63M-2.006. Sick Call

(1) Sick Call shall be conducted only by a licensed nurse or higher licensure level.

(2) Sick Call shall be regularly scheduled in each facility.

(3) All youth with a complaint, illness, or injury shall have the opportunity to access care through the Sick Call process.

(4) Review and triage of Sick Call requests shall be conducted as follows:

(a) A licensed nurse, or higher licensure level, shall review, triage promptly, and screen for urgency all Sick Call requests such that emergency conditions are not delayed for the next regularly scheduled sick call session.

(b) When a licensed health care professional is not on site, the shift supervisor shall review all sick call requests as soon as possible, within four (4) hours after the request is submitted.  Issues requiring attention prior to the next scheduled Sick Call shall be addressed as per Rule 63M-2.009, F.A.C.

1. A Registered Nurse, or higher licensure level health care staff, after review of the Sick Call requests, shall make an assessment while conducting Sick Call, and determine whether a nursing or medical intervention is appropriate.

2. If a facility utilizes a Licensed Practical Nurse (LPN) without the presence of a Registered Nurse, the LPN shall conduct the Sick Call.  The LPN shall review all sick call requests daily (either telephonically or in person) with someone at the level of a Registered Nurse or a higher licensure level.

(5) After appropriate evaluation of the Sick Call requests has been completed:

(a) For residential commitment programs, a list of youth who have requested to be seen at the next Sick Call shall be generated and provided to the nurse.

(b) For detention facilities, the staff shall utilize JJIS and FMS to enter the Sick Call requests generated by the youth. This entry must then generate a notice to the nurse for his/her timely review. Every facility shall have a backup method for notification to the nurse in situations where the computerized system is unavailable.

(6) Youth identified as having the same complaint and seen by the nurse three times within a two-week period shall be referred to the Physician, ARNP or PA.

(7) A youth who has received medical evaluation and treatment by the ARNP or P.A. more than once for the same complaint that has demonstrated no improvement after two medical evaluations shall be referred immediately to a physician (on-site, off-site or Emergency Room).

(8) The RN, ARNP or P.A. shall immediately notify the DHA (physician) when he or she cannot determine the nature and/or severity of a youth’s medical or clinical condition. The Designated Health Authority has the final authority for determining the next medical course of action.

(9) When a non-licensed staff person has a concern regarding a youth’s need to be seen as early as possible in Sick Call, whether or not the youth has made a Sick Call Request, the staff shall notify the nurse as soon as possible.

(10) The Sick Call documentation shall be as follows:

(a) Youth in Residential Commitment Programs shall complete the Sick Call Request Form (HS 032). The Sick Call Request Form (HS 032, February 2010) is incorporated into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-03811 or may be obtained by contacting: DJJ, Office of Health Services, 2737 Centerview Drive, Tallahassee, FL 32399.

(b) For youth who need assistance completing the form, a staff person shall be available. The staff person must communicate to the youth that this then gives them access to the youth’s personal information. The staff person shall maintain the youth’s confidentiality.

(c) The completed Sick Call Request forms shall be placed in a secure location inaccessible to youth to be provided to the nurse.

(d) The completed Sick Call Request form is to be filed with the progress notes in the Individual Health Care Record in reverse chronological order.

(e) Detention facilities shall utilize the established Facility Management System (FMS) and the Juvenile Justice Information System (JJIS) to coordinate and document Sick Call. A copy of the completed electronic Sick Call Request form shall be placed in the youth’s Individual Health Care Record.

(f) When the youth is evaluated and treated by the facility’s Physician, PA or ARNP, the Chronological Progress note section shall be utilized to provide documentation for the Individual Health Care Record. The documentation shall include subjective findings, objective findings, the medical assessment of the youth, and the plan of care for treatment of the youth.

(g) Sick Call complaints shall be listed on The Sick Call Index form (HS 030), and filed in the section reserved for the Core Health Profile in the Individual Health Care Record. The Sick Call Index (HS 030, October 2006) is incorporated into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-03812 or may be obtained by contacting: DJJ, Office of Health Services, 2737 Centerview Drive, Tallahassee, FL 32399.

(11) An aggregate Sick Call/Referral Log (HS 031) must be utilized at each residential program. The Sick Call/Referral Log (HS 031, October 2006) is incorporated into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-03813 or may be obtained by contacting: DJJ, Office of Health Services, 2737 Centerview Drive, Tallahassee, FL 32399. The facility may utilize a form of their choice as long as the form includes all information required on the Sick Call/Referral Log.

(12) Detention facilities shall utilize the sick call log generated by the JJIS system.

Rulemaking Authority 985.64(2) FS. Law Implemented 985.64(2), 985.145, 985.18 FS. History–New 6-20-14.