BROWARD COUNTY SCHOOL BOARD

HEALTH SCIENCE

CLINICAL GUIDELINES

ACADEMIC YEAR

2015-16

TABLE OF CONTENTS

  1. Student information
  2. Vaccinations/ TB
  3. Student Clinical rules and guidelines
  4. Dress Code
  5. Student Clinical Contract
  6. Receipt of Handbook

STUDENT INFORMATION

Name of School: ______Program: ______

Student Name: ______

Home Address: ______City______ZIP ______

Home Number:( )______Cell Number: ( ) ______Date of Birth: ______

Name of Parent/Guardian: ______Relationship: ______

Contact number: ______Emergency Number______

Name of Alternate or

Emergency Contact: ______Relationship: ______

Contact number: ______Emergency Number______

Name of Family Physician: ______Phone Number: ______

Address: ______City ______ZIP ______

Schedule:

Period / Subject / Teacher Name
1
2
3
4
5
6
7
8

THE SCHOOL BOARD OF BROWARD COUNTY, FLORIDA

Health Science Education

STUDENT TESTS AND IMMUNIZATION RECORD

NAME______

(PRINT) Last First Middle Social Security Number

Immunizations are required for all Health Science Education programs, and must be completed prior to the programs clinical experience. Applicants who are less than 18 years of age must be accompanied by a parent or guardian for tests and immunizations.

TEST/IMMUNIZATION / DATE / RESULTS / SIGNATURE/STAMP
HEALTH CARE PROVIDER
TETANUS/DIPHTHERIA (Td)
within five (5) years if from outside USA, ten (10) years if from USA
RUBEOLA, MUMPS, RUBELLA TITERS*
Proving Immunity OR
MMR #1
MMR #2
HEPATITIS B TITER*
Proving Immunity OR
HEPATITIS B:
First Dose
Second Dose-one month after first dose
Third Dose-six months after first dose
VARICELLA TITER*
Proving Immunity OR
#1 vaccine
#2 vaccine - 4 to 8 weeks after the first
TUBERCULIN (PPD) 2 step required yearly OR CHEST X-RAY *PPD First Step
PPD Second Step one to three weeks after first test
OR CHEST X-RAY REPORT
FLU SHOT annually during flu season (Oct - March)

* LAB REPORTS of the TITERS must be submitted by the student for this form to be considered complete.

** THIS FORM MUST BE SIGNED OR STAMPED BY THE HEALTH CARE PROVIDER **

I have received Disease and Immunization Information and understand the importance of complying with the above requirements/recommendations.

Student Signature Date

Parent/Guardian Signature (If under 18 years of age) Date

PHYSICAL and IMMUNIZATION FACILITIES

Broward County Public Health Centers (Call for information)

South Regional Health CenterPaul Hughes Health Center

4105 Pembroke Road205 NW 6th Avenue

Hollywood, FL 33021Pompano Beach, FL 33060

954-467-4700954-467-4705

North Regional Health CenterFort Lauderdale Health Center

601 West Atlantic Boulevard2421 SW 6th Avenue

Pompano Beach, FL 33060Fort Lauderdale, FL 33315

954-467-4705954-467-4700

Edgar Mills Health Center

900 NW 31st Avenue

Fort Lauderdale, FL 33311

954-467-4705

NOTE: The above location and contact information for the Broward County Public Health Centers is being provided as a convenience. We encourage you to seek any doctor or clinic of your choosing for the required physical and immunizations.

The School Board of Broward County, Florida, prohibits any policy or procedure which results in discrimination on the basis of age, color, disability, gender identity, gender expression, national origin, marital status, race, religion, sex or sexual orientation. Individuals who wish to file a discrimination and/or harassment complaint may call the Director, Equal Educational Opportunities/ADA Compliance Department at 754-321-2150 or Teletype Machine (TTY) 754-321-2158. Individuals with disabilities requesting accommodations under the Americans with Disabilities Act Amendments Act of 2008, (ADAAA) may call Equal Educational Opportunities/ADA Compliance Department at 754-321-2150 or Teletype Machine (TTY) 754-321-2158.

Clinical Rules and Guidelines

All students in the Allied Health Program are expected to behave responsibly and maturely in the clinical setting. The students at Cypress Bay High School are not only representing themselves, they are representing the instructor and the entire high school in the community. A positive attitude and desire to learn in a variety of clinical settings is essential to success in this program. It is my aim to provide each student with the optimum learning environment. It is imperative that the students I send out in the community are dependable and trustworthy. The following rules will be strictly adhered to. Failure to comply will result in consequences.

  1. All students are required to purchase Student Health Professional Liability insurance coverage to be eligible to participate in a Health Science Program clinical activity. Students will pay $12.25 on line by September 10th.
  1. All students will come to school/clinical sites dressed in required uniform. The uniform should be clean and wrinkle free. Jewelry should be limited to post earrings and a watch. Makeup should be minimal. Long hair should be pulled back or up. White leather sneakers should be worn. Absolutely no acrylic nails nor nail polish will be accepted. Male students should be shaven.
  1. All students will maintain a GPA of 2.5 (minimum). Recommendations will be made for students falling below a 2.5 to be provided alternate assignments until grade improves. Students with any outstanding, incomplete work will not be allowed to participate in the clinical setting until work is completed. All hospital journals are expected on time.
  1. All students are expected to arrive to the classroom/clinical setting on time. The students are provided with the instructor’s cell phone number to contact in the case they are unable to get to the clinical setting on time. Failure to contact the instructor in a timely matter will result in the consequences per Broward Schools Code of Conduct book. Excessive absences/tardies could result in removal from the clinical setting and /or Health Science program.
  1. All students are expected to return to school for their classes on time. If for some unforeseen circumstance, a student is delayed, they will contact their instructor for assistance.
  1. Students will be provided a hospital ID badge at orientation. Depending on the hospital, a deposit or fee may be charged for the ID badge. The badge is part of their uniform and is imperative they have it on them at all times for security measures while on hospital property. Failure to have their badge will result in loss of clinical day and an alternate assignment will be provided for the first occurrence. Additional occurrences will result in a zero for the day.
  1. Any disruption, distraction or problems occurring at the clinical sites will be discussed with the instructor and consequences will be dependent on the severity of the occurrence.
  1. Students are only allowed to perform tasks that they have learned in class when they are directly supervised by their clinical mentor. Do not perform any skill or activity in the clinical setting that you have not been taught to do. This can be dangerous to both you and the patient. If you are put in a situation where someone is asking you to do something that you are not sure of or you are uncomfortable with, notify the instructor immediately. Don’t ever feel pressured into doing something you do not feel comfortable with, it is ok to say “No, I am not comfortable with this activity or assignment”. Your safety and the patient’s safety is my utmost concern. I am always available to discuss any concerns you have whether it be with myself, a clinical or hospital assignment or another student.
  1. At no time are you to document anything in a patient’s chart either in the clinical setting or the hospital setting. If this situation arises please notify the instructor immediately.
  1. Students must have their own transportation to their clinical sites. I realize on occasion transportation problems will arise. Please notify the instructor in as timely matter as possible, so that arrangements can be made to get you to your clinical assignment or provide an alternate assignment.
  1. Should you be absent on the day of a clinical assignment, it is your responsibility to contact the instructor in a timely manner. Makeup assignments for excused absences are a 2 page paper; topic is to be based on the area missed. Please use at least 2 references and provide citations - No references = no credit. This assignment is due upon students return to school. If extenuating circumstances exist, please discuss with the instructor.
  1. At NO TIME are you remove any materials, scrubs or equipment from any hospital, clinic nor doctor’s office!!
  1. If at any time you are uncomfortable or do not feel well at your clinical site, please notify me immediately for your safety and the safety of those around you.
  1. It is extremely important that you eat breakfast/lunch before clinicals. Hospitals have sights and smells that you are not accustomed to and having breakfast/lunch decreases the possibility of having any reactions to these new experiences.

HEALTH SCIENCE UNIFORM DRESS CODE

The Dress Code is intended to ensure that all students dress in a manner, which reflects the professionalism, enhances their safety, and projects a positive image, so as not to offend patients, visitors, and other staff members. Students are to follow these rules at all times.

 Uniform

 Scrubs shall be clean, pressed, and in good repair.

 Shoes shall be white, closed, non –permeable (ie, leather or vinyl), clean and neat.

 Appropriate undergarments shall be worn and shall not be noticeable.

 Hair

 Shall be neat, clean, and combed, and above the collar so as to not interfere with work or be a safety hazard.

 Hair shall not be of extreme color or style. No designs or verbiage cut into hair.

 Male facial hair shall be shaven.

 Students who choose to wear cosmetics are required to maintain a professional and business- type appearance.

 Fingernails

 Shall be clean, neatly groomed, and trimmed to a conservative length.

 Nail polish or acrylic nails is not permitted per CDC/OSHA standards.

 No perfumes, aftershave lotions, or perfumed body lotions may be worn.

 Any electronic device such as cell phones or headphones may not be used while on duty.

 Jewelry

 Earrings shall be limited to only one stud earring per ear.

 No other visible body piercing is permitted.

 Tattoos may not be visible.

My signature below confirms that I have read, and agree to abide by the student rules as listed above.

Student Name (print):______Student Signature:______

Parent signature ______Date ______

STUDENT CLINICAL CONTRACT

The clinical sites of the Health Science Education Program have provided an educational experience dedicated to developing students interested in health care with the information and skills needed to make viable choices for the future. In order to maintain the high standard of the Health Science Education Program, the following rules and regulations have been established.

As a student in this program:

  • I will arrive promptly to my designated department and remain for the assigned period of time.
  • I will check in and out of the internship location with the clinical supervisor.
  • I will conduct myself as a lady/gentleman at all times and will be cooperative and respectful to all school and clinical staff.
  • I will exemplify a positive attitude and inspire positive behavior.
  • I will notify my instructor and/or department contact of any change in my daily schedule.
  • I will obey all the established rules of travel by reporting directly to the internship site and returning promptly to school during my assigned hours.
  • I will park only in designated areas at the school and clinical site
  • I will dress in the required clinical uniform and wear student identification at all times while on the clinical site.
  • I will hold in confidence all information or facts pertaining to patients that I might encounter in accordance with HIPAA rules.
  • I will also abide by the rules and policies listed in the student handbook at the clinical site as well as on school campus.

I have read the above and understand that failure to follow any of the rules/regulations will lead to dismissal from the Health Science Education program.

Student signature ______Date ______

Parent signature ______Date ______

Acknowledgement of Receipt of Health Science Clinical Guidelines Packet

Student Name: ______Student ID#______

I ______have received the Health Science

(Print Parent/Guardian Name)

Information Packet for ______

(Print Student Name)

I understand that my son/daughter must submit completed documents or he/she will not be allowed to participate in off campus clinical experiences.

I further understand that should this occur, my child will be provided alternate assignments and could be permanently re-assigned to an alternative program.

I have also received the information concerning Medical Health Screening. I understand this must be completed by a physician, at my expense, by the designated due date.

I understand that the high school does not provide transportation to clinical sites. Therefore, the CTSO Driving-Riding Permission must be signed, NOTARIZED, and returned with my son/daughter, by the designated due date.

I understand that failure to comply with any portion of these Broward School District-wide requirements will result in re-assignment to another program.

______

(Parent/Guardian Signature )

______

(Date)

Paperwork Checklist for ______

To participate in off campus experiences it is necessary to complete all of the following paperwork. Only complete packets will be accepted. Failure to comply by due date may result in removal from the program and schedule change.

Due date:______

  1. ____ CTSO packet (4 pages; 4th page must be signed by a notary)
  2. ____ FHSAA documentation (physical for PE)
  3. ____ Immunization record (including proof of recent PPD; influenza vaccine will be required by end of September)
  4. ____ Copy of Health insurance card or confirmation of purchase of school health insurance
  5. ____ Syllabus/classroom expectations
  6. ____ Student Clinical Contract
  7. ____ Dress Code
  8. ____ Behavior and Equipment CTE Department Policy
  9. ____ Sensitive Topic Letter
  10. ____ Receipt for Liability insurance ($12.25)
  11. ____ Receipt for HOSA dues ($50)
  12. ____ Receipt for Fall Leadership Conference ($22)
  13. ____ Fee for uniform ($25 cash or check made to Geltex USA)
  14. ____ Deposit for ID Badge ($10 cash only – exact change)
  15. ____ Copy of CPR and First Aid card
  16. ____ $20 – clinical/gym fee (cash only)

______

Will you be driving? ____yes ____no (if not, what transportation arrangement do you have?)______

If yes, you will need:

  1. ____ Copy of driver’s license
  2. ____ Copy of registration
  3. ____ Copy of auto insurance

(If possible, copy all of the above onto one page)