Regional Guidelines for CHA/Ps
Give Flu Shots without Standing Orders or RMT: CHAs without standing orders may give flu vaccines without RMT. Full documentation in RAVEN is required. The patient’s vital signs and screening questionnaire must be normal. Call Immunization at 543-6121 if there is a question or concern.
Use of Albuterol before RMT: CHAs may give one bullet of Albuterol neb for patients with wheezing, shortness of breath, SPO2 of 93% or less, or respiratory distress (cyanosis, fast respiratory rate, retractions, nasal flaring, grunting,). Document the patient’s lung exam and vital signs before and after treatment (the SPO2 is repeated 15 minutes after neb treatment) and state if the nebulizer treatment helped or not. These patients must be reported urgently. DO NOT let any patient in respiratory distress leave the clinic until approved by RMT provider.
Use of Acetaminophen or Ibuprofen before RMT: CHAs may give one dose of Acetaminophen (per CHAM dosing charts) to patients greater than 3 months of age, or one dose of Ibuprofen to patients greater than 6 months of age, FOR a rectal temperature of 100.4 F or more (or oral temperature of 99.5 F or more in older children and adults), or a pain scale /FLAAC of 7 or more. In 30 minutes, get another temperature and state if the patient is better or not.
WIC Visits without RMT: CHAs may do WIC exams without RMT. If any concerns or abnormal vital signs/hemoglobin, evaluate the problem using CHAM/RMT, or treat using Standing Orders. Give nutrition education at all WIC visits, such as “General Guidelines for Wellness”, “Nutrition”, “Basic Guidelines for a Healthy Diet”, “Nutrition for Breastfeeding Women”, or “Good Resources of Key Nutrients.
Abscess Recheck Visits without RMT: CHAs may do abscess care re-check care without RMT as long as the patient is better and there are no concerns. RMT if the abscess is staying the same or getting worse.
Giving Expedited Partner Therapy to Partner(s) of Patients with positive GC or CT without Standing Orders or RMT: CHAs may give Expedited Partner Therapy (EPT) to partner(s) of patients with positive Gonorrhea or Chlamydia infections without RMT. Document in the chart of the patient with the infection: “EPT #___ dose(s) given to patient for partner(s).” Document the medicine and dosage and CN #. Do not document name(s) of patient getting EPT.
Obtain Pediatric Lipid Screening without Standing Orders or RMT: CHAs may order lipid panel (fasting or non-fasting) for patients 9 years old to 11 years old who have never had a pediatric lipid screening without RMT. Use health maintenance during visit to determine if the patient has or has not had a pediatric lipid screening in the past. Full documentation of lab draw in RAVEN is required. Please order the lipid panel under the village clinic’s primary care provider’s name.
Give Fluoride Varnish without Standing Orders or RMT: CHAs may apply fluoride varnish to patients’ teeth every 3 months without RMT. Give patient education after/during fluoride varnish treatment for “brushing your teeth” and “flossing your teeth” for patients greater than 2 years; give patient education for “early childhood cavities” for patients less than 2 years. Full documentation in RAVEN is required.
