Introduction
The Clinical Procedure Guidelines For Connecticut School Nurses (Clinical Guidelines) is the merger of the Connecticut State Department of Education’s Specialized Health Care Procedure Manual for School Nurses (1997) and Serving Students with Special Health Care Needs (1992). This updated document integrates valuable concepts identified in the previous manuals and offers a contemporary and practical format intended to assist school nurses in developing the procedural aspects of individualized health care plans for students with special health care needs and in providing task-specific training for other school personnel, when indicated. The Clinical Guidelines may also serve as a resource for other health professionals in schools, as well as school administrators, nurses, and other health professionals in early intervention programs. Information that addresses the procedures identified in this manual is intended to be used as a guideline in conjunction with:
- sound theoretical knowledge;
- medical research and evidence-based clinical references;
- collaboration with professional peers and expert consultants; and
- collaboration with students, educators, families and caregivers.
The procedural guidelines delineate the general steps of physical health care activities and must always be used in conjunction with fundamental principles, standards, and safe practices recognized as vital to working with children with special or complex health care needs. Those principles, standards, and practices are reviewed in chapters 1 and 2, and should form the basis for planning, implementing and evaluating all specialized health care services for students, along with the following considerations that are critical for quality health services in schools:
- collaboration between family; student; members of the school team, including the school medical adviser; and the student’s health care providers is essential to the development of an appropriate plan of care to successfully and safely meeting the health care needs of students;
- a primary focus of health services planning is the promotion of student competence and independence in self-care, consistent with their transition plans;
- recognition that each student and family has unique cultural, spiritual, economic, social, and educational factors and values that influence their approach to health care;
- school nurses (registered nurses) are specifically identified as the medical professionals for facilitating appropriate delegation of select components of health care procedures;
- implementation of health care in schools;
- school nurses or other health care professionals must make delegation decisions based on the health care status and needs of students, legal requirements within the State of Connecticut, and state and national standards for professional practice;
- school nurses and other health care professionals must be licensed, clinically knowledgeable and competent to provide the necessary care and, if supervising the licensed practical nurses (LPN) or delegating care and supervising unlicensed assistive personnel (UAP), ensure the competency of these individuals to perform the delegated or supervised health care activities;
- school nurses are responsible for maintaining the level of competency required to create plans and perform medical or other procedures. This may often require acquisition of new or updated skills and knowledge;
- school nurses should consult with the school medical adviser, as indicated, in the assessment, planning, implementation and evaluation process; and
- local and regional boards of education need to support the ongoing clinical competency development of school nurses.
Additional considerations include the often rapid advancement of medical technology and revisions of procedures based on newly integrated evidence-based research. These considerations must be taken into account when planning, implementing, and delegating health care procedures.