Page 2881 - Week 09 - Thursday, 13 August 2015

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Parents’ stories highlighted the unique pressure that having a child with a disability brings to a family. Consultation with health professionals found that registered nurses are required to undertake professional development and to engage with the profession to maintain skills, knowledge and evidence-based practice, and that this was especially important when working in an isolated and autonomous environment such as a specialist school

Under the specialist school nurse model, the registered nurses were unable to leave the school during the day, and this precluded them from further professional development opportunities. Where the specialist school nurse model still operated, the nursing positions were not perceived as a positive career option by nurses, as evidenced by numerous failed attempts to fill vacancies.

Analysis of the feedback provided and the language used by parents and teachers conveyed the perception that all possible health issues could be resolved by an onsite nurse. However, this places unrealistic expectations on the nurse and increases the potential for breaches of scope of practice. Presuming that one nurse has the medical and first-aid knowledge of all of the students at the school poses a number of risks. The nurse cannot be in all places at once and is left juggling the routine procedures and the calls to first aid and non-routine events. This poses risks for the students and subsequently for the nurse.

The introduction of the HAAS pilot had allowed children with a HAAS care plan and a trained school staff member to safely attend offsite activities. A registered nurse is not required to be the first level response to first aid, and in emergency incidents as the designated trained first-aid officer, supported by the ETD first-aid policy, is an adequate and appropriate response. There is a widespread assumption that providing first aid is a normal function of a registered nurse, which is not the case.

In response to the consultation findings, the industrial consultative committee agreed on the following principles to guide the development of the revised HAAS model. The model needs to meet the variety of health needs experience by students attending specialist schools in a way that is not a one-size-fits-all approach. The range of healthcare needs can be catered to by people with varying levels of expertise and needs to include first-aid officers, registered nurses and learning support assistants but not teachers. A transitioning period will be required.

The healthcare tasks have been mapped to the appropriate skill level of workers as part of the review. A revised HAAS model is being developed that will comprehensively address the health needs of the entire specialist community and meet the concerns that have been raised through the consultation process. The revised HAAS model proposes a combination of level 2 registered nurses, first-aid officers and LSAs in a tiered approach to health care.

All specialist schools would have nursing services that include a nursing presence available at all schools for parents to provide advice and support on student health needs, development of care plans in partnership with parents for students with chronic and healthcare needs, consultation with other health professionals to support this care, and training and competency assessment of LSAs caring for students with chronic and complex healthcare needs.

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