Safe and Professional Performance in Clinical Laboratory Settings (BSN/MEPN Programs)

The purpose of establishing safe and professional clinical performance standards is to: 

1. Identify the expectations of the College of Nursing;
2. comply with licensure regulations and clinical agency agreements; and
3. identify students who need assistance and provide support to promote their success in the nursing program.

Safe Practice Standards

Safe practice occurs when students:

1. practice in accordance with the standards of care published by professional nursing organizations;
2. adhere to the policies and procedures of the health care agencies to which they are assigned for clinical rotations;
3. practice within the scope of the student nurse role, including required skills, as defined by course guidelines;
4. promote and protect patient rights;
5. comply with the American Nurses Association (ANA) Code of Ethics for Nurses;
6. adhere to the rules and expectations outlined in applicable course syllabi
7. adhere to the rules and expectations outlined in the applicable program-specific handbook; and

8. comply with the requirements of the Arizona Nurse Practice Act.

Questions about safe practice standards or behaviors should be referred to course faculty and/or the program director.

Unsafe Patient Care

Unsafe patient care occurs when a student practices outside the scope of the student nurse role and thereby places the safety of patients, self, or others at risk. Examples of unsafe patient care include, but are not limited to, the following:

1. failure to demonstrate the essential application of theoretical knowledge or psychomotor skills required for safe patient care;
2. failure to comply with the safe practice standards outlined above;
3. violation of clinical site, institutional, or applicable federal policies and procedures, including but not limited to HIPAA requirements; and

4. violations of professional or ethical standards, including inappropriate behavior, ineffective or unprofessional communication, repeated tardiness, or reporting to a clinical experience under the influence of drugs or alcohol.

Determination of Unsafe Practice

Determinations regarding unsafe or unprofessional clinical practice are made by appropriate nursing faculty based on a review of the student’s conduct in light of the standards set forth in this policy. In making such determinations, faculty shall consider the nature, severity, frequency, and context of the behavior, including whether the conduct posed an imminent risk to patient safety or the safety of others.

A single incident may warrant immediate removal from the clinical setting when the conduct presents an imminent risk to patient safety or involves illegal or unethical behavior. Other incidents of unsafe or unprofessional practice may be addressed through progressive review, coaching, and the implementation of a Student Success Plan, as appropriate.

This determination process is intended to support fair, consistent, and educationally sound decision-making while prioritizing patient safety and professional accountability.

Implementation and Response

Following a determination of unsafe or unprofessional clinical practice, the College of Nursing may remove a student from the clinical rotation and/or recommend dismissal from the nursing program for conduct that is unsafe, illegal, or unethical, as outlined in this policy. A student who has previously been placed on a Student Success Plan for unsafe patient care and subsequently engages in an additional act of unsafe patient care may be subject to immediate dismissal, depending on the nature and severity of the conduct.

Incidents of unsafe or unprofessional behavior shall be documented using a Trellis Report. Unsafe or unprofessional behavior may be documented in final course clinical evaluations, regardless of whether the concern was isolated, remediated, ongoing, or involved multiple incidents.

In addition to completing the Trellis Report, the course chair shall promptly notify the Division Chair and Program Director when a student:

1. has placed patient safety at risk while participating in a clinical experience; or
2. is at risk for not providing safe patient care due to identified skill deficiencies.

The Trellis Report shall indicate whether the student has provided unsafe patient care or is unable to demonstrate the knowledge and skills necessary to provide safe patient care. In all cases, the course chair shall meet with the student as soon as practicable to review the Trellis Report and discuss potential academic or clinical implications, which may include failure to demonstrate required competencies or removal from the clinical setting.

Students identified as having skill deficiencies must complete a Student Success Plan and demonstrate the required competencies prior to returning to the clinical practice setting. The Trellis Report shall document the Student Success Plan, including identified concerns and the established timeline for completion.

Student Rights and Support

The student has the right to provide information or documentation regarding their clinical performance and to consult with the clinical instructor, course chair(s), faculty advisor, and/or program director. The clinical instructor shall document unsafe or unprofessional behaviors and take appropriate action, which may include one or more of the following:

1. A conference between the student and the clinical instructor;
2. Consultation among the clinical instructor or course chair (s), the student and/or program director;
3. Referral to appropriate university services including Campus Health, Counseling & Psychological Services, Disability Resources Center, etc. for support & recommendations;

4. Temporary or permanent removal from the clinical experience,

Relationship to Academic Progression and Dismissal Policies

Any suspension or dismissal from the nursing program resulting from unsafe or unprofessional clinical performance shall be subject to the College of Nursing’s academic progression, dismissal, and appeal policies, as applicable.