CLINIC MANAGEMENT

  • Nurse is properly identified as a registered nurse

  • Follow up with corrective action will be completed by:

  • Classroom is a non-hazardous environment. Free of spills, clear traffic pattern, neat, orderly and free of clutter

  • Follow up with corrective action will be completed by:

  • Supplies are easily accessible.

  • Follow up with corrective action will be completed by:

  • All equipment is state/district approved and in working order.

  • Follow up with corrective action will be completed by:

  • Blood Pressure Cuff Present (Adult and Pediatric)

  • Reister Automatic blood pressure machine w/ adult and child cuff present

  • Nonin PalmSAT handheld Pulse Oximeter w/adult and pediatric finger sensor present

  • Suction machine and tubing present

  • Mabis CompMist Compressor Nebulizer present

  • ThermoFocus Thermometer present

  • Otoscope present

  • Littman Stethoscope present

  • Sphygmomanometer medic kit 3 present

  • Adult and Pediatric ambu Bag present

  • First Aid supplies
    No expired supplies, verify by checking the bottles for expiration dates
    Only supplies approved by FBISD SPED Department are found in classroom.

CLINIC VISIT DOCUMENTATION

  • Accurate and complete documentation of assessments in electronic health record according to TAC 217.11

  • Follow up with corrective action will be completed by:

  • Accurate and complete documentation of interventions in electronic health record according to TAC 217.11

  • Follow up with corrective action will be completed by:

  • Accurate and complete documentation of response to interventions in electronic health record according to TAC 217.11

  • Follow up with corrective action will be completed by:

MEDICATION PROCEDURES

  • All medication orders are signed by the parent. Prescription medication orders or 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 requests are kept in a properly labeled binder and are readily accessible.

  • Follow up with corrected action will be completed by:

UNLICENSED ASSISTIVE PERSONNEL

  • Medication skills checklists are complete 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

  • DMMP current and signed by the parent and physician.

  • Follow up with corrective action will be completed by:

  • EMS - Extra copies of DMMP in labeled envelope for EMS personnel.

  • Follow up with corrective action will be completed by:

  • UDCA authorization present on DMMP or UDCA authorization form.

  • Follow up with corrective action will be completed by:

  • UDCA checklists completed and readily accessible.

  • Follow up with corrective action will be completed by:

  • Transportation plan complete if bus rider. Copy given to bus driver and transportation supervisor.

  • Follow up with corrective action will be completed by:

  • Emergency Action Plan (EAP) for each student completed as needed (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

  • Level 1 Anaphylaxis training completed and documented with epinephrine auto-injector and/or medication skills training checklist.

  • Follow up with corrective action will be completed by:

  • Level 2 (staff specific) Anaphylaxis training completed and documented with epinephrine auto-injector and review of Action Plan.

  • Follow up with corrective action will be completed by:

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

  • Follow up with corrective action will be completed by:

  • Epinephrine auto-injectors are kept in an 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 complete if bus rider. Copy given to bus driver and transportation supervisor.

  • Follow up with corrective action will be completed by:

SEIZURE CARE

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

  • Follow up with corrective action will be completed by:

  • Parent questionnaires, 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 complete if bus rider. Copy given to bus driver and transportation supervisor.

  • Follow up with corrective action will be completed by:

SPECIAL PROCEDURES

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

  • Follow up with corrected action will be completed by:

  • Special procedure skills checklists are complete 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 for students in classroom are 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 within 120 days of enrollment and documented in the electronic health record.

  • Follow up with corrected action will be completed by:

  • Scoliosis screenings completed by spring break for grades 6 and 9.

  • Follow up with corrected action will be completed by:

  • Acanthosis screenings completed.

  • Follow up with corrected action will be completed by:

  • Screening referrals documented in the electronic health record and follow-up completed or on schedule.

  • Follow up with corrected action will be completed by:

  • Self-audit of Hearing, Vision, and Spinal State Report 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:

HEALTH CONDITIONS AND INDIVIDUAL HEALTH PLANS (IHPs)

  • Skyward alert information has been updated/added, critical alert box checked if appropriate.

  • 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 nursing protocol.

  • Follow up with corrective action will be completed by:

  • Notification of need-to-know staff has been done 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:

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:
    First semester drill completed and documented. Date:

  • Follow up with corrective action will be completed by:

  • AED/Crisis Team DRILLS/TRAINING:
    Second semester drill completed/scheduled. Date:

  • Follow up with corrective action will be completed by:

  • Emergency cart is stocked, contents are unexpired, and readily accessible.

  • Follow up with corrected action will be completed by:

  • Emergency cart contents checklist complete and easily accessible.

  • Follow up with corrected action will be completed by:

  • Evacuation plan in place for students, medications, special procedures, and diabetes supplies/equipment.

  • Follow up with corrected action will be completed by:

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

  • Follow up with corrected action will be completed by:

SUBSTITUTE BINDER

  • SECTION 1: Campus Information

  • Follow up with corrective action will be completed by:

  • SECTION 2: & 3: Administrative Guidelines and Expectations for the Contract Nurse

  • Follow up with corrective action will be completed by:

  • SECTION 4: Medication Administration procedures

  • Follow up with corrective action will be completed by:

  • SECTION 5: Daily Medication List

  • Follow up with corrective action will be completed by:

  • SECTION 6: Daily Procedure List

  • Follow up with corrective action will be completed by:

  • SECTION 7: PRN Medication List

  • Follow up with corrective action will be completed by:

  • SECTION 8: Evacuation Plan

  • Follow up with corrective action will be completed by:

  • SECTION 9: Additional Forms

  • Follow up with corrective action will be completed by:

  • Section 10: Student Information

  • Follow up with corrective action will be completed by:

COMPREHENSIVE SCHOOL HEALTH PROGRAM

  • Classroom education done supporting health TEKS.

  • Professional development hours completed with content relevant to school nursing.

  • Special event/committee involvement?

  • Review of professional goals.

Signatures

  • Coordinator of Health Services

  • School Nurse

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