Health Services
The Board and Superintendent recognize that health services enable scholars to participate in the educational process. The focus of these services is to promote health, maintain a safe environment, prevent or control spread of disease, and minimize the impact of illness or disability.
Delegation of Health Services
The District's commitment to provide for the health and safety of all scholars in the school setting includes the provision of needed health care services by qualified staff. Sometimes health care services may need to be provided by an individual or individuals other than the school District's professional nursing or other health services staff. The Board recognizes and approves such delegation under certain conditions.
Delegation of nursing or other health services responsibilities must adhere to the Michigan Public Health Code and Grand Rapids Public Schools "Guidelines for the Delineation of Roles and Responsibilities for Health Procedures." The Guidelines are considered as part of this policy statement and incorporated by reference herein. The guidelines will not be modified without action by the Board.
The Superintendent is authorized to assign school health services providers to develop necessary rules, procedures, and guidelines to see that scholar health and safety are protected if the delegation of health services is necessary.
Grand Rapids Public Schools Guidelines for the Delineation of Roles and Responsibilities for Health Procedures
1.0 Activities of Daily Living
| Procedure | Physician Order Required | Registered Nurse (RN) | Licensed Practical Nurse (LPN) | Unlicensed Assistive Personnel |
|---|
| 1.1 Toileting/Diapering | | A | A | A |
| 1.2 Bowel/Bladder Training (Toilet Training) | | A | A | A |
| 1.3 Oral Hygiene | | A | A | A |
| 1.4 Lifting/Positioning | | A | A | A |
| 1.5 Feeding | | | | |
| 1.5.1 Nutrition Assessment | | A | X | X |
| 1.5.2 Oral Motor Assessment | | X | X | X |
| 1.5.3 Oral Feeding (special needs) | * | A | A | S |
| 1.5.4 Naso-Gastric Feeding | * | A | A | X |
| l.5.5 Monitoring of Naso-Gastric Feeding | | A | A | X |
| 1.5.6 Gastrostomy Feeding | * | A | A | S |
| 1.5.7 Monitoring of Gastrostomy Feeding | | A | A | S |
| 1.5.8 Jejunostomy Tube Feeding | * | A | A | X |
| 1.5.9 Monitoring of Jejunostomy Tube Feeding | | A | A | S |
| 1.5.10 Total Parenteral Feeding (Intravenous) | * | A | S | X |
| 1.5.11 Monitoring of Parenteral Feeding | | A | S | X |
1.5.11 Naso-Gastric Tube Insertion
| * | A | S | X |
1.5.12 Naso-Gastric Tube Removal
| * | A | S | X |
1.5.13 Gastrostomy Tube Reinsertion
| * | A | S | X |
3.0 Medical Support Systems
| Procedure | Physician Order Required | Registered Nurse (RN) | Licensed Practical Nurse (LPN) | Unlicensed Assistive Personnel |
|---|
3.1 Ventricular Peritoneal Shunt
| | | | |
3.1.1 Pumping
| * | A | X | X |
3.1.2 Monitoring
| * | A | S | X |
3.2 Mechanical Ventilator
| | | | |
3.2.1 Monitoring
| * | A | X | X |
| 3.2.2 Adjustment of Ventilator | * | X | S | X |
| 3.2.3 Equipment Failure | * | A | S | X |
| 3.3 Oxygen | | | | |
3.3.1 Intermittent
| * | A | S | S |
3.3.2 Continuous (Monitoring)
| * | A | S | S |
3.4 Central or Intravenous Lines
| * | A | S | X |
3.5 Peritoneal Dialysis
| * | A | S | X |
3.6 Apnea Monitor
| * | A | S | S |
3.7 Pulse Oxime
| | A | A | S |
6.0 Respiratory Assistance
| Procedure | Physician Order Required | Registered Nurse (RN) | Licensed Practical Nurse (LPN) | Unlicensed Assistive Personnel |
|---|
6.1 Postural Drainage
| * | A | S | S |
6.2 Percussion/Flutter
| * | A | S | S |
6.3 Suctioning
| | | | |
6.3.1 Pharyngeal/Oral
| * | A | S | S |
6.3.2 Deep Suctioning
| * | A | S | X |
6.3:3 Tracheostomy (shallow/tip suctioning)
| * | A | S | S |
6.4 Tracheostomy Tube Replacement
| * | A | S | X |
6.5 Tracheostomy Care (Cleaning)
| * | A | S | X |
8.0 Specimen Collecting/Testing
| Procedure | Physician Order Required | Registered Nurse (RN) | Licensed Practical Nurse (LPN) | Unlicensed Assistive Personnel |
|---|
8.1 Blood Glucose
| * | A | S | S |
8.2 Urine Glucose or Ketones
| * | A | S | S |
8.3 Spirometer
| * | A | S | S |
DEFINITION OF SYMBOLS
A - Qualified to perform task, not in conflict with professional standards
S - Qualified to perform task with RN supervision and training
X - Should Not Perform
Unlicensed Assistive Personnel (UAP) "an unlicensed person trained to perform a nursing activity" (Resha & Taliaferro, 2017)
