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Health and Nutrition Services Refresh Training

Get a refresher on health and nutrition services, including special diets, medications, community networking, and health screenings. Learn best practices and stay up-to-date with the latest information.

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Health and Nutrition Services Refresh Training

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  1. Health Nutrition Services Presents: HNS Refresher Training 8/17/2017

  2. 2016-2017 school Year Review:

  3. Routings and Referrals :

  4. Special Diets and Food Services • 164 Active Special Diets • 110 Medically Necessary • 54 Preference/Religious 1 Medically Necessary Special Diet = 40-60 Food Substitutions In the 2016-2017 School Year, the Food Services Team served on average 73,000 meals per month.

  5. Medications: • 137 Active Medication Plans • 92 Rescue Inhalers • 26 Epi-Pens • 6 Emergency Seizure Rx • 13 Other Rx LOT Numbers are collected and noted on the Quarterly Medication Checks

  6. Community Networking:

  7. Center visits: • Epi-pen Trainings • Asthma/ Inhaler Trainings • Seizure Trainings • Care Plan Staffing's • OAE and Sure Sight Screenings …rescreens. • Dental Treatment Visits (Translation) • Emotional Support (Oral Surgeries) • CACFP Monitoring • Child Plus Case Management • Home Visits • Center Intervention • Self- Assessment Site Visits • Parent Meeting Presentations • New Staff Orientation • New Staff HNS Trainings • Community Network Meetings: Lead Council, MDAC, Dental Networking

  8. Moving forward: https://brightfutures.aap.org/about/Pages/About.aspx

  9. Health Screenings • Hearing: Audiometer and Welch Allyn OAE Screener (HNS use only) • Vision: LEA Symbol Vision Screener and Sure Sight Vision Screener (HNS use Only) • Blood Pressure: Digital Wrist Cuff • Growth Assessment: Measuring Tape and Digital Scale

  10. http://www.infanthearing.org/videos/echo-pure-tone-hearing.htmlhttp://www.infanthearing.org/videos/echo-pure-tone-hearing.html Hearing: Hearing: • Before Testing: • Inspect your equipment, start by testing Audiometer @ 15 dB.If you can hear the tone on each side, the machine is working and you’re ready. • Visually inspect child’s ears. Do not test if you see any drainage or ear is irritated. • Set Frequency at 25 dB • Testing Procedure: • Explain instructions to child and do some practice runs … • For best results, screen in quiet area. Start with the RIGHT ear first. • Headset: Red / Right and Blue / Left. • You will be testing at : • Intensity:Tone: Frequency: • 25 dBPure/ Pulse/ Warble 1000, 2000, 3000, 4000 • Start frequency from 1000 thru 4000, Red / Right ear . • Continue on Blue / Left , frequency should start at 4000 thru 1000. Press on Tone for “One- Mississippi” count. • Give child option to respond by raising hand or putting object in container. Watch for visual cues.

  11. Warning Signs: • Speech is delayed. • Speech is not clear. • Does not follow directions. This sometimes is mistaken for not paying attention or just ignoring, but could be the result of a partial or complete hearing loss. • Often says, “Huh?” • Turns the TV volume up too high • See Policy and Procedures for guidance on when to refer to HNS Resource: https://www.cdc.gov/ncbddd/hearingloss/freematerials/JustInTimePostATRISKEnglish.pdf

  12. Vision: https://www.youtube.com/watch?v=jOoZ2cMOGmk • Measure 10 feet between chart and child. • Establish a method of communication such as naming or pointing. Decide with the child which names will be used to identify the symbols. Use Flash card kit. • Briefly point to the first symbol in each line and start with biggest symbol. • Move down until the child hesitates or misidentifies a symbol. • Move back up one line and ask the child to identify all the symbols on that line. • If the child identifies all symbols correctly go to the next line with smaller symbols and ask the child to identify all symbols on the line. • If the child skips a symbol ask the child to try again while briefly pointing to that symbol.

  13. A child with an amblyopic eye may typically skip symbols within a line of symbols. • Visual acuity is recorded as the last line on which at least 3 of the 5 symbols are identified correctly. • When tested at 3 meters (10 feet) the visual acuity value is found in the margin adjacent to that line. • After obtaining good response with binocular testing, proceed by testing each eye separately.

  14. Blood pressure: Warning Signs: • Eyes that are misaligned (look crossed, turn out, or don't focus together) • White or grayish white color in the pupil • Eyes that flutter quickly from side to side or up and down • Eye pain, itchiness, or discomfort reported by child. • Redness in either eye that doesn't go away in a few days • Pus or crust in either eye • Eyes that are always watery • Drooping eyelids • Eyes that often appear overly sensitive to light • See Policy and Procedures for guidance on when to refer to HNS https://www.healthychildren.org/English/health-issues/conditions/eyes/Pages/Warning-Signs-of-Vison-Problems-in-Children.aspx

  15. Blood Pressure: For best results refrain from screening child during recess, while child is upset or ill. Screen in quite calm area. Sit comfortably in a chair near flat surface. Place monitor on left wrist. Position wrist at heart level. Press START, refrain from talking of moving during reading. See Policy and Procedures for guidance on when to refer to HNS

  16. Height and Weight: • Remove the child’s shoes and any bulky clothing. • Have the child stand with feet flat, together, and against the wall. Make sure legs are straight, arms are at sides, and shoulders are level. • Make sure the child is looking straight ahead and that the line of sight is parallel with the floor. • Take the measurement while the child stands with head, shoulders, buttocks, and heels touching the flat surface (wall). (See illustration.) Depending on the overall body shape of the child, all points may not touch the wall. • Use a ruler to form a right angle with the wall and lower the headpiece until it firmly touches the crown of the head. • Make sure the measurer's eyes are at the same level as the headpiece. • Lightly mark where the bottom of the headpiece meets the wall. • Accurately record the height to the nearest 1/4 inch. • See Policy and Procedures for guidance on when to refer to HNS

  17. Parent Release of Confidential Information:

  18. Routings and Referrals: • LOC ID Codes (i.e. 1240D, 1230A, etc.) be sure to include with all routings and referrals. Required for special diets and medications. • Referrals: Send in documentation of efforts made to obtain missing or needed treatment. • Referrals: Make sure all signatures are present before sending to HNS. • Referrals: Send copy of Health insurance information. • Routings: Make sure that Site Supervisor initials. • Asthma Routings: Ensure that Parent consent form is complete, Parent and Physician must use same medication name. Emergency section must be complete.

  19. Health Documentation:

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