Management of Students with Specialised Health Needs

Version Number

1.5

Implementation Date

12/02/2016

Scope

All state schools

Purpose

To provide guidelines to ensure that schools make reasonable adjustments to allow students with specialised health needs, including those requiring specialised health procedures, to learn and participate a​longside their peers whilst attending school or school-related activities.​​

Overview

This procedure provides guidelines for a consistent approach to health care management for students with a specialised health need whilst attending school or school-related activities. Identified health risks are managed collaboratively among school staff, parents/carers and an appropriately qualified health practitioner to promote best practice for making reasonable adjustment to support students’ health needs.

Responsibilities

The principal is responsible for ensuring safe management of students’ specialised health needs, including those requiring specialised health procedures, whilst attending school or school- related activities.

Process

Principals

  • ​at enrolment, or as new health needs and procedures are identified , consult with parent/carer of the student (and the student, where applicable) to assess risk and where applicable, consult with a qualified health practitioner, to determine the appropriate routine care and emergency first aid response 
  • ensure details of students’ specialised health needs are recorded in OneSchool, and in accordance with confidentiality considerations in the Education (General Provisions) Act 2006 and Section 426 of the Information Privacy Act 2009 
  • determine the need for, and manage the development of, an Individual Health Plan (IHP) and/or if required an Emergency Health Plan (EHP) as per Flowchart 1
  • follow the Checklist for development of an IHP and/or EHP if it has been determined that an IHP and/or EHP is required and provide parent/carer with a completed letter​ regarding this process 
  • ensure IHP, EHP and Action Plans are kept current and reviewed annually or more frequently if changes occur to the student’s health needs or other factors that may affect the plan e.g. change in class teacher, camps or excursions
  • ensure the original signed IHP and EHP are returned to the qualified health practitioner for filing and a copy of the IHP, EHP and Action Plans are stored in the Health Management section in OneSchool   
  • ensure IHP, EHP and Action Plans are accessible, taking confidentiality issues into consideration, to all relevant staff who provide direct supervision or are assigned to support students with a specialised health need or health procedure
  • ensure EHP and Action Plans are located with the student’s emergency medication or equipment  
  • ensure staff, including relief staff, are made aware of relevant students’ IHP and EHP prior to undertaking responsibility for the class 
  • where no EHP or IHP exists for a student, ensure staff are aware of the First Aid Guideline​, sections 8.1, 8.2 and 8.3 for the management of medical or potential life threatening emergencies
  • Where guidelines exist for a specialised health need, refer to these documents to best support students e.g.:
  • ​develop a whole of school Anaphylaxis Risk Management Plan to support students with anaphylaxis to minimise risks 
  • if student/s meet the relevant criteria, complete and submit the Application for Supplementary Teacher-Aide Support – Students with Specialised Health Requirements regional process​, noting that the Regional Office may request further information about IHP or EHP requirements.
Medical equipment, medication and consumables
  • ensure that equipment, medication and consumables used to treat students’ specialised health conditions during school and school-related activities are:
    • stored in the original container and in accordance with the manufacturer’s recommendations 
    • readily accessible at all times i.e. not locked in a cupboard or room
    • available for use by students for school activities held out-of-school hours  e.g. camps, dances
  • ​establish a system to ensure parents/carers regularly monitor and maintain equipment, medication and consumables and check expiry dates  
  • allow student with a specialised health need to wear medical alert apparel   
  • ensure record management systems are in place for the administration of medication​ and for IHP, EHP, Action Plans and related documentation.
Training and Support
  • ​identify and plan support for students with specialised health needs who require specialised health procedures as per Flowchart 2​
  • inform school staff of the voluntary nature of performing specialised health procedures and any associated training and provide information about indemnity for staff when acting within the scope of their duties.
  • if there are no or insufficient volunteer/s available to perform specialised health procedures, contact the Regional Office to determine alternate local solutions 
  • ensure necessary training (including refresher training), assessment and ongoing supervision is provided by the SSRN, or other qualified health practitioner, to school staff who volunteer to support the implementation and management of the student’s specialised health needs
  • ensure school staff are aware of the policies and procedures for referral and releasing information to the SSRNs and other qualified health practitioners 
  • ensure all relevant staff are aware of and are provided with information regarding students’ health conditions and of disclosure protocols  in accordance with the Information Privacy Act 2009 (Qld) and s.426 of the Education (General Provisions) Act 2006
  • ensure the school community is aware of the specialised health condition where necessary to minimise risk to students’ health (e.g. advising parents of anaphylaxis and strategies to reduce risk)
  • ensure processes are in place to support students’ health needs if the regular classroom teacher is not supervising the class 
  • ensure relief staff are informed of students’ health needs including providing the student’s IHP, EHP or Action Plan/s 
  • maintain a register of staff who have received training in routine and emergency first aid responses, as per First Aid procedure
  • maintain a register of staff who have received training for specialised health procedures. 
Self-management of Specialised Health Procedures 
  • ​approve students to be responsible for self-management of health conditions in accordance with the student’s IHP, EHP or Action Plan and with parent/carer consent where applicable
  • work with parents/carers and qualified health practitioners where appropriate to assist students to build the capacity to self-manage stages of their health needs or their health conditions.

School Staff:
Manage the implementation of student health plans:
  • support the implementation of IHP, EHP and Action Plans
  • respect student privacy and dignity when supporting students 
  • consider students’ health needs when planning and managing risks in school curriculum activities e.g. cooking, field studies, camps, excursions 
  • identify all relevant medical details and ensure all health records are updated in OneSchool, based on advice received from parents/carers on consent forms, in preparation for excursions or camps. See School Excursions and International School Study Tours procedure 
  • discuss proposed camps and excursions with parents/carers well ahead of the proposed departure dates and advise the qualified health professional who developed the IHP/EHP to include any adjustments or prepare a camp-specific IHP/EHP, if required
  • provide coordinators of camps and excursions with details of students’ health needs prior to the event 
  • ensure relief staff have access to relevant information and training required to safely support student’s health needs.
  • In the event of any health and safety incident, refer to the Health and Safety Incident Reporting, Notification and Management procedure
Medical equipment, medication and consumables
  • ​ensure specialised equipment, medication and consumables are maintained and stored appropriately while at school and on school-related activities
  • inform parent/carer when equipment, medication or consumables require servicing, resupply or are close to expiry date.
Training and Support Services
School staff who volunteer to support student’s specialised health needs and procedures:
Parents/Carers:
  • are primarily responsible for the health and wellbeing of their children, including costs associated with their health needs, while at school and school-related activities
  • inform the principal of the school in writing of their child’s health condition upon enrolment or as soon as possible after diagnosis and when there are changes to the student’s health needs or procedures that would need the IHP, EHP or Action Plan to be revised by the qualified health practitioner
  • consent to the principal/delegated officer disclosing relevant information about their child’s specialised health condition to the school community where necessary to minimise risk to their child’s health (e.g. to minimise risks of an anaphylactic event) 
  • complete/sign and provide all relevant documents, equipment, medication and consumables to support the student’s health needs prior to enrolment or as required, including:
  • ​ensure that the equipment, medication and consumables provided are well maintained, not out of expiry date and are labelled clearly with the student’s name, dosage and relevant instructions
  • ensure that equipment, medications or consumables requiring servicing, resupply or nearing expiry date are serviced and/or resupplied in a timely manner
  • where principal authorisation for self-management of the student’s health need or health procedure is sought, discuss the matter with the school principal and provide evidence and guidelines to the principal to inform the decision 
  • ensure they are readily contactable by the school and promptly collect their child from school when they are too unwell to participate in their educational program
  • provide medical alert apparel when appropriate.

Online Resources

Review Date

30/01/2018
Attribution CC BY

Action Plan 
is developed by a medical or qualified health practitioner to provide guidelines to support a student with their specialised health needs e.g.  anaphylaxis or asthma. There are a variety of nationally approved and standardised Action Plan proformas developed by peak medical organisations available for medical or qualified health practitioners to complete.

Emergency Health Plan (EHP) 
is developed when a student’s health needs may require a response from school staff that extends beyond basic first aid. It provides clear step-by-step directions of how to safely manage a predictable medical emergency specific to certain chronic health conditions and the correct use of emergency medication. The plan is developed by a qualified health practitioner, in consultation with the school staff, parent/carer, student, medical and other health professional. The plan is developed for use in the school setting only.

Individual Health Plan (IHP)
provides school staff with an understanding of a student’s health condition and the reasonable adjustments required to accommodate the student on a daily basis at school and to inform school planning. . The plan is developed by a qualified health practitioner, in consultation with the school staff, parent/carer, student, medical and other health professional. The plan is developed for use in the school setting only.

Medical Practitioner
is a doctor registered with the Medical Board of Australia, through the Registers of Practitioners, Australian Health Practitioner Regulation Agency (AHPRA).

Qualified Health Practitioner 
is a health professional with the relevant skills and knowledge to assess, plan and evaluate care. This can be the student’s treating medical practitioner/team or State Schools Registered Nurse. Qualified Health Practitioners are registered with AHPRA or eligible for membership in the relevant national professional body. 

Reasonable adjustment
is a measure or action (or a group of measures or actions) taken by an education provider that has the effect of assisting a student with a disability to participate in education on the same basis as a student without a disability, and includes an aid, a facility, or a service that the student requires because of his or her disability  (Ref: Section 3.3 in the Disability Standards for Education 2005 at http://docs.education.gov.au/node/16354)

Specialised Health Need 
is where a student requires routine/daily health procedures, infrequent emergency needs/procedures or has a medical status which may require an emergency response to a potential life-threatening crisis. The health conditions associated with a specialised health need may include asthma, diabetes, severe allergy or anaphylaxis, epilepsy, cystic fibrosis, dysphagia (swallowing difficulties), continence management (bladder and bowel), rare genetic disorders or other health needs requiring health plans. 

Specialised Health Procedures 
are prescribed procedures that must be performed during the school day to facilitate reasonable adjustments necessary to support the student’s access to the educational program.  They are requested by a qualified health professional, and can be either routine or emergency procedures.  Procedures include, but are not limited to, enteral feeding (gastrostomy, nasogastric), urinary management (catheterisation, urostomy care), airway management (tracheostomy care, oral suctioning, oxygen therapy), bowel management (colostomy/ileostomy care), diabetes management.

State Schools Registered Nurses (SSRNs) 
are employed by the Department of Education and Training to work in state schools, to assist school personnel to safely manage the health needs of students with specialised health needs, supporting their participation in an educational program.