The Basic and Specialized Procedure Manual for WV Public ...



2009Recommendation The Use of Pulse Oximeters in the school settingThe Basic and Specialized Procedure Manual for WV Public Schools currently has two procedures which have a pulse oximeter listed as equipment needed. Those are: Mechanical Ventilator and Phrenic Nerve Stimulator. These are student specific and ordered by a physician. The pulse oximeter is to be supplied by the parent / guardian. The student specific order should include interventions for abnormal readings. Use of a pulse oximeter as an assessment tool for general school nurse practice should be determined by the comfort level of the individual school nurse. In this use, the pulse oximeter should be considered an assessment tool, not a procedure.It is the West Virginia Council of School Nurses recommendation that if a school nurse chooses to utilize a pulse oximeter as an assessment tool to complement other forms of patient assessment, that school nurse must be familiar with how to use it, decide what its purpose will be and what actions will be taken if an abnormal reading is obtained.Each nurse who utilizes this tool must be aware that several variables can cause an abnormal reading. Some of these variables include lighting, nail polish, cold temperatures (causing vasoconstriction) and certain disease processes.Also, there is a “lag time” with a pulse oximeter. When using the oximeter to assist with assessment for anaphylactic reactions or asthma, it must be understood that by the time the pulse oximeter gives a low reading, the patient may already be in serious trouble and needing intervention. When in doubt, the school nurse must rely upon clinical judgement / assessment skills, rather than the machine.Devised: November 2009ReferencesWest Virginia Council of School Nurses. (2006). Basic and Specialized Health Care Procedures Manual for West Virginia Public tina,Sandra M. (2006). Lippincott Manual of Nursing Practice 8th Edition.? pp. 213-214 Lippincott, Williams & Wilkins Publishers, Philidelphia, PA.:.?Lewis, Sharon M. (2004). Medical Surgical Nursing 6th Edition.? pp. 547-548, 1772. Mosby, St. Louis, MO.:? DISCLAIMER: The “Recommendation” of the West Virginia Council of School Nurses (WVCOSN) is not representative of West Virginia State Code or West Virginia State Board of Education recommendation or policy. This is a recommendation based on consensus, evidence-based practice reviews and current research from the WVCOSN. The WVCOSN is set forth by W.Va. Code §18-5-22. The certified school nurse is responsible for utilizing nursing judgment and skill to determine the safest delivery of health care on an individual case-by-case situation in the West Virginia public school setting while protecting the welfare and health of the student. Every situation is unique and requires a collaborative team approach lead by the certified school nurse, which includes, but not limited to, the student, parents/guardians, school administrator, experts in the field and the student’s primary health care provider, at the local level. ................
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