North Carolina Board of Nursing

Nursing Education

Resources for Program Directors

Assessing a Clinical Agency

Suggestions for Assessing a Clinical Agency for
NAII or Nursing Student Use

Prior to placing students in a clinical setting an assessment of the appropriateness of the area is important. The information detailed below is intended to provide guidance to the Program Dean/Director or designee for the completion of the assessment of a clinical site for student use, as well as suggestions for what to include in the contract/letter of agreement with the clinical site. This information is for the use of the Program Dean/Director or designee. Do not send this information to the Consultant at the North Carolina Board of Nursing.

The Consultants at the North Carolina Board of Nursing remain available to assist in a consultative role as you gather information and determine the appropriateness of clinical sites for students.

Determining Appropriateness of Site (Program Aspects)

  • Determine objective(s) to be met relative to level of student and course content.
    1. How do the objectives play out in the clinical experience?
    2. Will this be a faculty-supervised or a precepted/buddy experience?
    3. What is the faculty experience/competency in this clinical area?
  • Identify an appropriate clinical site/agency.
  • Initiate contact with the clinical site/agency.
  • Identify person(s) with authority for approving clinical site/agency use and coordination of student experiences. (The person with authority to approve clinical placement of students may be different from the person who coordinates student placement)
  • Determine units or areas available for student use. Do the available experiences and average patient census support the curriculum and the objectives of the course in which the students will be enrolled during this clinical experience?
  • Are there sufficient staff members available for mentoring and/or role identification? (Are a high number of supplemental/agency staff utilized? Are there staff members appropriately performing in the role for which you are preparing the student to function as a graduate?)
  • Determine and resolve scheduling conflicts with other nursing education programs.

Determining Appropriateness of Site (Clinical Site Aspects)

  • Identify the organizational structure. Who has authority for nursing personnel and nursing activities?
  • Review the position descriptions for nursing personnel (look at all that have nursing responsibilities. For example, the unit secretary or a tech may also function as a NAI or NAII) Are the responsibilities defined within the legal scope of practice or within the legal activity limit for that category of worker?
  • Is the staff functioning within the legal scope of practice/activity limit?
  • Review policies related to supervision of the LPN and unlicensed assistive personnel; delegation; nursing assessment; care planning (including evaluation of patient response to interventions/progress toward meeting established goals); and medication administration/security.
  • Are there sufficient equipment and supplies available for the students to meet the objectives of the experience? (for example, if the objective is to learn to take blood pressures, are there enough blood pressure cuffs available that the students could complete the assignment in a reasonable time?
  • Have there been any findings from regulatory/accreditation surveys/reviews that are of concern or would interfere with the students meeting the objectives of the experience? (Division of Facility Services: www.facility-services.state.nc.us; Joint Commission on Accreditation of Healthcare Organizations: www.jcaho.org)

Suggestions of Items to Include in the Contract/Letter of Agreement with the Clinical Site

  • Responsibility for patient care
  • Responsibility for students, including supervision and evaluation
  • Number of students
  • Communication of student scheduling; objective of the experience
  • Availability of faculty (on site vs. on call)
  • Requirements for immunization, special training (OSHA, BCLS)
  • Right of denial of individual students at the clinical site.
  • Inclusion of any other requirements of the College or the Clinical Site.

Orientation Needs to Consider Related to Use of the Clinical Site

  • Faculty
    1. Is the faculty member experienced in caring for this type of patient?
    2. Is the faculty member familiar with this clinical agency? With the specific area where students will be assigned?
    3. Is there anything specific or unusual about the way this particular area functions that the faculty member will need to know?
  • Students
    1. Who will provide/assure that regulatory/agency specific requirements are met (OSHA, BCLS, confidentiality statements, etc)?
    2. Who will provide orientation to the agency/clinical site?
    3. Who will provide orientation to the assigned clinical area?
    4. Where will pre- and/or post-conferences be held?
    5. Is there space for students to store items (coats, books, purses, etc)?
  • Faculty and Students
    1. What documentation system is being used? Will the students be permitted to use it? Who will provide any needed orientation, and when will it be done? Does the faculty member need to cosign student entries?
    2. What medication control and administration system is being used? Does the faculty member need a special code to use it? If a code is necessary, will students be given an individual code, or will the faculty member need to use his/hers when the students access the system?