Health Care Guidelines Health Staff Training

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Health Care Guidelines Health Staff Training
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Overview

• Background
• Benefits of Health Care Guidelines
• Organization of Health Care Guidelines TAG
• Review and Approval Process
• Resources

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Background

• Standing Orders TAG was first developed in 1978
  and revised in 1991
• November 2003brainstorming session held in
  Silver Spring, MD, to outline changes to the
  Standing Orders TAG

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Background (continued)

• Brainstorming team comprised of
• National Nurse Consultant
• Regional Health Consultants (RHCs)
• Center nurse
• Health support contractor staff
• Final draft of the TAG reviewed by all RHCs

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Background (continued)

• Proposed Changes
• Revise content to include current standards of
  care
• Organize the TAG in a format that is useful to
  the health and non-health staff
• Determine a method of delivery of new TAG to
  center
• Develop a training plan to educate Job Corps
  Center staff on the new TAG

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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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Organization of Health Care Guidelines TAG

• TAG is divided into five sections
• Authorizations
• Professional Standards of Care
• Treatment Guidelines for Health Staff
• Symptomatic Management Guidelines for Non-health
  Staff
• Medications

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Organization of Health Care Guidelines TAG
(continued)

• Authorizations
• Types of Authorizations
• Center nurse
• Advanced practice clinicians
• Non-health staff

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Organization of Health Care Guidelines TAG
(continued)

• Authorizations
• Center nurse
• Includes a list of patient care activities that
  may be performed by the center nurse
• Is not all-inclusive
• Center physician in consultation with HWM should
  complete a personal authorization for each center
  nurse
• A copy of each center nurse authorization should
  be kept in the health and wellness center
  original filed in the employee's personnel record

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Organization of Health Care Guidelines TAG
(continued)

• Authorizations
• Advanced Practice Clinician
• Advanced practice clinicians include nurse
  practitioners, physician assistants, and
  physicians other than the center physician who
  provide clinical services to students on center
• Includes a list of patient care activities that
  may be performed by the advanced practice
  clinician
• Is not all-inclusive

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Organization of Health Care Guidelines TAG
(continued)

• Authorizations
• Advanced Practice Clinician (continued)
• Center physician in consultation with HWM should
  complete a personal authorization for each
  advanced practice clinician
• A copy of each advanced practice clinician
  authorization should be kept in the health and
  wellness center original filed in the employee's
  personnel record

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Organization of Health Care Guidelines TAG
(continued)

• Authorizations
• Non-health staff
• Includes a list of patient care activities that
  may be performed by non-health staff
• Center physician in consultation with HWM should
  complete a personal authorization for each center
  staff member who may be called upon regularly to
  assist sick or injured students
• A copy of the personal authorization should be
  kept in the health and wellness center original
  filed in the employee's personnel record
• 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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Organization of Health Care Guidelines TAG
(continued)

• Professional Standards of Care (PSOC)
• Addresses the need for clinical assessment,
  follow up, documentation, and health education by
  center health staff
• Includes such topics as
• Medical, mental health, and oral health
  emergencies
• Immunization protocols
• Medication protocols
• Standard laboratory studies

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Organization of Health Care Guidelines TAG
(continued)

• PSOC (continued)
• Includes topics such as (continued)
• Cursory and physical examinations
• Biochemical testing (on entry/on suspicion)
• After hours care
• Reporting of actions taken
• Referral of students off center
• Promotion of healthy lifestyles

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Organization of Health Care Guidelines TAG
(continued)

• Treatment Guidelines for Health Staff (TGs)
• TGs organized by diagnosis
• Each TG defines When to Refer to Center
  Physician, Mental Health Consultant, and/or
  Dentist
• Alphabetized for easy access

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Organization of Health Care Guidelines TAG
(continued)

• Symptomatic Management Guidelines for Non- health
  Staff (SMGs)
• SMGs organized by presenting symptom
• Each SMG defines When to Contact The On-Call
  Health and Wellness Staff
• Alphabetized for easy access

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Organization of Health Care Guidelines TAG
(continued)

• Job Corps Medication List
• Comprised of three lists not an exclusive
  formulary
• Preferred prescription medications
• Preferred psychotropic medications
• Non-prescription medications
• All medications recommended in TGs and SMGs are
  included in these lists
• Updated biannually from the Perry Point catalog

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Review and Approval Process

• Centers will submit a review package to the
  regional office
• Contract centersonce a year at the time of
  contract renewal
• Conservation centersonce a year at the beginning
  of the fiscal year

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Resources

• Posted on the Job Corps Health and Wellness Web
  site (www.jobcorpshealth.com)
• TAG M Health Care Guidelines in PDF and Word
  format
• Contact Regional Health Consultants for technical
  assistance