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FAIRFAX MEDICAL RESERVE CORPS ROLE SPECIFIC TRAINING SPECIAL NEEDS UNIT ASSISTANTS And ASL INTERPRETERS rev 6.2 Special Needs Unit Mission • To provide services for clients with mobility, visual, hearing, cognitive, or emotional impairments • To provide these services in a smaller, less congested area of the dispensing site • Unit will include intake, contact screening, registration/education, medical screening, and medication dispensing Special Needs Unit Overview • All services of the dispensing site will be provided in one area • Family members of those with special needs may accompany them through the Special Needs Unit • Unit staff must be familiar with all tasks performed in the unit • Flexibility will be key to accommodating the needs of individuals going through this unit Learning Objectives • To understand the tasks and responsibilities required in each of the following Units Intake Ill person triage Contact Investigation Registration/Education Screening Dispensing Post Dispensing • You may be assigned to assist with any or all of these functions Importance of Your Role • You will be working with citizens who need extra help in understanding the information being provided at the Dispensing Site • Your patience, flexibility, and creativity will be key to insuring that these individuals receive the maximum benefit from the Dispensing Site Basic Knowledge Required • Familiarize yourself with the fact sheet on the disease of concern • Be familiar with the dispensing site educational materials and forms • “Just in Time” Training during the first twelve hours of the clinic will provide this information Tips on Handling the Public • Model a calm, positive attitude • Be patient – people will ask some unnecessary questions • Refrain from getting into long conversations that might hold up the line Tips on Handling the Public (2) • Observe people for signs of significant anxiety/stress – refer to mental health through unit leader • Report all inter-personal conflicts to unit leader so security can be summoned if necessary– don’t put yourself in harm’s way • Don’t speculate or express your opinions about the crisis Overview of Dispensing Sites • Purpose: – to provide education and medication to individuals living in Fairfax County in the event of a release of a biological weapon – to accomplish this in an efficient manner and in the shortest time possible Overview of Dispensing Sites (2) • • • • • 24 high schools and GMU 1 team per shift per school 12 hour shifts 3-5 day duration Public bused to high school – From all regular high school stops – Special transport via Fastran & FCPS • Volunteer parking on-site: will obtain parking pass when you get your MRC photo ID badge Dispensing Site Flow Ill Person Triage Intake Unit Holding Area Contact Unit Education and Registration Unit Interpreter Unit Screening Unit Data Entry Unit Vaccination/ Medication Dispensing Unit Mental Health Unit Special Needs Unit Flow Control Unit Pharmacy Unit Post-vaccination/ Dispensing Holding Unit Special Needs Unit • All the tasks of the Dispensing Site are provided in one self-contained space • Nurses and Site Assistants will provide intake, education, registration, screening, and dispensing in different areas of this space • Some clients will move from area to area within the Unit • Some clients will need all services in one place Special Needs Unit (2) • Staffing: – – – – – 1 MD 1 NP/PA (Nurse Practitioner/Physician Assistant) 7 RNs 6 SNAs (Special Needs Assistants) 4 SAs (Site Assistants) • Interpreters may be needed in this Unit • All paperwork will be available in the top 5 nonEnglish languages • Tele-interpreter service may be used Special Needs Intake Area • Purpose: to screen arriving Special Needs clients for those who: – are non-English speaking – display signs or report symptoms of the disease of concern – who are contacts of individuals who may have the disease of concern • This assessment will occur in an area outside the Special Needs Unit (and probably outside the building) • Staffing: 1 RN and 1 SNA Special Needs Intake Tasks • Greet persons approaching the Dispensing Site and give them the Intake Form • Review form with client • If person speaks a language other than English, apply a hand stamp to their left wrist as follows: – S = Spanish C = Chinese – E = English O = Other – K = Korean – V = Vietnamese – U = Urdu – F = Farsi • Place a white wrist band on left wrist of speakers of other languages • Give a yellow index card to those who are deaf or hard of hearing Special Needs Intake Tasks(2) • If person notes symptoms, refer to Ill Triage area • Observe people for symptoms of disease of concern; if observed, refer to RN/Unit Leader • If person reports contact with an ill individual, give them a pink index card and direct to an area of the Unit where a contact interview will be conducted • Request an interviewer from the Contact Unit come to Special Needs Unit Contact Area Purpose: – to obtain demographic information on contacts of people with disease of concern – to educate contacts about symptoms, and instruct them about travel restrictions and reporting requirements – to initiate prompt case investigation based upon contact’s report – To refer medical questions to physician • Staffing: 1 RN with epidemiology training, 1 SNA Contact Area • Special Needs Assistant will distribute language appropriate Contact Investigation forms and help client fill them out – use interpreters as necessary – answer non-medical questions • Ensure a sufficient supply of forms and supplies Holding Area • Area for clients waiting to receive education and to begin filling out registration forms • Model calm, patient behavior • SNA will help clients find a seat and distribute educational materials and registration forms • Alert Unit leader if non-English speakers are present and will need interpreters Holding Area (2) • Site Asst’s will help clients begin to complete forms • Interpreters may be needed to help nonEnglish speakers with forms • Tele-interpreters available Education Area • Educational material and forms will be distributed • Using DVD, VHS tape, overhead slides, Power Point, or script the educational program will be presented by RN or SA • If necessary, divide group according to language spoken • Insure that clients have something with which to write Education Area(2) • Content of session includes: – – – – – clinic process signs/symptoms of disease of concern treatment options medication/vaccination information contraindications to and side effects of medication/vaccine – isolation and quarantine – explanation of forms Education Area (3) • Depending on language needs and numbers of clients, more than one education session may run concurrently • Help each client complete paperwork – Registration forms – Medical history – Answers should be clearly printed • Check that forms are completely filled out and legible • Direct clients to Medical Screening area. Screening Area • Purpose: to identify those who should not receive medication/vaccination due to medical contraindications • Staffing: 1 MD, 1 NP/PA, 1 SNA, 1 SA Screening Area (2) • SAs will review forms to identify those who: – have marked “yes” to any screening question – may have contraindications – have questions regarding interactions with their regular medications • These individuals will be referred to the NP/PA/RN • If no boxes are checked indicating a need for medical evaluation, stamp form “OK”, and retain appropriate forms Screening Area (3) • NP/PA/RN will sign off on forms if there are no flags • Evaluate those with flags, highlight the checked boxes and direct individuals to Medical evaluation area • Retain proper forms • Direct client to dispensing area Screening Area (4) • Medical Evaluation area: – Clients interviewed/examined by MD – SNA and/or Interpreter may need to be present • MD will determine if client should go home with a Deferral of Treatment letter, or may continue to the dispensing area – Those deferred will be given appropriate information about restrictions and follow-up • Those cleared will have paperwork stamped “OK” and be directed to the dispensing area Dispensing Area Purpose is to administer vaccine or provide medication to clients who may have been exposed to a biological agent Staffed by 3 RNs, 1 SNA, 1 SA, and interpreters as needed Dispensing Area • RNs will: – Administer vaccine or provide medication dispensed by pharmacy – Document as appropriate – Direct client to Post Dispensing area Dispensing Area (2) • SNAs will: – check registration forms for “OK” and ask client to give to the RN – help clients prepare site (roll up sleeve) if vaccine being given – weigh children and infants as appropriate – apply Band-Aid as directed – assist nurse as necessary – direct client to Post-Dispensing area – gather forms and deliver to data entry – monitor and request supplies as needed Dispensing Area (3) • Interpreters may be needed to explain: – procedures – instructions for taking medication, if given • Tele-interpreter service may be used Post Dispensing Area • Purpose: – Observe clients for immediate reactions/adverse effect, if vaccine given – provide supportive nursing care, if needed – answer any remaining questions • Staffing: 1 NP/PA/RN, 1 SNA Post Dispensing Area (2) • NP/PA/RN will: – monitor clients for adverse reactions – answer medical questions • SNAs will: – be familiar with disease fact sheets – provide literature on follow-up to vaccine, if given – direct clients to pick-up area outside building • Interpreters will assist with any questions and answers, as necessary QUESTIONS?