Instructions for Completing Temporary Staff Documentation
for
Physician Support Services and Community Physician Network
Abuse Reporting Forms (Child Abuse Report Form; Domestic Abuse Report Form;
Suspected Adult Abuse Reporting Form)
Instructions: Temporary/contract/registry employee must read, sign and date the
each abuse reporting form. Give signed copy to agency representative for
enclosure in personnel file as well as to FPG HR.
Confidentiality Agreement
Instructions: Temporary/contract/registry employee must read, sign and date the
Confidentiality Agreement. Give signed copy to agency representative for
enclosure in personnel file as well as to FPG HR.
HIPAA Training Module
Instructions: Temporary/contract/registry employees must read, complete and sign
HIPAA training Module and post test. An additional required confidentiality
agreement is attached to the end of the test. Give signed copy to agency
representative for enclosure in personnel file as well as to FPG HR.
Drug Screening
Instructions: Drug Screening must be conducted on each
temporary/contract/registry employee. Copy of the evidence of drug testing must
be enclosed in agency personnel file as well as given to FPG HR.
Background Check
Instructions: Background check must be conducted on each
temporary/contract/registry employee. Copy of the evidence of drug testing must
be enclosed in agency personnel file as well as given to FPG HR.
Review of Nondiscrimination Policies
Instructions: The temporary/contract/registry employee must read the
Nondiscrimination Policies. These include the Nondiscrimination and Affirmative
Action Policy Regarding Academic and Staff, Whistleblower Complaints, and
Sexual Harassment Policy. Agency representative will note in the personnel file
the Nondiscrimination Polices were distributed to temporary/contract/registry
employee.
C-ICARE Training Module
Instructions: The temporary/contract/registry employee must read and complete
the C-ICARE Training Module and post test. This is an on-line requirement. As
instructed on the link, the Temporary/contract/registry employee will select the
option “If you don’t have an employee ID and have not applied for a temporary
ID plese click here”. A temporary ID will be generated and the online process can
begin.
This module produces a certificate at eh conclusion of the test. Please print and
complete this certificate. Agency representative will place certificate ion the
personnel file. A copy will also be given to FPG HR.
For Temporary Staff Assigned to the Community Physician Network add:
Medical Clearance Criteria and TB Testing
Instructions: Medical Clearance Criteria:
Temporary employee must have proof of immunity, (e.g. blood titers), to the
following conditions: Measles (Rubella; Rubella (German measles); Mumps;
Varicella.
Temporary employee must be either offered or given Hepatitis B vaccine series; or
demonstrate immunity to Hepatitis B; or sign a declination for Hepatitis B
vaccination.
Temporary employee must be tested for Tuberculosis by the “2 Step Tuberculin Skin
Testing” AND be free of tuberculosis. Individual must be TB tested annually,
thereafter, and be free of tuberculosis at all times.
Temporary employees smut be offered the Tdap (Tetanus, Diphtheria, Pertussis)
Vaccine
Temporary employees must be physically and medically cleared by a physician to
perform the essential functions of the temporary assignment.
CPR/BCLS Card and Professional License and/or Certification
Instructions: Temporary/contract/registry employee must provide a valid
CPR/BCLS Card and original Professional License and/or Certification to agency
representative, if applicable. A verified copy must be made of the CPR/BCLS
Card. Be sure to draw a line through the copy and write or stamp the work “copy”
on it to prevent unlawful duplication.
Temporary/contract/registry employee must also show their original CPR/BCLS
Card and original Professional License and/or Certification, if applicable, to the
FPG Community Physician Network manager on their first day of the assignment
and on the first day of each subsequent assignment at any of the CPN locations. A
copy of the verification(s) may be requested from the agency.
All required certification and professional licenses are to be kept current at all
times to be eligible for assignment.
Age Specific Education Module and Post Test
Instructions: The temporary/contract/registry employee working in a Patient Care
or Patient Care Support position must read the Age-Specific Education Module
for each age group and complete post test on each age group. Agency
representative will review and correct the post tests with the
temporary/contract/registry employee. Completed tests will be enclosed in the
personnel file. A copy will be given to the CPN manager on site.
Restraints Guidelines
Instructions: The temporary/contract/registry employee must read the Restraints
Quick Reference Guide and Essentris Guide. Agency representative will note in
personnel file that Restraints Guidelines were distributed to
temporary/contract/registry employee.
Sedation Guidelines (RN’s only)
Instructions: The temporary/contract/registry RN employee only must read the
Sedation Quick Reference Guide and Sedation Presentation. Agency
Representative will note in personnel file that Sedation Guidelines was distributed
to temporary/contract/registry RN employee.
Answer keys
Instructions: Agency reprehensive will review and correct post tests with the
temporary/contract/registry employee. Completed tests will be enclosed in the
personnel file. A copy will be given to the CPN manager on site.
HIPAA Privacy Standards – Basic Training Module
HIPAA Privacy Standards – Healthcare Provider Training Module
Age Specific Education Module