The board authorizes qualified staff to provide clean, intermittent bladder catheterization (CIC) of students or assisted self-catheterization. Such procedures shall identify which staff are qualified to perform such catheterization procedures and shall conform to pertinent rules of the State Board of Nursing.

Catheterization is authorized under the following conditions:

1. A parent, legal guardian or other person having legal control over the student file a written, current and unexpired request that the district provide for the catheterization of the student;
2. A licensed physician of the student file a written, current and unexpired request that catheterization of the student be provided for during the hours when school is in session or the hours when the student is under the supervision of school officials.
3. A registered nurse provides written, current and unexpired instructions regarding catheterization which states which staff members designated to provide for catheterization and a description of the nature and extent of supervision that is required; and
4. Any staff member who is authorized to provide for catheterization must receive training from a registered nurse consistent with the rules of the State Board of Nursing. Licensed practical nurses (LPNs) are trained to provide catheterization as part of their professional preparation and are not subject to this training requirement.

The district and its staff and the staff member who provides for catheterization in substantial compliance with this policy and the rules of the State Board of Nursing shall not be liable in any criminal action for civil damages arising from providing catheterization. The district may discontinue catheterization service for a student without being liable so long as the student’s parents/guardians are given advance oral/written notice.

Diapering and/or Toileting:
The board authorizes qualified staff to provide diapering and/or toileting to students. Students may require diapering and/or toileting due to health, physical or cognitive disabilities. These students may require diapering or toileting on a scheduled or on an “as needed” basis. These tasks should be performed with dignity and respect for the student in a private and safe setting.

When a staff member receives an assignment to diaper or toilet a student, they must be given student-specific training and instructions for the student to ensure student safety. This training may be provided by an occupational/physical therapist and/or school nurse, in accordance to the student’s plan of care from licensed health care provider (LHP) and/or parent/guardian.

Two adults should always be present when performing diapering and/or toileting tasks. Staff may request training or seek advice from the occupational /physical therapist, school nurse, the teacher and parent regarding diapering and toileting students.

1. School Site Administrator is responsible for ordering needed equipment/supplies for students (see below for complete list of possible equipment/supplies needed).
2. All staff are required to complete the mandatory Blood Borne Pathogen trainings upon being hired and at the beginning of each new school year (within the first 6 weeks).
3. Special Education staff need to consult with the school site administrators each month for the scheduled safety trainings that are provided at each site.
4. Special education staff will be trained in the diapering/toileting procedure by the supervising site case manager or other skilled designee. This will be done at the beginning of each new school year (within 2 weeks).

Equipment/Supplies:
The following list of equipment and supplies identifies the minimum necessary to provide the safest environment for both students and staff.

1.    Running water, soap and towels.

2.    Adjustable changing table. At the minimum, an unbroken, clean, sturdy surface off the floor should be provided; you should NOT diaper a student on the floor or on a desk.

3.    Lifting device. Depending on the size and mobility of the student, some equipment may be needed to assist in the safe handling of a student. This may include: Hoyer lift, transfer belt, transfer board, and electronic lifting device with appropriate slings. Discuss with the IEP team the importance of specifying in the IEP what lifting and transferring equipment is needed.

4.    Privacy curtain.

5.    Gloves – non-latex in different sized and lengths to appropriately fit all staff.

6.    Sleeves, aprons, masks (as required by task).

7.    A covered and lined refuse receptacle for waste and contaminated PPE.

8.    Sanitized and disinfectant cleaning cloths for surfaces.

9.    Chucks and/or table paper.

10.  Supply of soap, toilet paper, wipes and paper towels.

11.  Paper towels.

Schools should have these basic facilities:

1. Running water
2. Handicapped accessible stalls
3. Adequately ventilated
4. Storage cabinet (locked) for supplies that is accessible to changing area

 

Cross Reference:
Education of Students with Disabling Conditions -  Policy 2161
Communicable Diseases – Policy 3414

Legal Reference:
Catheterization of School Students – Immunity from Liability -  RCW 28A.210.290
Provision of health services in public and private Schools – Employee job description RCW 28A.210.255
Catheterization of public and private school students – RCW 28A.210.280
Provision for Clean, Intermittent Catheterization in Schools – WAC 246-840-820

Contagious diseases, limiting contact—rules and regulations - RCW 28A.210.010
Contagious Disease—School Districts and Day Care Centers - Chapter 246-110 WAC
Training—School Employees—HIV/AIDS Washington Industrial Safety & Health Act (WISHA)
requirements-Occupational exposure to blood borne pathogens - Chapter 392-198 WAC 296-62-08001

Highline School District 401
Adopted by the Board: April 1992
Revised by the Board: 1.09, 11.19
Classification: Priority