2023-2024 CFISD School Health Services Clinic Audit

• Campus

• Campus Nurse Name

• Conducted by

• Date Conducted

  Date

Medication Administration FFAC (local)

• Principal designee for medication administration form completed and filed in Medication binder

  Yes

  No

• Permission forms from parent/MD completed and filed in Medication binder

  Yes

  No

• Controlled Substance log documentation

  Yes

  No

• Medications organized and stored according to CFISD policy

  Yes

  No

• All emergency medications are stored in unlocked cabinet marked "Emergency Medications"

  Yes

  No

  n/a

• Permission for self-administration of medication completed and filed in appropriate binder

  Yes

  No

  n/a

• Administration of medication is documented daily in electronic medical record (EMR)

  Yes

  No

Office Visit Documentation

• Thorough and appropriate documentation of assessment in narrative section of daily log entries

  Yes

  No

• Thorough and appropriate documentation of interventions in narrative section of daily log entries

  Yes

  No

Immunization Documentation

• Immunization compliance report is up to date (as medically possible)

  Yes

  No

• Immunization exemption certificates and MD letters are filed in Exemption binder and documented in EMR

  Yes

  No

  n/a

• Documented parent/guardian notification of immunization requirements

  Yes

  No

  n/a

• Documented notice to campus administration concerning immunization non-compliance

  Yes

  No

  n/a

Screening

• Vision and hearing screening completed 120 days from student enrollment

  Yes

  No

• Spinal and acanthosis nigricans screening completed 120 days from student enrollment

  Yes

  No

  n/a

• Documented monthly biological calibration of audiometer

  Yes

  No

• Demonstrated knowledge of community assistance for vision exams including documented referrals when appropriate

  Yes

  No

Clinic Management

• Clinic is orderly and free of clutter

  Yes

  No

• Supplies are easily accessible

  Yes

  No

• Otoscope, pulse ox., thermometer, and sphygmometer are in working order

  Yes

  No

Substitute Notebook

• Organized according to CFISD guidelines found in health services handbook

  Yes

  No

• Updated with current campus specific information including substitute spare key location

  Yes

  No

• Current telephone lists with nearest campus RN phone numbers included

  Yes

  No

• Current campus Alert roster included

  Yes

  No

Special Services

• Documented campus staff health awareness education

  Yes

  No

• Documented transportation health awareness education

  Yes

  No

  n/a

• Current IHPs for identified students

  Yes

  No

  n/a

• Current orders (updated annually) for special procedures in appropriate binder

  Yes

  No

  n/a

• Documented training for delegated procedures<br>

  Yes

  No

  n/a

• Documented supervision of delegated procedures

  Yes

  No

  n/a

• Principal UDCA delegation form signed and filed in Diabetes binder

  Yes

  No

• Documented UDCA training filed in Diabetes binder

  Yes

  No

  n/a

Emergency Preparedness

• Evacuation plan in place

  Yes

  No

• Emergency trauma bag properly stocked and easily accessible

  Yes

  No

• Rolling wagon to evacuate medications is easily accessible

  Yes

  No

• AED checklists current (inspected monthly)

  Yes

  No

Audit Results

• Is follow up audit necessary?

  Yes

  No

• When will follow up audit take place?

  2 weeks

  1 month

  2 months

• Auditor's Signature

  Sign

• Additional Remarks

• Campus Registered Nurse Signature

  Sign