Richard Calica, Director 03-12-12 Copyright © 2012 by the Illinois Department of Children and...

03-12-12 Copyright © 2012 by the Illinois Department of Children and Family Services

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Richard Calica, Director

Instructional tool CENTRALIZED NURSING REFERRAL

PROCESS

Illinois Department of Children and Family Services

DCFS Child Welfare Nurse Specialists


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GOALS

Enhance the knowledge of the centralized nursing referral process whereby increasing the utilization of consultation services provided by DCFS Child Welfare Nurse Specialists (CWNS) utilizing consistent formalized training

Enhance job performance and expectations of DCFS Child Welfare Nurses

Improving the overall quality of health care acquisition and resources for children with special health care needs


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Instructional objectives

Upon completion of the training the learner will be able to:

Recall an operational definition of children with special health care needs

Know the job performance and expectations of the DCFS CWNS

Recognize the need to request consultation services from a CWNS


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Instructional objectives

Know the types of nursing referrals Discuss the steps of the centralized nursing referral

process Locate policy transmittal 302 Appendix O and the

nursing referral form (CFS 531) on the DCFS D-Net and SACWIS template


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Policy Guidelines for Nursing Referral Process

DCFS Policy Transmittal – 2008.09 effective May 16, 2008

Policy Transmittal revisions:– 302 Appendix O – 300.70 Subsection (i) – 300.80 Subsection (g)– 302.388 Subsection (f) (2)– CFS – Nursing Referral Form


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Richard Calica, Director How to define a child with special health care

needs

The Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (MCHB) defines children with special health care needs (CSHCN) as:

“...those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.” (McPherson, Arango, Fox, Mcmanus, Newacheck,Shonkoff, Strickland, 2012)


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Diagnosis for children with special health care needs

Any rare genetic disorder ( e.g.,Tay-Sachs) Asthma (moderate, persistent or severe) Apnea episodes Cerebral palsy Multiple psychiatric hospitalizations and/or medications Compromised immune system (HIV) Sickle Cell Disease/Trait Failure to thrive Diabetes type I or type II


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Diagnosis (continued)

Environmental modifications Metabolic disorders, (galactosemia, PKU

(phenylketonuria) Second & third degree burns Respiratory problems Seizure disorder

– Expanded list can be found on D-Net Policy Transmittal 302 Appendix O


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Child Welfare Nurse Specialist is:

An Illinois licensed Registered Nurse functioning primarily as a

Health care services Consultant Liaison – consultant to residential and skilled

nursing facilities providing: Advocate


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Services NOT provided by CWNS

Second medical opinions

Direct care

Case management duties

Consent Approval


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Richard Calica, Director Reasons for Requesting consultation

Assessment and evaluation for placement Protective custody for children with special health

care needs (EMERGENCY) Consultation – medications/regimen, compliance,

regimen, polypharmaceutical evaluations *consult with medical director for further clarity if needed.

Understanding the cause and functional changes of

documented diagnosis


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Requesting consultation services

Participation in staffings’ and CIPP (clinical intervention for placement preservation)

Home modifications

home/school and hospital discharge assessments

Assistance in coordination of medical transportation for children with special health care needs


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Requesting consultation services

Consent procedure CWNS does not sign consent

assist with problem identification

Dr. Billie Adams (773) 288-4824/ or Dr. Chaudhary 217-492-2618 will provide approval for surgical procedure

* authorized agents located in regional offices will sign consents


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Types of nursing referrals

Formal Nursing Referral Most commonly used for all request for nursing

consultations Suspected medical abuse/neglect Participation in staffings/CIPPs Medical record review Physician contact Home visit/hospital discharge assessment visits


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Formal Nursing Referral

CWNS will respond to the referral source (caseworker, DCP, Healthworks, etc.,) within 5 days of receiving the nursing referral from the central office

• Contact will be made via phone, e-mail and or in person• Please ensure once referral is submitted – a contact

number is provided – for nurse


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Formal Nursing Referral

o Documentation is submitted to the central office for review per policy transmittal 302 Appendix O.

o Accepted documentation will be sent to worker/supervisor or entered into the SACWIS system

o NANDA Documentation: Assessment Nursing diagnosis Plan Implementation Recommendations/evaluation

*NANDA (approved documentation)


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Types of Nursing Referrals

Emergency Nursing Referral Protective custody children with special health care needs

needing immediate placement

Note: form 418J must be initiated during protective custody investigations by DCP for a child with special health care needs


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Emergency Nursing Referral

CWNS will respond to the referral source (DCP) within 12 hours of receiving the nursing referral from the central office

Note: after hours – Chief Nurse is available 24 hours via cell phone for consultation as well as “gatekeeper” in specialized care for specialized placement. Children should be taken for observation via emergency room. DCFS nurse will receive Emergency referral during next business day to provide extended consultation


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Casual Inquiry not “client specific” Requesting information, e.g., understanding of a specific drug, how to complete a nursing referral what is the definition of a medical condition etc. May occur in various settings, regional office(s), telephone or

in person Used by DCFS nurses “only”


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Notification only Health Works lead agencies status change client being seen at one of our Health Works lead agencies 5 day response time after receipt by CWNS When submitting nursing referral – attach CHE

(Comprehensive Health Evaluation)


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Richard Calica, DirectorCFS 531 Nursing Referral Form

Request for all nursing consultations (Formal, Emergency, and Notification Only) must be initiated by completing the Nursing Referral Form (CFS 531).

DCFS, Health Works, or access to DNet – CFS 531 may be complete and submitted via SACWIS

No access to DNet-CFS 531 may be faxed

Form will not be processed if it is handwritten


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Nursing Referral Form CFS 531

3 ways to submit CFS 531 requesting nursing consultation: SACWIS E-MAIL – complete form to “nurseref” via DCFS outlook

(DCFS/DCP, Health Works – are to use e-mail submission FAX – complete form to 1-866-531-1459 (outside agencies

with no access to DCFS Outlook email system)


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Nursing Referral Form CFS 531

CFS 531 – Hard copy 11 page document Pages 1- 4 completed by the individual making the

request for nursing consultation Pages 5-11 completed by CWNS * nursing

documentation will be noted on pages 5-11


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Richard Calica, DirectorCFS 531

Page 1

Date of Birth – refers to the child's date of birth

Legal status of child – must be identified

Primary language needed *(Burgos decree - bi-lingual nurses are available)

Complete caregivers section

Workers referral information

Region/Site/ Field must also be completed


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CFS 531

Page 2


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CFS 531

Page 3


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CFS 531

Page 4


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CFS 531

Page 5


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SACWIS CFS 531–screen shots are identical to the hard copy CFS

531


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Screenshot 1-click New Nursing Referral hyperlink after clicking Nursing Referral on left side of eHealth.


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Screenshot 2-select a Referral Type. Enter a required comment. Click the Add hyperlink.


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Screenshot 3-after adding the Nursing Referral, it can be deleted (if mistaken entry, etc) by clicking the Delete hyperlink.Click the Save button if retaining the referral.


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Screenshot 4-Click the SUBMIT button to submit the referral to the nurses.


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Screenshot 5-the Response Detail is accessed and filled out by the Nurses.


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Screenshot 6-Shows the referral request date and the status. After the Nurses accept it, the Acceptance Date and Assessment date are displayed.


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Richard Calica, Director Summary of Centralized Nursing Referral

Process

CFS received via:– Fax 1-866-531-1459– E-mail “nurseref”– SACWIS– Logged onto our Data base

– Reviewed by Chief Nurse at central location– Referral is assigned to CWNS


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Richard Calica, DirectorSummary (continued)

CWNS makes contact per authorized time frame (5 days,12 hours)

Verbal recommendations initially

hard copy – worker/supervisor/health works or SACWIS input once reviewed and accepted (PT 302 App. O) *approval pending DCP


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Case Study

12 hours

(emergency referrals)

12 hours (emergency

referrals)

Referral Evaluated

logged onto

database

logged onto

database

Make an assesment & provide verbal health

safey recommendations

Nurse assigned from Central office will contact referral

source

531- complete all applicable areas-email to nurseref (via

outlook)Complete 531 in SACWIS

Referral source may be

contacted for clairity and for

ALL EMERGENCY REFERRALS

Consultation Complete

Consultation Complete

Chief Nurse contact ref. source

5 days (formal referral)

5 days (formal referral)

Documentation of assessment & health safety

recommendations submitted to Central office- reviewed

document disseminated to referral source or placed on

SACWIS


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References

McPherson, M., Arango, P., & Fox, H. B. (1998). A new definition of children with special health care needs. Pediatrics, 102, 137-140.

American Nurses Association. (2011). The nursing process: A common thread amongst all nurses. Retrieved http://nursingworld.org/EspeciallyForYou/StudentNurses/


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Richard Calica, Director 03-12-12 Copyright © 2012 by the Illinois Department of Children and...

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