SECTION A CLARK COUNTY SCHOOL DISTRICT HEALTH SERVICES PROGRAM

SECTION A CLARK COUNTY SCHOOL DISTRICT HEALTH SERVICES PROGRAM ORGANIZATION, INTERDISCIPLINARY RELATIONSHIPS, JOB RESPONSIBILITIES, AND SPECIAL ASSIGNMENTS

SECTION A CONTENTS SECTION A - ORGANIZATION, INTERDISCIPLINARY RELATIONSHIPS, JOB RESPONSIBILITIES, AND SPECIAL ASSIGNMENTS Pg A-3 Pg A-4 Pg A-5 Pgs A-6 Pg A-8 Pgs A-9 Pgs A-11 Pgs A-13 Pg A-15 Mission Statements School Health Program and the Role of the School Nurse Health Services Department Organization Health Services Department Shared Governance Structure Interdisciplinary Relationships in the Coordination of School Health Services School Nurse Job Responsibilities School Nurse Special Assignments CCSD Clinics Staff Development Child Find Immunizations AED New Nurse Orientation FASA Training Vision Services Transportation Title I Nurse Feeding Team Support Staff Job Responsibilities Specialized Procedures Nurse Specialized Health Aide First Aid Safety Assistant First Aid Safety Assistant Float First Aid Safety Assistant Screener CCSD Employment Position Descriptions Page A-2 of A-15

HEALTH SERVICES DEPARTMENT MISSION STATEMENT The mission of the Health Services Department is to enhance the educational potential of all students in the Clark County School District by promoting wellness and facilitating the resolution of health concerns, which create barriers to learning. STUDENT SUPPORT SERVICES DIVISION MISSION STATEMENT The division provides leadership, services, and support to protect student rights and strengthen the capacity of schools, families and communities to enhance success through collaboration in the educational process. Page A-3 of A-15

The School Health Program and the Role of the School Nurse The primary goals of the school health program are to: Facilitate access to primary health care Provide mandated health screening and referrals Provide immunization monitoring Provide a process for the identification and resolution of students health needs that affect their education Promote prevention and early intervention Provide acute, chronic, episodic, and emergency health care Provide health education and health counseling Collaborate with parents, community agencies, and the medical community The school nurse functions as a member and leader of the school health program. School nursing is a specialty branch of professional nursing which seeks to identify or prevent student health problems and intervenes to remedy or modify these problems. School nurses apply nursing practice to the unique needs of individuals, groups, and populations of schools. The school nurse promotes and implements the Standards of School Nursing Practice as established by the profession. The purpose of school nursing is to enhance the educational process by maximizing the health and well-being of school-aged children and adolescents physically, intellectually, socially and emotionally. The school nurse accomplishes this through the modification and/or removal of health-related barriers to learning and through the promotion of an optimum level of wellness. School nurses provide services to students 3 through 21 years of age in general and special education settings. The school nurse utilizes the nursing process in decision-making and in determining any action plan. Decisionmaking is based on a systematic process in which the school nurse assesses, plans, implements, and evaluates. School nurses are the pivotal component in the continuity of care through the coordination, planning, delivery and assessment of school health services. The practice of school nursing has expanded and diversified to meet the needs of medically complex students. Public laws and federal mandates have expanded nursing services to students with special needs and provided education in the least restrictive environment. School nurses provide complex health procedures in the school setting, such as gastric tube feedings, catheterization and tracheal suctioning. This comprehensive scope of practice demands appropriate educational preparation to enable nurses to perform their roles effectively and meet the contemporary health needs of students in our society. The Standards of School Nursing Practice (American Nurses Association), the Guidelines for a Model School Nursing Service Program and The School Nursing Scope and Standards of Practice (National Association of School Nurses) serve as the foundation for school nursing practice. School nurses must be familiar with these documents and base their school nursing practice on the theoretical framework. School nurses must also be knowledgeable regarding the Nevada Nurse Practice Act and Advisory Opinion, IDEA, Section 504 of the Rehabilitation Act and CCSD policies and regulations. Page A-4 of A-15

HEALTH SERVICES DEPARTMENT Revised 6/09 DIRECTOR OF HEALTH SERVICES Diana Taylor Area 1 Coordinators Kim Rakow Julie Bolton Area 2 Coordinators Irma Pumphrey Yvette Wintermute Area 3 Coordinator Sheri McPartlin Area 4 Coordinator Lynn Row Page A-5 of A-15

HEALTH SERVICES DEPARTMENT SHARED GOVERNANCE STRUCTURE Health Services administrative staff work collaboratively with school nurses, team leaders, the School Nurse Advisory Board and the School Nurse Advisory Committee (SNAC) to develop practices and procedures consistent with standards of school nursing practices, as well as to resolve departmental conflicts and develop resolutions to meet the growing needs and demands of the student population. These persons and groups serve an essential role and aid in the communication between staff school nurses and Health Services administration. School Nurse Advisory Board This board is comprised of school nurses elected by school nurses to serve as their representatives. Terms are for two years. The mission of the Clark County School District School Nurse Advisory Board is to enhance student performance through the application of professional school nursing standards of practice to facilitate departmental communication, guidance and strategic planning. School Nurse Advisory Council (SNAC) As provided for in Article 10 of the collective bargaining agreement, the School Nurse Advisory Council was established to monitor and address issues related to working environment and job satisfaction. School nurses volunteer to serve on this council. The goals of SNAC are to: Monitor staff morale Apprise administration of actual or potential problems involving professional staff Maintain communication between administration and professional staff Provide input into the budget Other issues as provided for by the agreement School Nurse Team Leader All school nurses are assigned to a team. There are several teams per region. Each school nurse team has a team leader elected by team members. Primary responsibilities of the team leader include: Gathering, communicating and disseminating information and ideas Discussing the status of the teams work needs and providing recommendations and assistance, as needed Scheduling of health procedures, coverage and the coordination of team screening Overseeing team activities Serving in an advisory capacity to team members Attending team meetings with Health Services administration Serving to problem-solve at the team level and to bring significant concerns or problems to the attention of Health Services administration Site School Nurse School nurses are assigned to schools by Health Services. They communicate and collaborate with school teams, nursing teams, nurse coordinators and the Director of Health Services. Page A-6 of A-15

School Nurse Task Committees School nurses may be assigned or may volunteer to work on specific committees. Committee chairpersons communicate and collaborate with nurse coordinators and the Director of Health Services. All school nurses are encouraged to provide input on all projects and task forces within the department. Committees may include: Forms Staff Development Health Education FASA Staff Development Project-Specific Task Forces Page A-7 of A-15

Interdisciplinary Relationships in the Coordination of School Health Services The Health Services Program is under the administrative direction of the Student Support Services Division, Director of Related Services. The Director of Health Services: Organizes, coordinates and assesses school health services while serving as a consultant and resource person on school health concerns. The Director of Health Services is responsible for health services management, school nurse performance and upholding the standards of school nursing practice in the delivery of health services to students. He/she works collaboratively with nursing coordinators to ensure that the practice of school nursing is applied consistently. He/she works with the departmental Medical Director to develop, review and implement policies and procedures related to school health. Health Services Nursing Coordinators are administrative staff members under the direction of the Director of Health Services and are responsible for the development and implementation of activities which promote student health and safety. They are responsible for the supervision and evaluation of school nurses and departmental support staff personnel within their areas. School Site Administrators/Administrative Designees are responsible for the curriculum, instruction, discipline and public relations in schools. The site administrator has the ultimate responsibility for all activities in his/her school. It is essential that he/she have a thorough understanding of the role and duties of the School Nurse and First Aid Safety Assistant/Specialized Health Aide and of mandated health-related activities. School Nurses are responsible for providing a variety of health-related services to students, implementing and executing the Health Services program in the school and serving as a consultant to administrators, teachers, parents/guardians and community health agencies. School nurses also provide direct care to medically fragile students, train unlicensed personnel and are responsible for the delegation of care. School nurses participate in special education eligibility procedures and development of individual education programs for students with significant health concerns. Specialized Procedures Nurses are responsible to perform specialized nursing procedures, such as insulin administration, IV therapy and- tracheal suctioning. Agency Nurses provide services to schools under an outside contract. They perform duties in accordance with CCSD Policies and Procedures and the Nevada State Board of Nursing. School First Aid Safety Assistants (FASAs)/Specialized Health Aides provide first aid and emergency care to students, assist with the administration of medication and maintenance of health records. Specialized Health Aides are assigned to special schools. FASA Screeners and FASA Float Staff are assigned to the Health Services Department to assist with additional site-based needs, such as first aid, emergency care and vision/hearing screening and immunization data entry. School Clerical Staff are responsible for all clerical duties of the school. The clerical staff and the site FASA are directly under the supervision of the site administrator. They serve as designated back-up personnel for the health office. The school nurse, FASA and clerical staff work together as a team to maintain and document student health and safety. Page A-8 of A-15

SCHOOL NURSE JOB RESPONSIBILITIES-OVERVIEW Primary Function To facilitate the educational process through health supervision and health education To provide a variety of health services to students, including the identification of health problems, referral, follow-up, health counseling and supervision of medication administration and emergency care To serve as a resource to administrators, staff, parents and community agencies on student health To promote the role of the professional school nurse through staff education and school health program administration Directly Responsible To the Director of Health Services and the Nurse Coordinators for Health Services To the school site administrator/designee for the general school health program Responsibilities Communication Establish and maintain comprehensive school health program. Maintain communication with Health Services and assigned site administrators regarding daily location and schedule changes Maintain effective communication with school staff and Health Services utilizing the School Nurse InterAct site, FASA InterAct site and school InterAct site(s) Establish and maintain effective communication with first aid safety assistant Read personal Mailbox InterAct messages at least once daily Utilize the School Nurse InterAct Conference for general messages and informal information Emergency Preparedness Complies with District emergency drill protocols Ensure the provision of first aid kits, portable first aid kit and emergency evacuation supplies Maintains current information on medically-involved students for purposes of emergency crises and evacuation Serves as a trained responder for AED drills Oversees the daily checks of AED equipment and completion of checklists Serves as CPR/AED instructor for staff members at designated sites Computerized Health Records Program Maintain currency of student health information in District computer programs, such as Healthmaster and SASI Maintain competency in the use of computerized health records systems Management of Students Needs Maintain and supervise the maintenance of health immunization records on all enrolled students Identify students with health problems, initiate referral for treatment, conduct follow-up, consult with staff, parents and community agencies. Conduct home visits, as needed, to assess student health concerns, medical resources and to assist the family in obtaining the necessary services Organize and implement screening programs for vision, hearing, height, weight and scoliosis at specified grade levels Develop health plans for students with health concerns Train and monitor first aid safety assistants (FASA), oversee the performance of their health-related duties and assist in their evaluations, as requested Page A-9 of A-15

Report suspected/confirmed communicable/infectious diseases to the local health authority Maintain site-based records for suspected communicable/infectious diseases Provide training for back-up and substitute health office personnel using the First Aid/Emergency Guidelines for School Personnel-PUB 648 Assist in monitoring on-site Specialized Procedure Nurse, in conjunction with the Director of Health Services and Nurse Coordinators Perform specialized procedure(s) and serve as back up for other school nurses Process referrals for medical problems, Homebound Program, CCSD Clinics, Child Protective Services, etc. Special Education Participate in school team meetings (e.g., MDT, IEP and 504) Participate in student intervention team meetings and perform vision/hearing assessments and medical records review, as requested Complete health assessment and review of developmental/behavioral history and medical records for students referred for special education Assist in the development of Individual Education Program for students with significant health needs (IEP) Health Education/Health Counseling Offer individual health counseling and education to students, as requested Act as a health resource person for teachers providing health education Present Growth and Development programs for 5 th grade students Provide other health education programs to students/staff, as requested Other Duties May be assigned other related duties and responsibilities by the Director of Health Services and/or Nurse Coordinators. Page A-10 of A-15

SCHOOL NURSE SPECIAL ASSIGNMENTS Special assignments are made at the discretion of the Director of Health Services to facilitate the mission of the Health Services Department. These assignments vary and are based on departmental needs and existing staffing. CCSD CLINICS The CCSD provides the following clinics: Medical Consultant, Neurology, Genetic and Scoliosis. The school nurses assigned to facilitate and coordinate these clinics are responsible for scheduling, reviewing referral packets and consulting with school nurses and teams, attending the clinics with the site-based teams, disseminating a report to school teams and parents and providing community resources and educational information. Nurses assigned to coordinate clinics have additional school and/or departmental assignments. STAFF DEVELOPMENT Departmental staff development nurse(s) may assist with the orientation of school nurses and designated support staff personnel. He/she participates on the staff development committee and may provide direct school nurse assistance with the implementation of programs for medically fragile students. He/she also conducts research on specific topics for ongoing staff development. The nurse(s) assigned to this role has additional school and/or departmental assignments. CHILD FIND Nurses assigned to Child Find perform physical assessments, review developmental/behavioral histories, review medical records and attend IEP s for students referred to Child Find. They initiate medical referrals and medical records requests and develop health care plans. Nurses may be assigned full time to Child Find or will have other school/departmental assignments. IMMUNIZATIONS The nurse(s) assigned to this role facilitates and coordinates all aspects of the Immunization Program in compliance with state mandates, serves as a liaison to the local health authority and the District Information Systems Department for immunization data management and provides training, as requested, to school nurse and FASAs. The nurse(s) assigned to this role has additional school and/or departmental assignments. AED The AED nurse assists with the management of the AED program at designated sites within the school district. The nurse is assigned to the Health Services Department and serves as a consultant for staff and administrators in the areas of training, compliance and monitoring of the AED program. The nurse assigned to this role has additional school and/or departmental assignments. NEW NURSE ORIENTATION The nurse assigned to this role develops, facilitates and coordinates all aspects of the orientation training program for new school nurses. This includes planning, training, site-based visitations and collaboration with the Director of Health Services, nurse coordinators and nurse mentors. The orientation nurse also provides annual nurse mentor training. The nurse assigned to this role may have other school and/or departmental assignments. FASA TRAINING The nurse assigned to this role develops, facilitates and coordinates all aspects of the initial awareness training for new FASAs and FASA Floats. This includes planning, training, site-based visitation and collaboration with the Director of Health Services, nurse coordinators, FASA mentors and site nurses. This role also includes planning and facilitating staff development programs for FASAs and FASA Floats. The nurse assigned to this role may have other school and /or departmental assignments. Page A-11 of A-15

VISION SERVICES The nurse assigned to this role facilitates and coordinates the provision of vision services for eligible students. He/she also serves as a resource to site-based nurses for obtaining vision services from a variety of community agencies. The nurse assigned to this role will have other school or departmental assignments. TRANSPORTATION The nurse assigned to this role develops, facilitates and coordinates the appropriate District transportation for students with medical needs. He/she provides instruction to unlicensed personnel who accompany medically complex students on the bus, such as bus aides, bus drivers and special procedures nurses. TITLE l SCHOOL NURSE ROLE The Title I nurse provides a variety of health services to students in the Title l PreK Programs including identification of health problems, referral, follow up, health screenings, health assessments, health education. He/she serves as a consultant by interpreting health based assessment information to school administrators, teachers and parents. FEEDING TEAM The nurse assigned to this role serves on the District Feeding Team, consults with school staff, nurses and physicians regarding student feeding concerns. He/she provides training to school nurses, SPNs and other personnel, as requested, and also serves as a liaison with and obtains feeding orders from community physicians. The nurse assigned to this role will have other school and/or departmental assignments. Page A-12 of A-15

HEALTH SERVICES SUPPORT STAFF JOB RESPONSIBILITIES FIRST AID SAFETY ASSISTANT (FASA) Primary Functions Perform first aid and emergency care to students. Assist with the administration of medication to students. Perform safety measures, such as playground inspections and AED equipment checks and drills. Maintain health-related student records. Assist the school nurse in the provision of school health services program. Supervision Joint responsibility between the school site administrator and the school nurse. The school site administrator oversees the personnel areas and evaluation. The school nurse provides basic and ongoing training for health-related activities to meet the health programs goals and provides input for evaluation, as requested. Responsibilities Communication Establish and maintain effective communication utilizing InterAct personal email, Fantastic FASAs icon, and school site icon. Maintain effective communication method or system for school nurse contact. Maintain confidentiality of student information. Stay current with Health Services departmental updates. Complete First Aid Safety Assistant Information Checklist, HS-214. First Aid/Emergency Care Provide first aid and emergency care for ill or injured students according to the First Aid/Emergency Guidelines for School Personnel, PUB-648. Comply with CCSD procedures for drills such as fire, shelter in place, and emergency evacuation. Follow documentation guidelines outlined by Health Services and CCSD. Medication/Specialized Procedures Assist with the administration of medications. Perform specialized procedures such as nebulizer or blood glucose testing after training, as directed by school nurse. Follow documentation guidelines outlined by Health Services and CCSD. Health and Safety Serve as health and safety designee. Review Health Services Emergency CPR/AED Plan for High Schools. Perform daily check of Automated External Defibrillator (AED) and document AED Checklist. Perform duties associated with AED school site drills. Perform and document monthly playground inspection. Monitor and check assigned areas to assist in enforcing safety and disciplinary rules. Report and document communicable diseases to school nurse and Southern Nevada Health District. Report and document bloodborne pathogens incidents, as directed. Report and document suspected child abuse and neglect to Child Protective Services and school nurse. Page A-13 of A-15

Assist students with intermittent personal care such as toileting, as directed by school nurse. Health Office Maintenance Assist school nurse with organization of health office. Prepare and distribute first aid kits. Replenish first aid supplies, per teacher request. Maintain a portable first aid kit and emergency response kit. Maintain adequate health office supplies and forms. Maintain a clean and orderly health office, including daily cot cleaning (minimum). Health Record Maintenance Review Supplemental Health Cards and update health information in computer, as directed by school nurse. Assist school nurse with student health status reporting process, as directed by school nurse. Bring significant medical information, student needs, and/or follow-up issues to school nurse s attention. Review and input immunization data in computer and assist with immunization non-compliance monitoring. Student Screening Perform baseline vision and hearing screening on new students, or as directed by school nurse. Assist with screening program and record information, as directed by school nurse. Assist with height and weight screening, as directed by school nurse. Other Duties Notify school nurse of referrals or requests from staff, parents, and students. Complete other related duties and responsibilities, as assigned by school nurse, Health Services, or site administrators. SPECIALIZED HEALTH AIDE Assigned to special schools where all students are physically, emotionally and/or mentally handicapped. Assist students with administration of medication, provide first aid/emergency care and render other specialized health care services. Perform duties consistent with First Aid Safety Assistant job responsibilities FIRST AID SAFETY ASSISTANT FLOAT Serve as itinerant personnel assigned to schools throughout the district by Health Services Region Nursing Coordinators. Assist in the health office and provide similar services as the site FASA. Serve as a backup to the screening team. Perform mentoring duties for new site-based FASAs, as assigned. Perform duties consistent with First Aid Safety Assistant job responsibilities FIRST AID SAFETY ASSISTANT SCREENER Serve as itinerant personnel assigned in teams to screen vision and hearing. Perform screening and data entry under the supervision and direction of the school nurse. Perform duties consistent with First Aid Safety Assistant job responsibilities Page A-14 of A-15

SPECIALIZED PROCEDURES NURSE Licensed by the State Board of Nursing as LPNs or RNs Assigned by Nurse Coordinator to assist school nurses with the provision of specialized health procedures for students, either 1:1 or on an itinerant basis. Assigned to perform other tasks related to health office activities and screenings. Cannot be requested to fulfill the job responsibilities of the professional school nurse, such as developing IEPs, providing health counseling, performing special education health assessments or providing classroom education. CCSD EMPLOYMENT POSITION DESCRIPTIONS Position descriptions can be found on the CCSD website (CCSD.net) under Job Opportunities or on the School Nurses InterAct site under the icon, Job Descriptions. Page A-15 of A-15