Procedure For Use Of Health Clinic Pass Schools With On Site HST Or Nurse
The following steps are designed to facilitate communication relating to a student’s visit to the health clinic with the parents / guardians and teachers. The School Board of Broward County Clinic Pass is to be completed for each clinic visit. The forms are to be distributed to the classrooms at the beginning of the school year and replenished as needed.
- When a student has a health complaint, the teacher / school representative is to complete the top portion of the School Board of Broward County Clinic Pass identifying the student name, date, time, date of birth, teacher name, grade, and reason for referral.
- When the student presents to the health clinic with a pass, the remainder of the pass is to be completed by the person assigned to the clinic. This person will document the time the student arrived, nature of the complaint, action(s) taken, disposition of the child, and time the student left the clinic. A check is to be placed in the appropriate boxes and the pass is to be signed by the person handling the clinic action(s).
- The top white copy remains in the clinic. The yellow copy is to be given to the student to take to his parent/guardian. In the event the student is returned to class, the yellow copy will be given to the student to present to the teacher. The teacher will review the copy and return to the student to take to his parent/guardian.
- All completed clinic passes should be kept in a locked cabinet in a secure place, preferably the school clinic.
- The clinic passes should be placed in the student’s Cumulative Health Folder by the end of the school year by a principal designee.
PROCEDURE FOR USE OF DAILY CLINIC LOG
The Daily Clinic Log is designed to collect data on students who visit the clinic. The information required is non-confidential.
- Start a new form for each day (some schools may need multiple pages per day)
- The name of the school, the name of the health room staff, and the date are to be completed at the top of each page.
- The staff person assigned to the clinic will enter the required information for each student encounter.
- For every student record the student’s time in, name, grade, gender and time out.
- Place the appropriate code reflecting the following: the visit type, health problem, outcome, procedure, injury location, services by provider, and referral in the boxes on the log. Refer to the Codes for Completing the Daily School Health Services Log to find the appropriate codes.
Note: This form is not to be used as a substitute for documentation of care provided.
PROCEDURE FOR USE OF STUDENT HEALTH RECORD
The Student Health Treatment Record is designed to be the form that school personnel (including contracted health personnel, e.g. Nurse, Health Support Technician, etc.) document information regarding student health issues. Such information would include:
- A summary of additional student physical findings that are not included on the School Board of Broward County Clinic Pass (see sample attached).
- Documentation of conversations/correspondence with students, parents, health care providers (see sample attached).
- Documentation of school actions in response to a school health issue (see sample attached).
The Student Health Treatment Record will be maintained with the students’ health records
- The Student Health Treatment Record should be kept in a locked cabinet in a secure place, preferably the school clinic.
- The Student Health Treatment Record should be placed in the student’s Cumulative Health Folder by the end of the school year by a principal designee.
All of the above forms can be located on the Coordinated Student Health Services web site. Go to www.browardschools.com. Choose Departments, Health Education, then Health Forms.
For more information contact Maureen O’Keeffe, RN Coordinated Student Health Services at