Health Care Guidelines Non-health Staff Training

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Health Care Guidelines Non-health Staff Training
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Overview

• Introduction
• Benefits of Health Care Guidelines
• What is a life-threatening emergency?
• What should be done in a life-threatening
  emergency?
• What is an urgent situation?
• What should be done in an urgent situation?

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Overview (continued)

• What should be done when health staff are not
  available?
• What are Symptomatic Management Guidelines
  (SMGs)?
• Who is authorized to use SMGs?
• Where can SMGs be found on center?

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Overview (continued)

• SMG example
• How should non-student health problems be
  addressed?

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Introduction

• Health care guidelines for non-health staff
  provide instructions on procedures to use when
  confronted with a variety of health situations
  including life-threatening emergencies, urgent
  health situations, and response to a health
  problem when health staff are not readily
  available

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Benefits of Health Care Guidelines

• Benefits of Health Care Guidelines include
• Help ensure the safety and comfort of students
• Provide evidence-based scientific rationale to
  support decisions regarding treatment of students
  
• Decrease the possibility of medicolegal concerns
  for center staff
• Provide information and training on current
  health care practices for the staff

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Benefits of Health Care Guidelines (continued)

• Benefits of Health Care Guidelines include
  (continued)
• Save time for the consulting medical personnel to
  address other problems requiring their special
  attention
• Allow the center physician to assume a
  supervisory/teaching role rather than only a
  service delivery role
• Facilitate the orientation of new health and
  non-health staff

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Benefits of Health Care Guidelines (continued)

• Benefits of Health Care Guidelines include
  (continued)
• Provide non-health staff with direction for
  action, especially when a member of the health
  services staff is not available or not on center

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What is a life-threatening emergency?

• Causes death in minutes
• Includes the inability to breathe, inability of
  the heart to pump at a normal rate, and
  uncontrolled bleeding
• Examples choking, severe allergic reaction,
  poisoning/drug overdose, gunshot/knife wound,
  drowning, head trauma, severe chest pain, acute
  asthma with difficulty breathing, shock,
  attempted suicide

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What should be done in a life-threatening
emergency?

• First contact the local emergency response team
  by calling 911
• Maintain airway and administer CPR if indicated
• Control bleeding
• Prevent and treat for shock
• Monitor vital signs

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What should be done in a life-threatening
emergency? (continued)

• Inform the rescue team of known medical history,
  student medications and details of the event
  (when began, what changed, medications and
  treatment administered, vomiting)
• Once student is stabilized and/or transported off
  center, notify health staff, center director, and
  family contact

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What should be done in a life-threatening
emergency? (continued)

• Document all that occurred in writing for
  inclusion in the students health record

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What is an urgent situation?

• Health problems that need evaluation by the
  center physician, center mental health
  consultant, or center dentist within a few hours
• May soon result in a life-threatening situation
  or produce permanent damage

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What is an urgent situation? (continued)

• Examples
• Fractures
• Serious lacerations
• Second degree burns (blistering)
• Diarrhea or vomiting lasting more than 24 hours
• Abdominal pain

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What is an urgent situation? (continued)

• Examples (continued)
• Complication of pregnancy
• Moderate/mild asthma
• Foreign body in the eye
• Severe depression or anxiety

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What should be done in an urgent situation?

• Notify the on-call health staff member
  immediately
• If health staff is unavailable, contact the local
  emergency response team

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What should be done in an urgent situation?
(continued)

• If the student is taken off center, inform the
  rescue team of known medical history, student
  medications and details of the event (when began,
  what changed, medications and treatment
  administered, vomiting)
• Once student is stabilized and/or transported off
  center, notify health staff, center director, and
  family contact

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What should be done in an urgent situation?
(continued)

• Document all that occurred in writing for
  inclusion in the students health record

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What should be done when health staff are not
available?

• For an emergency situation
• First contact the local emergency response team
  (Call 911)
• For an urgent situation
• If health staff are not reachable after repeated
  attempts, contact the local emergency response
  team

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What should be done when health staff are not
available? (continued)

• For an urgent situation (continued)
• If authorized to do so, follow symptomatic
  management guidelines for non-health staff
• Provide basic first aid measures if needed
• Keep the student warm and comfortable
• Administer CPR if properly trained and certified
• Stop bleeding by applying constant, direct
  pressure on the wound

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What are Symptomatic Management Guidelines (SMGs)?

• Assist non-health staff during hours when no
  health staff are present on center
• Provide guidance on how to handle common student
  symptoms
• Suggest parameters to follow (i.e., when to refer
  student urgently to the on-call health staff or
  to local emergency response team when on-call
  health staff are not available)

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Who is authorized to use SMGs?

• SMGs are approved by the center physician in
  consultation with the health and wellness manager
  (HWM)
• The center physician, center director, and HWM
  determine which patient care activities a center
  staff member may be called on to perform

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Who is authorized to use SMGs? (continued)

• Personal Authorizationthe document outlining
  which patient care activities a center staff
  member may be called on to perform
• Personal Authorization is filed in the health and
  wellness center and in each staff members
  personnel folder
• Each department/dorm on center should have a copy
  of the SMGs and a copy of the personal
  authorizations for those staff members who
  usually work in that department/dorm.  For
  instance, the RA's authorizations should be in
  the dorm they usually monitor, teachers personal
  authorizations should be with the SMGs in
  academics, the rec staff authorizations should be
  in recreation with the SMGs, etc.

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Where can SMGs be found on center?

• Residential advisors office
• Security office
• Health and Wellness Center
• Center Directors office

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EXAMPLE SYMPTOMATIC MANAGEMENT GUIDELINES FOR
NON-HEALTH STAFF  COLD AND SINUS
CONGESTION     Authorized non-health staff may
manage a cold and sinus congestion as
follows   1.  For fever, offer the student
acetaminophen 1000 mg every 4 hours or ibuprofen
400 mg every 6 hours as needed. Encourage oral
hydration.   2.  Students with fever gt101oF
should be referred to the health and wellness
center for further evaluation.   3.   For severe
sinus congestion, offer saline nasal spray or
nasal decongestant spray or pseudoephedrine
(Sudafed) 30 mg 60 mg every 8 hours until
evaluated by health staff. Note that nasal
decongestant spray should not be used for more
than 3 days.    WHEN TO CONTACT THE ON-CALL
HEALTH AND WELLNESS STAFF         If the student
has a persistent fever gt101oF that is
unresponsive to medications listed in
1       If the student is wheezing or has
difficulty breathing       If the student has a
severe sinus headache  
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How should non-student health problems be
addressed?

• For an emergency situation
• First contact the local emergency response team
• (Call 911)
• For all other situations 
• Provide basic first aid and make patient
  comfortable
• Suggest person go to private physician or
  hospital emergency room
• Complete appropriate records and an incident
  report