No

TRAVEL CLINIC APPOINTMENTS - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Sat, 08/27/2011
Revised: 
Wed, 07/26/2017

UCSC Student Health Center works with the UCSC Division of Global Engagement (DGE), the UC Education Abroad Program (EAP), and with students traveling abroad outside of campus sponsored programs to prepare students for safe, healthy travel experiences. This procedure delineates the standard elements of an EAP and a non-EAP Travel Consult, both locally coordinated by UCSC DGE. It also provides the process for obtaining UC-wide EAP  and DGE coordinated travel program clearance for participation in one of these programs.

EXPEDITED TREATMENT OF WOMEN WITH URINARY TRACT INFECTIONS - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Sat, 08/27/2011
Revised: 
Tue, 05/09/2017

Urinary Tract Infections are a common and disturbing problem for young women. Good evidence indicates that several findings are sufficiently predictive of the presence of a Urinary Tract Infection in symptomatic women to support empiric treatment for these women. This procedure provides specific guidelines to guide the RN in providing expedited treatment of uncomplicated urinary tract infections to women presenting to the UCSC Student Health Center.

Procedure

EAR IRRIGATIONS TO REMOVE IMPACTED CERUMEN - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Sat, 08/27/2011
Revised: 
Sun, 08/28/2011

Impacted cerumen is a common complaint. This procedure allows an RN to assess the amount of cerumen in the ear canal and to initiate the process of clearing the ear canal when the RN or clinician assesses excess cerumen.
Procedure
 The patient may be pre-treated with a solution to soften cerumen prior to the procedure:

CRYOTHERAPY FOR VERRUCA VULGARIS AND/OR PLANTAR WARTS - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Sun, 12/01/2002
Reviewed: 
Sat, 08/27/2011
Revised: 
Tue, 09/12/2017

Successful eradication of plantar warts and some common warts frequently requires repetitive treatments. Benign small and usually painless growths, warts are typically raised, rounded, rough and may have significant surrounding callous. This procedure gives the RN authority to use liquid nitrogen to treat plantar warts and common warts after diagnosis and referral from a UCSC clinician. This procedure does not allow treatment of genital or periungal warts.

CONTRACEPTIVE REFILLS - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Sat, 08/27/2011
Revised: 
Tue, 02/07/2017

This procedure outlines the situations in which the RN may provide a contraceptive refill to patients without a clinician visit.
Procedure
Three Month Contraceptive Recheck

CONTRACEPTIVE OPTIONS PRIOR TO EXAM (COPE) - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Sat, 08/27/2011
Revised: 
Tue, 02/07/2017

Rapid, easy access to contraception for young women is critical to preventing unintended pregnancy. This standardized procedure allows RNs to provide a 3 month supply of contraceptives to young women who do not have contraindications to use of hormonal contraception. Women at risk of pregnancy are also at risk of sexually transmitted infections. This procedure uses the opportunity of a discussion on contraception to educate,  assess, and  order testing for sexually transmitted infections for this at-risk patient group.

ALLERGY IMMUNOTHERAPY INJECTIONS - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Fri, 08/19/2011
Revised: 
Tue, 10/24/2017

This procedure provides RNs at the UCSC Student Health Center (SHC)  the standards for the administration of allergy serum injections to students.

Procedure

Patients requesting allergy injections are instructed to review the UCSC Student Health Center Allergy Clinic Information Sheet (HC#891c).

Self-Directed ASYMPTOMATIC STI TESTING - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/06/2017
Reviewed: 
Wed, 09/06/2017
Revised: 
Wed, 09/06/2017
Policy: 

This Student Health Center policy allows patients to order their own testing for 4 sexually transmitted infections: HIV, Syphillis, Chlamydia and Gonnorhea.  This policy includes permission for patients to order and to self-collect rectal and/or vaginal swabs for Gonnorhea and/or Chlamydia testing.  The policy reviews the RNs role in reviewing self-directed STI results.

Procedure: 

1. Student goes to the lab.

2. Swab It Bulletin Board educates students on what tests to order, when to order them, and what body parts to test.  Swab It Board refers student to SHOP or to the on-line STI Wizard site for additional education and assistance in identifying what tests are indicated.

3. Student completes lab slip indicating the tests they wish to perform.

4. Lab provides urine cup or Aptima test swabs for self-collected urine, vaginal or rectal samples.

5. Lab draws blood for HIV and/or syphillis testing.

6. RNs review Self-Directed STI lab results every morning.

7.  Students with negative test results receive secure email message with results.  Positive test results are forwarded to the Medical Director or Patient Care Coordinator who contacts the student for appropriate treatment.

Key Points: 

CDC Guidelines recommend that all women under age 26 be tested annually for chlamydia and gonnorhea.

Men who have sex with men are recommended to test every 3 to 4 months.

Santa Cruz County has seen a dramatic increase in rates of syphillis and gonnorhea.  Rectal and oropharyngeal gonnorhea rates have been rising more rapidly than genital rates.

Barriers to testing, such as requirements for a clinician visit, reduce access to needed testing.
This procedure minimizes barriers to routine testing.

Rapid diagnosis and treatment of STIs is a public health imperative. Barriers to testing remain a significant source of delayed identification and treatment of STIs, particularly HIV. The implementation of self directed at the the UCSC Student Health Center expedites timely STI Testing.

ANAPHYLAXIS EMERGENCY CARE - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Sat, 08/27/2011
Revised: 
Fri, 02/03/2017

This procedure gives the RN the delegated authority to initiate appropriate care of the patient presenting with an anaphylactic reaction. Anaphylactic reactions are rare but life threatening. The timely use of Epinephrine, Benadryl and oxygen is critical to appropriate care of the patient.
Procedure
RN assesses patient and notes evidence of anaphylaxis. Percentages noted in parenthesis indicate likelihood of having this symptom as an indicator of impending anaphylaxis.
Evidence of developing anaphylaxis includes:

ANKLE AND FOOT X-RAY ORDERS - STANDARDIZED NURSING PROCEDURES

Effective Date: 
Wed, 09/01/2010
Reviewed: 
Sat, 08/27/2011
Revised: 
Sun, 08/28/2011

This standardized procedure uses the Ottawa Rules for x-ray of the Ankle and the Foot as guidelines to allow the RN to order x-rays prior to clinician appointment when the patient meets the established criteria. In a meta-analysis, the Ottawa Rules for x-ray of the Ankle had a 97.6% sensitivity and reduced the unnecessary use of x-rays by 34%.
Procedure
RN orders x-ray of the ankle if the patient meets the following criteria
 Bone tenderness at posterior edge or tip of the lateral malleolus OR

Syndicate content