Health Policies andProcedures Handbook

2021-2022

Revised: August 2021

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TABLE OF CONTENTS

Introduction 3

General Procedures 4Infirmary Documentation 4Infirmary Reports 4Students sent to their homes 4Students sent to the hospital 5Annual Medical Exams 5First aid kits 6

Administration of medication and utilization of medical equipment 7Unused or expired medication 9Infirmary Attention Protocol 10Protocol for the delivery and notification of justified disabilities and absences 11Protocol for the transfer of a student to a health center 12Protocol for the administration of medication during the school day 13Protocol for the management of Annual Medical Exams (Enrollment) 13Protocol for the absence of a sick student after a bimestral exam or school activity 14Infirmary Attention Protocol during MACC 14

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Introduction

This handbook provides an orientation to health personnel, teachers, administrators andstaff members in the practice of school Infirmary at Marymount School Barranquilla. Itincludes the roles of the school nurse and doctor, procedures for releasing ill or injuredstudents; emergency response; medication administration and utilization of medicalequipment; appropriate delegation of care; and sample forms. This handbook is updatedannually to assure that the school community has the most current information andresources.

School Nursing, as a specialized field of Nursing, protects and promotes the health ofstudents and staff members and facilitates optimal development. School Nurses, groundedin ethical and evidence-based practice, are the leaders who bridge health care andeducation, provide care coordination, advocate for quality student-centered care, andcollaborate to design systems that allow individuals and communities to develop their fullpotential.

With this handbook we aim to optimize student and employee health and learning, byadvancing the practice of school nursing as well as for our community to rely on a healthyand safe school environment.

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General Procedures

Healthcare for students and staff members who become sick or injured at school, is theresponsibility of the school personnel and an integral part of the health services providedby the school. It is fundamental that, in case of any accident or illness treatment plan thatthe school personnel be responsible for:

● providing immediate care● notification to the student’s parent / guardian● arranging for disposition and / or transportation to the nearest first aid room, home

or hospital● guiding parent/guardian, when necessary, to sources of care

Note: At least one staff member per section, in addition to the school’s health personnel,should be trained to provide first-aid.

Infirmary DocumentationThe school nurse must document the following in the infirmary log for students under hercare: Name, grade level, time in/time out, chief complaint, treatment, back to class, senthome, and parent contact information.

Infirmary ReportsEvery Bimester the school nurse must send an infirmary report to the MSS Head to informan overall of the provided services to students, identify common care reasons andrecommendations for Section Directors.MSS Head shares this report with Section Directors in order to implement suggestedrecommendations.

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Students sent to their homesIt is advisable to send an ill or injured student home when:

● The illness or injury does not allow them to continue comfortably in the schoolactivities.

● Students need special medical services.● Parents consider it necessary to get the student home.

When a student needs home care, every effort is made to have the parent/guardian (or ifunable to do so, the person designated as emergency contact) come to school to pick upthe student. A student who is ill or injured may not be sent home without a parent/guardian.(see Nursing Care Protocol pg. 10)

Students sent to the hospital

It is advisable to send an ill or injured student or staff member to a hospital emergencyroom when determined necessary in any case in which:

● The parent / guardian and other responsible people concerned with the incidentagree that the illness or injury is not compatible with home care.

● The parent / guardian of a student whose condition apparently demands promptmedical care cannot be located within a reasonable time.

Extreme emergencies may demand immediate action without preliminary attempts tolocate responsible adults; however, these adults are to be notified as promptly as possible.

Note: No ill or injured student is to be allowed to go to the hospital without beingaccompanied by a member of the school staff in the absence of a parent or guardian. (Seeprotocol for the transfer of a student to a health center pg. 12)

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Annual Medical ExamsAnnually, during the enrollment process, parents are asked to update the student's medicalinformation. In addition, Preschool and Elementary School students are asked to send theirvision and audiometry exams.These exams are reviewed by the medical staff and the speech therapist of the school. Ifany anomaly is identified in a student, it is immediately reported to the counselor so thatshe can communicate with the parents and do the respective follow-up.

First aid kitsIn order to promote the safety and well-being of the community in all its surroundings, wehave distributed First Aid Kits on campus in order to attend to emergency situations whilethe person is transferred to the infirmary point, or while the health personnel arrive toprovide care. There is a rigorous protocol that allows monitoring of the medications in eachfirst aid kit.

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Administration of medication and utilization ofmedical equipment

Ideally, the administration of medication or utilization of equipment should take place athome. However, students or staff members with health problems may require medication,or other types of equipment in order to allow them to function as close to a normal level atschool. Consequently, a need exists to provide these services to those individuals whorequire them to make it possible for them to remain in school.

This procedure applies only to medication, equipment, or machinery necessary to keep theindividual at school, as prescribed by the family health care provider. MarymountBarranquilla DOES NOT DIAGNOSE HEALTH CONDITIONS OR PRESCRIBEMEDICATION TREATMENT TO ANY INDIVIDUALS.

No medication or treatment will be administered at School to the students without acompleted prescription and a signed parent's authorization form. According to theColombian Health Ministry, Resolution 1403 of 2007, a person who is 14 years old or olderhas the right to refuse medication. In such cases, the medication will not be given. This actwill be documented, and the parent will be notified. The prescription must include the fullname of the student, doctor’s name, signature, medical seal, medical registry number,telephone number, the name of the medication(s), the dosage(s) and the frequency.

The School health personnel will provide instruction for administration of medication or useof equipment to the school staff who have direct involvement with the student. All approvedrequests will expire on June 30th of each academic year or whenever a change in dosageor type of equipment is requested. This procedure must be carried out in its entirety everyyear.

Note: A written order, by a physician, on a prescription or letterhead is acceptable for achange of dose or equipment.

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Criteria

The following criteria have been established as a basis for consideration of requestsfor administration of medication at School:

● The purpose of the medication is to enable the student to function well at school.● Medication must be prescribed by a qualified healthcare provider through

prescription.● Written parental approval is required.● The parent will provide the medication.● The equipment/machinery must be prescribed by a qualified healthcare

provider through prescription.● Operating instructions must accompany equipment.

Note: See Protocol for the administration of medications during the school day pg. 13

Student self-Administration of medication withsupervision

In specific cases, students will be allowed to be directly responsible for the administrationof their medication with supervision of the health specialist: Nurse and/ or Doctor (thisperson will be the one who keeps the medication). This will occur after approval of theparents and family health care provider.

The student must demonstrate the ability to:● Identify his/her medication.● Sign the medication sheet as acknowledgment for having taken the

medication/treatment.● Demonstrate a cooperative attitude in all aspects and be punctual in arriving for and

taking the medication.

Parents must sign a medication authorization format for this purpose.

● Specific Medication authorization Format● Authorization for medicine administration during school hours

Note: Emergency rescue inhalers, EpiPens and glucagon can be used without priorapproval of the school nurse.

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Unused or expired medicationStudents medication:Unused or expired medication must be returned to the parents for disposition.The school nurse should:

● Contact and ask the parent to pick up the medication in person, or send writtenauthorization with a responsible adult in lieu of the parent.

● Record the date, time, amount, and type of medication being sent home on thehealth record.

Note: If the parent or authorized responsible adult does not pick up medication within 10days of notification, the School Nurse shall destroy / discard unused or expired portions.

Infirmary Inventory:Note: Any medication in stock that expires will be taken down from the shelf and put inplastic bags and will be put in the waste disposal facilities.

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Protocols

Protocolo de atención de enfermería1. The student informs the teacher or person in charge about his/her symptoms and

requests permission to go to the Infirmary.2. In Elementary School, the teacher or the person in charge of the group completes

and signs the nurse pass with the required information.The High School students go to the Section Principal’s office to confirm theircondition and get approval for the transfer to the Infirmary.Note: If the High School student is not able to walk, the Principal’s Assistant willcommunicate with the Infirmary to request the nurse to come to the patient and offerFirst Aid services.

3. The student goes to the Infirmary and hands the nurse pass. The health staff entersthe student information into the Nurse Attendance Registry and writes the student’stime of arrival in the Infirmary format.

4. The student is examined and the complexity of the situation is determined:a. Mild condition (Headache, scratches, stomach ache, dizziness, mild hits,

among others): The necessary care is offered. Once the need is met, thestudent goes back to his/her group.

b. Intermediate condition (Vomits, fever, ear infection, cold symptoms andcough, stomach pain, among others.): First aid is offered at the Infirmary andparents or guardians are contacted so that the students get picked up andtaken to the family physician or the pertinent professional.

c. Emergencies (Fractures, injuries that require stitches and/or presentbleeding, cardiac arrest, failure to breath, poisoning, among others.): Theambulance transfer service (AMI - tel: 3532911), the parent or guardian andthe Principal’s office are contacted to inform them of the situation. In case theparent or guardian can’t make it to the school, a representative of the schoolwill accompany the student until the parent or guardian can get there.

5. Once the student is directed to the type of attention required, Infirmary format isfilled out with the student departure time, signature and seal. Once the situation isidentified, the following procedures might take place:

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● Go back to school activities: The student hands the nurse pass to the teacheror the person in charge of the group when entering the classroom.

● Absence: The student hands the nurse pass (the comment that the studentwill be picked up is added) to the teacher or the person in charge. Thestudent picks up his/her belongings and goes back to the Infirmary. Once thestudent is picked up, the exit slip is handed to him/her, which should be givenat the gatehouse upon leaving the premises. If the student is not able to pickup his/her belongings, a call is placed to the Section Principal’s office so thathis/her things can be taken to the Infirmary.

● Immediate transfer: The Section Principal’s office is notified so that thestudent belongings can be taken to the Infirmary as soon as possible. TheInfirmary will inform the gatehouse about the ambulance arrival and thestudent exit.

Note:● Medication will only be given to those students who have the authorization form

filled out and signed by the parent or guardian.● There are umbrellas in the Elementary and High School buildings in case of mild

rain. When rain is on the forecast, the Doctor will go to the High School building andwill be at the First Aid spot, and the Nurse will go to the Elementary School buildingand will offer First Aid at the First Aid spot.

Protocol for the delivery and notification of justifieddisabilities and absencesOnce a student is absent from school due to sickness or health reasons, he/she should fillout the corresponding disability format or certificate of assistance to a medicalappointment.

1. The student should bring the document to the office with a legible name andgrade before 9am.

2. The Area Secretary should keep the documentation in the student file thatshould be sent to the Infirmary every day at 9 am.

3. Once the documentation gets to the Infirmary, the Nurse will notify the interestedparties via email keeping in mind the following:✔ The disabilities or permissions for 1 or 2 days will be notified to the class

teacher and the Section Principal.

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✔ When this is for 3 or more days, all grade teachers will be informed aswell as the Section Principal.

✔ In case of disabilities, excuses and authorizations related to sports thePE teachers, class teacher and Section Principal will be notified.

4. The information is registered in the Disabilities Report shared with each AreaSecretary and the documentation is filed in each student’s file at the Infirmary.

Note:

▪ Disabilities or authorizations that arrive after 9 am will be notified the next day oftheir arrival.

▪ In case of having an electronic document, it should be sent via email to the followingoptions:infirmary@marymountbq.edu.coinfirmary.ps@marymountbq.edu.coadriana.montenegro@marymountbq.edu.co

Protocol for the transfer of a student to a health center

1. Call the parent or guardian and notify them that the student needs to be transferredto a health center. The AMI service is offered (if the parent does not accept thenhe/she is responsible for the transfer of the student).

2. The emergency system is activated by calling the AMI line 353-2911.3. If the health personnel of the school considers that the situation of the student

requires immediate transfer with the help of AMI, a staff member (first option is theassistant teacher and as a second option the Section Principal’s Assistant. In thecase of MACC, the first option is the Administrative Assistant and the second optionis the Sports Coordinator) will accompany the student to the hospital until the parentor guardian arrives at the place.Note: The school must provide return transportation for the staff member back to theschool.

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Protocol for the administration of medication during theschool dayIn case a student requires medication during the school day, he/she should:

1. Fill out the Authorization format for the administration of medicine during the schoolday signed by the parent or guardian as well as the medical prescription.

2. For 1st - 3rd grade students, the health personnel will go to the classrooms at thetime of the medication and will give it to the students.

3. For students from 4th - 6th grade it is arranged accordingly with the medicationschedule. HS students should go to the Infirmary to get their medication.

4. Once the student takes the medication he/she should sign the format Daily Controlof Medication.

NOTE:-The students that can take the medication under the supervision of a caregiver or MSSstaff member, agree to meet with the person in charge in the meeting spot assigned to takethe medication.-The students with allergies who require to receive medication should fill out the documentEmergency Attention Protocol in Case of Allergic Reactions

Protocol for the management of Annual Medical Exams(Enrollment)

1. The Academic Secretary receives the medical exams at the moment of enrollmentand sends them to the Infirmary, duly labelled with the name of the student andgrade level.

2. At the Infirmary they are sorted by grade.3. The digital database Medical Exams is updated with the results obtained for each

student.4. The Nurse flags those students that present changes in their results5. The Nurse informs the professionals in charge (Speech Therapists, Counselors or

Doctor), so that they can issue recommendations for the students and they shouldbe in charge of keeping track of the progress follow-up of the student.

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6. The Nurse shares the recommendations with the counselors from each section sothat they can support in the follow-up process.

7. The Nurse files the information at the Infirmary.

Protocol for the absence of a sick student after abimestral exam or school activity

In the case a student has serious health problems and only goes to school to takebimestral exams or another school activity and then goes back home:

1. The parent or guardian should send an email or formal note where it is notified thatthe student will be picked up, with the information of the person picking up thestudent. If possible, attach the copy of disability or medical certificate.

2. Once the student is done with the exam or activity, the student must pick up his/herbelongings and head to the Infirmary.

3. Once he/she gets to the Infirmary, the parent or guardian is notified via telephonethat the student is ready to be picked up.

4. The exit permission is signed and the gatehouse is notified that the student will bepicked up.

5. The parent or person assigned should go into the Infirmary to pick up the student.

Infirmary Attention Protocol during MACC1. Identify the student presenting the calamity:

● Mild condition (the student is able to move): The trainer or person in chargeof the group should move him/her to the infirmary located in the coliseum.

● Moderate condition (the student is NOT able to move): The trainer or personin charge should inform the doctor/nurse so that he/she can go to the locationwhere the student is.

2. The health staff in charge examines the student and determines the complexity:● Mild condition (mild hits, scratches, mild injuries, among others): The

necessary care is offered. Once the need is met, the student goes back tohis/her normal activities.

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● Emergencies (fractures, open fractures, injuries that require stitches,bleeding that is hard to control, loss of consciousness, cardiac arrest, amongothers): The health staff in charge contacts the ambulance service (AMI), theparent or guardian and the Section office to inform about the situation. Incase the parent or guardian can’t get to the school, a representative of theschool will accompany the student until the parent or guardian gets to theplace.The health staff in charge should let the gatekeeper know about theambulance entry and the location of the school where it should go.

●

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