate drug concentrations used for intravenous infusions. Students who cannot demonstrate current knowledge and do not meet the cardiac anesthesia clinical objectives at any time during the cardiac anesthesia rotation will be placed on clinical probation. Students must perform satisfactorily and meet all clinical objectives to progress in the program.

2. Failure to meet the clinical objectives at the end of the cardiac anesthesia rotation will result in unsatisfactory progress and dismissal from the program.

3. Students must complete an anesthesia care plan as requested by clinical faculty prior to delivery of anesthesia.

4. The rotation schedule for the rotation will be developed by the clinical coordinator/cardiac anesthesiologists. Changes to the schedule will not be made by the student.

Clinical Objectives At the completion of the cardiac rotation, the learner will be able to:

1. Discuss specific areas of preoperative evaluation of the patient scheduled for open heart surgery.

a. Pertinent history b. Physical findings related to current cardiovascular pathophysiology c. Diagnostic findings, eg. cardiac cath, laboratory data, vital signs d. Identify potential problems/difficulties eg. vascular access such as external

jugular veins, peripheral veins 2. Discuss and set up appropriate anesthesia equipment for an adult patient having open-

heart surgery. 3. Discuss and compare the pharmacological characteristics, mode, and site of action, of the

vasodilator drugs used in open heart surgery. a. Nitroprusside b. Nitroglycerin

4. Discuss and compare the pharmacological characteristics of positive inotropic appropriate for selection in open-heart surgery and anesthesia.

a. Dopamine b. Dobutamine c. Isoproterenol d. Calcium chloride

5. Discuss the effect of anesthetic medications related to cardiac pathophysiology.


6. Develop and discuss a specific plan of management for: a. induction. b. endotracheal intubation and attenuation of sympathetic response. c. pre bypass period. d. frequent pre bypass problems.

7. Identify and compare the basic concepts and arrangement of complete and partial cardiopulmonary bypass (CPB).

a. Venous return b. Arterial fusion c. Type of CPB

8. Develop a checklist plan in preparation for commencing cardio pulmonary bypass. 9. Discuss specific monitoring during CPB bypass.

a. Arterial pressure b. CVP c. EEG d. Oxygenation e. CO2 elimination f. Temperature g. Anticoagulation h. Progress of surgery

10. Discuss the specifics of defibrillation, rewarming, and separation from bypass. a. Antiarrhythmic drugs b. Inotropic drugs c. Atrial and/or ventricular pacing

11. Discuss the pharmacological management of the post bypass period. 12. Discuss a plan for patient transport to the cardiac surgical Intensive Care Unit.

PEDIATRIC ROTATION


1. All students are required to read and understand the pediatric objectives and notes from the recommended reading list prior to beginning the pediatric rotation. Students who are unprepared to demonstrate adequate knowledge as determined by the CRNA or anesthesiologist clinical faculty will be dismissed from the rotation and be placed on clinical probation. Students must complete the pediatric rotation satisfactorily or they will be placed on probation or can be dismissed from the program.

2. Failure to meet the clinical objectives at the end of the cardiac anesthesia rotation will result in unsatisfactory progress and dismissal from the program.


4. The rotation schedule for the pediatric rotation will be developed by the clinical coordinator/pediatric anesthesiologists. Changes to the schedule will not be made by the student.

Clinical Objectives At the completion of the pediatric rotation, the learner will be able to:


1. Conduct a comprehensive preoperative evaluation as it relates to: • Pertinent medical history • Physical examination • Diagnostic findings (eg. lab assessment, neurologic imaging results, etc.)

2. Construct an anesthetic plan based on all pathophysiologic processes in relation to the pediatric patient.

3. Construct a plan for fluids/blood, blood products based on type of surgery and patient history.

4. Demonstrate patient positioning to avoid peripheral nerve injuries related to pediatric surgical procedures.

5. Discuss pharmacodynamic properties of anesthetic medications related to the pediatric patient.

6. Discuss methods of pain management for the pediatric patient during the intra/postoperative period.

7. Describe the landmarks, local anesthetic concentration, techniques and complications associated with a caudal block.

8. Describe the anesthetic management for a pediatric patient having out of OR procedures. 9. Discuss the identification and treatment of intraoperative and postoperative airway

emergencies. 10. Describe different methods of warming the pediatric patient during intraoperative

management. 11. Review the American Heart Association Standards in relation to pediatric advanced life

support.

NEUROSURGICAL ROTATION


1. All students are required to read and understand the neurosurgical objectives and notes from the recommended reading list prior to beginning the neurosurgical rotation. Students who are unprepared to demonstrate adequate knowledge as determined by the CRNA or anesthesiologist clinical faculty will be dismissed from the rotation and be placed on clinical probation. Students must complete the neurosurgical rotation satisfactorily or they will be placed on probation or can be dismissed from the program.

2. Failure to meet the clinical objectives at the end of the neurosurgical anesthesia rotation will result in unsatisfactory progress and dismissal from the program.


4. The rotation schedule for the neurosurgical rotation will be developed by the clinical coordinator. Changes to the schedule will not be made by the student.

Clinical Objectives At the completion of the neurosurgical rotation, the learner will be able to:

1. Conduct a comprehensive preoperative evaluation as it relates to: • Pertinent medical history • Physical examination


• Diagnostic findings (eg. lab assessment, neurologic imaging results, etc.) 2. Discuss a comprehensive plan of care with the clinical faculty for:

• Need for invasive line insertion and clinical monitoring modalities • Construct an anesthetic plan based on neurologic and non-neurologic

pathophysiologic processes for the following; a. induction of anesthesia b. attenuation of sympathetic nervous system response during direct

laryngoscopy and intubation c. maintenance of anesthesia (eg., PaCo2, CPP, glucose, etc.) d. emergence from anesthesia e. crises management (eg. acute hemorrhage, increased ICP, etc.)

• Chooses appropriate medications based on pharmacologic principles and patient pathophysiology.

• Constructs a plan for fluids/blood, blood products based on type of surgery and patient history.

• Positions patients to avoid peripheral nerve injuries and complications related to neurosurgical procedures.

3. Discuss the pharmacodynamic properties of anesthetic medications as they relate to neuroanesthesia.

4. Identify factors that increase and decrease cerebral metabolic rate of oxygen consumption (CMRO2).

5. Discuss cerebral vasculature autoregulation as it relates to neurophysiology, neuropathology, and neuroanesthesia.

6. Describe the indications and anesthetic considerations for the following neurophysiologic monitoring modalities:

• Electroencephalogram • Somatosensory evoked potentials • Motor evoked potentials • Brain stem evoked potentials • Visual evoked potentials • Direct spinal cord stimulation

7. Identify specific anesthetic concerns for the following neurosurgical procedures: • Acute head injury • Epidural/subdural hematoma evacuation • Awake craniotomy • Infratentorial/supratentorial intracranial tumors • Posterior fossa surgery • Intracranial aneurysms • Spinal reconstructive surgery

8. Discuss the causes, identification and treatment for syndrome of inappropriate ADH secretion and diabetes insipidus.

9. Discuss the pathophysiology, signs and symptoms, and treatment for venous air embolism.

10. Construct a comprehensive plan of care for postoperative management and postoperative complications.


OBSTETRIC ROTATION


1. All students are required to read and understand the obstetric objectives and notes from the recommended reading list prior to beginning the obstetric rotation. Students who are unprepared to demonstrate adequate knowledge as determined by the CRNA or anesthesiologist clinical faculty will be dismissed from the rotation and be placed on clinical probation. Students must complete the obstetric rotation satisfactorily or they will be placed on probation or can be dismissed from the program.

2. Failure to meet the clinical objectives at the end of the obstetric anesthesia rotation will result in unsatisfactory progress and dismissal from the program.


4. The rotation schedule for the obstetric rotation will be developed by the clinical coordinator. Changes to the schedule will not be made by the student.

Clinical Objectives At the completion of the obstetric rotation, the learner will be able to:

1. Conduct a comprehensive preoperative evaluation as it relates to: • Pertinent medical history • Physical examination • Diagnostic findings (eg. lab assessment, neurologic imaging results, etc.) • Anesthesia consent

2. Plan the anesthetic management of patients presenting for: • Normal spontaneous vaginal delivery • Elective caesarean delivery • Emergency caesarean delivery • VBAC

3. Differentiate between and manage situations that may arise such as: • high spinal • intravascular injection • postdural puncture headache • incomplete block • breakthrough pain • amniotic fluid embolism • fetal distress • postpartum hemorrhage • pregnancy induced hypertension

4. Discuss the pharmacodynamic properties and administration of the following medications as they relate to obstetric anesthesia:

• Pitocin • Methergine • Hemabate • Magnesium Sulfate


5. List the relative advantages and disadvantages of GA vs. RA in OB anesthesia. 6. Describe airway management techniques for management in the parturient 7. List abnormalities of placentation and describe the management of patients with these

conditions. 8. Identify fetal distress through fetal heart rate tracings, its causes, diagnosis and treatment. 9. Explain the anesthetic management of the anticoagulated parturient. 10. Understand placental transfer of drugs.

REGIONAL ROTATION


1. All students are required to read and understand the regional objectives and notes from the recommended reading list prior to beginning the regional rotation. Students who are unprepared to demonstrate adequate knowledge as determined by the CRNA or anesthesiologist clinical faculty will be dismissed from the rotation and be placed on clinical probation. Students must complete the regional rotation satisfactorily or they will be placed on probation or can be dismissed from the program.

2. Failure to meet the clinical objectives at the end of the regional anesthesia rotation will result in unsatisfactory progress and dismissal from the program.


4. The rotation schedule for the regional rotation will be developed by the clinical coordinator. Changes to the schedule will not be made by the student.

Clinical Objectives At the completion of the regional rotation, the learner will be able to:

1. Discuss the physiology of nerve blockade. 2. Describe the anatomy of the:

• brachial plexus and the innervation of the upper extremity • lumbar-sacral plexus and the innervation of the lower extremity

3. Describe the indications, contraindications, various approaches and complications associated with common peripheral nerve blocks

4. Discuss the pharmacologic principles of local anesthetic agents and additives used for peripheral nerve blocks

5. Recite the onset and duration of the local anesthetic agents 6. Evaluate the signs and symptoms and treatment of local anesthetic toxicity 7. Understand various peripheral nerve stimulators and various insulated needles and their

uses 8. Discuss the principles of ultrasound and its application to regional anesthesia 9. Perform various common peripheral nerve blocks utilizing ultrasound guidance 10. Manage perioperative pain issues, including using adjunctive techniques such as local

anesthetics, neuraxial blocks, peripheral nerve blocks, and patient-controlled analgesia. 11. Choose the appropriate regional block technique for various types of surgery


12. Evaluate the adequacy of pain control, assess patient pain levels, institute changes in pain control and ensure adequacy of the pain control methods prescribed, particularly when regional anesthesia techniques have been performed as a primary means of pain control.


16. IMPORTANT CONTACT INFORMATION

Kaiser Permanente School of Anesthesia 100 South Los Robles, Suite 501 Pasadena, CA 91188 (626) 564-3016 (626) 664-3099 (fax) www.kpsan.org

Program Director John Nagelhout (626) 564-3012 [email protected]

Assistant Directors Michael Boytim (academic) (626) 564-3007 [email protected]

Sass Elisha (clinical) (626) 564-3012 [email protected] Faculty Sandra Bordi (626) 564-3623 [email protected]

Jeremy Heiner (626) 564-5361 [email protected]

Jennifer Thompson (626) 564-3027 [email protected]

Ed Waters (626) 564-5122 [email protected]

Administrative Assistants Retta Smith (626) 564-3000 [email protected]

Sandra Hinkson (626) 564-3016 [email protected]

Web development/IT staff Walaa Elcott (626) 564-3013 [email protected]

Bryun Sakaye (626) 564-5926 [email protected]

Other Contacts Employee Health

(626) 405-7177 Employee Assistance Program (626) 564-5910

Health Connect Help Desk (888) 457-4872

Examsoft (888) 792-3926

Medatrax (800) 647-4838

Jennifer Crum, CSUF Graduate Nursing Advisor (657) 278-7610

See clinical coordinator contact information and clinical site information at kpsan.org

http://www.kpsan.org/


DAILY CLINICAL EVALUATION TOOL

Evaluator’s name: ______________________________

Student’s name: ________________________________

Date: ____________________________________________

Student registered nurse anesthetists must function at an appropriate level for their stage of anesthesia education for each of the following objectives. PATIENT CARE-Objectives:

• Utilizes a variety of current anesthesia techniques, pharmacologic agents, adjunctive drugs and equipment. • Utilizes standard universal precautions and infection control measures. • Participates in proper patient positioning to prevent injury. • Protects patients from iatrogenic complications. • Identifies and appropriately intervenes when confronted with anesthesia equipment malfunctions. • Demonstrates vigilant patient care throughout the perianesthetic continuum. • Demonstrates competence in procedural/technical skills. • Demonstrates competence in a variety of airway/ventilator management techniques. • Utilizes effective critical thinking and problem solving during perioperative anesthetic management for patients of all ages and physical conditions for a variety of surgical and medical procedures including trauma and emergency cases. • Evaluates changes in physiologic/pathophysiologic parameters and modifies anesthetic management accordingly. • Evaluates and appropriately responds to perianesthetic complications. ____ EXCEEDS OBJECTIVES

____ MEETS OBJECTIVES

____ DOES NOT MEET OBJECTIVES (please comment below)

Comments desirable/Necessary if SRNA does not meet objectives:

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________


MEDICAL KNOWLEDGE-Objectives: • Performs and comprehensive history and physical assessment. • Performs a pre-anesthetic and post-anesthetic assessment. • Formulates an appropriate plan of anesthesia care based on results from the pre-anesthetic assessment. • Selects appropriate equipment and anesthesia medications for patient care. • Conducts a comprehensive and appropriate equipment check. (eg. anesthesia machine check per FDA guidelines) • Interprets and utilizes data obtained from invasive and noninvasive monitoring modalities. • Calculates and appropriately manages fluid and blood component therapy. • Applies knowledge to practice in decision making and problem solving. • Provides nurse anesthesia care based on sound principles and research evidence. • Applies appropriate crises management strategies during the perioperative period. • Demonstrates knowledge of the surgical procedure and implications for anesthetic management.

____ EXCEEDS OBJECTIVES ____ MEETS OBJECTIVES ____ DOES NOT MEET OBJECTIVES (please comment below) Comments desirable/Necessary if SRNA does not meet objectives: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________ PROFESSIONAL PRACTICE-Objectives: • Protects confidential patient health care information. • Delivers culturally competent care throughout the perianesthetic period. • Functions as a productive member of the anesthesia care team. • Accepts responsibility and accountability for his/her practice. • Demonstrates professional behavior towards patients and staff. • Functions as a registered nurse upholding all professional, ethical and legal

standards. • Actively seeks feedback regarding daily clinical performance. • Demonstrates effective verbal, nonverbal, and written communication with individuals

who influence patient care. ____ EXCEEDS OBJECTIVES ____ MEETS OBJECTIVES ____ DOES NOT MEET OBJECTIVES (please comment below) Comments desirable/Necessary if SRNA does not meet objectives: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

81 Kaiser Permanente School of Anesthesia Handbook

PHOTOGRAPHIC AND VIDEOTAPING AGREEMENT & RELEASE FORM

I understand that in the event future videotapes, motion pictures, digital pictures or movies, audio recordings, and/or photographs (all of which are referred to as ‘Pictures’ that will be taken) are produced, that KPSA faculty will ask for my consent as a volunteer in these pictures. I hereby consent to the Pictures that will be produced by Kaiser Permanente School of Anesthesia. I further grant Kaiser Permanente School of Anesthesia, its agents or assigns, exclusively and perpetually throughout the world and elsewhere, all rights of every kinds, whether known or unknown, for the unlimited use both now and in the future of such Pictures of me, as named below. I understand that I will not receive monetary compensation for participating in this project either now or in the future. I do hereby release and hold harmless Kaiser Permanente School of Anesthesia, its officers, employees, agents, or assigns from any claims. This Agreement constitutes the entire Agreement between Kaiser Permanente School of Anesthesia and me. The parties have read and agreed to all the terms set forth herein.

_______________ _________________________ _________________________ Date Signature Printed Name

______________ ________________________________________

Date KPSA Faculty Representative

82 Kaiser Permanente School of Anesthesia Handbook

STUDENT NURSE ANESTHETIST STATEMENT

This will acknowledge acceptance of my appointment as a Student in the Kaiser Permanente School of Anesthesia program. Such services will commence on and conclude by

providing that all academic and clinical requirements of the program have been met successfully.

I agree to accept the duties, responsibilities and clinical rotations assigned; to abide by all rules and regulations; to complete medical reports promptly; to conduct myself in an ethical and moral manner; abide by the southern California Kaiser Permanente drug policies and procedures (SCR-HR-5.03); and to comply with those conditions outlined in the Student Handbook.

I understand, I am covered with respect to losses or claims where liability for alleged negligence is imposed for acts in the course and scope of the Kaiser Permanente Medical Care Program. This means coverage for an act that occurred during the clinical practicum even if I am no longer a student in the program. Professional liability coverage is not provided for any activities outside the Kaiser Permanente School of Anesthesia Program.

I understand that the appointment and this contract can be terminated if my academic and or clinical performance is unsatisfactory.

I have reviewed the Student Handbook with the KPSA academic faculty, and I fully understand all the materials as described and written.

_______________ _________________________ _________________________

Date Signature Print Name

_______________ ________________________________________________

Date Program Director, Kaiser Permanente School of Anesthesia