CLINIC MANAGEMENT

  • Nurse properly identified as a registered nurse

  • Clinic is a non-hazardous environment. Free of spills, free traffic pattern, spills cleaned up promptly

  • Follow up with corrective action will be completed by:

  • Supplies are easily accessible.

  • Follow up with corrective action will be completed by:

  • Equipment (audiometer, otoscope, scales, pulse ox, sphygmometer, Titmus) in working order.

  • Follow up with corrective action will be completed by:

CLINIC VISIT DOCUMENTATION

  • Accurate and complete documentation of assessments in electronic health record

  • Follow up with corrective action will be completed by:

  • Accurate and complete documentation of interventions in electronic health record

  • Follow up with corrective action will be completed by:

  • Accurate and complete documentation of response to interventions in electronic health record

  • Follow up with corrective action will be completed by:

MEDICATION PROCEDURES

  • All medication orders are signed by the parent. Prescription medication orders or OTC medication given longer the 15 days signed by the parent and physician.

  • Follow up with corrective action will be completed by:

  • All medication orders entered in the electronic health record.

  • Follow up with corrective action will be completed by:

  • All medication properly labeled and secured in a locked cabinet.

  • Follow up with corrected action will be completed by:

  • Original medication orders are kept in a properly labeled binder and are readily accessible.

  • Follow up with corrected action will be completed by:

  • Medication Administration Principal Designee Form present

  • Follow up with corrected action will be completed by:

UNLICENSED ASSISTIVE PERSONNEL

  • Medication training checklists current for all staff members who have been assigned by the Principal to administer medications (UAP, coaches, field trips, extra-curricular).

  • Follow up with corrected action will be completed by:

DIABETES CARE

  • DMTP current and signed by the parent and physician.

  • Follow up with corrective action will be completed by:

  • UDCA authorization present on DMTP or UDCA authorization form

  • Follow up with corrective action will be completed by:

  • UDCA Principal Designee Form present

  • Follow up with corrective action will be completed by:

  • UDCA training checklists current and readily accessible.

  • Follow up with corrective action will be completed by:

  • Transportation plan current and documented for bus riders. Copy given to bus driver and faxed to transportation supervisor.

  • Follow up with corrective action will be completed by:

  • Emergency Action Plan (EAP) for each student completed as appropriate (teachers, coaches, specials).

  • Follow up with corrective action will be completed by:

  • Emergency kits available for diabetic students, or students self carry in the event of a lock down or evacuation.

  • Follow up with corrective action will be completed by:

SEVERE ALLERGY AND ANAPHYLAXIS

  • Anaphylaxis training for designated staff (staff members who are responsible for direct care of student with severe allergy) completed and documented with epinephrine auto-injector return demonstration and review of Action Plan.

  • Follow up with corrective action will be completed by:

  • EAPs for each student completed as appropriate (teachers, coaches, specials).

  • Follow up with corrective action will be completed by:

  • Epinephrine auto-injectors housed in a secure, unlocked, labeled cabinet.

  • Follow up with corrective action will be completed by:

  • Epinephrine auto-injectors are clearly labeled to be rapidly identifiable for emergency use.

  • Follow up with corrective action will be completed by:

  • Transportation plan current and documented for bus riders. Copy provided to bus driver and faxed to transportation supervisor.

  • Follow up with corrective action will be completed by:

SEIZURE CARE

  • Seizure Action Plan current and signed by the parent and physician.

  • Follow up with corrective action will be completed by:

  • Parent questionnaire, and/or information about seizure condition is present and current.

  • Follow up with corrective action will be completed by:

  • Seizure Action Plan in place with need-to-know staff.

  • Follow up with corrective action will be completed by:

  • Transportation plan current and documented for bus riders. Copy provided to bus driver and faxed to transportation supervisor.

  • Follow up with corrective action will be completed by:

SPECIAL PROCEDURES

  • Orders for special procedure(s) current and signed by parent and physician.

  • Follow up with corrected action will be completed by:

  • Special procedure skills training current and documented for any staff member who assists with special procedures and are readily accessible.

  • Follow up with corrected action will be completed by:

IMMUNIZATION COMPLIANCE

  • Immunizations current/updated and documented in the electronic health record.

  • Follow up with corrected action will be completed by:

  • Conscientious and Medical Exemptions current, signed by parent or physician according to nursing protocol, notorized, documented in the electronic health record, and the original filed in student file.

  • Follow up with corrected action will be completed by:

SCREENINGS

  • Hearing and Vision screenings completed in accordance with DSHS schedule, preferably within 120 days of enrollment, and documented in the electronic health record.

  • Follow up with corrected action will be completed by:

  • Scoliosis screenings completed in accordance with DSHS guidelines and nurse protocol

  • Follow up with corrected action will be completed by:

  • Acanthosis screenings completed by spring break for grades 1, 3, 5, 7

  • Follow up with corrected action will be completed by:

  • Screening referrals documented in the electronic health record with evidence of follow-up.

  • Follow up with corrected action will be completed by:

  • Self-audits of Hearing, Vision, and Spinal documentation has been completed and corrections to data entry have been made.

  • Follow up with corrected action will be completed by:

  • AN screening updated and documented in RFES website.

  • Follow up with corrective action will be completed by:

  • Monthly Biological Callibration of audiometer documented according to DSHS protocol and easily accessible.

  • Follow up with corrective action will be completed by:

HEALTH CONDITIONS AND INDIVIDUAL HEALTH PLANS (IHPs)

  • Skyward alert information has been updated/added and critical alert box checked in accordance with nurse protocol.

  • Follow up with corrective action will be completed by:

  • Health conditions and alerts updated in electronic health record and designated 0, 1, or 2 in accordance with nurse protocol.

  • Follow up with corrective action will be completed by:

  • Notification of need-to-know staff completed and documented (teachers, 504 coordinator, coaches, extra- curricular sponsors, child nutrition manager).

  • Follow up with corrective action will be completed by:

  • IHPs have been created or updated for identified students.

  • Follow up with corrected action will be completed by:

  • IHPs include evidence of interventions completed and goals being met or in progress (notes in office visit, medication administration notes, on IHP, skills checklists, etc.).

  • Follow up with corrected action will be completed by:

  • Syndromic Surveillance report completed and documented daily on the Fort Bend County Health Services website.

  • Follow up with corrected action will be completed by:

EMERGENCY PREPAREDNESS

  • Emergency care consent forms are printed and available to be quickly accessed during an emergency.

  • Follow up with corrected action will be completed by:

  • AED/Crisis Team has been identified.

  • Follow up with corrected action will be completed by:

  • AED/Crisis Team DRILLS/TRAINING:
    Works in collaboration with campus administration. First semester drill completed and documented.

  • Follow up with corrective action will be completed by:

  • AED/Crisis Team DRILLS/TRAINING:
    Works in collaboration with campus administration. Second semester drill completed/scheduled.

  • Follow up with corrective action will be completed by:

  • Emergency bag stocked, contents unexpired, and readily accessible.

  • Follow up with corrected action will be completed by:

  • Emergency bag contents checklist complete and easily accessible.

  • Follow up with corrected action will be completed by:

  • Evacuation plan in place for students and staff requiring assistance evacuating the facility.

  • Follow up with corrected action will be completed by:

  • Evacuation of clinic emergency supplies has been practiced with at least one fire/evacuation drill.

  • Follow up with corrected action will be completed by:

  • AED daily, monthly, and annual checks are performed and documented.

  • Follow up with corrective action will be completed by:

SUBSTITUTE BINDER

  • SECTION 1: Daily Schedule/ Essential Information

  • Follow up with corrective action will be completed by:

  • SECTION 2: Medical Alert Information

  • Follow up with corrective action will be completed by:

  • SECTION 3: Emergency procedures

  • Follow up with corrective action will be completed by:

  • SECTION 4: Clinic procedures

  • Follow up with corrective action will be completed by:

  • SECTION 5: Communicable Disease Guidelines

  • Follow up with corrective action will be completed by:

  • SECTION 6: Telephone Lists/Communication

  • Follow up with corrective action will be completed by:

  • SECTION 7: Miscellaneous

  • Follow up with corrective action will be completed by:

  • SECTION 8: Clinic Forms

  • Follow up with corrective action will be completed by:

COMPREHENSIVE SCHOOL HEALTH PROGRAM

  • Classroom education completed or scheduled supporting Health TEKS.

  • Special Event/Committee Involvement?

  • Additional Remarks

  • Is an additional audit required?

Signatures

  • Coordinator of Health Services

  • School Nurse

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