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Foreword

2

Table of Contents

3

A. Overview of the School Health Services Program

6

A-1 Components of the School Health Services Program

7

A-2 Responsibilities

8

A-3 Chain of Command

9

A-4 Role of the School Nurse

10

B. DoDEA Policies, Regulations, and Instructions

11

B-1 Introduction

12

B-2 Child Abuse

12

B-3 Children with Disabilities

12

B-4 Health and Safety

12

B-5 Health Education

13

B-6 Immunizations

13

B-7 Support from Local Medical Treatment Facilities

13

B-8 Other Policies & Regulations

13

C. Professional and Legal Issues

14

C-1 Introduction

15

C-2 Ethics

15

C-3 Protection of Student Health Information

16

C-3-1 Related Federal Guidelines

16

C-3-2 Privacy Act Guidelines

17

C-3-3 Definitions of Student Health Records

18

C-3-4 Protecting Student Health Information

19

C-3-5 Guidelines for Disclosure of Student Health Information

20

C-3-6 Guidelines for Storage and Disposition of Student Health Information

21

C-4 Regulation of Nursing Practice

23

C-5 Delegation of Nursing Care

24

C-6 Liability and Malpractice Protection

26

C-7 Consent for Health Services

28

C-8 Documentation and Record Keeping

29

C-9 Child Abuse Reporting

31

C-10 Laws Relating to Children with Disabilities

33

C-11 Reference

34

D. Administration of the School Health Services Program

35

D-1 School Health Office Equipment and Supplies

37

D-1-1 School Health Equipment Office Supplies

37

D-1-2 Consumable Medical Supplies

37

D-1-3 First Aid Kits

38

D-2 The School Year at a Glance

39

D-2-1 Starting the School Year

39

D-2-2 Common Monthly Health Observances

40

D-2-3 End of School Year

42

D-3 School Health Records

43

D-3-1 Student Health History

43

D-3-2 Individual Health Plan

43

D-4 Incident Reports

44

D-4-1 Accident/Injury Reports

44

D-4-2 Serious Incident Reports

48

D-5 Evaluation of the School Health Program

48

D-6 Coverage of Two or More Schools or When the School Nurse is Unavailable

49

D-7 Home Visits

51

D-8 New School Nurse Information

51

D-8-1 Introduction to the Organization

51

D-8-2 Organizational Chart

52

D-8-3 Acclimation to the Military Structure

53

D-8-4 Introduction to School Nursing

53

D-8-5 School Health Services Manual

54

D-8-6 Chain of Command

54

D-8-7 Student Support Services

54

D-8-8 Relationship to Medical Treatment Facilities

54

D-8-9 Performance Standards

55

D-8-10 Professional Growth Plan

55

D-8-11 Position Description

56

D-8-12 State Licensure and Recertification for DoDEA

56

D-8-13 Continuing Education

56

D-8-14 Insurance and Liability

57

D-8-15 DoDEA Policies, Regulations and Instructions

57

D-8-16 Teacher and Parent Handbooks

57

D-8-17 School Nurse Resources

58

D-8-18 Computerized Database/Student Information System

60

E. The Health Education Program

62

E-1 Health Education

63

E-2 Reference

63

F. Health Services, Practices, and Procedures

64

F-1 Registration

66

F-2 Immunizations

66

F-2-1 Screening Immunization

66

F-2-2 Immunization Compliance

67

F-2-3 Immunization Exemption

68

F-2-4 Talking to Sponsors/Parents/Guardians About Immunizations

69

F-3 Medication Policy

70

F-3-1 Administrating Medications

70

F-3-2 Safe Administration of Medications

71

F-3-3 Standing Orders

72

F-3-4 Storage of Medications

72

F-3-5 Self-Administration of Medications by a Student

73

F-3-6 Administration of Medications on Study Trips/Sport Events

74

F-3-7 Medication Incidents

74

F-4 Office Visits, First Aid, and Emergencies

75

F-4-1 Procedures for Illness and Minor Injury

75

F-4-2 Emergency Medical Care/First Aid

76

F-4-2-1 AED

77

F-4-3 Emergency Plans

78

F-5 Universal Precautions

78

F-5-1 General Information

78

F-5-2 School Nurse Role

79

F-5-3 Universal Precautions

79

F-6 Health Screening Procedures

79

F-6-1 Observation and Referral

79

F-6-2 Screening Program

80

F-6-3 Prior to Screening Students

80

F-6-4 Notifying Sponsors/Parents/Guardians of Screening Referrals

81

F-6-5 Follow-up

81

F-6-6 Vision Screening

81

F-6-7 Hearing Screening

83

F-6-8 Height/Weight/Body Mass Index

86

F-6-9 Postural Screening

88

F-6-10 Dental Screening and Preventative Care

91

F-6-11 Blood Pressure Screening

92

F-7 Child Abuse and Neglect

93

F-8 The School Nurse’s Role: Children with Disabilities

93

F-9 Substance Abuse

94

F-9-1 Substance Abuse Education

94

F-9-2 Substance Abuse-Medical Emergency, Non-Emergency, Suspected Chronic Abuse

94

F-9-3 Children of Alcoholics and Other At-risk Students

95

F-10 Crisis Intervention

95

F-11 Adolescent Health Issues

95

F-11-1 Confidentiality

95

F-11-2 Contraception

96

F-11-3 Pregnancy

96

F-11-4 Sexually Transmitted Diseases

97

F-12 Non-RN Substitute Coverage in the School Health Office

97

F-13 Volunteers in the School Health Office

100

F-14 Food Allergy Management

101

F-15 Reference

102

G. Specific Illnesses and Injuries

103

G-1 Clinical Guidelines

104

G-1-1 Communicable Disease Control

104

G-1-2 Pediculosis Protocol

104

G-1-3 Hand Hygiene

106

G-1-4 First Aid and Emergency Care

107

G-1-4-1 Basic Wound Care

107

G-1-4-2 Anaphylaxis Protocol

107

G-1-4-2-1 Anaphylaxis Protocol – Known

108

G-1-4-2-2 Anaphylaxis Protocol - Unknown

109

G-1-4-3 Head Injury Protocol

109

G-2 Resources

113

H. Health Forms (Link to Volume II)

114

I. Information Sheets

115

I-1 Childhood Immunization Information

116

I-2 Professional Library

117

I-3 Communicable Disease List and Reference

118

I-4 Substitute School Nurse Folder

121

I-5 Non-Nurse Substitutes Guidelines

122

I-6 Teacher Folder

124

I-7 Rights of Medication Administration

125

I-8 Safe Administration of Medications Guidelines

126

I-9 Medical Emergency Procedures

128

I-10 Study Trip First Aid

130

I-11 Anaphylaxis, What School Personnel Need Know

131

I-12 Asthma, What School Personnel Need Know

132

I-13 Concussion, What School Personnel Need Know

133

I-14 Diabetes, What School Personnel Need Know

134

I-15 Pediculosis, What School Personnel Need Know

135

I-16 Seizures, What School Personnel Need Know

136