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Planning for Students with Special Health Care Needs

ObjectivesUpon completion of this lecture, you will

be better able to:• Develop an individualized health care plan for

students who have special medical needs• Develop an individualized emergency medical plan

for students who have special medical needs• Explain the importance of completing an emergency

information form for students who have chronic health conditions

• Understand and accommodate the provisions of Section 504 of the Rehabilitation Act of 1973

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Planning for Students with

Special Health Care Needs

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Plans and Forms

The following plans/forms should be created as appropriate and filed with the student health record

• Individualized Health Care Plan (IHCP)

• Individualized Emergency Medical Plan (IEMP)

• Emergency Information Form (EIF)

• 504 Plan

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INDIVIDUALIZED HEALTH CARE PLANS (IHCP)

• HISTORY• ASSESSMENT • NURSING DIAGNOSES• NURSING INTERVENTIONS• GOALS• EXPECTED OUTCOMES

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HISTORYREMEMBER THAT A

GOOD HISTORY STARTS WITH GOOD

QUESTIONS!!!!

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ASSESSMENT •Should include both subjective and objective information

•Should reflect the student’s medical diagnosis

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NURSING DIAGNOSES

• Use nursing diagnoses that correlate with the student’s needs to help organize the IHCP.

• Nursing diagnoses can help the school nurse create goals for the students

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NURSING INTERVENTIONS

•Goal-oriented•Focus on the

actions of the school nurse and how nursing services will be utilized

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GOALS•Should be written•Should be measurable

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EXPECTED OUTCOMES

• May be written for long–term or short-term use

• Outcomes should reflect the most desirable state for the student to achieve

• Write each outcome in a statement format

• Outcomes should be achievable

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INDIVIDUALIZED EMERGENCY MEDICAL

PLAN (IEMP)• Developed by the school nurse in

conjunction with parent/guardian and primary health care provider

• Can be used to train other staff• Available for immediate reference• Must be evaluated and revised

regularly

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IEMP SHOULD INCLUDE

• Step by step action for each presenting problem

• Chain of command for management in school

• Special precautions or adaptations for student

• Request for transport to the ED

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IEMPIT IS IMPORTANT TO REMEMBER THAT

AN IHCP IS NOT THE SAME AS AN IEMP!!!!

• An emergency care plan may be included in an IHCP

• An IEMP gives procedural guidelines on how to handle emergency and life-threatening incidents.

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DEVELOPING AND UTILIZING AN IEMP

• COLLECT INFORMATION• DEVELOP THE IEMP• REVIEW WITH PRINCIPAL • INSTRUCT STAFF ON IEMP• PROVIDE ACCESS TO THE IEMP• MONITOR PROGRESS OF EACH

STUDENT WITH AN IEMP

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504 PLANS AND ACCOMMODATIONSSTUDENTS ARE DEFINED AS DISABLED IF

THEY:– Have a physical or mental

impairment that impedes activities of daily living (ADL’s)

– Have a record of this impairment– Are regarded as having an

impairment as defined in Section 504

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WHAT TO INCLUDE IN 504 PLANS• A description of the reason for the concern• A description of the basis for determining

the disability• Details on how the disability affects ADL’s• Information on services, aids, and

accommodations necessary for student• Date for review and reassessment• All individuals involved with the plan

including the case manager

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Emergency Information Form

• Developed by the American Academy of Pediatrics (AAP) and the American College of Emergency Physicians (ACEP)

• Record of key baseline medical data for students with special healthcare needs

• Copies can be filed at home, school, primary care provider, ED, local EMS and anywhere the student spends time

• Requires review and updating on a regular basis• Copy of the 2-page form located in SNEC

manual and available via AAP and ACEP websites

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SUMMARYAn IHCP acts as a framework to help you maintain personalized

care instructions for students with special medical needs or disabilities.

An IEMP is an invaluable adjunct to the IHCP, with step by step instructions for student care during an emergency.

Implementation of a 504 plan is essential in ensuring compliance with the relevant provisions of the Rehabilitation Act of 1973

The EIF form provides a clear, consistent record of emergency information that can be filed with all care providers and in places where the student spends time

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ANY QUESTIONS??