SUBJECT: WOUND CARE: initial visit
PERSONNEL: RN, LVN who has demonstrated competency in the care of wounds.
EQUIPMENT: Various supplies for the cleaning and dressing of wounds.
SUBJECT: Tuberculosis Test Results
PERSONNEL: RN, LVN who has demonstrated competency
EQUIPMENT/LOCATION: Millimeter ruler , ball point pen, patient chart, and good light are needed. Any location including Triage, Same Day Clinic, AIT
SUBJECT: TUBERCULOSIS TESTING
PERSONNEL: RN, LVN, or MA (by clinician order) who has demonstrated competence in tuberculosis testing.
TB safety syringe, Tubersol, alcohol swab, gloves
SUBJECT: AUDIOMETRY PROCEDURE
PERSONNEL: RN, LVN, MA
EQUIPMENT: AMBCO 650A AUDIOMETER
Personnel shall check the audiometer for AC power supply and make certain all parts are in good working order. Provide a quiet environment.
The triage nurse is the point of entry for Same Day Clinic at the Student Health Center. A consultation with the triage nurse is available to any registered student, regardless of insurance status. All students presenting to the Student Health Center with symptoms of alarm are seen by the triage nurse. The job of the triage nurse is to determine appointment priority and to assist students to make a plan of care appropriate to their complaint. This may include assisting a student to identify a provider who accepts their insurance, teaching student’s about simple self-care, or initiating emergency response. Under standardized procedures the triage nurse may provide a number of additional services including emergency contraceptive refills, ordering ankle x-rays according to the Ottawa guidelines, and providing expedited antibiotic treatment for uncomplicated UTIs for selected patients who meet criteria for uncomplicated UTI and who decline clinician appointment. The policy of the Student Health Center is to see all students who present for care in as timely a manner as possible. The triage nurse works to optimize clinician schedules and student access.
1. The triage nurse is an RN who has completed her orientation at the Student Health Center including at least 10 sessions observing in triage.
2. Patients registered are seen in the triage office in the order in which they register unless there is evidence of obvious urgent distress/alarm such as active vomiting, bleeding, respiratory difficulty, altered mental status, fainting, severe pain, or medical emergency.
3. The triage nurse determines the best plan of care for students with options including immediate appointment, same day appointment, scheduled f/up appointment, emergency expedited care, referral to off-campus provider, or treatment under Standardized Procedures.
4. It is the policy of the Health Center not to turn away students requesting same day medical care without an interview by a licensed health professional. The triage nurse works in collaboration with the charge nurse to coordinate schedules within the building to maximize efficiency and flow. Low acuity students may be offered next day appointments in the event that clinicians are fully scheduled for that day. All true emergencies will be evaluated by a registered nurse and in collaboration with a clinician provided a disposition that includes transport off campus after stabilization at the SHC.
5. Using standardized procedures the triage nurse may manage a variety of common presenting issues including: emergency contraceptive refills, asymptomatic STI testing, ordering ankle x-ray per Ottowa guidelines prior to clinician appointment and treatment of uncomplicated UTIs.
6. Each patient encounter is documented in the patient's EMR, including assessment and disposition.
7. Any student evaluated by the Triage Nurse and sent away without a clinician evaluation, even if returning for an appointment later that same day, will have vital signs performed including Temparature,Pulse,Respiratory rate, Blood pressure and oxygen saturation by oximetry as indicated.
7. The triage nurse acts as a second RN for the Same Day Clinic should a situation arise in which nursing care is required in the Same Day Clinic .
All students presenting to the Student Health Center with alarm symptoms are seen by the triage nurse
The job of the triage nurse is to work with the student to develop the most appropriate plan of care for the student.
The triage nurse assesses the priority of the student's presenting complaint and arranges care as indicated.
The policy of the Student Health Center is not to turn students away without an interview by a licensed health professional. In collaboration with the charge nurse the triage nurse manages the flow of patients to assure that all students are seen in a timely manner.
Under Standardized Procedures, the triage nurse can handle common issues including emergency contraceptive refills, ordering asymptomatic STI testing, treating simple UTIs, ordering urine pregnancy or dipstick analysis and ordering an ankle x-ray in advance of an appointment with a clinician.
Test: In-house sterility testing for Autoclaves
Sterility Spore Test ampules
Ritter M11 UltraClave
Pelton and Crane Delta
Precision Water Bath Model 181
Transportation off-campus for medical care can be provided by ambulance if condition warrants, or by taxi cab if no private vehicle is available or practical.
The student’s university account will be charged.
For a taxi, the nurse or clinician completes Clinic Taxi Authorization form (HC: 127). The student signs this form. Copies are distributed as indicated on the form.
Students may have 2 taxi voucher forms.
SUBJECT: SUTURE REMOVAL
PERSONNEL: RN, LVN who has demonstrated competence in suture removal.
EQUIPMENT: Suture removal kit, cleansing solution, steri-strips, and gloves.
A patient may present after being sutured here or from an outside facility. The nurse reviews chart or documentation from outside facility for suture removal instructions.
Standards for suture removal without a contravening order are:
Should there be a staff sharps injury, or splash or spill onto a staff member, said injured employee is referred to Santa Cruz Occupational Medical Center (SCOMC) for care. SCOMC is the Workers’ Compensation health care provider for the University of California Santa Cruz and provides competent care for injuries while being able to protect patient (staff) confidentiality. Injured employee immediately follows these steps:
The UC Santa Cruz Academic Senate passed a policy in 2007 which states that instructors will not routinely require verification of illness/injury for students missing class.
The Student Health Center does not routinely provide verification notes for students. A patient handout (No Note Policy) explaining this policy is located in the EMR references under patient support forms and is routinely provided to students presenting for verification notes. SHC staff will use their discretion in providing documentation verifying dates of illness/injury and functional impairments as appropriate.