Information
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Campus
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Campus Nurse
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Conducted on
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Prepared by
Comprehensive School Health Program
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School health office orderly and free of clutter.
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Equipment (audiometer, otoscope, scales, pulse ox, sphygmometer, thermometer, phone, computer) in working order
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Gloves are readily accessible in clinic.
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Visual inspection of Immunization Out of Compliance Report. Are all students compliant or in progress (notes of parent contact are present for students being considered for exclusion)?
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Visual inspection of Vision report. Is it correct/complete?
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Visual inspection of Hearing report. Is it correct/complete?
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Visual inspection of Spinal State report. Is it correct/complete?
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Visual inspection of AN report. Is it correct/complete in RFES?
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Audiometer monthly biological check offs done.
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Clinic stats reported every month.
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Records are bundled for shredding. Bundled records are shredded in a timely fashion (no excessive amounts of records overdue for shredding are present on campus).
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Special Procedure Orders are uploaded in Skyward under Medication
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Sharps container is securely stored and safely accessible when needed. Full Sharps need to be sent to ESC.
Health Conditions and Individual Health Plans
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IHPs include evidence of outcomes progress and goals being met (either in office visit or on IHP).
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Plan to communicate health needs to next nurse
Medication and Special Procedures. FFAC (legal and local)
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Monthly check offs of standing order medications is complete.
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Current Medication Opt out list is present in the medication cabinet and/or sub binder.
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Medication keys and medication cabinets are secured at at the time of the audit (visual inspection).
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Are controlled medications properly secured in a double locked cabinet?
Inventory of Controlled Medications
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Has an inventory sheet been implemented and performed weekly for each controlled medication on file in the clinic. Inventory reconciliation documents should be kept in the medication binder.
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Perform inventory check on meds. Medication counts are accurate.
Anaphylaxis
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Epinephrine auto-injectors are clearly labeled to allow for rapid identification.
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Epinephrine auto injectors are kept in an unlocked cabinet during the school day.
Emergency Preparedness
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Emergency care forms are printed and available to be quickly taken during an evacuation OR forms are saved to campus nurse laptop.
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Staff Emergency Numbers document printed and available to be quickly taken during an evacuation OR forms are saved to camppus nurse laptop.
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Emergency bag/cart is intact, readily accessible.
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Laptop power cord located in emergency go box.
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AED daily, monthly, annual check offs done.
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Campus Response Team training/drills held
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Door from office to clinic. What type of lock is on the door
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Plan in place for entry into locked clinic bathroom door.
- Slotted Lock- Coin available
- Keyed- Key needed to open- Add action item
Professional Nursing Practice
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Documentation of completed goal in Strive.
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Nurse is wearing name badge with credentials displayed.
Staff Signatures
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School Nurse
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Director of Health Services/Lead Nurse