Background Check and Drug Screening Guidelines for Valencia Allied Health and Nursing Programs Valencia does not have an official policy regarding student background checks or drug screening. However, all students entering the Nursing and Allied Health programs are required to submit to a criminal background check and drug testing because these programs include clinical rotations in a variety of external affiliate health care facilities, which have policies that we must respect pursuant to our contracts with them. Our affiliates policies require that students serving in a clinical rotation be free of specific offenses that would disqualify them for a student clinical and have their civil rights intact. In addition, our affiliates require that students return negative drug screening results based on a list of specified substances. These guidelines are derived from the requirements specified by our affiliates, and are subject to change upon any modification to our affiliates policies. PROCEDURES: Our affiliates require Level 1 and 2 criminal background checks and 10-panel drug testing of all students. This screening must be completed utilizing the Allied Health and Nursing Divisions process, including use of its designated vendor(s). The results of background checks and drug testing from other facilities or entities will not be acceptable for admission to Valencia s Allied Health and Nursing programs. The clinical portions of the programs are required for program completion and students cannot fulfill the program requirements if they cannot participate in the clinical experience. Incoming students: Background Checks Valencia s healthcare affiliates require Level 1 criminal background checks for all students who participate in clinical experiences in their facilities. The Agency for Healthcare Administration, which governs our affiliates, requires Level 2 background checks/ FDLE finger printing for students whose clinical program places them with vulnerable populations. Due to additional requirements from some of our clinical affiliates, employment verifications are included in the background effective February 2014. Valencia s health care affiliates have provided the administration with a comprehensive list of offenses that they deem unacceptable for students entering their facilities. This list is compiled solely by the affiliate, without any input from Valencia. When Valencia receives the results of each background check, those results are compared with the list provided by the affiliate to determine if a listed offense has been discovered. Valencia does not make any determination of the suitability of a student to serve in a clinical rotation or subjectively interpret any results; it merely determines whether an offense listed on a background check report is present on the affiliate s list of unacceptable offenses and advise the affiliate of that fact. The student may meet with the appropriate Academic Dean for consultation regarding the results of background checks; however, the Dean will advise the student only based upon clearly Revised 2-2014 Page 1
Background Check and Drug Screening Guidelines for Valencia Allied Health and Nursing Programs defined offenses provided by the affiliates. The Dean does reserve the right to consider the student for program entry at a later date; if the disposition of an offense is changed in the student s favor; he/shall may be reconsidered for entry to a program. Drug Testing 10 panel drug testing must be negative for all substances. Dilute negative specimens will not require retesting, unless required by specific health care agency. Valencia s health care affiliates have provided the college administration with a comprehensive list of substances that they deem unacceptable for students entering their facilities. This list is compiled solely by the affiliate, without any input from Valencia. When Valencia receives the results of each drug screening, those results are compared with the list provided by the affiliate to determine if the presence of a listed substance has been discovered. Valencia does not make any determination of the suitability of a student to serve in a clinical rotation or subjectively interpret any results; we merely determine whether a substance found through a drug screening is present on the affiliate s list of unacceptable substances and advise the affiliate of that fact. Positive results for any substance must have a viable medical explanation and the student shall have been prescribed treatment by a licensed health care professional. Where positive results do not have a medical explanation, students may be denied admission and may re-apply to the program at a later time. Incumbent students: If a student incurs a record as a result of an arrest or encounter with the law, he/she is required to disclose the incident to the Office of Clinical Compliance immediately. Depending on the circumstances, failure to self-disclose or the offense itself may result in withdrawal from the program. Clinical affiliates may perform a separate background check and, if an offense is discovered, may affect the student s clinical access. Random drug testing will be required at the student s expense in the event of o A previous positive result o Suspicion of substance use/abuse o Affiliate policy change A positive result upon random drug testing will result in withdrawal from the clinical assignment with commensurate inability to meet the completion requirements of the program. Revised 2-2014 Page 2
CLINICAL COMPLIANCE: STUDENTS AND FACULTY Valencia College Allied Health and Nursing Programs Background Check Summary Patriot Act Residency History Criminal Records Sex Offender Index Nationwide Healthcare Fraud and Abuse Scan Employment Verification FDLE/Florida Fingerprinting (Required by AHCA) Drug Test: 10-Panel Amphetamines Barbiturates Benzodiazepines Cocaine Methadone Methaqualone Opiates Phencyclidine Propoxyphene Marijuana Immunizations and Other Requirements: Physical Exam/Provider Signature verifying good health status for program) TST (tuberculosis skin test) annually Chest X-Ray Results/Report (if positive TST) TB Screen/Symptom Sheet (annually if positive TST/negative chest X-Ray) MMR MMR Varicella (Chicken Pox) Tetanus: Tdap one time, T/D thereafter every 10 years Hepatitis B Series AHA BLS Healthcare Provider Certificate of FIT Test N95
AHA Basic Life Support for Healthcare Providers All students enrolled in programs in Valencia s Divisions of Nursing or Allied Health shall be required to obtain and maintain the American Heart Association Basic Life Support (BLS) for Health Care Providers certification. For the purpose of Valencia student clinical rotations, ONLY American Heart Association certification is acceptable per our hospital affiliates. For students required by their respective program to have advanced certification (ACLS and/or PALS), only American Heart Association certification is acceptable. Students will upload a copy of their current American Heart Association card to their Certified Background tracker. It is the student s responsibility to maintain all certifications required by the program in which he/she is enrolled and to present documentation of updated certifications during the duration of their enrollment. Health Care Provider (CPR) Classes Available Valencia College is an American Heart Association Training Site Offers certification and re-certification classes at least once a month on the West Campus. The fee includes the student manual. You may register online with a credit card at http://valenciacollege.edu/cehealth. Sections are identified for Valencia degree students. You must have your V# to register in these special sections to obtain student pricing: o Certification $40.00 o Re-Certification of an unexpired AHA BLS card $20.00 For more information or to pay by check or cash, contact the Office of Continuing Education and Clinical Compliance Location: West Campus, HSB 200 Phone: 407.582.1793 or 407.582.1870 Email: cehealthinfo@valenciacollege.edu Other Student-Friendly American Heart Association Providers CPR for Citizens: (Rick McGarrity) For schedule, pricing and/or register for classes, call 407.629.5183 Provider accepts only cash or check, no credit cards All Care Health Services www.allcarecpr.com/student 407.432.4756 Present current Valencia I.D. To locate other approved American Heart Association providers, go to www.heart.org/heartorg/cprandecc/findacprclass s:\health sciences-common\west campus\division of health sciences\compliance\orientations\orientation_5-2014\compliance documents\individualcompliance docs\cpr bls certification requirement.doc
Page 1 Valencia College Divisions of Allied Health and Nursing HEALTH AND PHYSICAL FORM TO BE COMPLETED BY STUDENT: Name: VID #: Street Address: DOB: City/State/Zip Phone #: Health Science Program: Circle your program AVS CVT Dental Hygiene EMT Generic Nursing Paramedic Respiratory Radiography MRI CT Sonography Medical Information Technology RN Refresher TO BE COMPLETED BY STUDENT'S HEALTH CARE PROVIDER: PHYSICAL EXAMINATION: indicate ability to perform standards described below LIMITATIONS: Mobility: Physical abilities sufficient to move from room to room and maneuver small spaces; move freely to observe and assess patients and perform emergency care to include full manual dexterity of upper extremities,including neck and shoulders, unrestricted movement of lower extremities, back, hips,in order to assist in all aspects of care. Ability to touch floor to remove environmental hazards and to include nursing procedures as applying restraints bladder catheterization and injections. Revised: October 2013 Motor Skills: Gross and file motor abilities sufficient to provide safe and effective care Hearing: Auditory abilities sufficient to monitor and assess patient needs and to provide a safe environment Visual: Visual ability sufficient for observation and assessment necessary in the operation of equipment and care of patients Tactile: Tactile ability sufficient for patient assessment and operation of equipment Cognitive: abilities to include calculating medication dosages, interpreting and carrying out provider orders, read and comprehend course materials,patient care documents and facility policies and procedures PERSONAL HISTORY Describe any conditions (including allergies to substances normally found in a clinical setting) that could potentially impact the student's attendance and/or performance. if a student should present with any physical or cognitive limitation, each case will be reviewed on an individual basis. Reasonable accommodations will be made as determined by the Office for Students with Disabilities. HEALTHCARE PROVIDER SIGNATURE AND/OR STAMP Following the performance of a physical exam and utilizing history and immunization information provided to me by the student, I verify the above information to be true. Signature and/or Stamp of Healthcare Provider (MD,DO, PA, ARNP) Date: Provider Printed Name: Phone:
Page 2 Valencia College Divisions of Alied Health and Nursing HEALTH AND PHYSICAL FORM Student Name: VID #: Revised: February 2014 IMMUNIZATION INFORMATION DATE RESULTS TUBERCULOSIS TST (tuberculosis skin test/ppd) Date Placed: / / Date Read: / / Positive Negative CHEST X-RAY RESULTS/REPORT (if positive TST/PPD) Positive Negative TB SCREEN/TB symptom sheet to be done annually if positive TST/PPD MEASLES, MUMPS, RUBELLA Two MMR vaccines with dates or individual titers for each satisfy the requirement for Measles (Rubeola), Rubella (German Measles) DATE RESULTS MMR VACCINES (given after 1st birthday) Vaccine #1 Vaccine #2 (not required if born before 1957) TITERS Rubeola Titer Positive Negative Rubella Titer Positive Negative VARICELLA (CHICKENPOX) Two Varicella vaccines with dates, or a positive titer, or history of DATE RESULTS having chickenpox disease satisfy this requirement Documentation of Disease N/A Varicella #1 Varicella #2 Titer Positive Negative TETANUS/DIPTHERIA One time Tdap, then TD every 10 Years DATE Tetanus/Diptheria Tdap SEASONAL FLU VACCINE DATE HEPATITIS B (strongly recommended for healthcare workers) DATE RESULTS Vaccine #1 Vaccine #2 Vaccine #3 Titer Positive Negative HEPATITIS B DECLINATION ONLY (to be signed by student if refusing this vaccine series) I understand that, due to my exposure to blood or other potentially infectious materials, I may be at risk for acquiring the hepatitis B (HBV) infection. I have been informed of the recommendation that all healthcare workers be vaccinated with hepatitis B vaccine. However, I decline hepatitis B vaccination at this time. I understand that by declining this vaccine, I could be at risk of acquiring hepatitis B, a serious disease. STUDENT'S PRINTED NAME: STUDENT'S SIGNATURE: DATE
SEASONAL INFLUENZA VACCINE DECLINATION Influenza vaccine is strongly recommended for healthcare workers, not only to protect themselves, but also to reduce the chance of spreading influenza to patients, their families, and to the community. Influenza infection can lead to serious complications and can be fatal, especially in elderly or sick persons, including those who are hospitalized. In the U.S. approximately 200,000 people are hospitalized and 36,000 persons die from influenza each year. The influenza vaccine is highly effective in PREVENTING infection. Valencia Divisions of Nursing and Allied Health are committed to the health and well-being of students, faculty, and patients and we consider influenza vaccination a PATIENT SAFETY priority. PLEASE HELP PREVENT THE TRANSMISSION OF INFLUENZA BY RECEIVING THE ANNUAL INFLUENZA VACCINE. If you choose to decline the vaccination, please complete this form and upload it to your immunization tracker and/or provide it on demand in your clinical setting. PRINT NAME: First MI Last VALENCIA PROGRAM (circle one): Nursing Paramedic EMT CVT Respiratory Radiography Dental Hygiene Sonography Answer the following questions: 1. YES NO Have you ever had a severe allergic reaction to chicken eggs? 2. YES NO Have you previously had a severe reaction to an influenza vaccination OR other vaccinations? 3. YES NO Do you have an allergy to any preservatives used in vaccines? 4. YES NO Have you ever developed Guillian-Barre syndrome following influenza vaccination? DECLINATION OF VACCINE: I have read the above statement regarding seasonal influenza vaccine. I fully understand that my declination will necessitate my wearing a mask during the entire shift in some clinical settings as required by the facility. I am choosing not to take the vaccine for the following reason(s): Answered yes to the questions above (1-4) Dislike of needles Concern for side effects Don t think vaccines work Never get flu Fear of getting influenza from vaccine Other: Signature: Date: Rev. 1/20/2012
Valencia Community College Division of Health Sciences Tuberculosis Symptom Screening Sheet Form Revision Date: May 2010 FORM TO BE COMPLETED BY STUDENT Student Name (Print) VID # This form is required annually ONLY if the student has a positive TB skin test (TST or PPD) followed by a normal chest x-ray or has received BCG and has had a normal chest x-ray. PRINTED NAME: STUDENT SIGNATURE: DATE: Do you currently have, or have you had in the past two months, any of the following: SYMPTOM YES NO Productive cough Night sweats Shortness of breath Loss of appetite Unusual tireness Unintentional weight loss Fever Swollen or tender lymph nodes Please answer the following questions and comment on positive answers QUESTION YES NO DATE Have you ever been exposed to TB? If yes, when? Have you ever had a positive TB skin test? If yes, when? Have you ever taken BCG vaccine? If yes, when? Are you currently taking medication(s) for TB? Have you ever taken medication(s) for TB?
Centra Care, Florida Hospital Urgent Care & Valencia College Division of Health Sciences are excited to be Health Partners providing you an opportunity to receive your required Immunizations at a discounted rate at a Centra Care, Florida Hospital Urgent Care location, or Centra Care Onsite services. Immunizations Description Cost Hepatitis B Vaccination # 1 $50.00 Hepatitis B Vaccination # 2 $50.00 Hepatitis B Vaccination # 3 $50.00 MMR Vaccination (No Pregnancy) $65.00 (at South Orange, Colonial Town, Waterford, Altamonte & Sanford only) Varicella Vaccination (No Pregnancy) $95.00 (at Sanford & South Orange only ) Td Vaccination $25.00 TDAP $45.00 Influenza Vaccination $21.00 Lab Work: PPD / TB: Hepatitis B Titer (HBSAB) $50.00 Rubella Titer (RUBLG) $50.00 Varicella Titer (VARIGP) $50.00 PPD (Step One Only No Pregnancy) $20.00 History of + PPD N/C Health Review Form (HRF) N/C For a complete listing of locations/directions, hours of operation, or to schedule a No Wait Reservation, visit www.centracare.org. You may also call (407) 200-CARE Option # 9. We have 4 centers open until Midnight (Waterford Lakes, Lee Road, Lake Buena Vista, & Sanford). Most other centers are open by 8AM until 8PM and on weekends 8AM 5PM. Services available at centers ONLY: Chest X-Ray 1 view $70.00 Chest X-Ray 2 view $80.00 School/Sports Physical $50.00 Urine Dip $ 3.00 What to bring with you: 1. Your VC ID Badge or Centra Care/Valencia Authorization for Services 2. All VC required documentation for the doctor to complete. Revised Feb 2014