Excerpted from Chapter 3 of Children and Youth Assisted by Medical Technology in Educational Settings: Guidelines for Care, Second Edition, edited by Stephanie Porter, M.S.N., R.N., Marilynn Haynie, M.D., Timaree Bierle, B.S.N., R.N., Terry Heintz Caldwell, Ed.D., & Judith S. Palfrey, M.D.

Copyright © 1997 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

The following list provides steps for families and health care and school personnel to assist in the implementation, monitoring, and evaluation of a student with special health care needs in school:

1. Provide direct care as appropriate or supervise student’s health care provider(s). In some cases, the school nurse or another competent licensed nurse will provide the health care services delineated in the student’s IHCP. When care is delegated to unlicensed personnel, the school nurse supervises the student’s health care provider(s).
   
   
2. Update assessment of the student’s health status annually. Doctor’s orders and prescriptions for health care services in the school should be reviewed at least annually; some may need review every 3 months. For many students with special health care needs, periodic visits to the physician are common. Any change in the health status of a child and/or health care procedures should be reported to the school nurse and will require new physician’s orders. Reporting procedures will need to be established in the initial stages of school entry/reentry.
   
   
3. Update and evaluate student’s IHCP. The student’s IHCP should be reviewed at least yearly. Based on changes in the student’s condition, reassessment and revision of the health care plan may need to be done more frequently.
   
   
4. Document, review, and update skills training. There are many reasons to document health care services. Documentation provides a clear understanding of required health care needs, indicates the time and date that health care has been provided, indicates any problems observed, assists in answering questions or concerns of parents or health care providers, provides evidence of risk management, and provides information to school administrators as to number of students needing health care procedures in school.

The team reviews and updates the child’s IHCP and IEP at specified intervals and as necessary. This process helps prevent and manage problems and helps identify the need to modify an existing program. Team review provides the opportunity to assess whether the services are being delivered as planned and whether the plan is effective.

People responsible for the school-based health care of students with special health care needs benefit from continuing education opportunities to improve and maintain their knowledge and skills. In addition, care providers need to learn new approaches and techniques, which are developed and updated every year.