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DOCTOR OF NURSING PRACTICE PROGRAM
STUDENT HANDBOOK
2015-16
Table of Contents INTRODUCTION .............................................................................................................................. 1
COLLEGE OF NURSING POLICIES AND PROCEDURES ........................................................................ 1
PROGRAMS OF STUDY .................................................................................................................... 1
Sample programs of study for each DNP program offered at WSU can be found on the College of Nursing website. Click the links below to access these. ................................................................... 1
GENERAL GUIDELINES FOR THE DNP PROJECT ................................................................................. 1 The DNP Project ...................................................................................................................................... 2 DNP Course Faculty Role .......................................................................................................................... 2 The DNP Project Team ............................................................................................................................. 2 Role of Project Team Members: ............................................................................................................... 2
DNP Project Deliverables and Grading Rubrics by Course ................................................................ 3 NURS 518 ................................................................................................................................................ 3 NURS 557 Project Planning ...................................................................................................................... 3
NURS 557 ......................................................................................................................................................... 3 Grading Rubric Final Draft of DNP Project Proposal ........................................................................................ 3
NURS 558 Project Implementation ........................................................................................................... 4 NURS 558 ......................................................................................................................................................... 4 Grading Rubric Revised and Expanded DNP Project Proposal ......................................................................... 4
NURS 559 DNP Project Dissemination ...................................................................................................... 6 DNP Project Report Format ............................................................................................................................. 7 DNP Project Evaluation and 559 Paper Grading Rubric ................................................................................... 7
SUMMARY REGARDING NP PRACTICUM/CLINICAL EXPERIENCES ...................................................10
PREPARATION FOR CLINICAL EXPERIENCES ....................................................................................11 E*Value ................................................................................................................................................. 11 Graduate Student Passport .................................................................................................................... 11 Course Prerequisites .............................................................................................................................. 12 Familiarize Yourself with Clinical Course Rotation Requirements ............................................................ 12 FNP Program Student Learning Outcomes and Clinical Rotation Requirements: ...................................... 12 PMHNP Program Student Learning Outcomes and Clinical Rotation Requirements: ................................. 12 PH Program Student Learning Outcomes and Clinical Rotation Requirements: ........................................ 12 Researching Clinical Sites ....................................................................................................................... 13
Clinical at Your Place of Employment ............................................................................................................ 13 Oregon and Idaho Practice Sites .................................................................................................................... 13
Requesting Clinical Sites ........................................................................................................................ 14 Agency Contracts ........................................................................................................................................... 15
Onboarding/Credentialing at Clinical Sites ............................................................................................. 15
BEGINNING ROTATIONS ................................................................................................................15 Preceptors ............................................................................................................................................. 15 Clinical Faculty and NP Clinical Evaluators .............................................................................................. 16 Provide Your Rotation/s Schedule/s to WSU .......................................................................................... 16 Definition of Clinical Hours .................................................................................................................... 16 Resources for Clinical Practice ................................................................................................................ 17 Code of Conduct for Clinical/Practicum Experiences/Rotations ............................................................... 17
Site Visit Evaluation ............................................................................................................................... 17 Required Student Clinical Documentation .............................................................................................. 18
PERFORMANCE EVALUATION ........................................................................................................18 Leave of Absence/Reinstatement........................................................................................................... 19
PREPARING FOR NP PRACTICE AFTER GRADUATION ......................................................................19 Certification .......................................................................................................................................... 19 Licensure ............................................................................................................................................... 20 National Provider Enumeration System .................................................................................................. 20 Drug Enforcement Agency Number ........................................................................................................ 20 Paying It Forward-Your role as a mentor to future WSU CON grad students ............................................ 20
APPENDICES ..................................................................................................................................21 Appendix 1A: DNP Preceptor Letters ..................................................................................................... 21
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DOCTOR OF NURSING PRACTICE PROGRAM
INTRODUCTION
This document includes essential information regarding the Doctor of Nursing Practice Program at the WSU College of Nursing. If you have any questions about any of this information, please contact your academic advisor and/or course faculty. NOTE: This document includes accurate information about courses and is current as the date noted. You are responsible for being certain that you adhere to faculty and program requirements and for updating your knowledge about this information each semester. By accessing the most current information frequently and reading it thoroughly you will help to ensure your success throughout the program.
COLLEGE OF NURSING POLICIES AND PROCEDURES
In general, in all academic matters, all DNP courses, and in all related activities, all College of Nursing and Washington State University student handbook guidelines, academic policies, and standards apply. You are required to be familiar with the content of this document and the content of the College of Nursing Graduate Student Handbook (https://nursing.wsu.edu/a-z/). You are expected to be aware of and adhere to all Washington State University (www.wsu.edu), WSU Graduate School (gradschool.wsu.edu), and WSU College of Nursing (www.nursing.wsu.edu) policies and procedures; therefore, you should become familiar with them and review them periodically.
PROGRAMS OF STUDY
Sample programs of study for each DNP program offered at WSU can be found on the College of Nursing website. Click the links below to access these.
DNP – Family Nurse Practitioner: https://nursing.wsu.edu/academics/dnp-family-nurse-practitioner/ DNP – Psychiatric Mental Health Nurse Practitioner: https://nursing.wsu.edu/academics/dnp-psychiatric-mental-health-nurse-practitioner/ DNP – Population Health: https://nursing.wsu.edu/academics/dnp-population-health/ DNP – Post Master’s Degree: https://nursing.wsu.edu/academics/post-masters-dnp/
GENERAL GUIDELINES FOR THE DNP PROJECT
To complete the DNP project, students complete four courses: NURS 518 – Translational Research NURS 557 – Concepts of Practice Transformation NURS 558 – DNP Project I: Program Design and Data Collection NURS 559 – DNP Project II: Implementation, Evaluation, and Dissemination
All courses, (except NURS 518), include a practicum component. Students must earn a grade of B or higher in order to progress to the next course or to complete the DNP project.
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The DNP Project Students must complete a final project that demonstrates clinical scholarship prior to being awarded the Doctor of Nursing Practice degree. This scholarly project may take various final forms; however, the project must include planning, implementation, and evaluation components and must clearly present a dissemination plan. The DNP Project is course-based, designed to assist students in identifying and developing projects as part of agency- or discipline-based teams. Ideally, one faculty member supervises and evaluates small groups of students throughout the three sequential courses (9 semester credits). The project synthesizes evidence-based research, leadership, and practice inquiry. Most DNP projects demonstrate student skills in the use of evidence to initiate improvements in clinical outcomes or address a gap between the evidence and clinical practice. All DNP projects should: 1. Focus on a change that effects healthcare processes and/or outcomes either through direct or
indirect care 2. Have a systems or population/aggregate focus 3. Describe and, when possible demonstrate, implementation in an organization or area of practice 4. Include a plan for sustainability 5. Include an evaluation of processes and/or outcomes. *Projects should be designed so that
processes and/or outcomes will be evaluated to guide practice and policy. Note: Clinical significance is as important in guiding practice as statistical significance is in evaluating research.
6. Include a plan for dissemination – this consists of varied forms and should be targeted to appropriate audiences.
An integrative or systematic literature review alone does not demonstrate the required level of adequate academic rigor for a DNP project, as it does not provide opportunities for students to demonstrate, develop, and/or integrate a practice-based change-oriented project.
DNP Course Faculty Role The faculty who teach the DNP Project courses will serve as primary mentors for students as they complete their projects and will: 1. Serve as the PI for all studies requiring IRB application and/or approval. 2. Guide preparation of the project proposal, project development, implementation, evaluation, and
dissemination. 3. Ensure that:
a. Students have an appropriate DNP project team b. Students establish an appropriate plan for dissemination of the project and sustainability of the
project
The DNP Project Team Each student will identify and work with a DNP Project Team to complete the Project. The DNP project team should include the student or group of students working with at least one faculty member who holds a doctorate (usually this is the faculty member from the course in which student is enrolled) and at least one mentor from a practice setting. Students may collaborate with one another in the design of projects, but all students complete projects individually.
Role of Project Team Members: 1. Critique drafts of the developing DNP project proposal. 2. Participate actively in team meetings on the DNP project proposal. 3. Review drafts of the final DNP project, and the final DNP project product. 4. Meet with the student at least once before the student’s DNP project proposal is reviewed and
approved.
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DNP Project Deliverables and Grading Rubrics by Course
NURS 518 Students complete an initial draft proposal of DNP projects (narrative paper summarizing Part 1 of the DNP project template (see below).
NURS 557 Project Planning During this course, students must complete: 1. Table of Evidence for DNP Project 2. Final draft of DNP Project proposal (Narrative paper summarizing parts 1 and 2 of DNP project
template) 3. Submission of draft IRB application for exempt status 4. Site approval form (if applicable) 5. Practicum log documenting completion of a minimum of 120 hours of work
NURS 557
Grading Rubric Final Draft of DNP Project Proposal
Paper Sections Section and Description Possible Points
Introduction Introduction to the Project
Identify the focus of the project Establish the significance Include one or two background studies related to the topic State the project aims and relationship to your PICO
question Explain how the project is relevant to nursing practice.
Review of the Literature
Review of Literature Conduct a systematic review of the current literature
(within the last 5-10 years). Synthesize the literature on the topic (provide an
evidence table as an appendix). Summarize how the project will contribute to nursing
knowledge by filling in gaps, validating, or testing knowledge.
Framework Framework Describe the theoretical framework or conceptual model
to be used in the project. Connect the project and PICO question to the theoretical
framework.
Methods Methods
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Paper Sections Section and Description Possible Points
Describe the project design, including detailed
intervention information. Describe the setting of the project. Describe how data will be collected (include the validity
and reliability of any instruments to be used). Describe the statistical analysis to be used (as
appropriate to your project). Describe how data will be measured, state anticipated
findings. State the limitations of the project.
Sample Sample Describe the sample for the project, including inclusion
and exclusion criteria, sample recruitment process, and human subjects protection methods.
Some DNP projects will not have a sample. If this is the case for your project, briefly provide a rationale.
Timeframe
Time Frame Provide time estimates for the project, describing the time
it will take to complete each phase of the project. Provide a listing of activities from project initiation to
completion.
NURS 558 Project Implementation During this course, students must complete: 1. An IRB application to the WSU-IRB. Note: all projects must satisfy IRB requirements for Exempt
Status. See the WSU IRB site for details: www.irb.wsu.edu. 2. Updated table of evidence for the DNP Project 3. Scholarly paper that includes updated content from NURS 557 and expands to include content
described in the rubric below 4. Signed DNP Project Approval Form with Executive Summary, abstract or equivalent summarizing
the project 5. Practicum log that validates the completion of a minimum of 150 hours of work
NURS 558
Grading Rubric Revised and Expanded DNP Project Proposal Paper
Sections Section and Description Possible Points
Title & Abstract
1. Title Page
Indicates concerns for the improvement of quality (broadly defined to include the safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity of care).
States the specific aim of the proposed intervention. Identifies a study
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Paper Sections Section and Description Possible
Points method to be used (for example, “A qualitative study,” or “A randomized cluster trial”)
2. Abstract Drafts a summary of key information from various sections of the text using the abstract format of the intended publication. Note: Should not exceed 250 words. (Note: The Abstract will usually be written after completion of the body of the paper.)
Introduction Why did you start? 3. Background Knowledge & Local problem
Provides a brief, summary of current knowledge of the care problem to be addressed, and characteristics of organizations in which it occurs.
Describes the nature and severity of the specific local problem or system dysfunction that was addressed.
4. Study question
States precisely the primary improvement-related question and any secondary questions that the study of the intervention was designed to answer in PICOT format
5. Intended improvement
Describes the specific aim (changes/improvements in care processes and patient outcomes) of the proposed intervention.
Specifies who (champions, supporters) and what (events, observations) triggered the decision to make changes, and why now (timing).
6. Theory 1-3 Paragraphs
Provides a brief explanation of the theory used to guide this PTP.
Methods 2-5 Pages
What are you doing?
7. Ethical issues
Describes ethical aspects of implementing and studying the improvement, such as privacy concerns, protection of participants' physical well-being, and potential author conflicts of interest, and how ethical concerns were addressed.
8. Sample and Setting
Describes sample (population) involved in this PTP. This section may also need to describe the healthcare providers involved in this project.
Specifies/describes elements of the local care environment involved in the PTP; provides specifics of the practice (e.g. rural clinic, hospital, acute care, outpatient clinic, impatient unit, public health clinic, etc.)
Characterizes relevant elements of setting or settings (for example, geography, physical resources, organizational culture, history of change efforts), and structures and patterns of care (for example, staffing, leadership) that provided context for the intervention.
9. Planning the intervention
Describes the intervention(s) and its component parts in sufficient detail that others could reproduce it.
Indicates main factors that contributed to choice of the specific intervention(s) (for example, analysis of causes of dysfunction; matching relevant improvement experience of others with the local situation).
Outlines initial plans for how the intervention(s) was to be implemented: e.g., what is to be done (initial steps; functions to be accomplished by those steps; how tests of change will be used to modify intervention), and by whom (intended roles, qualifications, and training of staff).
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Paper Sections Section and Description Possible
Points Provides a timeline that depicts the PTP process inclusive of
baseline/pre-data, intervention(s), and post-data time frames. Explains the course of the intervention(s) (for example, sequence of
steps, events or phases; type and number of participants at key points), preferably using a time-line diagram or flow chart.
10. Methods/ data analysis
Describes data management plan (include how issues related to use/dissemination of data collected in/from the organization will be addressed).
Describes instruments and procedures (qualitative, quantitative, or mixed) to be used to assess a) the effectiveness of implementation, b) the contributions of intervention components and context factors to effectiveness of the intervention, and c) primary and secondary outcomes.
Reports validity and reliability of standardized assessment instruments (if applicable)
Explains methods to be used to collect data (for example training data collectors if applicable, process to be established to obtain data, setting up excel file and analysis methods to be used, etc.)
Appendix 11. TOE Produces a table of evidence validating the literature review that was
done with substantive enough content, across a multitude of disciplines, to demonstrate a solid investigation of the literature.
12. IRB Accepted IRB application from WSU IRB if applicable Clarity of Writing & Style
Writing style is clear, easy to follow, succinct, and complete. Paper is consistent with APA writing standards.
NOTE A grade of B or higher is required to pass the course.
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NURS 559 DNP Project Dissemination During this course, students must complete: 1. Final scholarly paper prepared according to the APA Style Manual, latest edition - this serves as
written documentation of the completion of the Project a. Distribution of a copy of the DNP project final paper write-up to each DNP project team
member. b. Submission of the report of the DNP project in both electronic format and a written hard copy
(once revisions are complete). c. The report is to be consistent with APA style. Content is consistent with Graduate School and
SQUIRE Guidelines 2. An Executive Summary of DNP Project 3. Practicum log documenting a minimum of 150 hours of practice 4. Completion of a DNP Project Dissemination Plan - Each student will develop a comprehensive
plan for the dissemination of the findings of the evaluation and describing the impact of the clinical practice change
5. Formal presentation of the DNP project a. The student’s DNP project committee will describe the final project presentation. The student
and faculty must attend, and members of the student’s project team should be invited to attend the final project meeting.
b. Typically the student will prepare a presentation that reviews the project.
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DNP Project Report Format The report is organized and at a minimum the report should include: 1. Title Page. 2. Signature Page 3. Executive Summary - The executive summary provides an overview of the project 4. Abstract – the abstract should conform to the appropriate chosen peer reviewed journal
guidelines. 5. Table of Contents 6. Body of Report
• Background and Significance • Problem or Purpose • Project Description • Evaluation • Results/Outcomes • Discussion
7. References 8. Any Appendices
DNP Project Evaluation and 559 Paper Grading Rubric
Paper Sections Section and Description Possible Points
Title & Abstract
1. Title Page
Indicates concerns for the improvement of quality (broadly defined to include the safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity of care).
States the specific aim of the proposed intervention. Identifies a study method to be used (for example, “A qualitative study,” or “A randomized cluster trial”)
2. Abstract Drafts a summary of key information from various sections of the text using the abstract format of the intended publication. Note: Should not exceed 250 words. (Note: The Abstract will usually be written after completion of the body of the paper.)
Introduction 3. Background Knowledge & Local problem
Provides a brief, summary of current knowledge of the care problem to be addressed, and characteristics of organizations in which it occurs.
Describes the nature and severity of the specific local problem or system dysfunction that was addressed.
4. Study question
States precisely the primary improvement-related question and any secondary questions that the study of the intervention was designed to answer in PICOT format
5. Intended improvement
Describes the specific aim (changes/improvements in care processes and patient outcomes) of the proposed intervention.
Specifies who (champions, supporters) and what (events,
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Paper Sections Section and Description Possible Points
observations) triggered the decision to make changes, and why now (timing).
6. Theory 1-3 Paragraphs
Provides a brief explanation of the theory used to guide this PTP.
Methods 2-5 Pages
7. Ethical issues
Describes ethical aspects of implementing and studying the improvement, such as privacy concerns, protection of participants' physical well-being, and potential author conflicts of interest, and how ethical concerns were addressed.
8. Sample and Setting
Describes sample (population) involved in this PTP. This section may also need to describe the healthcare providers involved in this project.
Specifies/describes elements of the local care environment involved in the PTP; provides specifics of the practice (e.g. rural clinic, hospital, acute care, outpatient clinic, impatient unit, public health clinic, etc.)
Characterizes relevant elements of setting or settings (for example, geography, physical resources, organizational culture, history of change efforts), and structures and patterns of care (for example, staffing, leadership) that provided context for the intervention.
9. Planning the intervention
Describes the intervention(s) and its component parts in sufficient detail that others could reproduce it.
Indicates main factors that contributed to choice of the specific intervention(s) (for example, analysis of causes of dysfunction; matching relevant improvement experience of others with the local situation).
Outlines initial plans for how the intervention(s) was to be implemented: e.g., what is to be done (initial steps; functions to be accomplished by those steps; how tests of change will be used to modify intervention), and by whom (intended roles, qualifications, and training of staff).
Provides a timeline that depicts the PTP process inclusive of baseline/pre-data, intervention(s), post-data time frames.
Explains the course of the intervention(s) (for example, sequence of steps, events or phases; type and number of participants at key points), preferably using a time-line diagram or flow chart.
10. Methods/ data analysis
Describes data management plan (include how issues related to use/dissemination of data collected in/from the organization will be addressed).
Describes instruments and procedures (qualitative, quantitative, or mixed) to be used to assess a) the effectiveness of implementation, b) the contributions of intervention components and context factors to effectiveness of the intervention, and c) primary and secondary outcomes.
Reports validity and reliability of standardized assessment instruments (if applicable)
Explains methods to be used to collect data (for example training data collectors if applicable, process to be established to obtain data, setting up excel file and analysis methods to be used, etc.)
RESULTS
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Paper Sections Section and Description Possible Points
11. Evaluation Plan
Implementation methods / tools / measures clearly described Analysis/Evaluation consistent with project plan Outcomes / evidence-based measures appropriate for objectives Tools / instruments described and linked to measures and objectives Method of analysis clearly described for each measurement
12. Results
Results organized in appropriate format Explains the course of the intervention (eg. sequence of steps,
events or phases; type and number of participants at key points), preferably using a time-line diagram or flow chart
Describes how and why the initial plan evolved, and important lessons learned from that evolution
Results linked to problem statement, objectives and evaluation plan Describes the extent to which the objectives were achieved Addressed key facilitators and barriers that impacted the project’s
objectives Describes unintended consequences (both positive and negative)
DISCUSSION 13. Discussion
Summarizes the most important successes and difficulties in implementing intervention components, and main changes observed in care delivery and clinical outcomes.
Highlights the project’s particular strengths Compares and contrasts study results with relevant findings of
others, drawing on broad review of the literature. Use of a summary table may be helpful in building on existing evidence.
Explores factors that could affect generalizability (external validity), e.g.: representativeness of participants; effectiveness of implementation; features of local care setting.
Addresses likelihood that observed gains may weaken over time, and describes plans, if any, for monitoring and maintaining improvement; explicitly states if such planning was not done
14. Interpretation
Explores possible reasons for differences between observed and expected outcomes.
Draws inferences consistent with the strength of the data about causal mechanisms and size of observed changes, paying particular attention to components of the intervention and context factors that helped determine the intervention’s effectiveness (or lack thereof), and types of settings in which this intervention is most likely to be effective
Suggests steps that might be modified to improve future performance
Reviews issues of opportunity cost and actual financial cost of the intervention
Considers overall practical usefulness of the intervention Suggests implications of the report for further improvement
interventions
15. Writing and APA format followed appropriately; writing is scholarly and clear;
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Paper Sections Section and Description Possible Points
Organization appropriate for doctoral level education 16. Synthesis Student can articulate response to program/clinical questions arising
from this project Extent to which student met goals/aims of project. If not, appropriate
rationale and explanation provided. Demonstrates practice inquiry skills including appraising and
translating evidence. Extent to which student analyzes issues and provided critique of
advanced nursing practice within the project Evidence of student’s ability to engage in collaborative
partnership(s) in designing and implementing DNP project.
Appendix 17. TOE Produces a table of evidence validating the literature review that was
done with substantive enough content, across a multitude of disciplines, to demonstrate a solid investigation of the literature.
18. IRB Accepted IRB application from WSU IRB if applicable Comments
Sources:
• Doctor of Nursing Practice DNP Handbook. (2012). University of Northern Colorado. Available at: http://www.unco.edu/nhs/nursing/dnp/DNP_DNP_manual_2012.pdf.
• Standards of Quality Improvement Reporting Excellence. (n.d.) Available at: http://www.squire-statement.org/guidelines
SUMMARY REGARDING NP PRACTICUM/CLINICAL EXPERIENCES
Practicum/clinical experiences are an important aspect of your education as a Nurse Practitioner and DNP student in the College of Nursing at WSU. It is in the practicum/clinical settings that you will apply theoretical and evidence-based knowledge gained in other courses, adding hands-on patient care experiences to develop and advance your nursing practice. The emphasis in the Nurse Practitioner Practicum/Clinical experiences is on the development of clinical and professional expertise necessary for comprehensive primary care practice in a variety of settings. It is expected that students’ clinical knowledge will be enhanced subsequent to each clinical course. Clinical course expectations reflect this enhanced clinical knowledge. The NP curricula and these clinical/practicum experiences prepare you for national certification and for future practice.
This Handbook provides detailed information necessary to the work you will complete in practicum/clinical experiences. It supplements information available to you in course syllabi and other documents.
To qualify for national certification, you must complete a minimum of 500 clinical hours supervised by qualified preceptors. WSU faculty members who are certified and licensed as nurse practitioners
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teach all courses that include clinical or practicum content in the nurse practitioner tracks. See the section below about Preceptors to learn more about who may be qualified to serve as your preceptor.
PREPARATION FOR CLINICAL EXPERIENCES
E*Value E*Value is the data management system used by the graduate program to manage and monitor data associated with graduate student clinical experiences, and ensure compliance with accreditation standards. It is the student’s responsibility to be able to understand, navigate, and maintain documents in this data management system. Critical data stored and managed within E*Value includes:
• Affiliation agreements with clinical sites • Student biographic information, including completion of Graduate Student Passport
requirements • Site requests for clinical placement • Preceptor eligibility verification for clinical rotations • Clinical site information, including patient care services, student placement requirements • Scheduling of student clinical rotations • DNP student documentation of clinical experiences, including time tracking and
diagnostic/procedural experiences (PxDx) • Evaluations for clinical rotations • Aggregate information for faculty to assess student learning progress
You will receive a login and password for the E*Value system upon your acceptance to WSU CON. Students use the E*Value for numerous functions throughout their enrollment at WSU CON. There are three student E*Value trainings on the student E*Value home page that align with E*Value information you need to know for specific phases of your program. Topics will vary with each training as you learn to use new and different aspects of E*Value to support your progression through DNP and Nurse Practitioner course work. It is very important to view these trainings in a timely manner to maximize your student clinical experience. View and download training on the E*Value page on the nursing website: https://nursing.wsu.edu/current/evalue/. In addition to trainings developed by WSU administrative staff and faculty, help files are available on the student E*Value home page. Lynn Turner, the Student Data Coordinator is also available to help you with the use of the site to maximize the student E*Value experience. You can reach her at [email protected] or 509-324-7284.
Graduate Student Passport An important aspect of preparing for clinical rotations is to complete all trainings, background checks, certifications, and other requirements within the WSU CON Graduate Student ‘Passport’. The Graduate Student Passport requirements are determined by a coalition of educational institutions and health care organizations in Washington and Oregon. The passport was developed as a minimum set of evidence based requirements to protect student, client and staff safety within the clinical setting. Adherence to these guidelines is crucial in WSU CON’s compliance with contract terms in the affiliation agreements with the clinical sites that provide educational experiences to students. The student passport is reviewed and updated annually by CPNW. Consequently, passport requirements may change during your enrollment at WSU CON.
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Upon admission, students are required to provide information to WSU demonstrating the completion of these requirements. Students must remain current on all passport items throughout the duration of their enrollment at WSU CON. Some items are required one time, and others must be updated periodically without going beyond the expiration date. Students will receive reminders on items that are due to expire. Please note that passport items should be updated in E*Value each August. Registration holds may be placed if passport items are not updated appropriately. ‘Passport’ and documentation requirements are located on the College of Nursing website: https://nursing.wsu.edu/current/admitted-students/ Course Prerequisites Most full time students in MN and DNP programs will start clinical placements and practicums in their second year of study, following one full year of didactic work. All prerequisites must be met before taking clinical courses. Refer to program of study to ensure all pre requisites have been met. Familiarize Yourself with Clinical Course Rotation Requirements Before requesting clinical sites, it is important to know the clinical requirements for the course you will be taking. In general, each specific course requires that you complete a minimum number of hours of clinical/practicum experience.
WSU and the organizations that offer certification examinations for graduates of NP programs define clinical hours as: “hands on assessment, diagnosis and treatment.” You cannot receive credit for observation, shadowing or operating room experiences, continuing education activities, or other types of experience that do not involve care in keeping with this definition.
The following charts outline the clinical course student learning outcomes and clinical requirements for all clinical courses in the FNP and PMHNP programs: FNP Program Student Learning Outcomes and Clinical Rotation Requirements: FNP Program Student Learning Outcomes and Clinical Rotation Requirements are located on the College of Nursing website: https://stage.nursing.wsu.edu/current/wp-content/uploads/sites/603/2015/07/FNP-student-learning-outcomes-and-clinical-requirements.pdf
PMHNP Program Student Learning Outcomes and Clinical Rotation Requirements: PMHNP Program Student Learning Outcomes and Clinical Rotation Requirements are located on the College of Nursing website: https://stage.nursing.wsu.edu/current/wp-content/uploads/sites/603/2015/07/PMHNP-student-learning-outcomes-and-clinical-requirements.pdf PH Program Student Learning Outcomes and Clinical Rotation Requirements: The DNP program director, Track Coordinators for the Family NP, Psychiatric Mental Health NP, Population Health tracks, and any individual employed by WSU to perform clinical supervision of NP students may assign additional practicum/clinical hours beyond those described in the syllabus if the student is not meeting clinical competency expectations.
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Researching Clinical Sites The process of requesting clinical sites for an upcoming semester begins with researching sites where you would like to be placed. You will be asked to submit clinical site requests to your clinical placement coordinator 3-6 months in advance of an upcoming clinical course. It is important that you prepare early by researching clinical sites and identifying ones that you want to request for upcoming rotations. If you need help identifying appropriate sites to request, WSU’s mapping tool can help you identify clinical sites to request that align with upcoming clinical rotation requirements.
Clinical Site Mapping Tool When you get to the mapping page: • enter your home address in the ‘My Starting Point’ field • Select the radius or distance from your home that you want to find a site within • In ‘Patient Care Focus contains’ field, enter a key word to help you locate sites specific to your
rotation need. For example: o PMHNP students taking NURS541 will need fall placement in a mental health setting that
provides individual counseling. Entering ‘mental’ in this field will pull in all sites within the radius you chose that offer mental health services. From there, you can see a list of which mental health services they offer.
o FNP students taking NURS567 will need placement in a family practice setting. Entering ‘family’ into this field will pull in all sites with the filters you chose that offer family practice services.
• Clicking ‘filter sites’ will then show you results based on the filters you chose. They will show in a list, and will also show on the map. Hovering your cursor over each one on the map will pop up information about individual sites.
Clinical at Your Place of Employment A student’s place of employment cannot be used as a clinical site. Students may, however, work in a different area of the same employment site in a non-paid position for up to 50% of the total required program hours. For example, if the student is an ICU nurse at hospital X and wants to complete a clinical practicum at a clinic associated with that hospital, then the student can complete up to 50% of the total required program hours at that site.
Generally, it is preferred that a student not cannot a clinical rotation in a site where a family member is employed; however, should a student desire to do so, permission from the specialty track coordinator will be required.
Oregon and Idaho Practice Sites Many students will complete clinical rotations in Oregon and/or Idaho. Obtaining a license in the state closest to your home will greatly increase clinical placement opportunities and is encouraged. If you obtain or have an out-of-state license, please enter that information into E*Value along with your Washington State nursing license information.
The Oregon State Board of Nursing (OSBN) requires that students who are enrolled in out-of-state programs must petition for approval to complete any clinical/practicum rotation in the state. You MUST submit the petition to the appropriate Clinical Coordinator (WSU-Vancouver: Katie Larson WSU-Tri Cities & Spokane: Joanie Christian) in a timely way; the Clinical Coordinator will finalize the document and forward it to the OSBN. Your petition to complete clinical/practicum rotations in Oregon must be approved by the OSBN before you can begin the clinical/practicum experience. This process will take a minimum of two months, so plan accordingly. If you will complete a clinical rotation in Oregon, you must review all information at the OSBN website. After you review the information and the forms, contact the appropriate Clinical Coordinator who will help you with the forms you need to submit.
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Oregon Nursing License
For information about obtaining a Registered Nursing license in Oregon, visit: http://www.oregon.gov/OSBN/Pages/RN-LPNlicensure.aspx
Idaho Nursing License
For information about obtaining a Registered Nursing license in Idaho, visit: http://ibn.idaho.gov/IBNPortal/BoardAdditional.aspx?Board=IBON&BureauLinkID=100 or access a licensure application at: http://ibn.idaho.gov/IBNPortal/IBN/FORMS/1%20-%20RN%20Licensure%20by%20Endorsement.pdf. The Idaho Board of Nursing offers students the option to obtain a temporary license for up to 90 days for use when completing a clinical rotation in that state. This temporary license cannot be extended beyond 90 days. The fee for this temporary Idaho nursing license is $25 and the application can usually be processed in less than 10 business days. Be sure to mark the check box on the application that indicates you are applying for a temporary license. These links provide further information about obtaining temporary or permanent Idaho licensure: http://ibn.idaho.gov/IBNPortal/LicensureByEndorsement.aspx?Agency=426&Board=IBON
http://ibn.idaho.gov/IBNPortal/IBN/FORMS/1%20-%20RN%20Licensure%20by%20Endorsement.pdf
Requesting Clinical Sites Securing clinical site placement is a collaborative process. Successful clinical placement occurs as the result of a partnership between you, your Clinical Placement Coordinator, faculty, and clinical sites. The Clinical Placement Coordinators for each campus are: Spokane: Joanie Christian, [email protected] 509-324-7226 Vancouver: Katie Larson, [email protected] 360-546-9164 Approximately 3-6 months in advance of an upcoming clinical course, the Clinical Placement Coordinator at your campus will send out Rotation Site Request forms to students using the E*Value system. These forms will go out via email and indicate an evaluation needs to be completed (making sure your contact information is correct in E*Value ensures these forms will get to you!). The student inputs courses, clinical sites and other information on this form about sites they would like to request, and then submits it. Once submitted, the Clinical Placement Coordinators receive them and can begin working on the requests by contacting sites. This process will be more thoroughly explained in your trainings each semester.
Rather than contacting sites themselves, it is important that the student follow the internal student placement process at WSU. Most clinical sites have requested to have a single point of contact at WSU to contact them for placement requests, and in the interest of site relations we are trying to honor that. If you know a provider at a clinic that has agreed to precept you, just let your Clinical Placement Coordinator know so they can follow the site’s official student placement process.
Clinical faculty/clinical evaluators must approve all clinical placements. In doing so they will consider the program outcomes, objectives of the course in which you are enrolled, and your overall performance in coursework and in previous clinical experiences. Under some circumstances, faculty may direct you to complete a clinical experience at a specific site or within a specific time frame based on assessment of your progress in the program.
You may be required travel and/or stay in outlying communities in order to secure appropriate clinical placement. Should travel for a clinical site be required, travel and housing expenses will be the responsibility of the student. We recognize that, while these sites provide excellent learning opportunities, leaving home and family may be difficult for you; thus, we try to limit the number of times we require you to accept placement at a distant site.
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Agency Contracts WSU is required to have a contract (affiliation agreement) with all clinical sites before students can begin a clinical rotation. When you request clinical site placement using the E*Value system, the clinical placement coordinators will review the status of the contract. The Clinical Contracts Coordinator will make every effort to ensure that a contract is in place so that you can complete a clinical rotation at a site that offers placement to you. However, please be aware that the process of negotiating a contract may take several months to finalize.
Onboarding/Credentialing at Clinical Sites When placement is confirmed for you, it is very important to complete the clinical site’s onboarding requirements before beginning your rotation(s). Most hospitals and large healthcare organizations, and many other health care systems and private practices require that students complete preclinical requirements.This is often referred to as “Provider Staff” ‘Privileging’, ‘Credentialing’, or ‘Onboarding’. Some sites require completion of additional items beyond those required in the Graduate Student Passport. For example, the student may be required to complete specialized HIPAA training, computerized charting training, and/or urine drug screening. Completion of these requirements is entirely your responsibility as a student. This process can take weeks to months and should be initiated as soon as a clinical placement at a site is confirmed. WSU stores any known site specific requirements and accompanying documents in E*Value under the site name. Please note that “onboarding” time at a clinical site will not account for clinical time at the site.
NOTE: Your preceptor may invite you to participate in inpatient care at a secondary site such as a hospital or urgent care center (rounds, surgery, treatments, obstetrics, etc.) as part of a clinical experience. If you are providing direct care at the secondary site, you must complete the credentialing process with that facility as well as the primary site – before you can provide any patient care. If you are accompanying the preceptor to the second site for observation only, you do not need to complete the credentialing process, unless the site requires that you do so. If you discover you will be at a secondary site, it is imperative that your clinical placement coordinator and clinical faculty are aware of the secondary site.
BEGINNING ROTATIONS
Preceptors Any licensed healthcare provider (MD, DO, ARNP/APRN or PA-C) who has been practicing in their field for at least one year, who has a current, unencumbered professional license, and holds a minimum of a Master’s degree may serve as the preceptor for a Nurse Practitioner student. Nurse practitioners who are currently enrolled in an NP program or in WSU’s DNP program may not serve as preceptors for other WSU DNP students.
The clinical placement coordinator at your campus will verify preceptor eligibility when arranging clinical placement.
A letter is provided in the appendices that you may send or give to your preceptor(s). This letter explains the course requirements and requests the preceptor’s help for you. It also provides information about how the preceptor can contact the course instructor.
Please arrange to meet with your preceptor for at least 30 minutes before you begin your practicum rotation. This could take place a week or two before you begin the rotation or even before office hours on your first day. During this meeting:
1. Provide your current resume to the preceptor if you have not already done so.
2. Describe your goals for the clinical setting; ask your preceptor to provide you with feedback about your goals, and provide a current copy of the syllabus for the clinical class in which you are enrolled.
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3. Determine a mutually agreeable rotation schedule.
4. Explain to your preceptor that a WSU faculty member or Clinical Evaluator will visit you to evaluate your work in the clinical setting.
5. Advise the preceptor that you may need to schedule additional time for site visit evaluations by your Clinical Faculty person as required.
6. Explain that an evaluation will be sent via email for the preceptor to complete during the course of the semester.
7. If necessary after the meeting, modify your goals and objectives for the rotation after you meet with the preceptor.
8. Provide your preceptor with a finalized copy of your revised goals and objectives as required.
Clinical Faculty and NP Clinical Evaluators Each semester you will be assigned to work with a WSU CON faculty member or community-based Nurse Practitioner (Clinical Evaluator) who will evaluate your clinical/practicum performance. It is your responsibility to communicate with your Clinical Faculty/Evaluator before you begin any clinical experience and periodically through the semester. Early in the semester, you will receive information about and contact information for this individual. If you do not receive this information, contact the course instructor. You cannot begin any clinical experience until you have received permission via email to do so. Give your clinical faculty a list of your preceptors, their contact information, and the location of their practice. Provide a list of personal goals and objective to the clinical site evaluator. Describe the experience you will have with each preceptor. Failure to obtain permission before starting in the practicum/clinical setting may result in the assignment of a failing grade for the practicum/clinical experience. Contact the clinical faculty immediately if there is any problem during all clinical/practicum experiences. Your success in communicating appropriately will be mirrored in your success in your course work.
Please note: Clinical Faculty Evaluators at WSU are practitioners who take time away from their practices and their families to assist you in achieving your educational goals and objectives. They are not available at all times to visit you in the clinical setting because they have professional and personal responsibilities. Please work with them to develop a mutually agreeable schedule for site visits.
Provide Your Rotation/s Schedule/s to WSU Before the start of the semester, the Clinical Placement Coordinator at your campus will send you a Rotation Schedule Dates Form. This will come to you from E*Value via email, and will indicate an evaluation needs to be completed. Upon opening the form, the student will see a list of all confirmed placements, and will need to enter the dates of each rotation on the form, and submit back to WSU. This step is essential to WSU staff scheduling your rotation in the E*Value system, so that evaluations and other details of the rotation go smoothly, and to have an official record of your placements.
Definition of Clinical Hours Though Clinical Placement Coordinators seek rotations that are direct, ‘hands on’ care of patients of all ages and healthcare needs, there are times when a student starts at a site, and finds that the experience will be more observational. As a Nurse Practitioner student, you must be able to perform assessments, develop diagnoses, formulate treatment plans, and communicate with patients and families about those activities (in collaboration with the preceptor). Observational/shadowing hours do not count towards your clinical hour requirements. If you are in a situation that will be mostly observational, please contact your Clinical Placement Coordinator and Clinical faculty right away, so suitable placement can be found for you.
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Resources for Clinical Practice It will be helpful for you to develop and maintain a system for accessing information at your clinical site. The system you develop may include but is not limited to: use of a smart phone, tablet computer, texts, or online resources. You should have ready access to prescribing and diagnostic testing information at all times while in the clinical setting.
Code of Conduct for Clinical/Practicum Experiences/Rotations 1. Observe all agency policies and procedures.
2. Maintain client confidentiality and adhere to HIPAA regulations for the protection of patient privacy and the security of electronic health records
3. Be aware of all emergency procedures (fire, etc.) including patient emergencies (seizures, codes, etc.).
4. Locate and memorize the location of emergency exits, fire extinguishers, oxygen supplies, etc.
5. Be prepared and punctual.
6. Adhere to standards and scope of practice for RN practice and in the student NP role described by the state’s nurse practice act.
7. Follow NP student dress code for the clinical experience.
8. Your mobile phone may be used for clinically relevant activities only. It is your responsibility to make sure it is set on silent so that it makes no sound with incoming calls or messages. You may not make personal phone calls or send personal messages when in the clinical setting unless you are on a break. You may not, under any circumstances, take a picture of any patient or any part of a patient’s body, even with their permission.
9. Consider each placement as an ‘audition’ for future placements. The reputation you develop while in your clinical rotations can open doors for future rotations, and even future employment. Alternatively, a negative experience with a student can impact a sites’ willingness to place future students.
10. Each week, discuss the following information with your preceptor(s)/clinical faculty.
a. Clearly and briefly present all cases to the preceptor. For tips, visit: How to Make an Effective Oral Presentation.
b. Updates on progress.
11. Leave the clinical site as you found it – with good will and a positive feeling toward their role in NP student education.
12. Formally thank each preceptor and staff who assisted you at the end of each clinical rotation.
13. Let your preceptor know that WSU CON can provide preceptor verification of hours if desired.
Site Visit Evaluation Faculty will observe you while you provide direct patient care at your clinical/practicum site for each of the clinical/practicum courses. It is your responsibility to arrange site visit evaluations with your Clinical Faculty member early in the semester. Each site visit will last 1.5 – 4 hours. You may be required to schedule the evaluation visit at a time other than your usual scheduled time with a preceptor. That is, you may need to change your work or personal schedule to arrange the required site visit. If the scheduled appointment changes, it is the student’s responsibility to make contact with the site evaluator. Failure to arrange a site visit for evaluation may result in the assignment of a failing grade in the practicum/clinical portion of the course.
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During the visit the faculty/evaluator will observe you providing care, presenting to your preceptor, and interacting with patients, family members, and staff. The faculty/evaluator will also consult with your preceptor about your progress and may review clinical documentation (chart notes) that you have completed.
You must earn a passing grade in all site visits. If you do not earn a passing grade in a site visit, an additional site visit may be required. If you do not earn a passing grade in two successive site visits, you will receive a failing grade in the course. It is your responsibility to arrange for additional visits as required.
Required Student Clinical Documentation Before you can receive a grade for the clinical/practicum coursework, the following information regarding your clinical experiences must be recorded in the E*Value system:
1. Log all clinical rotation hours in the ‘Time Tracking’ tile within E*Value. This provides record of your completion of required clinical hours, and also tracks clinical hours with preceptors, so that WSU can provide verification of preceptor hours to them for recertification. Important: Your preceptor must be chosen in the ‘choose a supervisor’ field in order to give credit for the hours to your preceptor. If your preceptor does not appear in the dropdown menu, please contact Lynn Turner, Student Data Coordinator [email protected] Your Clinical Faculty will review and approve your time tracking logs.
2. Log all patient encounters, diagnoses and procedures in the ‘PxDx’ tile of E*Value without using any patient identifiers. Your Clinical Faculty will review and approve your PxDx entries.
3. Four evaluations are generated for every rotation, and are sent via email to the evaluator:
a. Preceptor of student
b. Student of Preceptor
c. Faculty of Student
d. Faculty of site (only necessary if the site has not been evaluated in the last year)
The faculty of student evaluation is sent out early in the rotation, and the student/preceptor evaluations are sent out within a couple weeks from the end of the rotation. Please ensure the completion and submission of an evaluation by each of your preceptors (Electronic evaluation via E*Value is preferred, but a printed and/or handwritten evaluation may also be submitted in paper format to Lynn Turner, Student Data Coordinator [email protected]
A minimum number of SOAP notes will be required each semester. These SOAP notes are not submitted using the E*Value system, but are submitted via email or in person to the Clinical Faculty/Evaluator. Refer to your course syllabus for further details.
In accordance with accreditation requirements, annual reviews are required of all students and advisors, and an evaluation of your advisor upon graduation.
PERFORMANCE EVALUATION
The Clinical Faculty member/Clinical Evaluator will grade work that you complete in the practicum setting and will submit your grade to the course faculty at the end of the semester. You must earn a passing grade in both the didactic and the practicum/clinical experience in order to earn a passing
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grade in the course. Clinical faculty will determine if you will receive a satisfactory grade in consultation with the preceptor(s) and course faculty. The Clinical Faculty Evaluators along with your Clinical Course Instructor will evaluate the student and determine whether or not the student earned a passing grade based on several factors: • Review of your time tracking logs and completion of clinical hours requirements
• Review of your PxDx entries-you will be evaluated on sufficiently documenting your clinical experiences
• Consultation with and evaluations completed by your preceptor(s)
• Your successful completion of a minimum number of clinical documentation notes. If your work is satisfactory, you may complete only the minimum number. If concerns exist about your work or your documentation, you may be required to submit additional clinical documentation notes in order to earn a passing grade for this part of the course.
• Faculty observation of student in clinical setting and student earning a passing grade during site visits.
• No grade will be submitted (you will not receive a passing grade in the course) until you have completed all required documentation by the deadline listed in the course syllabus.
Leave of Absence/Reinstatement Once you begin clinical/practicum coursework in any course (NURS 567, 568, 569, 595: 541, 543, 546, or 548), you must remain continuously enrolled in a clinical/practicum course by enrolling and earning a passing grade in NURS 540 (FNP), NURS 599 (PMHNP) for a minimum of one credit (minimum 45 clinical/practicum hours) each semester until graduation.
If you do not wish to enroll continuously in clinical/practicum courses for any reason you must request a Leave of Absence from the program according to WSU and College of Nursing guidelines.
Reinstatement process
1. If you submit a Leave of Absence from the NP program after you have begun taking clinical/practicum coursework, you must formally request reinstatement in the clinical portion of the program before resuming coursework.
2. You must submit the reinstatement request no later than one month before the first day of the semester in which the student would like to enroll. This request should be submitted to the Academic Coordinator of the Graduate Nursing Programs. It will then be forwarded to he Associate Dean for Academic Programs, the MN or DNP Program Director, the NP faculty, and the Graduate Curriculum and Progression Committee (GCPC), all who must approve the request.
3. If your request for reinstatement is approved, you may be required to complete additional didactic and/or clinical/practicum credits before resuming enrollment in regular courses in the program.
PREPARING FOR NP PRACTICE AFTER GRADUATION
After you complete all the educational requirements for the Doctorate in Nursing Practice and successfully graduate from Washington State University, you must complete additional steps before you can practice as a Nurse Practitioner in any state.
Certification Certification is required by most states in order to qualify for licensure as an Advanced Practice Nurse. Two organizations offer examinations for Family Nurse Practitioner certification. These are the
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American Nurses Credentialing Center ANCC or the American Academy of Nurse Practitioners AANP. Only ANCC offers the certification exam for the Psychiatric Mental Health Nurse Practitioner.
Both organizations have helpful information on their websites. You should visit the websites at the beginning of your practicum/clinical experiences so that you understand the process you will follow to be eligible to complete one of the examinations.
Licensure To obtain a license as an Advanced Registered Nurse Practitioner (ARNP) or Advanced Practice Registered Nurse (APRN) after graduation, follow your state’s application process. In general, you will need to be licensed as a Registered Nurse in any state where you wish to obtain an ARNP/APRN license. Following are some link:
Washington Licensing Information
Oregon Licensing Information
Idaho Licensing Information
State Boards of Nursing for Licensing in Other States.
National Provider Enumeration System The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandated the adoption of standard unique identifiers for health care providers and health plans. The purpose of these provisions is to improve the efficiency and effectiveness of the electronic transmission of health information. The Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign these unique identifiers. How to Apply for NPI
Drug Enforcement Agency Number Before most pharmacies will fill prescriptions that you write and before you can write prescriptions for controlled substances, you must register with the Drug Enforcement Agency and obtain a DEA Number. For more information, visit: DEA Forms and Applications
Paying It Forward-Your role as a mentor to future WSU CON grad students After you have been in practice for 1 year after graduation, PLEASE consider sharing your expertise with a student, and being a WSU CON grad student preceptor! We would appreciate a post-graduation call to let us know where you are working, and if you would be willing to preceptor a student.
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APPENDICES
Appendix 1A: DNP Preceptor Letters
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Insert Date
Dear Insert Name Thank you for agreeing to be a clinical preceptor for a student in our Doctorate of Nursing Practice program. As a preceptor, you will play a critically important role in providing clinical education. During the time spent with you in your practice, the student is expected to assess, diagnose, manage, and educate clients about their health problems as well as about health promotion and self-care activities. These clinical experiences are intended to be “hands-on” learning opportunities. Your role in providing clinical supervision to the student could include the following:
• Define goals/expectations of the clinical rotation • Observe as the student performs one or more complete and/or focused exams. • Validate the assessment findings and recommended management plans • Assist the student to develop expertise in establishing an appropriate differential
diagnosis and in selecting the most appropriate diagnostic tests • Communicate with the student about successes and concerns • Notify WSU of any concerns or problems (see contact information, below)
While the student is working with you, a WSU-employed nurse practitioner Clinical Evaluator will visit the student for an evaluation. Please provide information about the student’s progress during this visit. The student can provide you with the name and contact information for the nurse practitioner Clinical Evaluator. We also ask that you complete an evaluation of the student at the end of the rotation. You will receive an email notification requesting that you complete this evaluation-instructions will be included in the email. For students to do a rotation at your site, there must be an affiliation agreement in place between your agency and WSU. If you have questions about the contract between your agency and WSU, please contact Jennifer Degon at 509-324-7224 or by e-mail, [email protected] If you have any questions or concerns please contact me as soon as possible. We sincerely thank you for your contributions to the education of FNP & PMHNP students and for your support of the WSU College of Nursing. Sincerely, Darryl J. DuVall, DNP, CRNA, ARNP Clinical Associate Professor Director, Doctorate of Nursing Practice Program 509.324.7241 | [email protected]
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Insert Date Insert Address Information Dear Insert Name: On behalf of the Washington State University, College of Nursing, we want to express our gratitude for serving as preceptor for Insert Student Name during the insert term/year semester. The time you have devoted to Insert Student First Name has added significantly to her skill sets and confidence as she transitions to the role of Doctor of Nursing Practice graduate. Enclosed is a certificate verifying your insert # of hours hours as a preceptor for a graduate nursing student in the following course: Nursing 583 - Advanced Population Health Internship. If you require documentation of these hours in another format, please let us know. We sincerely appreciate your time and effort mentoring students and the rich experience provided by your practice. It is an important contribution to WSU, the nursing profession, and to nursing students. We look forward to your continued participation as a WSU Nursing student preceptor! Yours truly, Dawn Doutrich, PhD, RN, CNS Associate Professor WSU Vancouver College of Nursing kf
