Module A:Module A: Receiving Health-Receiving Health-Related Services and Procedures Related Services and Procedures

in the School Settingin the School Setting

•Identify laws that guide health-related Identify laws that guide health-related services in school.services in school.

•Identify Services in schools designed to meet Identify Services in schools designed to meet the needs of students who have significant the needs of students who have significant

health support needs.health support needs.•Describe topics regarding funding, new roles, Describe topics regarding funding, new roles,

training and liability.training and liability.•Recognize the process of developing a health Recognize the process of developing a health

care plan.care plan.•Identify how to facilitate increased levels of Identify how to facilitate increased levels of

participation.participation.

Health Related Services and the Health Related Services and the Public SchoolsPublic 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.

Legal responsibilitiesLegal 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)

Technology dependentTechnology dependentRefers 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.

Key elements and controversial Key elements and controversial issuesissues

• Adequate Funding

• Availability of Appropriate Facilities

• New Roles and Responsibilities for School Personnel

• Lack of Appropriate Training

• Legal Liability Issues

Essential school servicesEssential school services

• Mechanisms

• Facilities

• Equipment

• Services

Developing a health care planDeveloping 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 Student’s Health Care Plan

• Team Meeting to Make Decisions:Regular Education and 504 Placement, or

Referral to Special Education

Key points in the health care plan Key points in the health care plan processprocess

• 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

A functional approach to A functional approach to curriculum Instructioncurriculum Instruction

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

Partial participationPartial 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.

Steps of partial participationSteps of partial participation

• Modify the Environment

• Modify the Skill Sequence of the Task

• Adapt Materials

• Provide Personal Assistance

Module B:Module B: the roles of the the roles of the school nurse and paraeducator in school nurse and paraeducator in

health-related serviceshealth-related services

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

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

Remember…….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.

The school nurse must…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.

The paraeducator must…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.

Universal precautionsUniversal precautionsAttending 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.

Action guide for providing emergency careAction guide for providing emergency careAssess 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 | _______________ | | Look at the student from head to toe Check vital signs (pulse and respiration) Consult the school’s treatment plan Follow school’s parental notification guidelines

Emergency prioritiesEmergency priorities

1. 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.

Module C:Module C: Functions of Functions of the Body’s Systemsthe Body’s Systems

• Identify body systems and symptoms that require referral to the school nurse.

• Identify guidelines related to infectious diseases in school-age children.

The body’s systemsThe body’s systems

• Cardiovascular and Respiratory System

• Musculoskeletal System

• Skin and Hair System

• Digestive and Renal System

• Central and Peripheral Nervous System

• Immune System

The cardiovascular and respiratory The cardiovascular and respiratory systemsystem

Cardiovascular• Pumps blood throughout the body.

Respiratory• Exchanges oxygen and carbon dioxide

The musculoskeletal systemThe musculoskeletal system

Muscles• Provide the body with strength and

mobility.

Skeletal• Provides structure for the body and frame.

The skin and hair systemThe skin and hair system

• Protects body (barrier) and maintains warmth.

The digestive and renal systemThe digestive and renal systemDigestive• Turns food and fluids into fuel for the

body.

Renal• Maintains proper fluid levels for the body.

The central and peripheral The central and peripheral nervous systemnervous system

• Controls overall body function, movement, and behavior.

• Sense of smell, taste, hearing, and feeling (touch) are connected to this system.

The immune systemThe immune system

• Protects the body from disease.