Audience
All state schools
Purpose
This procedure outlines the measures state schools must take to support students with health support needs at school, so that all students can safely participate in all aspects of school life.
Refer to the Supporting students with asthma and/or at risk of anaphylaxis at school procedure for information about managing asthma and anaphylaxis.
Overview
Principals have a non-delegable duty of care to students enrolled at and attending their school, which includes enabling students with health support needs to maintain their wellbeing and engage in learning safely. This requires consideration at the student and school level. A range of personnel and parents/carers have a role in providing a safe environment for students.
School staff, parents/carers and health professionals collaborate to manage identified health risks. Schools provide support with routine or emergency health support procedures for students, taking into account what is safe and reasonable in an individual case. Students’ support is documented on Individual health plans and/or emergency health plans (health plans), which are developed and updated by health professionals. School staff manage and implement health plans.
Responsibilities
Principals
- ensure safe management of students’ health support needs at school
- develop and document local processes to support student health including:
- risk minimisation;
- supply, storage and disposal of medication; and
- providing health support procedures
- determine the need for, and manage the development and implementation of health plans
- ensure personal protective equipment is available for staff performing health support procedures
- where appropriate, and in consultation with the parent/carer, approve students to be responsible for managing their health condition at school, which may include carrying and administering their own medication as per the Administration of medications in schools procedure
- approve staff training, ensuring that an adequate number and coverage of staff are trained to meet the needs of students at the school
- approve staff to perform students’ health support procedures based on the outcome of training
- ensure all relevant staff are aware of students’ needs and health plans
- ensure parents/carers understand that they are responsible for providing current information about the health support needs of their child and equipment, medications and consumables for use at school.
Regional offices
State Schools Registered Nurses
- assist state school staff to safely and effectively manage students’ health support needs
- support schools to assess and manage risks related to students’ health support needs as required
- develop and update health plans in collaboration with the student’s family and relevant health professionals
- use the Guidelines for planning and prescribing mechanical restraint and clinical holding for health professionals (DoE employees only) if clinical holding is indicated during a health support procedure
- obtain the parents and/or student’s informed consent to the health plan
- provide training to school staff on health topics as appropriate.
School staff
- take reasonable measures to minimise students’ identified health risks
- support the implementation of health plans.
Staff members who voluntarily undertake a student’s health support procedure/s
- complete training, including refresher training, to a competency standard determined by the health professional providing the training
- complete and retain currency in CPR training, as required
- administer health support procedures within the scope of their training, skills and competence and as outlined in health plans, using the prescribed personal protective equipment
- record all instances of health support procedures and medication administered to students
- in addition, teacher aides who voluntarily undertake a student’s health support procedure/s:
Parents/carers
- provide current information to the principal about their child's health condition/s, including written information from health professionals (e.g. doctor)
- ensure that the equipment, medication and consumables provided are supplied, well maintained, in-date and clearly labelled with the student's name, relevant instructions and dosage of medication
- provide medical alert apparel when appropriate.
Process
The principal is responsible for the overall management of students’ health needs at their school; however, one or more delegates may perform the tasks outlined in the process and summarised in Flowchart 1: Managing student health support needs at school. The principal or their delegate/s complete the actions that are appropriate, based on the individual needs of the student.
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1
– Managing student's health support needs process summary
Identify students with health support needs
The principal or their delegate/s will:
- ensure processes are in place to enable parents/carers to provide information about their student’s health support needs on enrolment, diagnosis, and as the student’s needs change
- consult with parents/carers and/or the student to ensure:
- the school is informed of the health needs of the student
- with their consent, the student's health professional provides written information about the implications and management of any health condition that may impact on the child’s schooling
- medication, consumables and other equipment required for the school to administer health support procedures are provided in a timely way and as agreed with the principal
- planning occurs to safely manage the student's health support needs at school including updating information and reviewing plans
- matters related to principal authorisation for self-management of the student’s health condition are discussed, and evidence is provided to the principal to inform the decision
- the family and student, if appropriate, understand that relevant information about the student’s health condition will be shared with identified school staff and volunteers where necessary to minimise risk to the student’s health
- record the student’s medical condition on OneSchool.
Plan supports for students
The principal or their delegate/s will:
- consult with the parent/carer of the student, the student (as appropriate), and a health professional as required, to assess risk and determine the appropriate health support procedures and risk management strategies
- consider the needs of students who self-manage their medication and/or health conditions
- determine if the student will be authorised to self-manage their health condition and medication at school
- plan for, and when required, provide assistance and/or supervision for the student
- consider students’ health support needs when planning and managing risks in school curriculum activities and school activities in collaboration with parents/carers
- determine how students with health support needs will be supported if there is a staff change (e.g. relief staff)
- consider how students’ health support needs can be safely managed when planning lockdown and evacuation procedures, and develop a personal emergency evacuation plan (DoE employees only) for each student who may require assistance during an evacuation.
Provide training and support for school staff
The principal or their delegate/s will:
- plan training for school staff as per Flowchart 2: Staff training for student's health support needs at school with the State Schools Nursing Service (DoE employees only) or other provider
- request school staff volunteer to undertake students' health support procedures
- ensure staff approved to perform students' health support procedures have current CPR training for required health procedures as advised by the State Schools Registered Nurse.
- request volunteers complete the Voluntary undertaking to perform a student's health support procedure form and arrange for a copy to be stored in their HR file at the school
- contact the regional office to determine solutions if no or insufficient staff volunteers are available to perform health support procedures
- maintain a register of staff who have completed training to perform a student's health support procedure/s and when refresher training is due.
Arrange for health plans to be developed by a health professional
A health plan must be developed for any student:
- whose parents are requesting support outside the scope of first aid
- who is known to be at risk of a health emergency due to a diagnosed health condition
- who requires health support procedure/s during school or school-related activities.
The principal can determine whether a health plan is required in other circumstances, where it would assist the school to support the student.
The principal or their delegate/s will:
- follow the Checklist for developing and updating health plans if it has been determined that a health plan is required
- make a request for State Schools Nursing Services (DoE employees only) if required
- consult with the parent/carer or student and health professional ensuring that:
- appropriate informed consent for the health support procedure to be performed at school has been obtained and maintained
- all consultation and decisions are fully documented in the student’s OneSchool record
- the prescribing health professional has provided clear instructions to the school concerning any health support procedure to take place during school hours or school-related activities
- ensure requirements for personal protective equipment are documented on the health plan.
Agree on the use of technology and smart devices
The principal or their delegate/s will:
- make an agreement with the parent/carer, student, health professional and relevant school staff about how technologies used to manage a student’s health support need or procedure will be managed and used in school hours, noting:
- the owner of the device is responsible for managing it with respect to charging, providing data, updates, ensuring acceptable working order, insurance and replacement; and
- students must have access to their medical devices at all times, which may include smart phones that contain apps for health monitoring. This includes during exams and tests. Written medical authorisation, documentation of reasonable adjustments and supervision may be required for standardised testing.
- In relation to a student’s medical devices, inform staff that they must not:
- provide their personal contact information;
- use their personal device to monitor a student’s health information; or
- agree to be a follower to a student’s device or health monitoring app.
- determine if a school smart device will be provided in certain circumstances (e.g. during a school camp)
- document the use of technologies as a reasonable adjustment and the agreed conditions for using the device during school hours in the student’s OneSchool record.
Record and store health plans
The principal or their delegate/s will:
- explain to the parent/carer and/or student that health plans will be stored and displayed in staff accessible locations to ensure that staff are aware of students who require health support procedures, how best to support the students, and where they can access this information
Note: health plans should not be stored and displayed in areas used by the general public e.g. the foyer of the administration building
- ensure all relevant staff who are responsible for supervising the student, including relief and specialist staff, have reviewed the health plan before supervising the student
- store a copy of the student’s emergency health plan/s with their emergency medication or equipment
- upload copies of the student’s health plans on OneSchool
- record in OneSchool if a student has approval to carry and administer their own medication at school
- ensure a copy of the endorsed health plan is returned to the health professional who developed the plan for filing
- manage versions of health plans to ensure that staff are using the most current plan.
Provide and review support
The staff member/s who voluntarily undertake students’ health support procedures will:
The principal and/or their delegate/s will:
- allow students to wear medical alert apparel provided by the parent as required
- ensure health plans are kept current by requesting the health professional review health plans annually or more frequently if the student’s needs change.
In any situation where emergency medication is administered and/or an ambulance has been called, the school will:
- contact the student’s parent/carer as soon as possible
- record the contact made with the parent in OneSchool
- record the details of the incident in MyHR WHS.
Manage the supply and storage of equipment, medication and consumables
The principal or their delegate/s will:
- ensure that equipment, medication and consumables used to manage students’ health conditions are:
- clearly labelled with the student’s name, and for medication, a pharmacy label;
- stored in accordance with the manufacturer’s recommendations;
- readily accessible at all times (do not store emergency medication in a locked space); and
- available for use by the student for school activities held out-of-school hours and off-site
- regularly monitor and maintain equipment, medication and consumables and check expiry dates
- inform the parent/carer when the student’s equipment, medication or consumables require servicing, resupply or are close to expiry date
- replace school purchased equipment, emergency medication and consumables (including PPE) promptly as they are used or nearing expiry date
- refer to the Administration of medications in schools procedure and the Guidelines for the administration of medications in schools for specific storage requirements of medication and recording incidents with medication.
Definitions
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Term
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Definition
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Health support need
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Occurs when a student has a health condition that requires routine, daily or emergency health procedures, or is potentially life-threatening. The health conditions associated with a health support need may include, but are not limited to, asthma, diabetes, anaphylaxis, epilepsy, cystic fibrosis, dysphagia (swallowing difficulties), incontinence (bladder or bowel), adrenal disorders or rare genetic disorders.
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Health support procedure
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A procedure prescribed by a health professional to manage a student's health support need at school. Health support procedures include, but are not limited to, enteral feeding (gastrostomy, nasogastric), catheterisation, urostomy care, tracheostomy care, oral suctioning, oxygen therapy, colostomy/ileostomy care or diabetes management.
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Health plan
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An overarching term describing documents completed by health professionals in consultation with other treating health professionals, school staff, the student and parents, which provide the school with directions or guidelines to manage student’s health support needs. Health plans include action plans, emergency health plans and individual health plans.
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Emergency Health Plan (EHP)
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A plan developed by a health professional that provides step-by-step directions on how to safely manage a predictable medical emergency at school, specific to the student, certain chronic health conditions and the correct use of emergency medication.
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Individual Health Plan (IHP)
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A plan developed by a health professional that provides school staff with an understanding of a student’s health condition and step-by-step instructions for performing the student’s health support procedure at school.
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Health professional
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A qualified health professional with the relevant skills and knowledge to assess, plan and evaluate management of a student’s health condition. This can be the student’s treating team, medical practitioner, registered nurse or allied health professional. Health professionals are registered with AHPRA or eligible for membership with the relevant national professional body.
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Informed consent
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Valid consent is voluntary, informed and specific. In relation to IHPs and EHPs, this means the person signing the health plan must know what health support procedure will be administered, how it will be administered, and for what purpose. Informed consent can only be provided by someone with capacity (maturity, intelligence and understanding) to provide the consent being sought.
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State Schools Registered Nurses
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Clinical nurses employed by the Department of Education to work in state schools to assist school staff to safely manage the health support needs of students.
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School
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For the purpose of this procedure, a school is a state school or education centre, including state outdoor and environmental educational centres and state school operated residential boarding facilities. The term ‘school’ may include locations used for school-related activities such as sporting fields and excursion sites.
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Legislation
Delegations/Authorisations
Other resources
Forms
Guidelines
Related policies and procedures
Superseded versions
Previous seven years shown. Minor version updates not included.
1.0 Management of Students with Specialised Health Needs
1.0 Managing students health support needs at school