Preceptor Nursing Instructor Annual Renewal

Preceptor Nursing Instructor has to renew privileges to have students at COA annually by submitting an Annual Renewal Packet to Mary Jane Prosser in Nursing Education and Research Center.   The packet consists of the following documents.

1.__ Non-COA Nursing Professional Demographic Data Document (click here)
    As part of this document you will read the Non-COA Staff Infomation Handbook to be current on the following topics, then sign and enter the date you completed it at the bottom of the document.  
        __ Fire Safety and Security Information
        __ Code of Conduct
        __ Infection Control
        __ Patient Safety Goals
        __ SBAR: Effective Communication
        __ Child Abuse and Neglect

2.__ Confidentiality and Nondisclosure Statement Form (click here)

3.__ Non-COA Non Bedside Nursing Instructor Continuing Competency Review Document (click here)
    Your supervisor is to complete this document verifying the following:
        __ You are qualified to provide bedside Patient Care for Pediatric Patients
        __ You have a current nursing license to practice in the State of Alabama
        __ Your Cardiopulmonary Resuscitation (CPR) training is up-to-date and you have a current card
        __ You are current with TB Skin Testing
        __ And your Varicella Status-Positive Titers, Immunizatiuons and Hepatitis B Vaccine has been done or documented

Please route the completed forms to Mary Jane Prosser, Nursing Education and Research office, Suite 410, in the Children's Harbor building of Children's Hospital.   For further instructions or any questions call (205) 638-9908.

Mary Jane Prosser, MSN, R.N.
(205) 638-9908 Office
(205) 638-6066 FAX