How to Complete a Health Care Plan

1. How to Complete a Health Care Plan TUTORIAL

3. This tutorial …. will walk you though the Health Care Planning process as described in the policy

4. Who needs a Health Care Plan? Any student who requires routine or as needed health care interventions performed or assisted by school personnel must have a written health care plan, as described in Policy JHC. This includes administration of medication (including an EpiPen®), response to seizures, assisting with blood glucose monitoring, gastrostomy feeding, catheterizing, and other interventions.

5. Who typically needs a HCP … The very young Those with developmental disabilities &/or physical disabilities that prevent them from accomplishing their personal care independently Those with health conditions that may at times mean they are not able to manage their own care (e.g. seizures, low blood sugar emergencies, anaphylaxis)

6. The most common health care interventions requiring a health care plan are … Administration of medication (including inhalers) Administration of an adrenaline autoinjector (EpiPen®) Response to seizures Administration of S.L. lorazepam (rescue medication for seizures) Cathererization Gastrostomy feeding & care Blood glucose monitoring And there are others …

7. Remember ... Students who are completely independent in providing their own health care interventions do not require a health care plan. However, if school staff play any role in supporting health care interventions, such as storing medication, a plan is required. Some students are completely independent performing their health care interventions but should still have an emergency response plan; i.e. a written plan describing how to recognize and respond to an urgent situation.

8. Remember ... Students who have Life-threatening allergy and do not bring an EpiPen to school do not qualify for URIS support and therefore do not require a health care plan. Students who have Asthma and do not bring an inhaler/medication to school do not qualify for URIS support and therefore do not require a health care plan. The students with health related needs that are not supported by URIS are supported by the school emergency response plan.

9. Health Care Plan forms … Can be downloaded from the Special Health Care in School website. The following slides will guide you through completing the forms.

10. URIS Group B Application This form documents that the parents have asked for assistance with a health concern and provides authorization to access medical information The parents should complete this form annually Please don’t fill it in for the parent unless it is not possible for the parent to do so.

11. Consent for Exchange of Information The URIS Group B applicaion documents that the parent(s) gives permission for the school to contact the doctor(s), nurses and other community professionals if necessary. The second page on the form has a space to enable identification of the physician.

12. Medical Assessment form Once the URIS Group B application is signed, the school can FAX or mail the Medical Assessment Form to the doctor and expedite the health care planning process. Some parents do not wish to give permission for school staff to contact their doctor. In this case the parent must return the completed Medical Assessment Form before the health care planning process can begin.

13. Medical Assessment Form

14. Medical Assessment Form … This form is completed by the doctor. According to the Privacy of Information Act, the doctor must have parent/guardian permission before releasing any personal health information to a school or other person. Therefore, if the parent isn’t taking the form directly to the doctor, a copy of the signed URIS Group B application form must accompany the Medical Assessment Form sent/FAX’d to the doctor.

15. Medical Assessment form … As a courtesy to the doctor, schools are asked to complete the STUDENT IDENTIFICATION and PHYSICIAN IDENTIFICATION sections on page 1 of the 2 page form. Schools can also complete the “return instructions” at the end of page 2.

16. The Health Care Plan

17. The Health Care Plan (HCP) … Typical questions about HCP’s: Who writes it? Who maintains it? Who has access to it? The HCP is a functional tool – focused on needs – not on tasks. It contains instructions about what to do, when intervention is required, how to recognize when a problem arises, and forms to record what has been done and by whom. Those responsible for recognizing signs of distress and implementing health care interventions need access to the HCP.

18. The Health Care Plan … HCP’s for Oral medication administration, Life-threatening allergies and Asthma have standard forms available. More complex plans will be completed collaboratively between the student/family/guardian, the school & Nurse Educator. Completing and maintaining a HCP is Teamwork.

19. Medication Administration The administrative rule JHC-R(1) Administering Medication to Students must be followed. Students requiring routine (non-urgent) medication at school are not qualified for support under URIS.

20. Medication Administration at School Divisional policy has been revised (Spring 2006) to reflect the changes implemented by URIS. Three forms have been developed in response to practice within the divisional schools. Authorization for Exchange of Informaiton (for the purpose of medication administration) Authorization for the administration of prescribed medication (less than or equal to 14 days duration) Authorization for the self-adminstration of prescribed medication

21. Asthma Students with Asthma who bring their medication to school will require a standard health care plan completed. Parents should be given the form to fill out annually/or a copy of the previous years to initial if no changes A copy of the HCP needs to be forwarded to the Nurse Educator for review.

22. Life-Threatening allergies Students with LTA who bring an EpiPen to school will need a Standard health care plan completed. The parent/guardian completes the form annually A copy of the HCP will be forwarded to the Nurse Educator for review

23. Teamwork … Who is on the team? The child and parents/guardian School administrators, resource teachers, classroom teachers, teacher assistants Health care professionals (including the Division Nurse Educator) & community agencies

24. The key to successful health care planning is … Collaboration Communication Following the HCP Informing team members when there is a change in the status/condition of the child

25. Documentation forms Health care interventions e.g. giving medication, catheterization or gastrostomy feeding a student, must be documented each time it is done. There are a couple of different forms that can be used. Select the form most appropriate to your situation.

26. Daily Record of Health Care Interventions This form is best used when there are many health care interventions routinely performed each day, such as catheterization or gastrostomy feedings

27. Medication Record This form is used to document the administration of individual medications If a student receives two different medications at school, each medication must be documented on a different record.

28. Other forms… Other Health related forms exist to help answer the question; “What next?” Now that we have the health care plan… Sample letters exist to request more information about Life-threatening allergies (LTA) and request support in reducing the allergen from the student’s environment Permission for the display of Photo and Health Information in staff accessible locations

29. That’s how its done! Contact Kerry Heather, WSD Nurse Educator at Prince Charles ERC @ 788-0203 ext.135 to help with your students with special health care needs at school.