Section 11: Medical & Health Care Services - Mississippi Department of Human Services

XI.9. Medical Release Summaries
XI.3. Health Care Personnel Qualification
XI.3. A Health Care Personnel Licensure Verification Form
XI.4. Medical Facilities Equipment and Environment Monitoring
XI.4. A Dental X-Ray Log-Form
XI.4. B Autoclave Log Form
XI.4. C 1. Medical Equipment Check List Form
XI.4. C 2. Medical Equipment Check List Form Blank Form
XI.5. First Aid Kits Spill Kits and External Defibrillator (AED)
XI.5. A First Aid Spill Kit Usage Form
XI.5. B First Aid Spill Kit Inspection Record Form
XI.5.C AED Unit Inspection Form
XI.6. Medical Supplies Inventory Management
XI.6. A Supply Control Form
XI.6. B Non-Prescription Supply Control Monitoring Form
XI. 7 Medical and Dental Instrument and Sharps Management
XI.7. A Sharps Inventory Control Form 25 Count
XI.7. B Sharps Inventory Control Form 50 Count
XI.7. C Medical Instrument Sharps Inventory Daily Count Form
XI.7. D Dental Instrument Sharps Inventory Daily Count Form
XI.7. E Medical Instrument Sign Out Form
XI.7. F Dental Instrument Sign Out Form
XI.8. Health Records Structure Documentation Confidentiality
XI.8. A Interdisciplinary Progress Notes Form
XI.8. Health Records Structure Documentation Confidentiality
XI.8. C Medical Abbreviations for Nursing Services
XI.8. D Vital Signs Form
XI.9. Medical Release Summaries
XI.9. A Medical Release Summary Form
XI.9. B Release Log Form
XI.10. Medical Department Shift Report
XI.11. Consent and Authorization to Treat
XI.11. A Release of Medical Information Form
XI.11. B Elective Procedure and Surgical Review Form
XI.12. Medical Notification of Designated Individuals
XI.13. Access to Health Mental Care
XI.13. A Health Call Form
XI.13. B Health Call Log
XI.13. C Physician Health Call Referral Log
XI.13. D Welcome Letter From Staff
XI.14. Administration of Medical Treatment
XI.14. A Doctors Order Form
XI.15. Admission Health Screening and Assessment
XI.15. A Nursing Intake Assessment Form
XI.15. B Admission Log
XI.15. C Hearing and Vision Screening Form
XI.15. D Medical Records Request Log
XI.15. E Initial Admissions Screening Tool
XI.16. Health Care Appraisal and Examination
XI.16. A 1. Physical Exam Form Boys
XI.17. Laboratory Services
XI.17. A Lab Log Form
XI.18. Optometry Services
XI.19. Dental Screening Examination Services
XI.19. A Dental Record Form
XI.19. B Dental Visit Log
XI.19. C Dental Referral Log
XI.20. Special Health Needs Programs
XI.20. A Medical Problem List Form
XI.20. B Health Care Plan and Medical Instructions Form
XI.20. C Asthma Management Flow Sheet
XI.21. Female Health Care
XI.22. Health Education Prevention
XI.22. A Teaching Learning Flow Sheet
XI.23. Therapeutic Diets Diet Referrals
XI.23. A Special Diet Request Form
XI.24. Juvenile Participation in Medical Records
XI.25 Medical Consultation Hospitalization
XI.25. A Medical Department Off Campus Log
XI.25. B Medical Consultation Form
XI.25. C Medical Transportation Instruction Form
XI.26. Emergency Medical Response and Services
XI.27. Emergency Medical Referral
XI.28. Infirmary Care
XI.29. Pharmaceutical Management
XI.30. Pharmaceutical Prescribing Procurement Administration Documentation Procedures
XI.30. A Medication Administration Record (MAR)
XI.30. B Medication Error Report Form
XI.30. C Medication Treatment Refusal Form
XI.31. Pharmaceutical Receipts Storage Inventory Disposal-Management
XI.31. A Non-Prescription Pharmaceuticals Control Form
XI.31. B Contingency Medication Controlled Substance Daily Count Sheet
XI.31. C Non-Prescription Pharmaceuticals Supply Monitoring Form
XI.32. Psychiatric Evaluations Content Referrals for Psychiatric Evaluation Use & Management of Psychotropic Medication
XI.32. A 1. Informed Consent for Psychotropic Medication Forms
XI.32. B Psychotropic Medication Standing Orders Form
XI.33. Communicable Disease Management
XI.34. HIV Screening Testing and Management
XI.34. A HIV Informed Consent and Confidentiality of Test Results Form
XI.35. Hepatitis Screening Testing and Management
XI.36. TB Testing and Management
XI.36. A TB Skin Testing Record Form
XI.37. Immunization Program
XI.37. A Hepatitis A Vaccination Protocol
XI.37. B Hepatitis B Vaccination Protocol
XI.37. C MMR#2 (Measles, Mumps, Rubella)Vaccination Protocol
XI.37. D Tetanus Toxoids Diphtheria Acellular Pertussis (TDAP) Vaccination Protocol
XI.37. E Varicella (Chickenpox) Vaccination Form
XI.37. F Meningococcal Vaccination Protocol
XI.37. G Human Papillomavirus (HPV) Vaccination Protocol
XI.37. H Seasonal Influenza Vaccination Protocol
XI.37. I Temperature Logs for Vaccines (Fahrenheit)
XI.38. Exposure Control and Standard Precautions
XI.38. A Standard Precaution Form
XI.39. Pandemic Response Plan for Medical and Mental Health Services
XI.39. A Flu Screening Form
XI.39. B 1. Ready Level Green
XI.39. B 2. Ready Level Yellow
XI.39. B 3. Ready Level Red
XI.39. C Influenza Vaccine Inactivated “The Flu Shot”
XI.39. D Influenza Vaccine Attenuated “The Nasal Spray Vaccine”
XI.40. Medical Services Review Monitoring Reporting
XI.40. A Health Services Supervisors Weekly Report
XI.40. B Health Care Services Monthly Report
XI.40. C Medical Services Review and Monitoring Tool
XI.40. D 1.Medical Records Review Monitoring Tools- Intake Admission
XI.40. D 2. Medical Records Review Monitoring Tools- Medication Continuity Review
XI.40. D 3. Medical Records Review Monitoring Tools- Medication Administration
XI.40. D 4. Medical Records Review Monitoring Tools- Dental Work F U
XI.40. D 5. Medical Records Review Monitoring Tools- Psychiatric Evaluation
XI.40. D 6.Medical Records Review Monitoring Tools- Psychiatric Progress Notes
XI.40. D 7. Medical Records Review Monitoring Tools- Psychiatric Protocols-Medication
XI.40. D 8. Medical Records Review Monitoring Tools- Psychiatric Discharge
XI.40. D 9 Medical Records Review Monitoring Tools- Injury Abuse- YIA-Form
XI.40. D 10. Medical Records Review Monitoring Tools- Problem List
XI.40. D 11. Medical Records Review Monitoring Tools- Health Call
XI.40. D 12. Medical Records Review Monitoring Tools- Health Call Boxes
XI.40. D 13. Medical Records Review Monitoring Tools- Health Care Plan and Medical Instructions
XI.40. D 14. Medical Records Review Monitoring Tools- Psychology Forms in the Health Record
XI.40. D 15. Medical Records Review Monitoring Tools- Special Health Needs