# Presentation: 047925

## Health Care Guidelines Health Staff Training

- July 2008

## Overview

- Background
- Benefits of Health Care Guidelines
- Organization of Health Care Guidelines 	TAG
- Review and Approval Process
- Resources

- July 2008

## Background

- Standing Orders TAG was first developed in 1978 and revised in 1991
- November 2003—brainstorming session held in Silver Spring, MD, to outline changes to the Standing Orders TAG

- July 2008

## Background (continued)

- Brainstorming team comprised of** **
- National Nurse Consultant
- Regional Health Consultants (RHCs)
- Center nurse
- Health support contractor staff
- Final draft of the TAG reviewed by all RHCs

- July 2008

## Background (continued)

- Proposed Changes
- Revise content to include current standards of care
- Organize the TAG in a format that is useful to the health and non-health staff
- Determine a method of delivery of new TAG to center
- Develop a training plan to educate Job Corps Center staff on the new TAG

- July 2008

## Benefits of Health Care Guidelines

- Benefits of Health Care Guidelines include:
- Help ensure the safety and comfort of students
- Provide evidence-based scientific rationale to support decisions regarding treatment of students
- Decrease the possibility of medicolegal concerns for center staff
- Provide information and training on current health care practices for the staff

- July 2008

## Benefits of Health Care Guidelines (continued)

- Benefits of Health Care Guidelines include: (continued)
- Save time for the consulting medical personnel to address other problems requiring their special attention
- Allow the center physician to assume a supervisory/teaching role rather than only a service delivery role
- Facilitate the orientation of new health and non-health staff

- July 2008

## Benefits of Health Care Guidelines (continued)

- Benefits of Health Care Guidelines include: (continued)
- Provide non-health staff with direction for action, especially when a member of the health services staff is not available or not on center

- July 2008

## Organization of Health Care Guidelines TAG

- TAG  is divided into five sections:
- Authorizations
- Professional Standards of Care
- Treatment Guidelines for Health Staff
- Symptomatic Management Guidelines for Non-health Staff
- Medications

- July 2008

## Organization of Health Care Guidelines TAG (continued)

- Authorizations
- Types of Authorizations
- Center nurse
- Advanced practice clinicians
- Non-health staff

- July 2008

## Organization of Health Care Guidelines TAG (continued)

- Authorizations
- Center nurse
- Includes a list of patient care activities that may be performed by the center nurse
- Is not all-inclusive
- Center physician in consultation with HWM should complete a personal authorization for each center nurse
- A copy of each center nurse authorization should be kept in the health and wellness center; original filed in the employee's personnel record

- July 2008

## Organization of Health Care Guidelines TAG (continued)

- Authorizations
- Advanced Practice Clinician
- Advanced practice clinicians include nurse practitioners, physician assistants, and physicians other than the center physician who provide clinical services to students on center
- Includes a list of patient care activities that may be performed by the advanced practice clinician
- Is not all-inclusive

- July 2008

## Organization of Health Care Guidelines TAG (continued)

- Authorizations
- Advanced Practice Clinician (continued)
- Center physician in consultation with HWM should complete a personal authorization for each advanced practice clinician
- A copy of each advanced practice clinician authorization should be kept in the health and wellness center; original filed in the employee's personnel record

- July 2008

## Organization of Health Care Guidelines TAG (continued)

- Authorizations
- Non-health staff
- Includes a list of patient care activities that may be performed by non-health staff
- Center physician in consultation with HWM should complete a personal authorization for each center staff member who may be called upon regularly to assist sick or injured students
- A copy of the personal authorization should be kept in the health and wellness center; original filed in the employee's personnel record
- Each department/dorm on center should have a copy of the SMGs and a copy of the personal authorizations for those staff members who usually work in that department/dorm.  For instance, the RA's authorizations should be in the dorm they usually monitor, teachers personal authorizations should be with the SMGs in academics, the rec staff authorizations should be in recreation with the SMGs, etc.

- July 2008

## Organization of Health Care Guidelines TAG (continued)

- Professional Standards of Care (PSOC)
- Addresses the need for clinical assessment, follow up, documentation, and health education by center health staff
- Includes such topics as:
- Medical, mental health, and oral health emergencies
- Immunization protocols
- Medication protocols
- Standard laboratory studies

- July 2008

## Organization of Health Care Guidelines TAG (continued)

- PSOC (continued)
- Includes topics such as (continued):
- Cursory and physical examinations
- Biochemical testing (on entry/on suspicion)
- After hours care
- Reporting of actions taken
- Referral of students off center
- Promotion of healthy lifestyles

- July 2008

## Organization of Health Care Guidelines TAG (continued)

- Treatment Guidelines for Health Staff (TGs)
- TGs organized by diagnosis
- Each TG defines “When to Refer to Center Physician, Mental Health Consultant, and/or Dentist”
- Alphabetized for easy access

- July 2008

## Organization of Health Care Guidelines TAG (continued)

- Symptomatic Management Guidelines for Non- health Staff (SMGs)
- SMGs organized by presenting symptom
- Each SMG defines “When to Contact The On-Call Health and Wellness Staff”
- Alphabetized for easy access

- July 2008

## Organization of Health Care Guidelines TAG (continued)

- Job Corps Medication List
- Comprised of three lists – not an exclusive formulary
- Preferred prescription medications
- Preferred psychotropic medications
- Non-prescription medications
- All medications recommended in TGs and SMGs are included in these lists
- Updated biannually from the Perry Point catalog

- July 2008

## Review and Approval Process

- Centers will submit a review package to the regional office
- Contract centers—once a year at the time of contract renewal
- Conservation centers—once a year at the beginning of the fiscal year

- July 2008

## Resources

- Posted on the Job Corps Health and Wellness Web site (_[www.jobcorpshealth.com](http://www.jobcorpshealth.com/)__)_
- TAG M:  Health Care Guidelines in PDF and Word format
- Contact Regional Health Consultants for technical assistance

- July 2008