Program Highlights

  • Immunization banner received in previous school year for 95-100% compliance

  • Special program /nurse recognitions

  • Special event/committee involvement.

  • Participates in opportunities provided by community partners

  • Dental Projects

  • Project Saving Smiles

  • UT School of Dentistry

  • Vision Partnership(s)

  • Kids vision for life

  • UH School of Optometry

  • Immunization outreach

  • Referral to School based or mobile health care services

  • Others

Estimated Program Acuity

  • Number of students with an invasive procedure.

  • Number of students with a documented chronic health condition requiring daily management during school hours (note: reflected in #IHP, includes meds)

  • Number of students with a documented chronic health condition at risk for emergent care during school hours.(note: this number also reflected by # IHP but likely to be less than number above)

  • Asthma

  • Risk for anaphylaxis.

  • Diabetes

  • Seizure

  • Other

  • Estimated % of day spent on students with chronic or invasive procedures

  • Number of nurses on campus full time

Medication Procedures

  • There are at least 2 ways safe administration is addressed.

  • Follow up corrective action will be completed by

  • Photo ID

  • Student says his/her name.

  • Student says name of medication and/or color of pill.

  • If other, enter here

  • Medication label matches administration form and orders. This includes supplements/formula. (Note :medication error form required if indicated.)

  • Follow up corrective action will be completed by

  • Medication error form needed?

  • Medication requests signed by the parent and physician for each medication on hand.

  • Follow up corrective action will be completed by

  • Self-carry medication administration orders are complete for each designated student.

  • Follow up corrected action will be completed by:

  • Completed SHARS training.

  • Follow up with corrected action will be completed by:

  • Principal Medication Designation form is complete and easily accessible

  • Medication skills checklists complete for all designees (initial and return demonstrations documented).

  • Drug information is included in the medication book.

Case Management of Students with Chronic Health Conditions

  • IHP and Emergency Plan developed for each student.

  • Follow up with corrected action will be completed by:

  • Medical Alert and Conditions screen in Chancery updated for all identified students.

  • Follow up with corrected action will be completed by:

  • Training conducted and documented for use of emergency medication (I.e Diastat, asthma rescue meds, auto injector).

  • Follow up with corrected action will be completed by:

  • Completed search in Chancery for students with medical alert/condition

  • Follow up with corrected action will be completed by:

Case Management of students with special healthcare needs/ invasive procedures

  • Students enrolled who require invasive procedures

  • Skip to last question in this section

  • IHP completed and on file for each student.

  • Follow up with corrected action will be completed by:

  • Emergency plan on file for each student including evacuation procedures.

  • Follow up with corrected action will be completed by:

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

  • Follow up with corrected action will be completed by:

  • Treatment consent form completed for each student including parent and physician signature.






  • Follow up with corrected action will be completed by:

  • Training conducted with Back-up Nurse.

  • Follow up with corrected action will be completed by:

  • Name of back up school

  • Office and designated staff informed of how and when to activate back up procedures in absence of nurse.

  • Follow up with corrected action will be completed by:

  • Itinerant nurse request form available and easy to access.

  • Follow up with corrected action will be completed by:

  • Knowledgeable of whether or not there are procedures at designated back-up school.

  • Follow up with corrected action will be completed by:

Anaphylaxis

  • Students in this category?

  • Epinephrine auto injectors kept in an accessible cabinet during the school day.

  • Emergency plan on file for each student including transport of meds in case of evacuation

  • Follow up with corrected action will be completed by:

  • IHP completed and on file for each student, updated for current school year including progress toward goal (s).

  • Follow up with corrected action will be completed by:

  • Food Allergy Awareness (Level 1) training completed and documented.

  • Follow up with corrected action will be completed by:

  • Food allergy level 2 if training including avoidance of allergen and emergency plan

  • Follow up with corrective action by

  • Level 3 training to specific staff including administration of epinephrine

Diabetes Care

  • Students in this category?

  • Diabetes Management and Treatment Plan is current, signed by parent and physician.

  • Follow up with corrective action by

  • Follow up with corrected action will be completed by:

  • Emergency plan on file for each student including procedures in case of evacuation.

  • Follow up with corrected action will be completed by:

  • IHP completed and on file for each student, updated for current school year with in evidence of evaluation of progress

  • Follow up with corrected action will be completed by:

  • Level I Staff-specific training completed and documented including emergency plan

  • Follow up with corrected action will be completed by:

  • UDCA Principal Designation Form signed

  • Follow up with corrected action will be completed by:

  • Level II UDCA skills checklist completed (initial and return demonstrations documented).

  • Follow up with corrected action will be completed by:

Emergency Preparedness

  • Emergency care forms are printed and available to be quickly retrieved during an evacuation.

  • Follow up with corrected action will be completed by:

  • Evacuation plan in place for medications, special procedure supplies/equipment

  • Follow up with corrected action will be completed by:

  • Emergency bag is intact, readily accessible.

  • Follow up with corrected action will be completed by:

  • Crisis Team has been identified with at least 2 persons trained in CPR.

  • Follow up with corrected action will be completed by:

  • AED equipment current including unexpired pads and batteries as evidenced by checklist for each AED.

  • Follow up with corrected action will be completed by:

  • Location of AED

  • Location

  • AED
  • Wall mounted

  • Completes 911 report and follow up as needed. (Note:Retain on campus).

Substitutes

  • Medication administration binder available.

  • Follow up with corrected action will be completed by:

  • Current student health condition information is readily available.

  • Follow up with corrected action will be completed by:

  • Emergency procedures and contacts for campus.

  • Follow up with corrected action will be completed by:

  • Process for documentation clearly defined.

  • Follow up with corrected action will be completed by:

  • Location of special procedures, emergency supplies, diabetes supplies clearly labeled.

  • Follow up with corrected action will be completed by:

Professional Accountabilty

  • Years of experience in HISD

  • Licensure renewal date

  • Select date

  • Continuing nursing education hours current.

  • Vision/hearing re certification due before December.

  • Knowledgeable of department goals.

  • Follow up with corrected action will be completed by:

  • Established individual goals for current school year.

  • Follow up with corrected action will be completed by:

  • Completed ANTES training

  • Follow up with corrected action will be completed by:

  • Self-assessment of skill level for invasive procedures

  • Female cath

  • Male cath

  • G tube/button feeding

  • Trach suctioning

  • Vent care

  • Seizure management using Diastat

  • Seizure management using VNS

  • Anaphylaxis management using auto injector

  • Diabetes management

Clinic equipment and procedures

  • Clinic environment free of clutter with student appeal and easy access to supplies and materials.

  • Follow up with corrected action will be completed by:

  • Audiometer annual calibration current

  • Follow up with corrected action will be completed by:

  • Audiometer biological calibration current as evidenced by biological calibration documentation

  • Follow up with corrected action will be completed by:

  • Serial number

  • Audiometer
  • Enter name of model

  • Enter serial #

  • Audiometer properly labeled.

  • Follow up with corrected action will be completed by:

  • Age-appropriate vision screening tools as evidenced by required charts - no copies, no charts with serifs

  • Follow up with corrected action will be completed by:

  • Utilizes Chancery and HEALTH HMS reports to document clinic activities.

  • Follow up with corrected action will be completed by:

  • Reference materials accessible

  • Access to HMS website

  • Individualized Health plans

  • Health Services Handbook

  • Guidelines for Care of Student With Specialized Procedures

Communicable Disease Surveillance

  • Student documentation reflects appropriate assessment of communicable disease risk.

  • Follow up with corrected action will be completed by:

  • Utilizes influenza-like illness electronic submission as appropriate.

  • Follow up with corrected action will be completed by:

Comprehensive School Health Program

  • Greater than 90% of students compliant for immunizations based on review of Chancery report and RN feedback.

  • Process in place to monitor immunization compliance

  • Follow up with corrected action will be completed by:

  • Screening programs complete

  • Visual inspection of Hearing, Vision, and Spinal State report/s/planning is correct/complete /practical.

  • Follow up with corrected action will be completed by:

  • Vision screening follow up percentage

  • Hearing screening follow up percentage

  • Spinal screening follow up percentage

  • Acanthosis screening follow up percentage

  • Process in place to monitor screening referral and followup.

  • Follow up with corrected action will be completed by:

  • Growth and Development education conducted according to health TEKS.

  • Enter TEKS addressed and presentations offered.

  • Participates in student assessment and academic placement

  • Utilizes Easy IEP

  • Collects and analyzes health information

  • Attends ARD, presenting pertinent health information

  • Participates in 504 process, presenting pertinent health information

Signatures

  • Comments

  • Nurse Specialist, Health and Medical Services

  • Select date

  • School Nurse

  • Comments

  • Select date

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