IHP nightmare!

bergren · Oct 22, 2004

I tried to send you a private message and it shows you have elected not to recieve them. There are two aspects to the question you are asking: 1. Are people doing them? 2. What is the legal requirement to do them? I have been fortunate enough to have had reasonable student loads and had IHPs on any child who needed interventions during the school day. That does not mean every kid whose mother said they had asthma had a care plan, but any asthmatic child who requires an inhaler and or meds, or would be at high risk for another reason, would have a care plan.

Since you have LPNs, your care plan must be very specific for the symptoms they observe and the actions you want them to take. For the asthma example, starting the intervention for specific signs and symptoms would also include paging you and when to call 911.

Three resources for you:

1. Join National Association of School Nurses and check out their web site. They have a special forum for school nurse supervisors. www.nasn.org(check for your state group on the affiliates page)

2. Get the legal reference: Schwab N. & Gelfman, M. H. B. (2001). Legal issues in school health services: A resource for school nurses, administrators and attorneys. North Branch, MN: Sunrise River Press. You can get it through www.macgill.com

3. School nurse care plan resources: The School Nurse's Source Book of Individualized Healthcare Plans - Volume 1 & Volume II - you can also purchase a disk with templates for the plans and you individualize them. the publishers web site is http://www.schoolnursebooks.com I checked Amazon and the used books are selling for around $15 ABOVE list price ? I am not sure what that is all about.

cmcssnurse · Oct 22, 2004

Thanks so much, I will work on the private message thing(New to chat rooms-desperate!) I already have all three books and just joined NASN. Okay Im on the right track! Just wondering how high to prioritize this among all other concerns.......The amount of students that I will have to address is staggering. So, I gather by your answer that legally it is where we are headed...still reading my books....... Thanks

bergren · Oct 23, 2004

While you are drowning with the care plan problem, prioritize the students by level of risk and use generic ones (even if it is just photocopying) marked "draft" until you get to the less seriously ill students. Does your district have local university nursing students doing clinicals with you? undergrads or grad students? Care plans are an area where they could help you - you would need to critique and edit, but at least you could get them going.

Thanks so much, I will work on the private message thing(New to chat rooms-desperate!) I already have all three books and just joined NASN. Okay Im on the right track! Just wondering how high to prioritize this among all other concerns.......The amount of students that I will have to address is staggering. So, I gather by your answer that legally it is where we are headed...still reading my books....... Thanks

cmcssnurse · Oct 23, 2004

No, not now (nursing students) but we do have a univeristy right next door to my office, not a bad idea! The school is my alma mater, maybe I can make a few calls! Thanks for your help, one more question, have you heard anything about reimbursement to the school for caths, tube feedings, etc. Now, how does that work? Sounds like a legal and paperwork nightmare, who gets the money? Nurses? Some other dept. I just don't understand that. Is it similiar to home Health situation?

bergren · Oct 23, 2004

To make it cost effective, you need to have a decent percetage of kids on Medicaid. I would make that a goal for next year!!! Check with Special ed and see if they are set up for billing for some of the other providers - PT, OT etc. If they are it will be easier to implement.