School Health Manual Vol 111

Page 1

SchoolHealthManualIII

TheMedicalDepartmentisappreciativeofthecontributionsfromthefollowingcommittee members:MicahBradley-Freeman,MSN,RN,CSN,PamelaKelly,MSN,MBA,BSN-RN, CSN,RithaBlain,MBA,BSN-RN,CSN,TaniaC.Connors,BSN,RN,CSN,Theresa Chukumba,MSN,BSN-RN,CSN,NgoziUbahMMD,BSN,CSN

TableofContents

TableofContents

ChildStudyEvaluation

CleanIntermittentCatheterization

CommunicableDisease

Handwashing

ConvulsiveDisorders

DiabetesManagement

Documentation

IncidentReportingStaff

IncidentReportingPupil

MedicalHomeInstruction

Medication

OxygenAdministrationviaTracheostomyCollar

PhysicalExamination

Routine Sports

RecordDisposal

Registration

RegulationofMedicalWasteInstructions

Screenings

SpecialNeeds

StandardProceduresforFirstAidTreatmentintheTrentonPublicSchools

SubstanceAbuse

TickRemoval

TrachealSuctioning

Transfers

WithintheDistrict

OutofDistrict

OutofState/Country

Forms

1

ChildStudyEvaluation

Policies

Regulations

5310HealthServices(8.d)

2412HomeInstructionDuetoHealthCondition

5200Attendance

5305HealthServicesPersonnel

2460.1SpecialEducation-Location,Identification,Referral

5600StudentCodeofConduct

2412HomeInstructionDuetoHealthCondition

2418Section504oftheRehabilitationActof1973-Students

2417StudentInterventionandReferralServices

Content/Resources

ChildStudyEvaluationReferralProcedures

FillableCSTReferral(NurseCompletePg5)

GrowthCharts:Boys,Girls

OnlineGrowthChartCalculator

Referralfor504AssistancePDF

CleanIntermittentCatheterization

Regulations

Resources

7420HandlingandDisposalofBodyWastesandFluids

CleanIntermittentCatheterizationProcedure

HC-01ParentAuthorizationforSpecializedPhysicalHealthCare

CC-01CleanIntermittentCathRecord

HC-04SpecializedPhysicalHealthCareProcedureDocumentation CICMales/CICFemales

2

CommunicableDisease

Policies

Handwashing

Regulations

8451ControlofCommunicableDisease

5305HealthServicesPersonnel

5320Immunizations

8453HIV

8451ControlofCommunicableDisease

5200Attendance

Content/Resources

CommunicableDiseaseProcedure

InfectiousDiseaseFlowchart

SH-07HeadLice/NitsNotice

NJDOHAdministratorReportingRequirements

N.J.A.C.57-1.5

HealthDeptForms

TrentonHealthDepartmentContactInfo

NJDOHCommunicableDiseaseGuidelines

NJDOHSchoolExclusionList

PromotingHealthandLearning:SchoolNursingPracticeinNew Jersey'sPublicSchools,Chapter4

NJImmunizationRequirements

Policies

Resources

8505WellnessPolicy

CDCHandHygieneHealthySchools

NJDOHHandwashingMaterial

3

ConvulsiveDisorders

Policies

Regulations

5530.05SeizureActionPlan

8441CareofInjuredandIllPersons

Content/Resources

ConvulsiveDisorder-GeneralProcedure

CD-01ConvulsionDisorderPupilConferenceSheet

CD-02SeizureActivityLog

CD-03ConvulsiveDisorder-P.E./PoolParticipationForm

CD-03AConvulsiveDisorder-P.E./PoolParticipation(NoMD)

CD-04TeacherActionPlan

SeizureActionPlan

CDCHealthSchools-epilepsy

CDCSeizureFirstAid

SchoolsandSeizurePrep-EpilepsyFoundation

APASeizureManagementinSchools

SpecialHealthCareNeeds:EmergencyPlan

DiabetesManagement

Policies

Regulations

5338 DiabetesManagement(M)

5310 HealthServices(M)

DocumentationonPolicy5338

5338 DiabetesManagement(M)

DocumentationonRegulation5338

CDCHealthPromotion/HandHygieneMaterials
4

Documentation

Content/Resources with Links

NJDOESchoolHealthServices

TPSDiabeticStudentProtocol

DiabeticLogSheet

DiabetesPupilConferenceSheet

TeacherActionPlan-Hypoglycemia

Hypo-HyperglycemiaSymptoms

TeacherActionPlan-Hyperglycemia

NJDOESchoolHealthServices

Powerpoint:CareOfStudentsWith DiabetesInNJPS

FrequentlyAskedQuestions

Powerpoint:DiabetesCareTasks

AdministeringGlucagon

FDAApprovesNasalGlucagonBASQSIMI

QuickReferenceEmergencyPlanForAStudentWithDiabetes

QuickReference(GENERAL)

ActionSteps

SampleDiabetesMedicalManagementPlanAndIHP

AimForAHealthyWeight

Policies

5308StudentHealthRecord

Regulations

5308PupilHealthRecords

Content/Resources

DocumentationProcedure

HowtoDescribeSignsandSymptoms

MD-03DailyNursingAssessment/TreatmentLog

IncidentReportingStaff

Policies

3159

TeachingStaffMember/SchoolDistrictReporting 5

Regulations

Responsibilities(Revised June27,2022)

4159 SupportStaffMember/SchoolDistrictReporting Responsibilities

5612 AssaultsonDistrictBoardofEducationMembersor

Employees(M)(Revised: 17Oct2022)

8442 ReportingAccidents

8461 ReportingViolence,Vandalism,Harassment, Intimidation,Bullying,Alcohol,AndOtherDrug Abuse(M)

1581 DomesticViolence(Revised28February2022)

1581 DomesticViolence(Adopted: 27March2023)

3362 SexualHarassmentOfTeachingStaffMembers

ComplaintProcedure

4352 SexualHarassment(M)

3159 TeachingStaffMember/SchoolDistrictReporting Responsibilities(Revised: 27June2022)

4159 SupportStaffMember/SchoolDistrictReporting Responsibilities

Content/ResourcesWithLinks

Accident/IncidentReportProcedure-Employees

DirectionToRobertwoodJohnson OfHamilton

WorkersCompensationIntakeLetter

NJSIGInstructionsForReportingNewWorkers' CompensationClaims

WorkersCompensationIntakePosterSpanish

IfYouGotHurtOnAJobForm

WorkersCompensationIntakeProcess

WorkersCompensationBusinessCards

WorkersCompensationBusinessCardSpanish

MitchellScript-WorkersCompensationFirstFill

EmployeeAccidentReportForm

ProceduresForReportingAccidents

6

IncidentReportingPupil

Policies

SupervisoryReportOfEmployeeInjuryOrIllness

WitnessStatementReportOfInjury/Illness

WorkplaceSafety...YourRole

AccidentIncidentReportingStaff

Regulations

8461ReportingViolence,Vandalism,Harassment,Intimidation, Bullying,AlcoholAndOtherDrugAbuse(M)

5519DatingViolenceAtSchool(M)

5512Harassment,Intimidation,AndBullying(M)(Edited: November2022)

5331 ManagementOfLife-ThreateningAllergiesInSchools(M)

8442ReportingAccidents

8462ReportingPotentiallyMissingOrAbusedChildren(M) (Revised. 27June2022)

5613RemovalOfStudentsForAssaultsWithWeaponsoffenses (M)(Revised:17Oct.2022)

8451ControlOfCommunicableDisease(M)

5512Harassment,IntimidationOrBullyingInvestigation Procedure(M)

5519DatingViolenceAtSchool(M)

5331ManagementOfLife-ThreateningAllergiesInSchools(M)

8451ControlOfCommunicableDisease(M)

8461ReportingViolence,Vandalism,Harassment,Intimidation, Bullying,Alcohol,AndOtherDrugAbuse(M)

8462 ReportingPotentiallyMissingOrAbusedChildren(M)

8467 Weapons(M) Content/Resources

Accident/IncidentReportingProcedure-Pupil 7

MedicalHomeInstruction

Policies

2412 HomeInstructionDuetoHealthCondition

2481HomeOrOut-of-SchoolInstructionForGeneral

EducationPupils

Regulations

2412-HomeInstructionDuetoHealthCondition

2481-HomeorOut-of-SchoolInstructionforaGeneral

EducationStudentsforReasonsOtherThanaTemporaryor

ChronicHealthCondition

Content/Resources

MedicalHomeInstructionProcedure

MedicalHomeInstructionForm

ReleaseFromMedicalHomeInstruction

Medication

Policies

5330AdministrationOfMedication

5331ManagementofLife-threateningAllergiesinSchool

Regulations

5330AdministrationOfMedication

5331ManagementofLife-threateningAllergiesinSchool

Content/Resources

MR-01DailyMedicationRequestForm

Self-AdministrationofMedicationInformationalLetter

MR-02Self-AdministrationofMedicationRequestForm

MR-03NoticetoRemoveMedicationFromHealthOffice

EM-26MedicalPupilIncidentReport
8

MR-04InformationRequest

MR-05MedicationRefillRequest

M-01DailyMedicationList–RedBinder

M-02DailyMedicationAdministration

M-04PRNMedicationList-RedBinder

M-03PRNMedicationAdministrationRecord

MC-01MedicationCount

EmergencyMedicationAdministration:

HC-06AllergicEmergencyEpinephrineCarePlan

HC-07RequestforEmergencyAdministrationofEpinephrineby DesignatedIndividual

HC-08EpinephrineAuto-InjectorTrainingChecklist

HC-09Epi-penandEpi-penJr InjectionDirections

HC-10EmergencyTelephoneProcedure

FoodAllergiesActionPlan

AsthmaActionPlan

AsthmaActionPlan

MeteredDoseInhalerProcedure

NebulizedMedicationProcedure

SpecialHealthCareNeeds:EmergencyPlan

OxygenAdministrationviaTracheostomyCollar

Content/Resources

OxygenAdministrationViaTracheostomyCollar

9

PhysicalExamination

Routine Policies

5310HealthServices

Content/Resources

StudentMedicalExaminationProcedure

UniversalHealthChildRecord

WorkingPapers

Sports

Policies

Regulations

2431AthleticCompetition

2431.2MedicalExaminationPriortoParticipationona

School-SponsoredInterscholasticorIntramuralTeamorSquad

Content/Resources

SportsPhysicalProcedure

SP-1StudentRequestforParticipationinSports

SP-4ApprovalForParticipationinSports

AthleticSportPackettoParticipate

SportsTransferPacket.pdf

RecordDisposal

Policies

Regulations

8350RecordsRetention

8330PupilRecords

10

Contents/Resources

InstructionsforDisposalForm11

DocumentDestructionRequest

PublicRecordsDisasterResponseforGovernmentAgencies

Registration

Policies

Regulations

5112EntranceAge

5111EligibilityofResident/NonresidentPupils

Content/Resources

RegistrationProcedure

SH-1HealthEnrollmentConsent/NotificationForm

SH-2PupilHealthHistory

SF-6EmergencyIllnessForm

UniversalChildHealthRecord

SH-2AStudentHealthHistoryTrentonCentralHigh

School/TNGA/DaylightTwilight

NJImmunizationRequirements

OnlineRegistrationSteps

RegistrationforK-12

RegulationofMedicalWasteInstructions

Policies

Regulations

7420 HygienicManagement

7420HandlingandDisposalofBodyWastesandFluids

Content/Resources

RegulatedMedicalWasteProcedure

11

Screenings

Policies

Regulations

5310HealthServices

5310HealthServices

Content/Resources

StudentHealthScreeningsProcedure

ColorDeficiency

EM-39HealthScreeningFollowUpdocumentation

EM-38ReferralForm

SpecialNeeds

Content/Resources

SpecialNeedsProcedure

SH-9SpecialHealthNeedsStudentList(canbegeneratedthrough PowerSchool)

SH-10SpecialHealthNeedsTeacherSign-off

StandardProceduresforFirstAidTreatmentintheTrentonPublicSchools Policies 8441CareofInjuredorIllPersons Regulations 7430SchoolSafety 8441CareofInjuredorIllPersons Content/Resources StandardProceduresforFirstAidTreatmentintheTrenton PublicSchools ChokingPDF EM-38ReferralForm 12

SubstanceAbuse

Policies

5530SubstanceAbuse/Use

5533StudentSmoking

8441Careofinjured&illPersons

5770PupilRightofPrivacy(searchpupilpossessions)

8461REPORTINGVIOLENCE,VANDALISM,HARASSMENT, INTIMIDATION,BULLYING,ALCOHOL,ANDOTHERDRUG ABUSE(M)

Regulations

5530SubstanceAbuse

5600StudentCodeofConduct

9320CooperationwithLawEnforcementAgencies

3280LiabilityforStudentWelfare

Content/Resources

SubstanceAbuseProcedures

TBOEDrugScreeningForm

TickRemoval

Content/Resources

TickRemovalProcedure

EM-05TickRemovalNotificationForm

EM-06LymeDiseaseTickAlert

TrachealSuctioning

Content/Resources

TrachealSuctioningProcedures

13

HC-01ParentAuthorizationforSpecializedPhysicalHealthCare

HC-04SpecializedPhysicalHealthCareProcedureDocumentation

Transfers

WithintheDistrict

TransferofPupilHealthRecordsWithintheDistrictProcedure

R-01/R-02Admissions/WithdrawalsTransferForms

R-03RequestforHealthRecords

OfficeofSchoolHealthServicesRE:TransferofStudentRecords

OutofDistrict

TransferofPupilHealthRecordsOutofDistrictWithintheState ofNewJersey

OutofState/Country

Forms

TransferofPupilHealthRecordsOutofState/Country

WelcomeLetterfromtheOfficeofSchoolHealthServices

A-01HealthOfficePass

CC-01CleanIntermittentCathRecord

CD-01ConvulsionDisorderPupilConferenceSheet

14

CD-02SeizureActivityLog

CD-03ConvulsiveDisorder-P.E./PoolParticipationForm

CD-03AConvulsiveDisorder-P.E./PoolParticipation(NoMD)

CD-04TeacherActionPlan

D-01DentistReferralForm

DI-01DiabetesPupilConferenceSheet

DI-02DiabeticLogSheet

DI-03TeacherActionPlan-Hypoglycemia

DI-04TeacherActionPlan-Hyperglycemia

TBOEDrugScreeningForm

EM-01EyeInjuryForm

EM-02WoundInformationNotice

EM-03HeadInjuryNotice

EM-04InjuryNotice

EM-05TickRemovalNotificationForm

EM-06LymeDiseaseTickAlert

EM-07VisittotheNurseNotice

EM-38ReferralForm

EM-39Follow-upofFailedHealthScreening

EM-42OutdatedEmergencyInformation

EmployeeAccidentReportForm

FillableCSTReferral(NurseCompletePg5)

HC-01ParentAuthorizationforSpecializedPhysicalHealthCare

HC-03OxygenSafetyPrecautions

HC-04SpecializedPhysicalHealthCareProcedureDocumentation

HC-05GrowthNoticetoParent/Guardian

15

HC-06AllergicEpinephrineEmergencyCarePlan

HC-07RequestforEmergencyAdministrationofEpinephrineby DesignatedIndividual

HC-08EpinephrineAuto-InjectorTrainingChecklist

HC-09 EpinephrineAuto-InjectorDirections

HI-01MedicalHomeInstructionForm

HI-02ReleaseFromMedicalHomeInstruction

I-06ImmunizationDeficiencyNotice

SF-6EmergencyIllnessForm

SH-1HealthEnrollmentConsent/NotificationForm

SH-2PupilHealthHistory

SH-2AStudentHealthHistoryTrentonCentralHigh

SH-3CReleaseofHealthInformation

SH-04PhysicalExaminationDeficiencyNotice

SH-07HeadLice/NitsNotice

SH-08HeadLice/NitsParentInformation

SH-08SHeadLice/NitsParentInformationSpanish

SH-9SpecialHealthNeedsStudentList

SH-10SpecialHealthNeedsTeacherSign-off

SP-1StudentRequestforParticipationinSports

SP-4ApprovalForParticipationinSports

AthleticSportPackettoParticipate

SportsTransferPacket.pdf

M-01DailyMedicationList–RedBinder

M-02DailyMedicationAdministration

M-03PRNMedicationAdministrationRecord

M-04PRNMedicationList-RedBinder

16

MD-01ISITAMEDICALEMERGENCY?

MD-03DailyNursingAssessment/TreatmentLog

MC-01MedicationCount

MR-01DailyMedicationRequestForm

MR-02Self-AdministrationofMedicationRequestForm

MR-03NoticetoRemoveMedicationFromHealthOffice

MR-04InformationRequest

MR-05MedicationRefillRequest

PC-1CyesisInformation(Pregnancy)

PC-2Post-PartumInformation

R-01TransferForm-Admission

R-02TransferForm-Withdrawal

R-03RequestforHealthRecords

Referralfor504AssistancePDF

UniversalChildHealthRecord

17

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