Information

  • Campus

  • Campus Nurse

  • Conducted on

  • Prepared by

Comprehensive School Health Program

  • School health office orderly and free of clutter.

  • Equipment (audiometer, otoscope, scales, pulse ox, sphygmometer, thermometer, phone, computer) in working order

  • Gloves are readily accessible in clinic.

  • 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)?

  • Visual inspection of Vision report. Is it correct/complete?

  • Visual inspection of Hearing report. Is it correct/complete?

  • Visual inspection of Spinal State report. Is it correct/complete?

  • Visual inspection of AN report. Is it correct/complete in RFES?

  • Audiometer monthly biological check offs done.

  • Clinic stats reported every month.

  • 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).

  • Special Procedure Orders are uploaded in Skyward under Medication

  • Sharps container is securely stored and safely accessible when needed. Full Sharps need to be sent to ESC.

Health Conditions and Individual Health Plans

  • IHPs include evidence of outcomes progress and goals being met (either in office visit or on IHP).

  • Plan to communicate health needs to next nurse

Medication and Special Procedures. FFAC (legal and local)

  • Monthly check offs of standing order medications is complete.

  • Current Medication Opt out list is present in the medication cabinet and/or sub binder.

  • Medication keys and medication cabinets are secured at at the time of the audit (visual inspection).

  • Are controlled medications properly secured in a double locked cabinet?

Inventory of Controlled Medications

  • 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.

  • Perform inventory check on meds. Medication counts are accurate.

Anaphylaxis

  • Epinephrine auto-injectors are clearly labeled to allow for rapid identification.

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

Emergency Preparedness

  • Emergency care forms are printed and available to be quickly taken during an evacuation OR forms are saved to campus nurse laptop.

  • Staff Emergency Numbers document printed and available to be quickly taken during an evacuation OR forms are saved to camppus nurse laptop.

  • Emergency bag/cart is intact, readily accessible.

  • Laptop power cord located in emergency go box.

  • AED daily, monthly, annual check offs done.

  • Campus Response Team training/drills held

  • Door from office to clinic. What type of lock is on the door

  • Plan in place for entry into locked clinic bathroom door.

Professional Nursing Practice

  • Documentation of completed goal in Strive.

  • Nurse is wearing name badge with credentials displayed.

Staff Signatures

  • School Nurse

  • Director of Health Services/Lead Nurse

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.