Integrating Health Care and Educational Programs

Chapter 9

IntroductionStudents with severe and multiple disabilities often have medical conditions and special health care needs.

Medical conditions

– Asthma– Pressure sores– Skin irritation– Dehydration– Anemia– Respiratory infections

Health care needs

– Feeding tubes– Catheters– Colostomy care– Tracheotomy suctioning

Introduction

It is important for teachers to understand these needs in order to:

understand how the illnesses can affect performance

know what to do if an emergency occurs monitor and intervene early.adapt appropriately

Maintain a Safe, Healthy Environment for all Students

Injury PreventionA. Keeping aisles clear (fall/trip hazard)B. Avoid animals in classroom (asthma)C. Avoid flashing lights (seizure

disorders)

Follow universal precautionsto prevent the spread of infection

A. Hand Washing• Teach students how and when to wash hands

B. Use personal protective equipment (PPE)• Masks and gloves

C. Follow proper decontamination proceduresD. Use personal hygiene precautionsE. Dispose of bodily fluids properly

Evacuation PlansA. From ClassroomB. Other areasC. Practice, practice, practice

Basic first aid, CPR

Common Medical Conditions

Nutritional deficits and anemia Causes: anything that will affect

receipt or absorption of nutrients Treatment and Prevention: • early detection, • balanced meals, • foods prepared for ease of chewing

and swallowing.

Dehydration Causes: insufficient fluid intake;

diarrhea, vomiting Treatment and Prevention: • Do the skin check• Regular fluid intake

Skin Irritation Causes: prolonged contact with sweat,

urine, feces Treatment and Prevention: • Thorough skin cleaning

Pressure Sores Causes: continuous pressure on bony

areas from lack of movement• Concerns: what we see is small

compared to the amount of damage below the surface!

Pressure Sores Treatment and Prevention: • Shift weight every 10-15 minutes• Do not allow students to sit in

wheelchair > 2 hours• Good skin care• Regular inspections

Ear Infections Signs – rubbing ears, hearing loss, ear

ache, banging head

Contractures Shortening of muscle fibers resulting from

limited movement. Causes a decrease in range of motion Prevention: PT/OT; range of motion

exercises, bracing equipment, activity!

Respiratory Infections Causes– build up of mucus in lungs due to weak

coughs, poor drainage Treatment and Prevention:

Aerosol therapy Postural draining Percussion Suctioning Regular exercise Infection control: cover cough; send sick

students home

Common Medications

Reference Table 9.1 in text – page 391.

Provides common drugs, uses and side effects.

Be familiar with what your students take!

Guidelines:Have permissionOriginal bottlesCheck expiration datesStore correctly and safely

Administering Medications:Have a policy in place for:

WHO can administer HOW training will occurPreventing medication errors

1. Right Drug2. Right Student3. Right Dose4. Right Route5. Right Time

Know possible side effects and what to do!

Teach students the how, when and why about their medication.

Common Health Care Procedures

Schools are mandated to provide services.WHO provides the service in the school is directed by the individual state’s

Nurse Practice Act, Regulations, school policies, team decisions.

Training If unlicensed (non-RN) are to perform

the procedures, appropriate training must occur with periodic monitoring/ supervision.

More than one individual trained!

Common Procedures:Tube Feeding (button or NG tube)Clean Intermittent Catheterization

Individualized Health Care Plan:Provides detailed information on the

student’s medical condition, and specific way in which it will be addressed.

ONE plan per procedure.When appropriate, include objectives for

the student to become responsible for their own self care.Include both an instructional plan and

task analysis.

Impact of Disabilities on Health and School Performance

Motor and sensory limitationsRestricted communicationFatigue and endurance limitationsGeneral health issuesExperiential deficitsNeurocognitive impairmentsPsychosocial and environmental factors

WORKING AS A TEAMTo manage effectively, school, home an medical personnel must work closely together.

COMMUNICATION!