Information
-
Campus Clinic-Nurse
- L.D.Bell-Leigh Ann Alford
- Trinity-Julie Dowden
- Trinity "W" Building**
- Buinger CTE
- FEW/KEYS-Linda Gleason
- Bedford Junior High-Lisa Bick
- Central Junior High-Janet Helsel
- Central DLS Room
- Euless Junior High-Diana Fisher
- Harwood Junior High-Aryn McFatridge
- Hurst Junior High-Joy Keohane
- Bedford Heights-Beth Pullman
- Bellaire-Daisy Jackson
- Bell Manor-Debbie Robbins
- Donna Park-Laura Lester
- Harrison Lane-Ceacy McDonald
- Hurst Hills-Sonja Dreiling
- Lakewood-Linda Harvey
- Meadow Creek-Leslye Ammons
- Midway Park-Elizabeth Dressell
- North Euless-Christi Evartt
- Oakwood Terrace-Chidi Ogba
- River Trails-Mary Eastabrook
- Shady Brook-Andrea Richey
- Shady Oaks-Karen Giangrosso
- South Euless-Anne Yelvington
- Spring a Garden-Nancy Mapes
- Stonegate-Carla Cochran
- Viridian-Erin Moore
- West Hurst-Caroline Estes
- Wilshire-Amy York
-
Conducted on
-
Evaluation prepared by:
ROOM SETUP
-
Bulletin Board
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
-
Educational Information available/visible?
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
-
Well Organized?
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
-
Cleaner for cots available/used?
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
-
Adequate supplies available?
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
-
Lunch time schedules posted?
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
-
Voicemails Updated?
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
-
Bathroom key is easily accessible?
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
Substitute Information
-
Location:
-
Substitute Information is:<br>Organized?<br>Clear?<br>Easy to Understand?
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
-
Complete with list of "Alerts"?
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
Medication Storage and Administration
-
Medication secured in a locked cabinet?
-
Will have corrected by:
- 5 Work Days-1 Week
- 10 Work Days-2 Weeks
- 1 Month
-
Keys to medication secure? Duplicate set kept?
-
Will have corrected by:
-
Controlled substances count by RN documented?
-
Will have corrected by:
-
Rx label and Medication Authorization match?
-
Will have corrected by:
-
Any medications left in the clinic from last school year?
-
Will have corrected by:
-
Any expired medications on campus?
-
Will have corrected by:
-
Classroom medications secure and monitored weekly by RN?
-
Will have corrected by:
-
Any missing medications?
-
Protocol followed for missing medication?
-
Will have corrected by:
-
Epi-Pens accessible and clearly marked?
-
Will have corrected by:
Case Management SHARS
-
Monthly SHARS up to date and on Monthly Report by 5th working day of the month?
-
Will have corrected by:
-
Copies of SHARS filed?
-
Will have corrected by:
IHCP/Orders
-
EAP's complete with MD orders when appropriate?
-
Will have corrected by:
-
Diabetic IHCP's complete with MD orders and signatures complete?
-
Will have corrected by:
-
Seizure IHCP's complete with MD orders and signatures complete?
-
Will have corrected by:
-
Allergy/Anaphylaxis IHCP complete with orders and signatures complete?
-
Will have corrected by:
-
Epinephrine Delivery devices clearly marked in unlocked cabinet?
-
Will have corrected by:
-
Epi-Trainers REMOVED, clearly marked, and in another location?
-
Will have corrected by:
-
PEEP's (Personal Emergency Evacuation Plan) completed and signed?
-
Will have corrected by:
-
Medical procedure IHCP complete with MD orders and signature complete?
-
Will have corrected by:
-
Attend meetings as needed? (ARD's, 504, etc)
-
Will have corrected by:
Documentation of Competency for Staff
-
CPR Certified Staff-(at least 2 per campus)
-
Will have corrected by:
-
UDCA (Unlicensed Diabetic Care Assistant)<br>Full Time RN on campus=1 per campus minimum
-
Will have corrected by:
-
Medication Administration:2 per Campus
-
Will have completed by:
-
Special Procedures: (if needed)
-
Will have completed by:
-
All training forms are complete and have signatures for: UDCA's, Medication Adminstration Staff Members, and Special Procedures Staff.
-
Will have corrected by:
Medical Alert/Emergency Contact Information
-
Medical Alert list printed and acknowledged?
-
Will have corrected by:
-
New medical alerts entered and confirmed in Nurse Aid?
-
Will have corrected by:
-
Medical Conditions Information entered into Nurse Aid?
-
Will be corrected by:
Daily Log Documentation (review/Audit Nurse Aid)-Random**
Immunizations
-
Effective tracking system in place to monitor compliance of all students?
-
Will have corrected by:
-
Immunizations entered into E-school in a timely matter (2 weeks for new students)
-
Will have corrected by:
-
Process in place to deal with non-compliance of immunizations?
-
Will have corrected by:
Pregnant and Parenting students (Secondary)
-
Process in place to identify pregnant/parenting students (Notification of process to faculty/staff)
-
Will have corrected by:
-
RN refers students for necessary services
-
Will have corrected by:
-
RN provides prenatal/parenting education to students?
-
Will have corrected by:
-
RN provides regular follow-up with pregnant students
-
Will have corrected by:
-
RN collaborates with Homebound services?
-
Will have corrected by:
-
Completed case files are sent to PRS Coordinator after student returns to school or at the end of the school year?
-
Will have corrected by:
Campus Projects (Sports Physicals, Back to school, Presentations)
-
List:
Vision and Hearing
-
Copies of referrals available?
-
Will have corrected by:
-
Will have corrected by:
-
Nurse Aid data entry completed by April 1st?
-
Will have corrected by:
-
Monthly biological checks of audiometer documented and stored in audiometer ?
-
Will have corrected by:
Spinal Screening
-
2nd Semester Spinal screening completed by the end of March?
-
Will have completed by?
-
Are second semester referrals in progress (P) or completed by the end of March?
-
Nurse Aid data entry for Spinal Screening completed by April 1st?
-
Will have corrected by:
Acanthosis Nigricans Screening
-
1st semester AN screenings completed by end of December?
-
Will have corrected by:
-
1st Semester AN Referrals* in Progress (P) or Completed (C) by end of December?
-
Will have corrected by:
-
2nd Semester AN screenings done by the end of February?
-
Will have completed by:
-
2nd Semester AN Referrals* in Progress (P) or completed (C) by the end of February?
-
Will have corrected by:
-
ANTES Data* entry in progress (P) or completed (C) by April 1st?
-
Will have corrected by:
Risk Management
-
Accident and Incident reports completed per HEBISD protocol?
-
Will have completed by:
-
RN follows communicable disease protocols (% of absenteeism, TCHD reportable diseases, exclusion criteria)?
-
Will have corrected by:
-
Campus Concerns/Issues:
NOTES
-
Signature of RN/LVN:
-
Signature of Evaluator: