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Resources - A collection of forms, attachments and
other resources
from each section of the manual
I. COORDINATED SCHOOL HEALTH PROGRAM
- Model of Coordinated School Health
- Supervisory School Nurse Evaluation - by Medical Supervisor
- Professional School Nurse Performance Evaluation - by Medical Supervisor
- Associate School Nurse Performance Evaluation - by Medical Supervisor
- School Nurse Performance Evaluation - by Non-Medical Administrator
- School Nurse Performance Evaluation - by Non-Medical Site Administrators
- School Licensed Practical Nurse Performance Evaluation
- School Health Assistant Performance Evaluation
- Decision Tree - Nurse Delegation to Nursing Assistive Personnel
- Decision Tree - Accepting Assignment to Supervise Unlicensed Assistive
Personnel
- Delegation Decision-making Grid
- School Nurse Licensure Application
- 16 NMAC 12.2.12(B) Standards of Nursing Practice (1-2-04)
- National Council of State Boards of Nursing Position: Delegation Documents
- ANA Position: Registered Nurse Utilization of Unlicensed Assistive Personnel
- NASSNC Position: Delegation of School Health
- NASN Issue Brief: Delegation of Care in the School Setting
- NASN Position: Delegation
- NASN Position: Assistive Personnel in School Health Services Program, Using
- Manual: Delegation of Care: Overview for the Registered Nurse Practicing
in the School Setting
II. NM STATUTES, ADMINISTRATIVE CODES, POLICIES AND REGULATIONS RELATING TO SCHOOL HEALTH
- General Screen and SAT Review
- Recommended Steps for SAT
- Flowchart for SAT
- PED Health Services Checklist
- School District Policy Confidential Information
- Student Health Record
- Sick Child Memo – English
- Sick Child Memo – Spanish
- Injured Child Memo – English
- Injured Child Memo – Spanish
- Hearing Screening
- Vision Screening Standards
- Vision Screening & Referral Form
- Confidential Services for Minors in New Mexico
- Public Health Authority for School Health Offices
- Adverse Events Reporting
III. SCREENING/ASSESSMENT PROTOCOLS AND GUIDELINES
- Familiar Sounds Audiogram
- Blood Pressure Percentiles
- Release of Medical Information
- Parental Permission to Obtain Information - English
- Parental Permission to Obtain Information - Spanish
- Referral Form - General
- Vision Referral Form and Letter
- Standards for Vision Screening in New Mexico Schools
- Student Health Assessment
- Initial Student Health History
- Special Education Nurse Screening Summary Form
- New Mexico Medical Oversight Committee BMI Position Statement
- School Sports Physical Form
IV. STUDENTS WITH SPECIAL NEEDS
- Asthma Action Plan
- Asthma Action Plan - Spanish
- Asthma Management: Initial Assessment
- Stepwise Approach for Managing Asthma
- Your Peak Flow Meter
- Strategies for Addressing Asthma
- School Nurse Asthma Assessment Tool
- Managing Asthma in New Mexico Schools
- National Institute Asthma Action Plan
- Asthma and Physical Activity in School
- Diabetes Medical Management Plan
- Guidelines for Hypoglycemia
- Diabetes Emergency Response Plan
- Carbohydrate Counting Worksheet
- Seizure Report Flow Log
- Seizure Activity Log
- Request for Homebound Instruction
- Confidential Nursing Report Special Education Students
- Helping the Student with Diabetes Succeed: A Guide for School Personnel
- Level 1 Training - Powerpoint
- Level 2 Training - Powerpoint
- Level 3 Training - Powerpoint
- Level 1 Training - Powerpoint
V. INDIVIDUALIZED HEALTH CARE PLANS
- Approved Nursing Diagnoses
- Individualized Healthcare Plan (IHP)
- ADHD Health Care Plan
- Severe Allergies Health Care Plan
- Asthma Health Care Plan
- Diabetes Health Care Plan
- Diabetes Emergency Plan
- Seizure Disorder Health Care Plan
- Integrative Therapies Consultant Call List
- Medication Incident Report
- Medication Log
- Individual Multiple Medication Log
- Medication and or Nursing Procedure Authorization - English
- Medication and or Nursing Procedure Authorization - Spanish
- Physician Order and Medication Authorization Form - English
- Physician Order and Medication Authorization Form - Spanish
- Student Medications at School Memo - English
- Student Medications at School Memo - Spanish
- Colostomy Care Skills Checklist
- Ileostomy Care Skills Checklist
- Urostomy Care Skills Checklist
- Suctioning - Nasal and Oral Technique Skills Checklist
- Suctioning - Sterile Technique Skills Checklist
- Gastrostomy Feeding Button - Slow Drip/Continuous Method Skills Checklist
- Gastrostomy Button - Bolus Feeding Method Skills Checklist
- Nasogastric Tube Feeding - Slow Drip/Continuous Method Skills Checklist
- Nasogastric Tube Feeding - Bolus Method
- Female Catheterization
- Male Catheterization
- Ventilator Machine and Circuit Skills Checklist
- Ventilator Troubleshooting Alarms Skills Checklist
- Summary of Skills Training and Recommendations
- Authorization to Administer Specialized Health Service
- Authorization to Administer Specialized Health Service Student Log
VIII. EMERGENCY SERVICES/FIRST AID
- Emergency Response Algorithms
- Scope of Practice for EMT
- Emergency Medical Authorization - English
- Emergency Medical Authorization - Spanish
- Action Plan for Automatic External Defibrillator (AED)
- Procedure for Use of AED
- Emergency Preparedness Worksheet for School Health Staff
- Learning CPR
- Pandemic Flu Model Plan
- Pandemic Influenza Planning
- FEMA
- CDC Emergency Preparedness and Response
- Basic Emergency Lifesaving Skills
- Emergency Medical Repsonse Action Plan
- Procedure for Use of Automatical External Defibrillator (AED)
-
Exemption from Immunizations
-
Information and Form
-
Title 6
-
-
Immunization Schedules - US and NM
-
NM School Immunization Requirements (K-12)
-
Recommended Childhood & Adult Immunization Schedule-- United States
-
Summary of Rules for Childhood Immunization
-
- Public Health Authority Letter
X. COMMUNICABLE DISEASE CONTROL
-
Notifiable Conditions in New Mexico
-
Reportable Communicable Disease Follow-up Algorithm
-
Antibiotics info brochure in English
-
Antibiotics info brochure in Spanish
-
Antibiotics info rack card in English
-
Antibiotics info rack card in Spanish
-
Hand washing music
-
Hand washing song in English
-
Hand washing song in Spanish
-
Keep Kids Healthy
-
How to wash in English
-
How to wash in Spanish
-
When to wash in English
-
When to wash in Spanish
- NM Notifiable Conditions
- NM Communicable Diseases Manual
- Bloodborne Pathogen Training
- MRSA Toolkit
-
Wellness Policy Rule Documents
-
Competitive Food Sales
- Seal America Manual
- Guide to Serving Children with Special Health Care Needs
- Understanding Self-Harm
- Confidential Services for Minors in New Mexico
XVI. SCHOOL HEALTH SERVICES REPORT
- PED Online Reporting Tool
XVII. BLOODBORNE PATHOGENS EXPOSURE & CONTROL
