Module A: Receiving Health-Related Services and Procedures in the School Setting

1
Module A Receiving Health-Related Services and
Procedures in the School Setting

• Identify laws that guide health-related services
  in school.
• Identify Services in schools designed to meet the
  needs of students who have significant health
  support needs.
• Describe topics regarding funding, new roles,
  training and liability.
• Recognize the process of developing a health care
  plan.
• Identify how to facilitate increased levels of
  participation.

2
Health Related Services and the Public Schools

• Students who were formerly institutionalized for
  health care and education are now receiving their
  health care and education during class hours in
  the public school setting.
• Health care is best provided in the school
  through assessment, planning, and monitoring by
  the family physician and the school nurse.
• Nurses may delegate tasks for which a license is
  required, to unlicensed persons, providing
  specific criteria are met.
• It is essential to have a health care plan for
  students with special health care needs.

3
Legal responsibilities

• Federal Legislation
• Rehabilitation Act of 1973 (PL 93-112)   We
  refer to this as Section 504. 
• Education of the Handicapped Act 1980 (PL
  94-142) The basis of special education as we
  know it.
• Individuals with Disabilities Education Act
  (IDEA) of 1990 (PL 101-476  The 2004
  reauthorization changed the actual name of the
  statute (Individuals with Disabilities Education
  Improvement Act of 2004 (PL 108-446)

4
Technology dependent

• Refers to those students who require devices or
  mechanical equipment to perform normal activities
  of daily living
• Respiration for breathing
• Urinary catheters for urination
• Feeding tubes for nourishment
• Wheelchairs and walkers for movement and
  ambulation
• Medications for the prevention of infections and
  maintenance of health.

5
Key elements and controversial issues

• Adequate Funding
• Availability of Appropriate Facilities
• New Roles and Responsibilities for School
  Personnel
• Lack of Appropriate Training
• Legal Liability Issues

6
Essential school services

• Mechanisms
• Facilities
• Equipment
• Services

7
Developing a health care plan

• Identification of a Student with Potential Health
  Needs
• Referral to the School Nurse
• Health Care Assessment
• Team Meeting to Develop the Students Health Care
  Plan
• Team Meeting to Make Decisions
• Regular Education and 504 Placement, or
• Referral to Special Education

8
Key points in the health care plan process

• Identifying Data
• Source of Medical Care
• Health Problems List
• Description of Illness and/or Condition
• Specific Precautions
• Health Care Treatment Plan
• Emergency Information
• Transportation Plan for Health Needs
• Re-evaluation Date

9
A functional approach to curriculum Instruction

• Skills are selected according to a specific
  target or ultimate goal needed by the student as
  he or she matures into adulthood.

10
Partial participation

• Individuals with Severe disabilities, regardless
  of their limited independence or level of
  functioning, should be permitted to participate
  at least partially in chronologically age-
  appropriate environments and activities.

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Steps of partial participation

• Modify the Environment
• Modify the Skill Sequence of the Task
• Adapt Materials
• Provide Personal Assistance

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Module B the roles of the school nurse and
paraeducator in health-related services

• Identify to role of the school nurse in
  health-related services.
• Identify the role of the paraeducator in
  health-related services.

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Remember.

• Only a school nurse can delegate.
• A delegated task can be withdrawn at any time by
  the school nurse.
• Documentation regarding the delegation is
  essential (who, what, when where and how).
• The school nurse must train the school personnel
  to do the delegated task and document the
  training.
• Medications given at school are included in the
  Delegatory Clause of the Nurse Practice Act.

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The school nurse must

• Delegate the task.
• Teach to master the task.
• Document the teaching and mastery of the task.
• Remember that he or she remains legally
  responsible whether or not the task is delegated.
• Recognize that some procedures cannot be
  delegated.

15
The paraeducator must

• Practice the designated task until completely
  comfortable with the task.
• Perform the task, as directed by the school
  nurse, with specific students.
• Document each time the task is performed as
  directed by the school nurse.

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Universal precautions

• Attending to Others
• Use a barrier when possible exposure to blood or
  bodily fluids.
• Bad soiled clothes.
• Bag waste and used gloves or barrier.
• Attending to the Environment.
• Use gloves to clean.
• Use disinfectant soaps
• Use disposable cleaning materials
• Disinfect affected area
• Secure waste in bag for disposal.
• Attending to Self
• Remove gloves and place in plastic bag.
• Immediately wash with disinfectant soap.

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Action guide for providing emergency care

• Assess the Situation
• Is the area safe for you?
• NO________________________________________YES
• Seek Help!
  _____________________
  
  
• 
  Assess the Student
• Is the
  student unconscious?
• Gently tap the
  student and ask, Are you O.K.?
• ____________________________________________
• Student is Unconscious
  Student is Conscious
• (Does not respond
  ( Responds)
• 
  
• __________________________
  _______
• If conscious and the
  If conscious and the
• situation is an emergency
  situation is not an emergency
• Activate the school emergency Protocol
  
• 
  _______________
• 
  

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Emergency priorities

• Remain calm.
• 2. Assess the situation.
• 3. Give immediate attention and call for
  emergency care and/or ambulance for the victims.
• 4. When immediate medical attention is
  indicated, call for emergency care. Otherwise,
  whenever possible, contact the parents first.
• 5. Under no circumstances should a sick or
  injured student be sent home without the
  knowledge and permission of the parent, guardian,
  or other responsible person.

19
Module C Functions of the Bodys Systems

• Identify body systems and symptoms that require
  referral to the school nurse.
• Identify guidelines related to infectious
  diseases in school-age children.

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The bodys systems

• Cardiovascular and Respiratory System
• Musculoskeletal System
• Skin and Hair System
• Digestive and Renal System
• Central and Peripheral Nervous System
• Immune System

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The cardiovascular and respiratory system

• Cardiovascular
• Pumps blood throughout the body.
• Respiratory
• Exchanges oxygen and carbon dioxide

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The musculoskeletal system

• Muscles
• Provide the body with strength and mobility.
• Skeletal
• Provides structure for the body and frame.

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The skin and hair system

• Protects body (barrier) and maintains warmth.

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The digestive and renal system

• Digestive
• Turns food and fluids into fuel for the body.
• Renal
• Maintains proper fluid levels for the body.

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The central and peripheral nervous system

• Controls overall body function, movement, and
  behavior.
• Sense of smell, taste, hearing, and feeling
  (touch) are connected to this system.

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The immune system

• Protects the body from disease.