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Hemophilia and School:  Developing an Individualized Healthcare Plan (IHP). Ideal Setting. Collaboration School Parent Medical Team. School Issues. Frequent absences Hard to catch up Decreased peer support Activity restrictions No contact sports

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Hemophilia and School:  Developing an Individualized Healthcare Plan(IHP)


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Ideal Setting

  • Collaboration

    • School

    • Parent

    • Medical Team


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School Issues

  • Frequent absences

    • Hard to catch up

    • Decreased peer support

  • Activity restrictions

    • No contact sports

    • Immobilization during bleeding episodes

  • Pain

    • Chronic/acute

    • Medication side effects

  • Infectious diseases


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Medical Management at School

  • Acute management

    • Factor replacement

    • Joint support

    • R.I.C.E.

    • Pain medications

      • Tylenol

      • Narcotics

      • NASIDS


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Medical Management at School

  • Subacute management

    • Exercise

    • Education

    • Counseling


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Individualized Healthcare Plan

  • History

    • Type/severity

    • Bleeding patterns

    • Hemophilia Treatment Center (HTC)

    • Medical Plan

      • Treatment Plan

      • Student’s participation

    • Past attendance patterns

    • Participation

      • Activities

      • PE

      • Other sports


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Individualized Healthcare Plan

  • Assessment

    • Knowledge/perception about hemophilia

      • School

      • Student/family

    • Students ability to do self care

    • Motivation for self care

    • Barriers

    • Health Status

    • Environmental Assessment


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Individualized Healthcare Plan

  • Nursing Diagnosis

    • Potential for injury related to factor deficiency

    • Potential for alteration in comfort

    • Potential for alteration in mobility

    • Knowledge deficit related to disease/management

    • Potential for noncompliance

    • Potential for alteration in student role


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Individualized Healthcare Plan

  • Goals

    • Prevent injuries/safety measures

      • Not always able to prevent bleeds

    • Develop emergency plan

    • Comply with medical treatment

      • Prevention

      • Treatment

    • Good decision making

    • Good attendance

    • Maximum participation


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Individualized Healthcare Plan

  • Nursing Interventions

    • Environmental assessment to prevent injury

    • Safety measures

    • Emergency plans for bleeding episodes at school

    • Adequate knowledge of medications and side effects

      • Appropriate authorizations

    • Obtain needed equipment/supplies


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Individualized Healthcare Plan

  • Nursing interventions

    • Keep accurate records

    • Discuss bleeding prevention with staff

    • Inservices as needed

    • Provide/coordinate health education opportunities

    • Choose and implement motivators to compliance

      • Remove barriers

    • Monitor attendance patterns/academic performance


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Individualized Healthcare Plan

  • Outcomes

    • The student will:

      • Describe disease and treatment

      • Identify healthy lifestyle decisions

      • Take appropriate safety measures/protective equipment

      • Maintain good attendance

      • Be a normal kid!


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Individualized Healthcare Plan

  • History

  • Assessment

  • Nursing Diagnosis

  • Goals

  • Nursing intervention

  • Outcome


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The School Nurse’s Source Book of Individualized Healthcare Plans

M.J. Gerber et al. Vol 1, Sunrise River Press


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