Annual South Carolina School Health LPN of the Year Award ( )

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1 Annual Suth Carlina Schl Health LPN f the Year Award ( ) The SC Schl Health LPN f the Year Award is presented annually by the SC Department f Health and Envirnmental Cntrl and the SC Department f Educatin t publicly recgnize the utstanding cntributins f a Licensed Practical Nurse (LPN) prviding schl health services in ur state. Nminatrs may nminate mre than ne LPN fr this award, but nt mre than ne LPN frm the same schl district. T nminate an LPN fr this award: 1. Read the Nminatin Prcess Overview and the Nminatin Packet Requirements n the fllwing pages. Pay clse attentin t the Eligibility Criteria and the Weighting Factrs. 2. Cmplete and submit Nminatin Packet Requirements (Parts 1, 2, 3 and 4) by Nvember 15, Submit the riginal and five (5) cpies f yur nminatin packet fr distributin t the Selectin Cmmittee by Nvember 15, 2017 t: Victria Ladd State Schl Nurse Cnsultant SC DHEC Divisin f Children s Health Mills/Jarrett Cmplex 2100 Bull Street Clumbia, SC Nte: Yur submissin must be hand-delivered r pstmarked n r befre Nvember 15, If yu have any questins r cncerns, please cntact Fran Bne at

2 ANNUAL SOUTH CAROLINA SCHOOL HEALTH LPN OF THE YEAR AWARD ( ) Nminatin Prcess Overview I. Purpse: T annually select and publicly recgnize a Licensed Practical Nurse (LPN) prviding health services in a schl in Suth Carlina fr her/his utstanding cntributins in the field f schl nursing. II. Eligibility Criteria: A. Nminee: LPN currently emplyed t wrk full time in a schl setting in Suth Carlina. Cnsistently demnstrates utstanding cmmitment, cmpetence and cmpassin in the prvisin f schl health services. Minimum f three years experience in schl nursing. Previus nminatin des nt preclude re-nminatin. Past recipients may nt be re-nminated. Nminee agrees that infrmatin submitted is accurate as evidenced by signature n the Nminatin Cver Page. B. Nminatin Packet Full cmpletin and submissin f Parts 1, 2, 3 and 4 f the nminatin packet. Nminatin supprted by a principal at a schl that the LPN serves as evidenced by signature n the Nminatin Cver Page. Nminatin supprted by an RN r LPN currently practicing schl nursing in Suth Carlina as evidenced by signature n the Nminatin Cver Page. An LPN may cmplete her/his wn nminatin packet; hwever, must secure the supprt f anther schl nurse (RN r LPN) practicing in Suth Carlina t serve as the nminatr n the Nminatin Cver Page. Nminatin submissin includes the riginal and five (5) cpies f the nminatin packet. Nminatin packet and cpies hand-delivered r pstmarked n r befre Nvember 15, III. Selectin Prcess: A. Nminatin instructins and frms will be distributed t nurses practicing in schl settings. B. All cmplete nminatin packets received r pstmarked n r befre the deadline date f Nvember 15, 2017 will be cnsidered fr the award. C. A Selectin Cmmittee will be appinted by the State Schl Nurse Cnsultant. The Selectin Cmmittee will cnsist f five LPNs wh practice in a schl setting in Suth Carlina. If LPNs cannt be recruited fr the Selectin Cmmittee, RNs wh practice in a schl setting in Suth Carlina may serve n the Selectin Cmmittee. D. All cmplete nminatin packets will be distributed t the Selectin Cmmittee. E. The Selectin Cmmittee members, acting with cmplete regard fr cnfidentiality, will individually evaluate the nminatin packets based n the eligibility and weighting criteria nted in sectins II and IV belw. Each

3 Selectin Cmmittee member will select her/his chice fr the Schl Health LPN f the Year, and return the name f the selected candidate t the State Schl Nurse Cnsultant. F. The State Schl Nurse Cnsultant will wrk with the Schl Nurse Cnference Planning Cmmittee t tally the results and finalize plans fr presenting the award at the Annual Schl Nurse Cnference. G. The nminee wh receives the mst vtes will be named Schl Health LPN f the Year. H. The decisin f the Cmmittee is final and nt pen t appeal. All ballts will be destryed upn ntificatin f the selected nminee. IV. Weighting Factrs: A. Evidence f ability t wrk with clients in the cntext f family. B. Evidence that nminee is actively seeking advancement thrugh frmal nursing educatin and/r cntinuing educatin activities. C. Evidence t supprt membership and active participatin in a nursing rganizatin such as the Natinal Federatin fr Licensed Practical Nurses r membership with the Natinal Assciatin f Schl Nurses/SC Assciatin f Schl Nurses. D. Evidence t supprt each f the seven (7) cmpnents t the questin in Part 3 f the Nminatin Packet Requirements. Check List fr Nminatin Packet Submissin This check list is prvided fr cnvenience. All f the cnditins nted in the Prcess Overview and Nminatin Packet Requirements must be met. Part 1: LPN Nminatin Cver Page All infrmatin cmplete All required signatures dcumented Part 2: Nursing Practice List cmpleted by RN r LPN practicing schl nursing in Suth Carlina Part 3: Summary Each f the 7 cmpnents addressed in ne page r less (Ariel pint fnt with ½ margins) Part 4: Letters f Endrsement Nminatin submissin includes riginal nminatin packet and five (5) cpies f the nminatin packet Retain a cpy f nminatin packet fr nminatr and nminee Nminatin submissin must be hand-delivered r pst-marked n r befre Nvember 15, 2017.

4 Nminatin Packet Requirements: SC Schl Health LPN f the Year ( ) Part 1: Cver Page (Use f this page is required.) I/We wish t place in nminatin: Name: Title: Phne #: Address: Schl District: Nminee Emplyed Full Time in Schl Setting: Yes N Number f Years f Schl Nursing Experience: Is nminee a past recipient f the SC Schl Health LPN f the Year Award? Yes N Name(s) f Persn(s) Submitting Nminatin: Name: Title: Phne #: Address: Name and Title f Nurse Submitting Nminatin (if different frm abve) Schl District: Signature f Persn Submitting Nminatin Signature f RN r LPN Submitting Nminatin Signature f Principal Date f Submissin Signature f Nminee: I have reviewed the nminatin packet being submitted n my behalf and I humbly acknwledge that the infrmatin is accurate. Signature f Nminee: Date:

5 Nminatin Packet Requirements: SC Schl Health LPN f the Year ( ) Part 2: Nursing Practice Nte: An RN r LPN practicing schl nursing in Suth Carlina must cmplete this sectin. List the Nminee s: A) Prfessinal nursing invlvement in prfessinal rganizatins, cmmittees, ffice held, etc.: B) Wrk-related activities: C) Civic and/r cmmunity activities: D) Hnrs and Awards received:

6 Nminatin Packet Requirements: SC Schl Health LPN f the Year ( ) Part 3: Summary Nte: An RN r LPN practicing schl nursing in Suth Carlina must cmplete this sectin. What d yu cnsider t be the majr cntributins f the nminee in the field f schl nursing? Write a brief summatin, using the seven (7) areas listed belw. Please use the Ariel fnt in 10 r 12 pt. with ½ margins. Yur respnse may be n lnger than ne (1) page. 1. Quality f Practice: Systematically reviews utcmes and wrks with supervising RN t imprve the quality and effectiveness f nursing practice. 2. Prgram Management: Manages the schl health ffice and implements care plans as directed by the supervising RN; recgnizes deviatins in health status and respnds apprpriately. 3. Leadership: Prvides leadership in the schl setting fr health-related services and activities. 4. Educatin: Attains knwledge and cmpetency that reflects current schl nursing practice. 5. Cllabratin: Wrks with ther members f the schl and health care teams in prmting and maintaining health and preventing disease. 6. Envirnmental Health: Prmtes practices that result in a safe and healthy schl envirnment fr students and staff. 7. Resurce Utilizatin: Makes apprpriate use f available resurces (e.g. technlgy, staff, cmmunity resurces) t meet the health needs f students and advcates fr resurces that wuld enhance schl nursing practice. Yu may find it helpful t review the Nursing Practice Standards fr the Licensed Practical/Vcatinal Nurse ( Part 4: Letters f Endrsement Yu may submit n mre than 4 (fur) letters f endrsement. They may be frm disciplines ther than nursing. Each letter shuld be n lnger than 1 page in length.

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