Island Health Nursing Support Services (NSS) Delegation Overview
Island Health Nursing Support Services (NSS) provides delegation in schools to support children's complex health needs. Delegation involves two parts: the individual nurse decision to delegate and adherence to organizational policies, professional standards, and regulations. Referrals to NSS must be submitted by the child's physician/nurse practitioner for consent and action. Delegated tasks include diabetes management, tube feeding, catheterization, oxygen administration, and suctioning. The delegation process includes training, observation, and feedback to ensure safe care at school.
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Island Health Nursing Support Services (NSS) General Overview of Delegation in Schools
Island Health NSS Team 9 Nursing Support Services Coordinators 12 School Districts Delegation in schools is only one aspect of an NSS Coordinators role
NSS Program Overview Provincial Health Services Association (PHSA) program http://www.bcchildrens.ca/our-services/sunny- hill-health-centre/our-services/nursing-support Services delivered by Island Health Delegation is a process the NSS program uses to enable school staff to better support children's complex health needs at school
Delegation Two parts Individual Nurse Decision to delegate 1. Delegation process 2. Organizational Policies Professional College Standards (BCCNM) Regulations & Legislation
REFERRAL to NSS Referrals are submitted by the child's Physician/Nurse Practitioner http://www.bcchildrens.ca/health- professionals/refer-a-patient/nursing-support- services-referral Referrals must be emailed directly to nssreferrals@cw.bc.ca or faxed to 604-708-2127 NSS Coordinators do not have consent to take action for, or discuss, a student until they receive a referral from NSS central intake.
Delegated Tasks Diabetes (Blood glucose monitoring, and insulin administration) Tube Feeds Catheterization Oxygen Administration Oral or Nasal Suctioning Must be a routine task with dependable outcomes Children under Delegation at school must be considered stable to be under the Delegated Care Plan at school.
Process Sign off of school staff for the delegated care plan when NSS nurse deems them ready NSS nurse provides in- person delegation training and demonstrations to designated school staff - then observes them doing the task and provides feedback NSSC notifies school of plan to delegate and provides pre-training materials. Decision to delegate and care plan creation (nurse and guardian discuss) Referral
Considerations for delegation Task must be performed on a regular basis by signed off staff School environment and preparedness of staff are a factor in determining appropriateness of delegation Availability of signed off school staff Having the necessary roles and responsibilities fulfilled by all parties (school, guardian, nurse) Capacity/competency of designated school staff Trust and open communication between school, family, and NSS nurse are required for delegation
Most importantly At all times, the nurse is responsible for assessing whether delegation is in the best interests of the child. If, at any time, the nurse deems it is not, delegation will be paused or cancelled.
Awaiting Delegation Delegation can take several weeks time intensive for NSS nurse and school staff being delegated Ensure school environment and staff are prepared. School is responsible for organizing and ensuring the following: Diabetic Support Plan and Medical Alert To be filled out by guardians and provided to the school Two staff designated to receive delegation Notify NSS nurse of the names of these staff and ensure they are given time to complete the pre-training materials Diabetes general information training for all school staff Hypoglycemia posters Printed and posted in visible locations around the school Glucagon/Baqsimi training Guardians are responsible for diabetes care in the meantime how parents provide this care is up to the school and parents. NSS nurse can consult and give safety recommendations to the school, if asked, but does not hold responsibility/accountability for agreements between school and guardian. School staff can encouraged to use the Diabetes Support Plan and Medical Alert for direction. School staff not able to use NSS care plan or provide delegated tasks to any students until officially signed off by NSS nurse
Care Plan Confidentiality Documents contained in the school care plan binder are legal, confidential, documents Bound by legislation regarding privacy and confidentiality (FOIPPA). Copying or distributing any part of the care plan without the NSS nurse s explicit permission is not allowed Keep in secure, but easily accessible location
Communication A phone conversation is required by the care plan in certain scenarios Texting should only be used for casual notifications as needed. Any time the care plan calls for communication with parents it must be through a phone conversation. NSS does not support EA s to use their personal phones and/or download health care apps on their phones A guardian or their designate must be available at all times when there is a diabetes concern requiring parental attention at school.
QUESTIONS Your NSS nurse s contact information is on the Care Plan NSS IH Program Coordinator Tarraneh Bouchard Tarraneh.Bouchard@islandhealth.ca Manager Child, Youth & Family Rehab Services Sarah Gatschene Sarah.Gatschene@islandhealth.ca
