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Clinical Agency Affiliation List UNIVERSITY OF SOUTH ALABAMA COLLEGE OF NURSING September 14, 2018 Clinical Agency Affiliations and Locations Agency Name Programs Agency Requirements Covered 1st Operations Medical Group MSN, DNP, Post Student must complete Attachment 1 Graduate Certificate, Hurlburt Field, Florida MSN to DNP 2D Medical Group MSN Student must complete the Trainee Agreement Addendum Barksdale AFB, Louisiana 3HC Home Health & Hospice Care Undergraduate and Graduate Students Goldsboro, North Carolina 4th Medical Group Seymour Johnson AFB, North Carolina 5th Medical Group-Minot AFB MSN and DNP Student must complete Trainee Addendum. Student may utilize agreement for a period of no Minot AFB, North Dakota more than 2 years at a time. 18th Medical Group, Kadena Air Nurse Practitioner Student must complete the Trainee Agreement Addendum Base Japan 21st Medical Group, Peterson Air Executive Nursing Executive Nursing Admin DNP ONLY Admin DNP ONLY Force Base Student must complete Attachment 1 Colorado 35th Medical Group, Misawa AFB Advanced Practice Student must complete Trainee Agreement Addendum Japan 48th Medical Group, Executive Nsg Please contact the following for interest in this site. Admin DNP ONY RAF ALANE C. GARLISI, Lt Col, USAF, NC Lakenhealth , UK Education and Training Flight Commander 48th Medical Group, RAF Lakenheath, UK [email protected] Student must complete the Trainee Agreement. 99th Medical Group, Mike Advanced Practice Student must complete Trainee Agreement Addendum O’Callaghan Federal Hospital Nellis Air Force Base, Nevada Renewal in process-set to expire on 9/9/2018 354th Medical Group, Eielson, Nurse Practitioner Student: Must complete the Trainee Agreement Addendum, provided by the facility. AFB, AK Alaska (Pediatrics Department Only) 377th Medical Group, Kirtland AFB Student must complete and sign the Trainee Agreement Addendum. While utilizing this New Mexico agreement, students are prohibited from engaging in off-duty employment at USAF MTF. 436th Medical Group Women’s Health Student must complete the Trainee Agreement Nurse Practitioner Addendum Dover Air Force Base ONLY Dover, Delaware 509th Medical Group RN-BSN, MSN, Student must complete Trainee Agreement Addendum Whiteman AFB, Missouri DNP 673rd Medical Group, Join Base, RN-BSN, MSN, Attachment 1 and 2 for Trainee Agreement Addendum Elmendorf-Richardson DNP 1 UNIVERSITY OF SOUTH ALABAMA COLLEGE OF NURSING September 14, 2018 Clinical Agency Affiliations and Locations Agency Name Programs Agency Requirements Covered JBER, Alaska A Agency Name Programs Agency Requirements Covered Abrom Kaplan Memorial Hospital Undergraduate and Graduate Nursing Kaplan, Louisiana Students Access Community Health Network Graduate Nursing USA/Faculty: Please see Exhibit A for all Facility Programs Sites. Chicago, IL (see Exhibit A for complete Student: Must obtain comprehensive health lists of affiliates covered by agreement) insurance. Shall provide to Agency evidence that they have met all requirements of CPR certification, hepatitis B vaccination, and OSHA compliance for prevention of transmission of blood borne pathogens and TB before being placed in the Program. A criminal background check and drug screen, as specified in Exhibit B, and as required by and acceptable to Agency, are required of each Participant prior to being placed in the Program. Each student prior to his/her arrival at the Agency Site are required to: (i) Follow the administrative policies, standards, and practices of Agency; and (ii) Obtain medical care at his/her own expense for any injuries or illnesses sustained as a direct or indirect result of his/her participation in the Program; and (iii) Provide his/her own transportation and living arrangements; and (iv) Report to the assigned Agency Site on time and follow all established regulations of Agency during the regularly scheduled operating hours of the Agency Site; and (v) Conform to the standards and practices established by USA while participating in the Program; and (vi) Meet the personal, ethical and professional standards required of employees of Agency and conduct themselves at all times consistent with the applicable professional Code of Ethics and the applicable standards of the Joint Commission and/or other relevant accrediting or regulatory bodies; and (vii) Obtain prior written approval of Agency and AFFILIATE before publishing any material relating to the Program. Access Health Care Physicians, Nursing USA/Faculty: See Exhibit A-Teacher/Learner Expectations. LLC 2 UNIVERSITY OF SOUTH ALABAMA COLLEGE OF NURSING September 14, 2018 Clinical Agency Affiliations and Locations Agency Name Programs Agency Requirements Covered Spring Hill, Florida Students must maintain health insurance and provide proof of health insurance to USA. Agency may request copy of proof. Adams Compassionate Healthcare- Undergraduate and ACHN Graduate Nursing Students Chantilly, Virginia Adena Health System MSN, DNP Agency contact: Monica Climer, Coordinator Graduate Clinical [email protected] 740- Chillicothe, Ohio 779-8821 USA/Faculty: Complete Attestation (Exhibit A). Inform facility of curriculum and sequence and of all courses and clinical experiences for each student. Notify facility of proposed schedule of student assignments to facility, including dates, number and names of students, their level of academic preparation. Student: Complete Exhibit B. Obtain health insurance coverage for the period of the clinical experience. Florida Hospital (Adventist Health Nursing Agreement covers NURSING Undergraduate Student must be N-95 respirator fit tested prior to System/Sunbelt, Inc.) (to include: • NON APRN attending clinical. Testing can be done for $25 at the Florida Hospital Altamonte - Agency clinic. Nursing Students please see Exhibit C 601 E. Altamonte Drive, Altamonte –Criminal Background Disqualifications Guidelines. Exhibit D- Physical and Mental Requirements. USA Springs, FL must provide a letter of good standing indicating that • Florida Hospital Apopka – a background check and drug screen has been conducted. Provide in writing the names of students. 201 N. Park Avenue, Apopka, FL • Florida Hospital Celebration Agency Contacts: – 400 Celebration Place, Non Clinical Rotation- Debbie Stunkard- Celebration, FL [email protected] • Florida Hospital East Orlando – 7727 Lake Underhill Clinical [email protected] (graduate students please go to www.FHGME.com Road, Orlando, FL for application. • Florida Hospital Kissimmee – Student’s research projects with additional 2450 N. Orange Blossom Trail, requirements: Each student will need to obtain Kissimmee, FL approval from the Principal Investigator on the • Florida Hospital Orlando & research study. The research must be approved in advance by and subject to the review of Hospital's Childrens – 601 E. Rollins Street, Institutional Review Board or receive a determination Orlando, FL of non-human subjects research. If research involves • Florida Hospital Winter the use of animals, the research must be subject to the oversight by an Institutional Animal Care and Garden – 2000 Fowler Grove, Blvd, Use Committee. Student may not serve as Principal Winter Garden, FL Investigators, but may assist as staff personnel, provided they have appropriate supervision. • Winter Park Memorial Students must obtain written approval of both parties Hospital – 200 N. Lakemont before publishing any articles, and will submit all Avenue, Winter Park, FL completed articles, etc., to Hospital for review and approval no less than 60 days prior to the date of Maitland, Florida submission for publication, disclosure or presentation. Florida Hospital (Adventist Health APRN Agreement covers NURSING Student must be N-95 respirator fit tested prior to System/Sunbelt, Inc.) (to include: • attending clinical. Testing can be done for $25 at the 3 UNIVERSITY OF SOUTH ALABAMA COLLEGE OF NURSING September 14, 2018 Clinical Agency Affiliations and Locations Agency Name Programs Agency Requirements Covered Florida Hospital Altamonte - Agency clinic. Nursing Students please see Exhibit C –Criminal Background Disqualifications Guidelines. 601 E. Altamonte Drive, Altamonte Exhibit D- Physical and Mental Requirements. USA Springs, FL must provide a letter of good standing indicating that • Florida Hospital Apopka – a background check and drug screen has been conducted. Provide in writing the names of students. 201 N. Park Avenue, Apopka, FL • Florida Hospital Celebration Agency Contacts: – 400 Celebration Place, Non Clinical Rotation- Debbie Stunkard- Celebration, FL [email protected] • Florida Hospital East Clinical [email protected] Orlando – 7727 Lake Underhill (graduate students please go to www.FHGME.com Road, Orlando, FL for application. • Florida Hospital Kissimmee – Student’s research projects with additional 2450 N. Orange Blossom Trail, requirements: Each student will need to obtain Kissimmee, FL approval from the Principal Investigator on the research study. The research must be approved in • Florida Hospital Orlando & advance by and subject to the review of Hospital's Childrens – 601 E. Rollins Street, Institutional Review Board or receive a determination Orlando, FL of non-human subjects research. If research involves the use of animals, the research must be subject to • Florida Hospital Winter the oversight by an Institutional Animal Care and Garden – 2000 Fowler Grove, Blvd, Use Committee. Student may not serve as Principal Winter Garden, FL Investigators, but may assist as staff personnel,
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