To purchase a copy of Children Assisted by Medical Technology in Educational Settings: Guidelines for Care, write or call:
Additional References:Project School Care
Gardner 6
300 Longwood Avenue
Boston, MA 02115
Phone: 617-735-6714
Fax: 617-735-7940
"A Practical Approach to Teaching Self-catheterization to Children with Myelomeningocele," Brown, J.P. (1990). Journal of Enterostomal Therapy, 17, 54-6.
AIDS/HIV: The Role of the School Nurse. (1990). Scarborough, ME: National Association of School Nurses, Inc. 201-883-2117
Care of a Percutaneous Endoscopic Gastrostomy (P.E.G.) and the Button Replacement Gastrostomy. (1987). Bard Interventional Products. (800) 826- BARD.
Clean Intermittent Catheterization. (1986) Video with manual. University of Colorado Health Sciences Center. Lawrence, KD: Learner Managed Designs, Inc.
"Developmental Assessment of the Technology-dependent Infant and Young Child," Ahmann, E. & Lipsi, K. (1992). Pediatric Nursing, 18 (3): 299-305.
Developmental Variations and Learning Disorders, Levine, M.D. (1987). Toronto: Educators Publishing Service, Inc.
Getting It Started and Keeping It Going: A Guide for Respiratory Home Care of the Ventilator Assisted Individual. (1987). Manual and video. Ventilator Assisted Care Program and Respiratory Care Department, Children's Hospital, New Orleans, LA.
Guidelines for the Delineation of Roles and Responsibilities for the Safe Delivery of Specialized Health Care in the Educational Setting. (1990). Joint Task Force for the Management of Children with Special Health Needs. Reston, VA: Council for Exceptional Children.
Guidelines for the Management of Students with Genetic Disorders: A Manual for School Nurses. Schwab, N. (Ed.). (1992). Box 682, Gorham, ME: New England Regional Genetics Group.
Healthy Care for Students with Disabilities; An Illustrated Medical Guide for the Classroom, Graff, J.C., Ault, M.M., Guess, D., Taylor, M. & Thompson, B. (1990). University of Kansas. Baltimore, MD: Paul H. Brookes Publishing Co.
Home Oxygen for Infants and Young Children (1988). Video and manual. University of Colorado Health Sciences Center. Lawrence KD: Learner Managed Designs.
How Schools Work and How to Work with Schools: A Guide for Health Professionals. (1990). Alexandria, VA: National Association of State Boards of Education. (703) 684-4000.
Integration Checklist: A Guide to the Full Inclusion of Students with Disabilities . (1990, Summer). New Hampshire Challenge. Family Support Bulletin. United Cerebral Palsy Association.
Managing the Student with a Chronic Health Condition: A Practical Guide for School Personnel, Larson, G. (Ed.). (Rev. 1990). North Branch, MN: Sunrise River Press.
Manual for Quality Nursing Intervention in the School, Hootman, J. (Rev. 1990). Multinomah Education Service District, School Health Services, 11611 NE Ainsworth Circle, Portland, OR 97220
Nursing Care of Infants and Children, fourth edition, Whaley, L. & Wong, D. (1991). St. Louis: Mosby Yearbook.
Nursing Guide to the Care and Maintenance of Hickman and Broviac Catheters. (1986). A Nursing Guide and a Video. Cranston, RI: Davol Inc. (800) 556-6275.
Pediatric Adaptive Technologies: Gastrostomy Tube Feeding. Zechman, R., Ross, A, & Watkins, J. (1986). Video and workbook. Seattle, WA: University of Washington.
Primary Care of the Child with a Chronic Condition, Jackson, P. & Vessey, J. (1992). St. Louis: Mosby Yearbook.
Serving Culturally Diverse Families of Infants and Toddlers with Disabilities. Anderson, P. & Fenichel, E. (1989). Washington, D.C.: National Center for Clinical infant Programs.
These Special Children: The Ostomy Book for Parents of Children with Colostomies, Ileostomies and Urostomies, Jeter, K.F. (1982). Palo Alto, CA: Bull Publishing Company.
Your Child Has a Tracheostomy: A Guide for Home Care, Crimlisk, J.T., Murray, S.V., Judas, M.L. Jorgensen, K.M., Thompson, J.A. (1990). Department of Health and Hospitals. Boston, MA: Boston City Hospital (617) 534-4030.
Your Complete Guide to Central Venous Catheters, Viall, C.D. (1990). Nursing 90. 2, 34-41
VI. STUDENTS WITH SPECIAL HEALTH CARE NEEDS
NURSING ASSESSMENT FORM for Students with Special Needs
STUDENT'S NAME:______________________ DATE of BIRTH______________
STREET ADDRESS_________________ TEL: Home_________ Work__________
CITY: _________________ CO:__________ PARENTS NAME_______________
SCHOOL NAME:__________________ EVALUATION DATE:_______________
EVALUATION SITE: (Circle One) Home School Other _______________________
DIAGNOSIS:________________________________________________________
REASON FOR EVALUATION:_________________________________________
HEALTH STATUS:___________________________________________________
EDUCATIONAL STATUS:_____________________________________________
FAMILY STATUS:____________________________________________________
PSYCHOSOCIAL CONSIDERATIONS:__________________________________
RESPIRATORY REQUIREMENTS:______________________________________
NUTRITIONAL REQUIREMENTS:______________________________________
TOILETING REQUIREMENTS:_________________________________________
MEDICATION REQUIREMENTS:_______________________________________
MOBILITY REQUIREMENTS: _________________________________________
TRANSPORTATION REQUIREMENTS:__________________________________
EMERGENCY PROCEDURES:_________________________________________
NEEDS FOR SCHOOL A TTENDANCE:_________________________________
___________________________________________________________________
The school will provide:_________________________________________________
The parents will provide:_________________________________________________
PHYSICIAN'S ORDERS:_______________________________________________
____________________________________________________________________
NURSING RECOMMENDATIONS:______________________________________
Medical services required during school:_____________________________________
___________________________________________________________________
Nursing services required during school:____________________________________
___________________________________________________________________
• Delegatable services (These must be supervised by an R.N.):____________________
___________________________________________________________________
• Non-delegatable services (These are required by the Nurse Practice Act to be done by
an R.N. or an L.P.N. -- who is supervised by an R .N.):________________________
___________________________________________________________________
Other Health Needs: ___________________________________________________
___________________________________________________________________
SUMMARY:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
School Nurse's Signature____________________________ Date:________________
Permission granted for use of this form from Anne Arundel County Health Department, School Nursing Program (Arundel County, MD).