Houston Community College Emergency Medical Services Training Programs 2/1/2013

Catalog Description: EMSP 2260 EMT-P Clinical Practicum (Credit 2 sem. Hr.)

Prerequisite EMSP 2444 + Texas Department of State Health Services or National Registry EMT Certification Documentation of 12th Grade Reading Level or ASSET or Compass Reading level, HS transcripts or copy of diploma or GED scores, CPR Completion: (AHA - Health Care Provider, ARC - Professional Rescuer), all Immunizations, background check, drug screen, physical exam are required for admission to the HCCS EMSP 2260.

STUDENT MUST COMPLETE THIS COURSE BEFORE STARTING EMSP 2434  ALL CLINICAL ROTATIONS / COMMUNITY SERVICE MUST BE DONE PRIOR TO DAY 1 OF EMSP 2434

Student Learning Outcomes:  Routinely perform history and comprehensive physical exam to enable treatment plans  Practices interpersonal and team work skills

Course Description: This course provides clinical/field training to manage medical/trauma patients in a supervised emergency room rotation, ambulance rotation, critical care unit and community service.

Purpose and Rationale: This practicum course provides clinical and skills practice/verification for the Emergency Medical Technician (EMT) to advance his/her training to the EMT Paramedic level. The training includes instruction on practical and clinical skills used to manage cardiovascular patients.

Clinical/Ambulance Affiliations: Area objectives and individual affiliation directives will be given to the students as an attachment to this syllabus. The clinical practicum (depending on availability) will consist of:

Hospital- Emergency Hospital Field Internship- Ambulance Critical Care Unit Community Service

SCANS Competencies and Foundations Resources: Identifies, organizes, plans, and allocates resources.  C1 Time: Selects goal-relevant activities, ranks them, allocates time, and prepares and follows schedules. Information: Acquires and uses information.  C8 Uses computers to process information Interpersonal: Works with others.  C9 Participates as a member of a team: Contributes to group effort.  C13 Negotiates: Works toward agreements involving exchange of resources; resolves divergent interests.  C14 Works With Diversity: Works well with men and women from diverse backgrounds Technology: Works with a variety of technologies.  C20 Maintains and Troubleshoots Equipment: Prevents, identifies, or solves problems with equipment, including computers and other technologies Basic Skills: Reads, writes, performs arithmetic and mathematical operations, listens, and speaks.  F2 Writing: Communicates thoughts, ideas, information, and messages in writing; creates documents such as letters, directions, manuals, reports, graphs, and flow charts. Thinking Skills: Thinks creatively, makes decisions, solves problems, visualizes, knows how to learn and reasons  F9 Problem Solving: Recognizes problems and devises and implements plan of action. Personal Qualities: Displays responsibility, self-esteem, sociability, self-management, integrity, and honesty.  F15 Sociability: Demonstrates understanding, friendliness, adaptability, empathy, and politeness in group settings.  F16 Self-Management: Assesses self accurately, sets personal goals, monitors progress, and exhibits self-control.  F17 Integrity/Honesty: Chooses ethical courses of action.

Course Textbooks: Required / Recommended

Required Texts: Mosby’s Paramedic Textbook and Workbook Package – 4th Edition Recommended: Mosby’s Intermediate and Paramedic Certification Preparation and Review JB Test Prep: Paramedic Success and / or www.emt-national- training.com Grading Scale:

90-100 A 3 Points 80- 89 B 2 Points 75- 79 C 1 Points Below 75 F 0 Points

Criteria includes :

Clinical online tests = 10%.  Tests will be opened for a period of time and if not taken student will receive a grade of “0” for missed tests.

Simulation Lab Rotation = 10%  Date set on clinical schedule will NOT be changed. It is mandatory student attends on that date.  Pre-Test = 10% - Difficulty Airway / Critical Thinking Case Based Scenarios = 90% 1. Cases for scenarios will come from knowledge learned from Basic thru 2444 (Cardiology)

 Students will be expected to:

o Come to class prepared by reviewing the pe-course/preparatory material published in the EMSP 2444 / 2260 Clinical course and completing the “PRE- TEST” assignments with a minimum of 80% score.

 Student MUST bring completed “PRE-TEST” to course.

 If not prepared student will be dismissed for the day – NO “make-up” sessions

o Student will receive a “0” as a grade  As this is a part of the clinical coursework students will be expected to:

o Participate in CRITICAL AIRWAY PROCEDURES / CRITICALTHINKING PATIENT CARE MANAGEMENT.

o Students are expected to achieve competency with Advanced Airway / Critical Case Based Patient Management.

o Complete Simulation Lab Evaluation form – Assessed by Preceptor

o Track the skills performed as part of the “Patient Contact” form.

Clinical/Field Documentation Completeness / Neatness = 45%

1. Student Clinical Data information (name, date, right form (ambulance, day, hospital) etc.) is completed accurately (10%)

2. Patient Assessment/Evaluation Completeness (35%)

Minimum Criteria: a. Patient Chief Complaint / General Impression b. History & Physical Exam/assessment c. Vital Signs d. Treatment e. Disposition

Clinical/Field Preceptor Evaluations = 35 %

1. Clinical (hospital and ambulance) Preceptor Evaluation Form (30%) a. Rating Scale – Score student receives (by adding the points given by preceptor on each forms) ÷ Maximum points available = rating score

2. Clinical Preceptor Skills Form (5%) a. Complete (5%) b. Incomplete (0%)

Skills Proficiency Check off utilizing the NR / DSHS Skills Criteria including. Students that are not competent on the skills will not be cleared for clinical rotations.

1. IV Bolus 2. IV Piggy back 3. Adult Intubation 4. IM administration 5. SQ administration 6. Withdrawing Medication from a Vial 7. Sublingual Administration 8. Synchronized Cardioversion 9. Defibrillation 10. EKG Recognition 11. Endotracheal Drug Administration 12. Patient Assessment – Medical and Trauma

Grading Policies: Completed clinical paperwork and evaluations must be placed in the student’s clinical notebook at the NE campus weekly. IF PAPERWORK IS NOT TURNED IN EACH WEEK 5 POINTS WILL BE DEDUCTED AT THE END OF SAID WEEK (DUE TO NON-ACTION BY THE STUDENT) AND REFLECT ON THE STUDENT’S OVERALL CLINICAL GRADE.

These clinical/field evaluations may result in a conference to discuss the student's progress. The grade for EMSP 2260 consists, but is not limited to the following: a. Written Patient Assessments - PCRs

 Written Patient Assessments

For students to complete the program he / she needs to track all patients assessed in the clinical setting. Faculty needs to be able to confirm the tracking documented via the student’s PCRs

Students will document via PCR - ALL patients assessed in each clinical/ambulance area.

Patients assessed will be tracked on form provided as part of the clinical paperwork.

These patient documentations will be evaluated based on the program patient assessment template provided the student.

Tracking Patient Contact Minimums – Needed for Graduation Students MUST track all requirements honestly. Non-honest tracking will be seen as scholastic dishonesty and student will be dismissed from the program. b. Ambulance Field Internship Evaluation: Student performance will be evaluated / scored by the field evaluators and the final grade will be assessed by the Clinical Coordinator and/or Primary Faculty (see eval sheets) c. Affective Evaluation: The student's appearance, attitude, promptness, professionalism (see evaluation form) will be assessed by the clinical preceptor and Clinical Coordinator/Primary Faculty. (see evaluation sheets)

Weighted Grade Calculation: A clinical grade will be determined from the clinical evaluations. The grade will be calculated on the following scale:

Cognitive Psychomotor Affective

If at any time a student's performance should jeopardize a clinical/ambulance affiliation or the well-being of a patient, the student will be removed from the setting (hospital or ambulance) by the preceptor or instructor. A decision regarding if the student will be allowed back into the clinical setting will be determined by the EMS Clinical Coordinator/Primary Faculty and the EMS Department Chair.

Parking: Students will be responsible for all expenses incurred during clinical rotation. HCCS will not reimburse the student. EMSP 2260: - EMT-P Clinical/Ambulance Assignments: Students with <75% grade average in EMSP 2444 will not be assigned clinical rotations. EMS students must maintain a 2.0 GPA in all EMS courses to be eligible for enrollment for future courses. Students must attend the clinical orientation and show proof of registration at the Orientation. Student must attend the orientation in full EMS uniform with stethoscope and goggles.

Clinical/Field training will be provided to the student based on availability. Students are expected to attend and successfully complete all scheduled clinical assignments. Immunization records must be current throughout the program, and will be maintained in the student file. Students will not be permitted in the clinical setting if immunization records are delinquent. All clinical scheduling will be done through the HCCS EMS office. Any rotations attended without the permission of the HCCS EMS Clinical Coordinator will not be accepted. Preceptor evaluation and specific clinical grading will be reviewed at the clinical orientation. Students not attending the clinical orientation will not be permitted in the clinical setting. If a student leaves the clinical site prior to completion of the rotation and does not contact the clinical coordinator he / she will be considered Absent without Leave (AWOL) (see consequences below).

Attendance Policy: Per the Texas Department of State Health Services requirement the students must meet / attend all class / clinical hours to complete the program. If the student is absent or tardy they MUST contact their lead EMS Instructor for additional information on what options are needed to meet all TDSHS requirements. Students must contact their EMS Instructor as soon as possible when they are going to be absent or tardy. Any student that is Absence Without Leave (AWOL) will be dismissed from the program pending Lead instructor and Department chair decision.

Clinical/Field training will be provided to students based on availability. Students are expected to attend all scheduled clinical assignments. Any problems must be reported to the Clinical Coordinator/Primary Faculty immediately. All clinical hours must be completed to satisfy TDSHS requirements.

Missed Class Time Policy: Clinical Assignment violation: The following is the HCC policy for any student that misses a clinical rotation.

1st time the student’s clinical grade will be dropped one letter 2nd time the student will fail the course (student will need to drop any other classes that are running concurrently in which they have not received a final grade).

Time missed by the student can place our clinical affiliation agreements in jeopardy. The EMS program cannot operate without the affiliations so the policy above has been put in place to assure loss of affiliates does not occur.

Students that miss a clinical rotation will have to do the following to complete his / her clinical rotations:

1. Pay $30.00 / hour for a 1:1 clinical make-up rotation 2. Inform Ms. Jan Hook of your available dates to get this accomplished. After an assessment of the clinical site and preceptor availability Ms. Hook will let you know your options. Understand that: 1. If Ms. Hook does not have an available site or preceptor with the dates you supply her with she will let you know so you can give her additional dates.

2. You may not finish your clinical course on time,

3. You may not be eligible to continue on to the next EMSP course in the program.

4. The missed time policy will be enforced.

Students that are failed due to time missed will have to re-register for a subsequent clinical(s) needed to complete their certificate.

Sleeping during ambulance rotations will NOT be tolerated. Student will be sent home by the preceptor (or other designee) with the service. This will be counted as missed time.

Electronic Devices (Pagers, Cell Phones, MP3, Lap top, etc…): During classroom sessions and clinical rotations, pagers and/or cell phones will be placed on vibrate or turned off. ALL OTHER ELECTRONIC DEVICES MUST BE TURNED OFF. In ALL Hospital settings electronic devices are NOT permitted.

Inclement Weather: If the training is occurring on an HCCS campus, the HCCS policy on inclement weather will determine when classes will be cancelled. In the clinical field internship, students are encouraged to attend all rotations that the student can safely attend. If inclement weather prevents a student from attending a rotation, they will contact the Clinical Coordinator/Primary Faculty using the clinical pager.

Patient Confidentiality: Students are expected to protect patient confidentiality in all aspects of the clinical/field internship. Students are NOT to discuss patient information outside of the clinical facility and are NOT allowed to copy patient records to complete patient documentations for the program. Students will be under the direct supervision of hospital, field, or HCCS preceptors and will follow their directive

In regards to current concerns of Social Networking sites, including but not limited to Facebook, MySpace, Twitter, YouTube, the Student must NOT POST ANY PHOTOS, VIDEO’S, PATIENT INFORMATION OR ANY OTHER DATA REGARDING YOUR PATIENTS, OR AFFLIATIONS. The student must keep in mind everything taught to them in school in regards to moral and ethical behavior plus, federal laws regarding HIPPA protected information and college policies regarding protection of privacy of the student’s patients. Students who breach these policies will be exited from the Program.

Student Background:

While in the program the student needs to self-report to the HCC department and the Department of State Health Services (DSHS) within 2 business days of a change in his or her criminal history or being arrested, charged or indicted for any criminal offense which can or does result in him or her being convicted or placed on probation, parole, deferred adjudication community supervision, deferred disposition. Contact at the DSHS office in Austin – 512-834-6700.

Alcohol / Illicit substance use: At no time shall the student use alcohol / or illicit substances while in the HCCS uniform. If a student is suspected of or found to be intoxicated the student will be removed from the program. The student will have to make an appointment with the Department Chair to be eligible for re- entry into the program. The student will also be removed from the program if seen ingesting substances that resemble alcoholic beverages (virgin drinks, near beer, etc.) / illicit substances while in an HCCS uniform. Refer to HCCS Student Handbook.

Code of Conduct violations: If the Code of Conduct is violated the student will be dismissed from class. The student must immediately contact the clinical coordinator or will be considered AWOL. Any HCC instructor or Clinical Affiliate is / are eligible to enforce the components of the Code and the student will abide by the discipline. Missed class time policy will be enforced.

Change in Heath Status:

Students that develop a medical or physical problem that would keep him / her from performing the Job Essentials of the profession, as published by the Department of State Health Services, found on the HCC EMS website need to inform the program faculty or director immediately upon the change. To get to webpage go to hccs.edu → Northeast (top of page) → Public Safety Institute (bottom left on page) → EMS (bottom of page).

Field/Clinical Problems or Emergencies: Any problem or emergency that occurs during field/clinical training will be brought to the attention of the Clinical Coordinator/Primary Faculty within 24 hours. If the problem is of a very serious nature, the student should page the Clinical Coordinator/Primary Faculty immediately on the clinical pager. Based on an initial investigation, the student may be allowed to continue to complete his/her training or the student may be temporarily suspended until a meeting can be arranged to discuss the results of the investigation.

Clinical Code of Conduct - A student shall:

1. Provide safe and professional patient/client care at all times and implement measures to promote a safe environment for each patient/client. 2. Comply with policies, procedures, and rules related to academic and clinical performance that are issued by NE EMS program, by HCCS, or by any clinical agency. 3. Not commit acts of omission or commission that cause or are likely to cause harm to patients/clients. 4. Not attempt care/activities without adequate orientation, theoretical preparation, assistance, or supervision. 5. Maintain patient/client confidentiality. 6. Take appropriate action to assure the safety of patients/clients, self, and others. 7. Provide care for the patient/client in a timely, compassionate, and professional manner. 8. Communicate with patient/client and healthcare team in a truthful, timely, and accurate manner. 9. Actively promote the highest level of moral and ethical principles, and accept responsibility for his/her actions. 10. Treat others with respect and promote an academic and clinical environment that respects human rights, values, and choice of cultural and spiritual beliefs. 11. Collaborate and cooperate in every reasonable manner with the academic faculty and clinical staff to assure the highest quality of patient/client care. 12. Abstain from the use of substances that impair judgment. 13. Report and document all patient/client assessments or observations, the care/ practice provided by the student for the patient/client, and the patient’s/client's response to that care/practice. 14. Accurately and timely report to the appropriate practitioner errors in or deviations from the prescribed regimen of care/practice. 15. Not falsify any patient/client record or any other document prepared or utilized in the course of, or in conjunction with patient/client care/practice. 16. Delineate, establish, and maintain professional boundaries with each patient/ client. When providing direct patient/client care, the student shall provide privacy during treatment and care/practice and shall treat each patient/client with courtesy, respect, and with full recognition of dignity and individuality. 17. Not engage in behavior that causes or may cause physical, verbal, mental or emotional abuse to a patient/client; or engage in behavior toward patient/client that may reasonably be interpreted as physical, verbal, mental or emotional abuse. 18. Not misappropriate a patient/client's property or engage in behavior to seek or obtain personal gain at the patient’s/client's expense; engage in behavior that may reasonably be interpreted as behavior to seek or obtain personal gain at the patient’s/client's expense; engage in behavior that constitutes inappropriate involvement in or interference with the patient’s/client’s personal relationships; or engage in behavior that may reasonably be interpreted as inappropriate involvement in the patient’s/client's personal relationships. For the purpose of this paragraph, the patient/client is always presumed incapable of giving free, full, or informed consent to the behaviors by the student set forth in this paragraph. 19. Not engage in sexual contact or romantic relationships with a patient/client; engage in conduct that may reasonably interpreted as sexual or romantic; engage in any verbal behavior that is seductive or sexually demeaning to a patient/client; or engage in verbal behavior that may reasonably be interpreted as seductive or sexually demeaning to a patient/client. For the purpose of this paragraph, the patient/client is always presumed incapable of giving free, full, or informed consent to sexual or romantic activity with the student.

Unsafe/Unprofessional Practice and Weak Practice with Potential for Unsafe and/or Unprofessional Practice A student shall provide safe and professional patient/client care/practice at all times. Unsafe care/practice, unprofessional care/practice, or weak care/practice with potential for unsafe and/or unprofessional care/practice occurs when the student’s behavior in providing care/practice to patients/clients may call into question the student's professional judgment and accountability and may violate the current:

 Standards of care/practice in Emergency Medical Services; or  State of Texas Emergency Medical Services Act; or  Code of ethics for Emergency Medical Technician; or  HCCS and/or clinical agency policies and procedures; or  Emergency Medical Services program goals and/or course objectives.

Depending upon the degree of actual or potential harm a patient/client may suffer, a student's one-time deviation from safe care/practice may be sufficient to judge a student unsafe. A student whose clinical care/practice is judged unsafe and/or unprofessional by NE EMS faculty or clinical staff may be removed from the clinical experience. To resume the clinical experience, a student who has been removed must comply with written stipulations prescribed by the faculty for readmission to the clinical experience.

The faculty responsible for the clinical experience will review the clinical care/practice of a student who exhibits weaknesses that may lead to unsafe practice and/or unprofessional practice. The faculty, with appropriate input from the student, will develop a set of expectations that the student is to attain to remedy those weaknesses in the current and/or subsequent semester.

Rationale

Faculty have a legal and professional responsibility to assure for the public, other students, NE College, and the Emergency Medical Services that students can practice safely and professionally in their various clinical care/practice.

HCC EMS POST EXPOSURE PLAN

Students enrolled in the hospital or ambulance clinical rotations of HCC, who become exposed to any infectious organism(s) during the clinical rotation, shall adhere to the following guidelines

1. Notify the clinical preceptor immediately immediately.

2. If in the In-hospital settings (ER, ICU, L&D, OR, etc.), contact the Infectious Disease Officer on duty, and follow their instructions.

3. Pre-hospital (ambulance) rotations will notify the preceptor immediately, and then follow steps 4 & 5 respectively.

4. Notify personal Physician and follow their instructions.

5. Notify the Clinical Coordinator - Frank Mettlach @ 281-793-0687 to fill out a Clinical Incident Report

Grievances Regarding Policies and Procedures

Students who disagree with a policy, procedure, or rule may file a student grievance as permitted by HCCS policy. The filing of a grievance, however, does not excuse compliance with current policies, procedures, and rules. Students shall comply with all policies, procedures, and rules until and if such policies, procedures, or rules are withdrawn or modified.

ADA Statement: Any student with a documented disability (e.g. physical, learning, psychiatric, vision, hearing, etc.) who needs to arrange reasonable accommodations must contact the Disability Services Office at the respective college at the beginning of each semester. Faculty is authorized to provide only the accommodations requested by the Disability Support Services Office.

For questions, please contact Donna Price at 713.718.5165 or the Disability Counselor at your college. To visit the ADA Web site, please visit www.hccs.edu then click Future students, scroll down the page and click on the words Disability Information.

District ADA Coordinator – Donna Price – 713.718.5165 Central ADA Counselors – Jaime Torres - 713.718.6164 Martha Scribner – 713.718.6164 Northeast ADA Counselor- Kim Ingram – 713.718.8420 Northwest ADA Counselor – Mahnaz Kolaini – 713.718.5422 Southeast ADA Counselor – Jette Lott - 713.718.7218 Southwest ADA Counselor – Dr. Becky Hauri – 713.718.7910 Coleman ADA Counselor – Dr. Raj Gupta – 713.718.7631

NOTICE: Students who repeat a course for a third time will face significant tuition/fee increases at HCC and other Texas public colleges and universities. Please ask your instructor / counselor about opportunities for tutoring / other assistance prior to considering course withdrawal or if you are not receiving passing grades.

Student issues: The protocol for the college in regards to issues, complaints or clarifications that are directly related to the programs, courses, and classes, is for students to contact the instructor of their class first. If no resolution is reached, they are then to contact the Chair or Associate Chair of the department. Should the issue still not be resolved, they would then contact the Dean of the division.

EGLS3 -- Evaluation for Greater Learning Student Survey System At Houston Community College, professors believe that thoughtful student feedback is necessary to improve teaching and learning. During a designated time, you will be asked to answer a short online survey of research-based questions related to instruction. The anonymous results of the survey will be made available to your professors and division chairs for continual improvement of instruction. Look for the survey as part of the Houston Community College Student System online near the end of the term.

HCC course materials/student records will be maintained for five years. The EMSP will not duplicate student state forms or notes. Students are encouraged to make copies of all forms submitted to the EMS program. HCCS EMSP 2260 EMT-P Clinical Practicum Student/Instructor Agreement

I have read and understand the contents of the HCCS EMS program syllabus

______Print Student Name

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Student Signature Date

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Lead Instructor Signature Date

Revised 2/2013