Download GMC Requirement Checklist/Guide: Instructors and Students Page 1

GMC Requirement Checklist/Guide:
Instructors and Students
Page 1 - INSTRUCTORS:
INITIAL
ANNUAL
VISITING Instructors
VISITING Instructors
Do Drug and Background Screening – give GMC access to view
on-line vendor screening results
Credentialing: copy of credentials to L. Horst
Last 4 SS# for myNetLearning login to L. Horst
With NL Login - Enroll in CBL curriculum: “New Instructor
Visit only CBLs” & complete
Sign/ complete/ turn in to L. Horst:
Agreement Concerning Faculty Supervision; or Board of
Regents Faculty Agreement
Confidentiality Agreement
Code of Conduct
MRI Form
ID Badge Form to L. Horst
NEW NURSING Instructors
Drug and Background Screening – give GMC access to view online vendor screening results
Credentialing: copy of RN License to L. Horst
Copy of current CPR card to L. Horst
Last 4 SS# for myNetLearning login & access codes to L. Horst
With NL Login - Enroll in CBL curriculum: “New Nursing
Instructor Orientation CBLs”
Attend Skills Day – 1pm on 2nd or 4th Tuesday of the month
Complete 4 hrs. of precepted time on assigned unit
Complete Computer Documentation Training 7/20/12 &
10/5/12 from 8:30am – 3pm at GMC.
Sign/ complete/turn in to L. Horst:
Nursing Instructor Orientation & Annual Requirements
Document
Agreement Concerning Faculty Supervision; or Board of
Regents Faculty Agreement
Confidentiality Agreement
Code of Conduct
MRI Form
ID Badge Form to L. Horst
Enroll in CBL curriculum: “Instructor Annual
CBLs”
Sign, complete/turn in to L. Horst:
Agreement Concerning Faculty Supervision;
or Board of Regents Faculty Agreement
NURSING Instructors
Update copies of licensure and CPR when
expired/renewed to L. Horst.
Enroll in CBL curriculum: “Instructor Annual
CBLs”
Assignment to new unit – requires 4 hrs.
precepted time, Preceptor signs off on
“Nursing Instructor Orientation & Annual
Requirements Document”
Sign, complete/turn in to L. Horst:
Agreement Concerning Faculty Supervision;
or Board of Regents Faculty Agreement
NURSING INSTRUCTOR Annual Unit Skills
and Processes Update Acknowledgment
Statements
Page 2 – School Coordinator submits to GMC for Students’ Placements
First Time Students At GMC
Contract between GMC and School must be in place.
Names of students and their instructor – 2 wks. prior to start
Drug and Background Screening – give GMC access to view on-line vendor screening results
Complete Orientation study materials as outlined on table-- Page 3.
{Student GMC employees request Verification of Employment Letter (VOE) from GMC – Human Resources Dept. – do
not need vendor screening or to do orientation study materials}
Complete/turn in to L. Horst
Completed LOG – signed by instructor or school designee (for GMC student employees, write employee after their
name if they submit a VOE).
Syllabus/objectives for placement
Authorization for Release of Records – signed / witnessed. (Use BOR or Non-BOR as appropriate to type of school.)*
Educational/Training Agreement – signed/ witnessed. (Use BOR or Non-BOR as appropriate to type of school.)*
*Midlevel students only-- must turn in Midlevel Process Form Signed by the Supervising Physician
Students Returning to GMC within the same academic year.
(Academic year is defined as Fall to Summer of the following year.)
Contract between GMC and School must be in place.
Names of students/instructor – 2 wks. prior to start
Complete/turn in to L. Horst
Completed LOG – signed by instructor or school designee. (Document after student name that they have done
orientation previous semester, e.g. Fall 2012 – would not need to do Spring 2013)**
Syllabus/objectives for placement
Authorization for Release of Records signed/ witnessed -(Use BOR or Non-BOR as appropriate to type of school.)*
Educational/Training Agreement – signed/ witnessed (Use BOR or Non-BOR as appropriate to type of school.)*
*Midlevel students turn in Midlevel Process Form Signed by the Supervising Physician
Students Returning to GMC the next academic year.
Contract between GMC and School must be in place.
Names of students and their instructor – 2 wks. prior to start
Complete Orientation study materials as outlined on table-- Page 3 for the new academic year.
{Student GMC employees request Verification of Employment Letter (VOE) from GMC – Human Resources Dept. – do
not need to do orientation study materials}
Complete/turn in to L. Horst
Completed LOG – signed by instructor or school designee. (Document after student name that they have done
orientation previous semester, e.g. Fall 2012 – would not need to do Spring 2013)**
Syllabus/objectives for placement
Authorization for Release of Records –signed /witnessed (Use BOR or Non-BOR as appropriate to type of school.)*
Educational/Training Agreement – signed/ witnessed (Use BOR or Non-BOR as appropriate to type of school.)
*Midlevel students turn in Midlevel Process Form Signed by the Supervising Physician
*Board of Regents (BOR) Schools use the BOR forms; and schools that are not BOR will use the Non-BOR forms – located
on the website: http://www.gwinnettmedicalcenter.org/programs-classes/GMCContentPage.aspx?nd=276
Page 3: Orientation Materials
All Students
Complete the Following Orientation Materials
Orientation Task to be completed, i.e. “X”
Study
Test
Acknowledgement
Sign
X
X
Orientation Topic
Environment of Care (EOC)
X
EOC Acknowledgement (Print)
X
Information Privacy and Security Module
Information Security Training Test (Print)
X
Confidentiality Agreement Form (Print)
X
X
Code of Conduct
X
Code of Conduct Acknowledgement ((Print)
X
Corporate Compliance Module
The Corporate Compliance Acknowledgement (Print)
Infection Control and Prevention
X
X
X
X
X
Infection Control and Prevention Acknowledgement (Print)
Magnetic Resonance Imaging Form (Print)
X
NURSING & EMS Students Complete
X
National Patient Safety Goal (NPSG)
X
X
NPSG Acknowledgement (Print)
Glucose Meter Study Guide
X
PCX and PXP Glucose Meter Test (Print)
X
PXP Glucose Meter Competency (Print)
Completed with your
Instructor or Preceptor on the unit.
All Operating Room (OR) or Procedural Shadowing Experiences Complete
GMC Student Protocol for the Operating Room Module
OR Protocol Acknowledgement (Print)
X
X
X