Return to Newsletter | Revised 2-20-02
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Bureau for Students with
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A project funded by the Georgia State Improvement Grant
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On-Line - Fall 2001
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The special education department of the Cobb County School District (CCSD), headquartered in Marietta, Georgia, has developed and implemented a comprehensive training and delivery system for special health care procedures for its students who require them. Currently over 150 students in the district require these procedures on a daily basis.
The district employs six system-wide registered nurses (RNs) who process referrals, complete parent intakes, develop individual student health care plans, obtain physician approvals, train school staff in special procedures, and monitor staff competency and ongoing student health status. Three additional RNs are employed to meet the critical needs of individual students at particular schools.
Students can be referred by anyone, but the referral form must indicate one or more goals on the student's Individualized Education Program (IEP) that cannot be met without the provision of nursing services. The nurse obtains intake information from the parent in the home in most cases, and also obtains signed releases for current medical records. An individual health care plan is developed for the student and sent to the attending physician for endorsement of the specific health care procedures prior to implementation. This plan outlines the various responsibilities to be assumed by the parent, the special education teacher and the nurse to ensure the ongoing health care of the student. The plan is then provided to the Individualized Education Program (IEP) committee for incorporation into the student's IEP.
To implement the health care plan, the nurse will train a minimum of three key individuals to perform the specific procedure(s) in the plan; however, many more may be trained if needed to monitor an individual student. Typically, the trainees are the special education teacher, the classroom paraprofessional, and another teacher or designee at the school. Bus drivers/aides and After School Program personnel are also trained as appropriate. The nurse only delegates specific procedures if permitted by the Georgia Nurse Practice Act.
The CCSD has compiled its own "Nursing Care Manual," consisting of specific training information, procedural guidelines and documentation forms for a multitude of health conditions. The extensive training provided by the nurse to each service provider involves studying this manual, watching training videos, and performing practice procedures until proficiency is demonstrated. The nurse then provides ongoing monitoring and feedback to the service provider to ensure that the student's plan is being carried out properly.
As needed, the nurses will provide orientations to staff and students regarding health conditions exhibited by particular students. Also, the nurses provide periodic system-wide trainings on universal precautions, emergency procedures, seizure control and medication administrations. Despite the complex challenges of providing a comprehensive system for special health care procedures, CCSD staff are demonstrating that they take all steps necessary to ensure the health and well-being of their students in a thorough, responsible and accountable manner.
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