**Meeting ID: 443 920 723 871 35** **Passcode: Ej2Rj7Ao** __________________________________ (May 18-22) ========= **DAY 1** ========= **Complio** ========= **Understanding the Student Perspective** **1. Creating a Student Account** -Schools will provide links to the students that they can be use to create their accounts -link Can be found in Confluence, but it is best practice for the student to get the link from the school -link will take them to a School-Specific web page where they can create an account and place an order -ex. Chamberlain University * Click ***"Register"*** * Personal Info, Contact Info, Account Info * Click ***"Create Account"*** lower-right * Advise the student to login * ***chamberlain.complio.com*** **Preferred Browsers** * ***Google Chrome*** * ***Mozilla Firefox*** **Multiple Complio Accounts** -Students may need multiple accounts with different institutions. These accounts should be Linked. -There are 2 ways to link an account: * When creating a new account -If student has 2 accounts that already exist: * Click ***"Edit Profile"*** tab * Click ***"Link Account"*** under account information * email address then password to link the accounts **2. Placing an Order** -After an account is made, an order can be placed. -Click ***"Get Started"*** button on the institution's home page to begin. -Top-right corner ***"View videos"*** -Refer the students back to their school if they don't know their program or package. -Click ***"Load Packages"*** then students will be able to choose their packages -Advise students to double check the information before placing an order -If student already placed an order before but the ***"Get Started"*** doesn't appear and they want to order again, they can click the ***"Shopping Cart"*** or ***"Place Order"*** button at the top-right corner of the screen. **3. Applicant Profile** **Uploading Documents** * students need to have a tracking package to access the ***"Upload Documents"*** but they should have a tracking package or subscription **Editing Documents** * Click the **student name** beside the ***"Welcome"*** at the top-right corner of the screen * Click the ***"Edit Profile"*** at the left-side panel of the screen **Map Documents** * students can view their uploaded documents and items they are mapped to * students can see ***"Not Compliant"*** status even if they already uploaded their documents because they haven't mapped the documents **Rejection Reason** * whenever a student's document is rejected, they will be provided with a written reason to let them know what is missing from their documentation * ***"We are just following the School Mandatory Requirements."*** **Order History** * When a student logs in, they will see a pop-up informing them of non-compliant items on their account **Legend:** * **Yellow** - means pending, **1 to 3 days** for the review team to check the document **Marking a Student "Graduated"** * Go to ***"Order History"*** * Select ***"View Details"*** for each other * Under ***"Package Details,"*** select ***"I have graduated"*** next to ***"Graduation Status"*** * Select ***"Yes"*** after something pops-up * Please Note: Being marked ***"Graduated"*** will not remove any docs or submissions. Any Screening or subscription report will no longer be visible to the school/institution. **Renewing a Subscription** * Students can renew expired Tracking packages within the ***"Order History"*** tab * Locate the subscription * Click the ***"Renew Subscription"*** link * Inform students the ***"Renew"*** option becomes ***available 30 days before expiration*** **Changing a Subscription** * Select ***"Order History"*** * Locate and select ***"Change Program"*** for the tracker * Once changing a program, the immunization/compliance is no longer available on the dashboard * It ***may take 24hrs - 48hrs (or 1 to 2 business days) to move the documents to the new program***, then they ***can see the immunization/compliance button*** * Inform the students to renew the subscription of existing program before changing to a new program so that the docs uploaded from the prior will be transferred to the latter. (Note: Only if the subscription is expired.) * Inform the students to upload the new or lacking requirements of the new program. **Profile Share** -Students are able to use profile sharing to share files: * ***background checks*** * ***drug tests*** * ***fingerprint results*** * ***compliance docs*** -Can send to: * ***employers*** * ***clinical sites*** * ***anyone else*** -Sharing can be done using "Profile Sharing" tab on the user's profile * Locating a ***"clinical rotation"*** -Adding a Maiden or Alias Name to account * go to ***"Edit Profile"*** * click the checkbox ***"I have an Alias or Maiden name"*** * click ***"Update"*** button at the bottom area of the page -Viewing Completed Reports * Select ***"Report"*** tab in the left-hand list * Select the desired report. Reports will exist for fingerprint, background check, drug test, child abuse verification, and compliance package orders, depending on the student's packages. * Note: American Data Bank was acquired by DISA last year (2025) **Required Documents** * accessed using the ***"Required Documents"*** tab * students can view any school-provided forms by package and category * some required docs may not be accessible here, and might need to be acquired from an outside source like the school directly, or a third party web site - ex. Physical Exam **4. Integrations** -An integration is a technical process which allows outside systems to import info into our platforms or to access info from our platform. -Some students may call for assistance integrating their Complio account with other ***(third-party)*** platforms, like ***MyClinicalExchange*** or ***AceMapp*** -On Profile Details, click ***"Portfolio"*** next to ***"Applicant Login"***, scroll down then check for ***"Integration(s)"*** **Submitting Tickets to PM** * If the system does not integrate properly, and troubleshooting steps do not help, we need to create a ticket to PM. **When to submit a ticket:** -**Compliance Status** * if the student has met all compliance requirements but their status does not update -**Failed Integration** * if integration fails and all troubleshooting steps do not help -**Failed Login** * it troubleshooting fails and all troubleshooting steps do not help -**Internal System Issues** **Process for Submitting a Ticket** * Compose an email * Make sure to include the required info * Choose the correct recipient address based on the situation **Format** -***Student:*** -***School:*** -***Agency:*** (Only for rotation, put NA if not or just remove) -***Node:***(Program or Order Hierarchy) -***Package:*** -***Email Body*** -***Summary of the Issue*** * ***complio@disahealthcare.com*** * Advise **Basic Troubleshooting Steps (BTS)** first if student is having a problem with the system before sending a ticket to PM ______________________________________________________________ **DAY 2** ========= **Provider Name** -When reviewing a doc, -**4 Types of Provider Names** 1. **Healthcare Facility** 2. **Individuals Person's Name** 3. **A Database** 4. **A Government Entity** -Ex. -Note: Agents need to make sure that the student provided docs with a provider's name **Individuals** Must either: -Indicate the person's medical credentials: * **MD** * **Dr. Name** * **RN Name** * **Name, ACNP/APRN/FNP** -indicate an action was performed that only a provider can do: * **Administered by ___________** * **Ordered by _______________** * **Given by _________________** **Database Names** Common medical databases: * **Patient Portal** * **MyChart** * **AllScripts** * **Epic** * **E-Charts/E-Clinical** * **And more** **Government Entities** -Some common ones: * **The Department of Veteran's Affairs (The VA)** * **Veteran's Health Administration (VHA)** * **Department of Defense (DoD)** * **American Embassies** * **Public Schools** * **Medicare and Medicaid documents** **Non-Acceptable Providers** -Some ***"providers"*** listed on forms and documents are **not** acceptable. -Unacceptable "Providers:" * **Employer Documents** * **Non-Provider Abbreviations** * **Compliance Companies** * **Any Companies that Print Forms** **Employer Documents** -Docs from an employee database are not acceptable alone, unless they also include an acceptable provider name, or address. -Unacceptable terms: * **Employee Health** * **Employee Health Services (EHS)** * **Occupational Health** * **Employee ID** * **Associate Health** * **Checking "Employee" on a Form** **Other Companies** -sometimes students will submit docs that contains the name of another company tha does not provide medical services Unacceptable Companies: * **CastleBranch** - A company like ADB that tracks compliance * **The Immunization Action Coalition** - Print forms * **Immunize.org** - Prints forms * **VaccineInformation.org** - Provides information on vaccines * **MED-PASS** - Makes medical products but does not provide services * **Mead Johnson's Baby Formula** - Provides childhood vaccine record cards **School Forms** -Some schools provide their own specific form to fill out, and the rules are slightly different for these. * If a student has submitted a form for the same school you are currently reviewing, the stamped or typed provider name is not required. * But, if the form is **NOT** for the school you are currently reviewing, the typed or stamped provider name is still required -Some schools have their own health clinics or hospitals * If a student submits a document from a school clinic or hospital, that is acceptable as a provider at any school **Recap - Provider Names** * We **CAN** take a document from pre/elementary/middle/high schools, or school districts, as long as we have the specific name of the school/district * We **CAN** take a school form without a typeset/stamped provider name if it is for the school we are reviewing * We **CAN** take documents from a different college's student health clinic or hospital, since this is an actual facility providing the record * We **CANNOT** take a different college's form (with places for information to be handwritten in with the intention of returning it to that school), unless it has a provider stamp on it **Student/Applicant Name** -Reviewers **MUST** match the first and last name on a document to the student's name in Complio. -If there is a **middle** name listed on both he document and the Complio account, they must also macth. -If the name on the document is ** different** than the name in Complio, the student must add a maiden or alias name to their Complio account to match it -In Complio, the student/applicant's **middle** name is highlighted in **red**. -Anything before the **red** is the first name, anything after the **red** is the last name. -If there is no **red**, and multiple first and/or last names, you can hover over a name to see whether it is a first name or a last name. Documents may list names in different formatting. -Last, First: * If a comma is present, that is a clue that this name is formatted Last, First. * Ex. Smith, John * Anything before the comma is a last name, anything after comma is a first name First Middle Last: * If no punctuation is present, we should match the first name as a first name, last name as a last name, etc. * NOTE: Complio will always list names as First Last. If document is formatted Last First (no comma) but still matches Complio, that is ok * EX. Mary Smith and Smith mary **First Name** -Document and Complio **must** match -Only 1 first name needs to match Complio * EX: Complio says first name is Mary Kate, document says Kate, that is a match * If the document and Complio both have 2 first names, but only one matches exactly, that is a match **Middle Name** -Only required if there is a middle name on both the document and Complio -Appears in **red** in Complio -Only 1 middle name needs to match Complio -Must either match exactly (George to George), or match an initial (George to G) -***"NMN"*** means ***"No Middle Name"*** **Last Name** -Document and Complio **must** match -Only one last name needs to match. * EX: Complio last name is Heiner-Clegg, on document it is only Heiner, that is a match * The name being matched must match completely. "Cle" does not match "Clegg" -If Complio and the document both have two last names, but only one last name is spelled correctly, that is acceptable. * EX: Strong Jaramillo matches Strong Jarmillo because Strong matches **If Three or More Names are Present...** -If a name on a document has three or more names, the first word is the first name, the last word is the last name, and the words in the middle can be considered first, middle, or last. * EX: Complio Name: Giovanna Jacob * Document Name: Giovanna Maria Stumpf Jacob Goncalv **Misc:** -Suffixes should be disregarded * Jr, Sr, I, II, III, etc. -Punctuation differences can be disregarded * 0Malley and 0'Malley match -Gender/Sex included in name lines on documents can be disregarded * Starned, Jeffrey, M-"M" stands for Male and can be disregarded -Numbers can be disregarded -If a name indicates "Test," the document should be rejected as a test **Issues With Names** **-Missing Name** * If the document is missing 1 or both names, use rejection note "2 Document must list name" **-Alias Name** * If the name is different, check the left panel to see if the name has been added as an alias **-Misspelled Name** * If the name is misspelled, use rejection note ***"2 Name does not match MISSPELLED"*** **-Appears to be Someone Else's Document** * If the name appears to be completely different in a way not explained by maiden or alias names, inform your supervisor **3. Provider Signature Field** -**Provider signature is a separate requirement from the stamped/typed provider name.** -If a document has a typed provider's name, but a blank provider signature field, it must be rejected. If it has a signature but not stamped or typed provider name, it must be rejected. **Required Fields:** If these fields appear on the document, they must be completed. * **MD Signature** * **RN Signature** * **Given by Signature** * **Administered by Signature** * **Healthcare Provider Signature** * **Physician Signature** * **Physician Assistant Signature** **Non-Required Fields:** These may appear on document, but a signature/stamp is not required for them. -Non-Signature Fields * ***"Name,"*** ***"Initials,"*** ***"Stamp"*** fields -Non-Provider Fields * ***"Signature"*** without specifying who -Fields for Other Services * Like an exemption section signature, if the student is not using that section **Special Case: Chamberlain's Annual TB Screening Form** -This document must have the signature or stamp. -The document must have a **full date** for the service being reviewed. -Acceptable Formats: * **MM/DD/YYYY** * **MM/DD/YY** * **DD/MM/YYYY** * **Month, DD YYYY** * **DD Month YYYY** **4. Service Date** - The date is entered by the student, but if they enter it incorrectly, the reviewer must change it to correct the date. -**DO NOT** hit enter after typing the date, click outside the box instead -If you hit enter, it will save the **ENTIRE ITEM** and remove it from your queue -When the date field is selected, if you scroll up or down, it will change the date! -To scroll up or down on the page, click outside of the date field to deselect it -If **REJECTING** the document, the date does not need to be corrected -If the date is entered in **DD/MM/YYYY** format, the reviewer must change it to **MM/DD/YYYY** format. **Dates (For Shots)** **-Acceptable Formats** * **Fill Date** * **Date Sold** * **Promised Date** * **Given Date** * **Administration Date** * **Date Done** * **VIS Given Date** * **Receipt Date** * **Bill Date** * **Any date next to or below a shot, unless admin note says cannot show payment **-NOT Acceptable** * **Printed Date** * **Forecast Date** * **Recommended Shot Date** * **Vaccines Recommended by Selected Tracking Schedule** * **Next Due Date** * **Letter Date** * **Order Date** * **Prescription Date** * **Future Date** * **Partial Date** * **VIS Date (Vaccine Information Statement - side effects of vaccine)** **VIS Date** -The date the paper was published. This has **NOTHING** to do with the administration of an actual vaccine. **VIS Given Date** -The date the paper was handed to the student. This is only done when a shot is being administered and can be taken as the date the shot was administered. **Dates on Charts** -Many documents combine lists of various vaccines and tests all done at different times. If there is indication of a different appointment and given date, use the given date for the vaccine you are reviewing. **Today's Date** If the center panel indicates ***"Today's Date,"*** always use the date of submission. The date the student submitted and the date you are reviewing might be different ***"todays."*** **Letter Dates** -Letters are only acceptable if they are very clear about when the shot was given. * **Example 1** **NOT ACCEPTABLE** -The letter indicates that a Tdap vaccine was received, but not **WHEN** that vaccine was received. * **Example 2** **ACCEPTABLE** -The letter indicates that a Tdap vaccine was received, **AND** it indicates that it was received **TODAY**. **Dose Declined Vs Shot Does Not Count** -These statements seem very similar, but they actually mean very different things. **"Dose Declined"** or **"Not Administered"** -If a dose was declined, or not administered, that means that no vaccine was given at all **Shot Does Not Count** -If a vaccine date is listed but the document says it ***"Does Not Count,"*** that means the vaccine was given, but is outside of the government recommended vaccine schedule. The school is not required to follow the government's timeline, and this is acceptable. **Consent Date and Ordered Date** -Some dates will be labeled ***"Consent Date."*** This does not indicate that a vaccine was given and is not acceptable alone. However, if it is present on a document that also indicates vaccine administration, we can use the consent date. ***"Ordered Date"*** is never acceptable. **Future Dates** -Future Dates are **NOT** acceptable. However, a student may submit a document from another time zone that may already be into the next day. Be careful to check for this. **''Status as of" Dates** -Some documents will list several things and show the status of that item, ***"as of"*** a date. If the document indicates that the item was a vaccine and is completed, we can take it as a vaccination date. **Multiple Dates on a Document** -Immunization documents will often have multiple dates on one document. -If you are reviewing something that expires, like a Flu or Tdap vaccine, use the most recent date available. -If the item is part of a series, like MMR (2 doses) or Hep B (2 or 3 doses), the item name will tell us which date to use. If the item name indicates 1 or first, use the first date in the series. If the item is 2 or second, use the second date, and so on. **5. Miscellaneous Rule** Some basic rules that all submissions must follow: 1. Must be a single type of document -The information **CAN** be spread across multiple pages of the **SAME** document 2. Must have the required information in English -The document **CAN** be primarily in another language IF all of the requirements can still be found in English, **EVEN** if the reviewer speaks the alternate language. 3. Cannot be altered by whiteout -If the document shows signs of being tampered with, skip review and send to a supervisor -Inked changes that have been signed or initialed by a provider are acceptable. 4. Cannot be a declination/waiver of the service being reviewed -Declination/Waivers are **ONLY** acceptable in Declination/Waiver items **Varicella Requirement Review** ========================= **Varicella & Chicken Pox** ===================== **-Varicella in the Clinical Setting:** * Varicella is the virus that causes Chicken Pox! * Most commonly found in children between the ages of 1 and 10 * Also known as Varicella Zoster Virus (VZV) * Students on Clinical Rotation will encounter children in the Clinical Setting -It's important to avoid spreading this to children already hospitalized for other conditions! * Most people gain immunity to Chicken Pox after getting the disease one time! This often leads to the disease **"Shingles"** later in life! -Remember: **Chicken Pox** and **Shingles** are 2 different diseases! **Reviewing Varicella:** -A Varicella category may ask for any of the following: * 2 vaccines (2 separate dates from ANY TIME) * Antibody Titer * History of Disease (HXD) * Declination Waiver **-Vaccine Timeline Diagram:** * **Vaccine #1** -Given at anytime * **Vaccine #2** -Given at least 1 MONTH after vaccine 1 * **Antibody Titer** -Tested at least 1 MONTH after vaccine 2 **Varicella Vaccines:** -These are all **Acceptable** vaccine name: * **Generic Names** * **Varicella / VAR** * **Chicken Pox** * **Varicella Zoster / V Zoster** * **VZV** * **MMRV (Combo of MMR & Varicella)** **Brand Names** * **Varivax** * **ProQuad (Combo of MMR & Varicella)** **History of Disease (HXD):** -A **History of Disease** is a statement indicating that the Student was infected with **Chicken Pox** at some point in the past -**Reminder: Most people are immune to Chicken Pox after being infected once!** There are **2 types of History of Disease statements**: * **Self-Reported** * **Medically Documented** * **MUST** have at least the year the Student was infected * **Self-Reported** = Statement from the Student * **Medically Documented** = Must be signed / stamped by a healthcare provider or it must be a record from a medical facility including facility letterhead **The Phrase ***"Medical Immune"***** -This phrase can sometimes be mistaken as a Titer result or an HXD -This phrase alone is NOT indicative of a Titer * Remember to look for context clues like ***"collection date"*** or ***"drawn date"*** or anything referring to a test * Look for words such as blood, serology, test results, or date of exam-Medical Immune is most often seen on US military documentation -We **avoid using this as a Qualitative Interpretation** because we **cannot confirm HOW the Student is immune** -!If you **cannot determine if this is a Titer Result or not**, **AND** there is **no other acceptable documentation** provided, we must **Reject & ask for clarification** -Explain that we need to show exactly how they are immune so we can ensure it meets the Guidelines **Guidelines That Sound Like a Trick!** -Check out this Guideline example: -Sounds like a trick, right? -One of the following is required: * 2 vaccines **AND** a positive antibody titer (lab report required)OR * Positive antibody titer (lab report required) * Note: If your titer is negative or equivocal, new alerts will be created for you to submit a booster dated after the titer. Read this Guideline a different way! * 2 Vaccines **AND** any Antibody Titer result (lab report required) * **OR** * A Positive Titer alone (lab report required) * Remove the word ***"Positive"*** from the first bullet point _______________________________________________________________ **DAY 3** =================================================== CIT: **Measles, Mumps, & Rubella (MMR)** ============================== **Intro to Measles, Mumps, & Rubella (MMR)** -MMR refers to a group of **3 diseases** * Measles, Mumps, & Rubella * They are commonly grouped together because one **combo vaccine** protects against all 3 diseases! -All 3 diseases are **highly contagious** & mass outbreaks are always a threat * Almost **ALL** Clinical Sites in the US require both employees & students to be vaccinated to prevent outbreaks **-Keep in mind:** * Measles is also known as **"Rubeola"** * Rubella is also known as **"German Measles"** * No other name for **Mumps** * **Be careful** of this while looking over Vaccine Records & Titer Results **Reviewing MMR:** -An MMR category may ask for any of the following: * 2 vaccines (2 **separate** dates from ANY TIME) * **Antibody** Titer * Declination Waiver Timeline Flowchart: **-Vaccine #1** * Given at **anytime** **-Vaccine #2** * Given at least **1 MONTH** after vaccine 1 -Antibody Titer * Tested at least **1 MONTH** after vaccine 2 **Common MMR Submissions** **-MMR Vaccines:** * These are all **Acceptable** vaccine names **-Generic Names** * **Measles, Mumps, and/or Rubella (separate or together)** * **MMR** * **MMR II** * **MMRV (Combo of MMR & Varicella)** **-Brand Names** * **Priorix** * **ProQuad (Combo of MMR & Varicella)** **MMR Requirements: Combined vs. Separated** -Reviewing MMR Requirements: * MMR Item submissions must include **ALL 3 components** of MMR together in the same submission, and they must have been given on the same date. Note: Need in the document for Lab Report * **Collection/Collected Date:** * **Drawn Date:** * **Specimen Date:** Noted: -During opening spiel: * Ask for last 4 digits of socials (SSN) and birthdate for US students * If student is from Canada, ask for their active email, birthdate, first and last name, username **Hepatitis B (HBV)** ================= Intro to Hepatitis B: -Hepatitis B is a **highly contagious liver disease** that spreads through contact with infected bodily fluids -**Several** vaccines exist for Hepatitis B -The majority of Clinical Sites in the US require Students to be immunized against Hepatitis B because it is one of the **easiest strains of Hepatitis to spread!** -May also appear as **HBV** or **Hep B** * **DO NOT** confuse this with HIB! * HIB is a **different disease**! **Reviewing Hepatitis B:** -A Hepatitis B category may ask for any of the following: * **Traditional 3-Dose Vaccine:** 3 vaccines (3 **separate** dates from ANY TIME) * **Heplisav 2-Dose Vaccine:** 2 vaccines (2 **separate** dates from ANY TIME) * **Surface** Antibody Titer --**AVOID** Core Antibody Titers! * Antigen Titer * Declination Waiver **Timeline Flowchart:** -Vaccine #1 * Given at **anytime** -Vaccine #2 * Given at least **1 MONTH** after vaccine 1 -Vaccine #3 * Given at least **5 MONTHS** after vaccine 2 -Titer * Tested at least **1 MONTH** after Vaccine 3 Hepatitis B 2-Dose Series: -There are also 2-Dose Hepatitis B Vaccines! * **Heplisav-B** * **HepB-CpG** -To be considered a 2-dose series, must be clearly labeled on vaccine document! * Otherwise, treat the vaccines as **traditional 3-dose series** -If the school asks for only Hepatitis B, we can only accept the 3-dose series. If they request Heplisav OR a 3-dose series, we can accept a Heplisav 2-dose series in a Heplisav item.* **Hep B 2-Dose Series Schedule** -**Vaccine #1** * Given at **anytime** -**Vaccine #2** * Given at least **1 MONTH** after vaccine 1 -**Titer** * Tested at least **1 MONTH** after vaccine 2 **Common Hepatitis B Submissions** -These are all **Acceptable** vaccine names: **-Generic Names – Traditional Series** * Hepatitis B / Hep B * HBV **-Brand Names – Traditional Series** * Heptavax * Engerix / Engerix-B * Recombivax / Recombivax HB * Comvax * PreHevbrio * TwinRix (Combo of Hepatitis A & B) **-Generic Names – 2-Dose Series** * HepB-CpG **-Brand Names – 2-Dose Series** * Heplisav-B * Dynavax (Heplisav Manufacturer) **Practice Examples** **Hepatitis B Titers to Avoid!** -Hepatitis B **Core** Titers are **NOT ACCEPTABLE** (unless stated in the Guidelines) -May also appear as: * **HBcAb** * **HBC** **Hepatitis B Titers to Avoid!** Hepatitis BE Titers are **NOT ACCEPTABLE** May also appear as: * **HBeAb** * **Hepatitis Be Antibody / Antigen** * **Hepatitis B e-antibody / e-antigen** * **Anti-HBe** **Intro to Hepatitis A:** ================== * Hepatitis A is another **highly contagious liver disease** that spreads through fecal contaminated food & water * There are also vaccines for Hepatitis A! * Due to the **highly contagious & infectious** nature of Hep A, many Clinical Sites require vaccination or proof of immunity * May also appear as **HAV** or **Hep A** **Reviewing Hepatitis A:** -A Hepatitis A category may ask for ask for any of the following: * 2 vaccines (2 **separate** dates from **ANY TIME**) * Titer * Declination Waiver **Timeline Flowchart:** **-Vaccine #1** * Given at **anytime** **-Vaccine #2** * Given at least **6 MONTH** after vaccine 1 **-Antibody Titer** * Tested at least **1 MONTH** after vaccine 2 _______________________________________________________________ DAY 4 ===== **#What are "Primary Childhood" Vaccines?** ================================== **About Primary Childhood Vaccines:** -Primary Childhood Vaccines are any vaccines given before the **age of 11** * Series of at least 3 to be considered **complete** -Guidelines may **specifically** ask for these vaccines * May be referred to as **"Primary Series"** * May also state **"Childhood Series"** * These phrases all mean the same thing -Most **common** Primary Childhood Vaccines: * **Polio** * **DTP / TDaP (Tetanus, Diphtheria, & Pertussis)** **Common Primary Childhood Vaccine Requirements** **Reviewing Primary Childhood Vaccines:** -A Primary Childhood Series consists of **at least 3 vaccines**, unless the guidelines state otherwise * When **guidelines** ask for a **"Primary Series"**, there must be at least 3 vaccine dates -The term **"At Least"** in the Guideline changes reporting rules * If a Guideline states "At least 3 vaccines" – we report **ALL vaccines provided** if we have the attributes to do so * Normally, we report only what makes the Student compliant * Most often found in **Polio** or **DTP Requirements** * Most often affects the **"Dose"** & **"Enter Interpretation"** attribute **Key Details About TDaP** ===================== -Target Diseases: * **Tetanus (T):** Causes painful, severe muscle spasms (often called lockjaw). * **Diphtheria (d):** Leads to breathing difficulties, heart problems, or paralysis. * **Pertussis (ap):** A highly contagious respiratory infection known for violent, severe coughing fits. -TDaP vs. DTaP: * **DTaP** (capital letters) contains full strength doses for babies and young children under age 7. * **TDaP** (lowercase "d" and "p") contains reduced doses of the diphtheria and pertussis components meant for adolescents and adults. **Standard Injection Schedule** * **Adolescents:** Typically given a single routine dose at **age 11 or 12** (often required for entry into 7th grade). * **Adults:** Anyone who never received a TDaP dose should get one, followed by a Td or TDaP booster **every 10 years.** * **Pregnancy:** A dose is recommended during **every pregnancy** (ideally between weeks 27 and 36) to pass protective antibodies directly to the newborn. Poliomyelitis (Polio) =============== **Polio in the Clinical Setting:** -Polio is **HIGHLY** contagious! * Typically spread from person-to-person via poor hygiene conditions, contaminated food, or from contact with oral fluid * The **very young & very old** are most at risk * Those that are pregnant are also at **high risk** -Given the infectious nature, Students **are often required** to be vaccinated against Polio to prevent spreading in the Clinical Setting * Students will **encounter** kids, the elderly, and pregnant patients! -There are **3 Types** of Polio * Types 1, 2, & 3 * Good News! Through worldwide vaccination efforts, **Type 2 has been completely eradicated since 2015!** **Reviewing Polio:** -**Guidelines generally ask for 1 of the following:** * Primary Childhood Series (**3 separate vaccines** dated before age 11) * 1 adult booster * **Antibody Titers for Type 1 & 3 Polio TOGETHER** -**Type 2 is not required**, unless stated in the Guideline * Declination Waiver Polio Vaccines: * These are all **Acceptable** vaccine name -Generic Names * **Polio** * **IPV** * **OPV** * **Polio Myelitis** -Brand Names * **Sabin (OPV)** * **Salk (IPV)** * **Pentacel (Combo TDaP & Polio)** **Polio Vaccine Submissions:** * At least 3 IPV or OPV would be considered a **complete series** * If a Student ever receives a mix of IPV & OPV, at least **4 doses** are required! * Additionally – **unlabeled Polio vaccines** require at least **4 doses** to be Acceptable! **Common Polio Submissions** **Polio Titers:** * **Type 1 & 3 Titers** are required together, unless otherwise stated in the Guidelines * Polio Titer results read **differently** than normal Titers * -----**Same concept** – **bigger** numbers are better! **Reviewing Polio – Attributes** **Completing Polio Attributes – Dates:** -For **Vaccines** – use the date the vaccine was administered * Use **most recent vaccine date** if multiple dates are given and you only have 1 date field -**Administered Date might also appear as: * **Promise Date** * **Fill Date / Filled Date** -**NEVER USE VIS DATE!!!** * This is a **common error** in any Vaccine Requirement! -Remember the **"At Least"** Rule when multiple date fields are provided! **Influenza (The Flu)** ================= **About Influenza – "The Flu"** -The Flu is a contagious respiratory illness caused by the influenza virus * Very easily spread through **close contact** with others -Spreads on a predictable basis known as **"The Flu Season"** -There are **countless strains** of the flu! * Medical researchers try to **determine** which strains will be most prevalent for the coming flu season * Each flu season, a new **flu vaccine** is released **The Flu Season** -The **Flu Season** refers to the months of the season * Each school determines their own flu season * This will be pre-set in Complio for each item **Sample Flu Seasons** * August 1st to May 31st * September 15th to March 31st **Reviewing Influenza** **Reviewing Flu Requirements:** **-A Flu category may ask for any of the following:** * 1 vaccine administered annually * Declination Waiver **-For Vaccines:** * Watch document standards carefully – **errors are common here!** * Some Schools **require** Vaccine Name, Lot Number, etc. **-For Declination Waivers:** * Often on a **School Form** * Often requires a **healthcare provider's signature** * **Read carefully!** **Influenza Vaccines:** * These are all **Acceptable** vaccine names **-Generic Names** * **Influenza / Flu** * **INF / INF Seasonal** * **LAIV** = Live Attenuated Influenza Vaccine * **RIV** = Recombinant HA Influenza Vaccine * **TIV** = Trivalent Inactive Influenza Vaccine * **IIV4** = Inactivated Influenza Quadrivalent **-Common Vaccine Names (Brand Names)** * Afluria * Fluvirin * Flucelvax * Fluarix * Fluzone * **FluMist** (Sometimes **NOT** allowed by the Admin Note) Completing Flu Attributes – Flu Renewals: -Majority of Schools require a Flu vaccine every Flu Season! -**Renewal Date** will most often be: * 1 Year from date of Vaccine or Declination / Exemption * A specific date each Flu Season Flu Field Examples Flu Document Standards? Find the: * Admin Date * Lot # * Expiration Date * Manufacturer * Site of Injection * Dose **COVID-19 (SARS-CoV-2)** ======================= **About COVID-19:** -Coronavirus Disease 2019 (COVID-19) is caused by the **SARS-CoV-2 virus** * first identified in December 2019 -Primarily spread through **close contact** with others -Presents **Flu-like** symptoms * Often requires testing due to similarities in diseases * Those with existing conditions or recovering from medical issues, as well as children & the elderly are at greatest risk -All these factors make COVID-19 **extremely dangerous** for both students & patients in the clinical setting! **Common COVID-19 Submissions** **Category May Require:** **-Proof of Vaccine(s)** * The vaccine series requested will depend on the school * Watch for specific **brand names** * **Vaccine Manufacturer** is typically needed **-Declination Waivers** * Check Admin Note closely * Includes Medical/Religious Exemptions **-Covid-19 Tests** * Rarely used **Common COVID-19 Guidelines** **Guidelines May Require:** **-Linked Alerts** * "COVID-19 Booster" Requirements" * COVID-19 2nd Action" Requirements * Watch for Requirements asking for specific Boosters * -----"Bivalent" or "Updated" * -----"2024-2025" **-Renewals** * Sometimes needed for **Declinations** or **Exemptions** * Watch for special notes about **Renewal** attributes **-Set the EXACT DATE for all Linked Alerts & Renewals** * **EVEN IF IT'S A DATE IN THE PAST!!!** * **NEVER** default to Upload Date **Pfizer-BioNTech COVID-19 Vaccine** * **Manufacturer:** Pfizer * Brand Names: COMIRNATY, Tozinameran, BNT-162b2 * Refer to Admin Notes for specific dates * **"PFR"** means Pfizer – **DO NOT** take "PF" as Pfizer abbreviation **Moderna COVID-19 Vaccine** * **Manufacturer:** Moderna * Brand Names: SPIKEVAX, NIAID * Refer to Admin Notes for specific dates * **"MOD"** means Moderna – **DO NOT** take "mRNA" as Moderna abbreviation **J&J Janssen COVID-19 Vaccine** * **Manufacturer:** Johnson & Johnson * Other acceptable names: **J&J Merck** as Merck partnered to assist in making vaccines * About Vaccine: 1-Dose Series * Refer to Admin Notes for specific dates **Novavax COVID-19 Vaccine** * **Manufacturer:** Novavax * Brand Names: Covovax, Nuvaxovid, NVX-CoV2373, TAK-019 SARS-CoV-2, rS with Matrix-M1 adjuvant * Refer to Admin Notes for specific dates **Bivalent & Seasonal COVID Vaccines** -Make sure to review the Admin Notes carefully! * The Admin Notes may provide **Date Ranges** that will determine how we review certain vaccines. * The vaccine may or may not **need** to be labeled "Bivalent" depending on those dates. **Novavax Seasonal COVID Vaccines** -Novavax also has **seasonal** COVID vaccines **-2023-2024 Series** * 2-Dose series * 3 weeks between shots **-2024-2025 Booster** * Not Acceptable **alone** * Must be submitted with **ANY** previous COVID vaccine * If previously unvaccinated, set **2nd Action for 8 weeks** **World Health Organization (WHO) Approved Vaccines** -WHO approved vaccines are allowed if: * The Admin Notes specifically say so * If the item has a field to enter manufacturer, but no specific manufacturer is given in the Admin Note -Astrazeneca / ASD1222 * **Manufacturer:** AstraZeneca/Oxford -SII / COvidshield * **Manufacturer:** State Institute of India & SK Bio -Sinopharm * **Manufacturer:** Beijin Bio-Institute of Biological Products Co., Ltd. * May also appear as **Vero Cell** -Sinovac-CornoaVac -Covaxin **CDC Vaccine Cards** **-Requires Student Name!** * Normal Standard Policy **-Will Contain:** * Manufacturer Name * Lot Number * Admin Date * Site or HCP **Declination Waivers** * Only allowed if a declination item is present * Might require a **School Form** Might require a **signature or other approval** from the School **Unlinked Booster Requirements** **Unlinked Boosters:** * Might see while **Cross Referencing** * If the date & time **match** in the **"Date Added"** column – this is a separate COVID requirement * May need to look at the COVID Vaccine requirement to **determine** which shot is the Booster * If the submission is **obviously a Booster**, just document it ________________________________________________________________ DAY 5 ===== Basic Requirements * Student Name/Applicant Name * Provider's Name (If it is not shown, we can use the stamped signature as the provider's name) * Signature Field (If handwritten, need stamp) * Service Date **CIT:** **Meningitis Requirement Review** =========================== **Meningitis (Meningococcal)** Meningitis in the Clinical Setting: -There are many different strains of Meningitis! * Vaccines exist to prevent some forms * May also appear as Meningococcal -Meningitis spreads easily in close quarters * Poor hygiene conditions combined with close contact with large groups can cause the spread of Meningitis * Those age 30 and under are most vulnerable -Due to this, many Students living on campus often get vaccinated * It's not just Healthcare Students at Clinical Sites * Students living in college dorms often must get vaccinated **Reviewing Meningitis:** -A Meningitis category may ask for any of the following: * 1 or 2 doses of Meningitis (Meningococcal) vaccine * Declination Waiver * Some items will auto-complete based on the student's age * -----They may need to enter their Date of Birth to trigger this **Meningitis Items:** * If the item name is **"Meningitis,"** then **any Meningococcal or Meningitis** shot name is **acceptable**. * If the item name is **"Meningococcal,"** **only Meningococcal** shots are **acceptable**. * If the item name **lists a specific vaccine**, we can **only accept that vaccine**. **Rabies** ======== **Rabies Items:** * Admin Notes may ask for 2 doses or 3 doses. * If Complio accepts the date of the vaccine, then take it. * -----Dose timeframes are set in Complio. * **REJECT** if the vaccine is labeled **"Administered Gluteus."** * **NOTE:** Rabies **TREATMENT** is not a **VACCINE** * -----Human Rabies Immune Globulin (HRIG) is not a vaccine. * -----This treatment may appear alongside follow-up vaccinations. **Other** ======== * **Human Papillomavirus (HPV):** * -----May be 2 or 3 doses, depending on the school * **Pneumococcal** * -----3 dose series * **Yellow Fever** * -----Single Dose **Vaccinations & the Immunization Process** ================================= **Vaccines & Immunizations** * **Vaccines** prepare your body to fight a disease or infection * Most vaccines require **multiple doses** to be effective * **Immunization** is the process of gaining protection from a given disease * All Healthcare Facilities that are used as Clinical Sites have certain **Immunization Compliance** policies * -----Clinical Site staff, Students, & School Faculty members must all be complaint! **Vaccines Schedules** * Once the process of Immunization begins, healthcare providers administer vaccines based on a **Vaccine Schedule** * The Vaccine Schedule tells us **2 things:** * -----**How many shots are in the series** * -----**How much time should pass between shots** **Intro to Titers** ============= **Titer Testing** * Titers are **blood tests** used to measure immunity levels or infection levels * -----You can test to see if you are **protected** * -----You can test to see if you are **infected** or have ever been infected * In Complio, Vaccines and Titer **will** be separate items, but some schools require titers specifically. **Titer Testing** * Titer items will ask for one of two things: * -----**ADB Standard for Titers** * ----------**Basic document standards** * ----------**Result** * -----**ADB Standard for Labwork** * ----------**Basic document standards** * ----------**Result** * ----------**Cannot be hand-written** * ----------**Collection date **OR** Reference Range** **Standard for Titer** -Basic Standards * Provider Name, Student Name, and Signature Field * -----Same as always * Service Name * -----Name of disease + indication that it is a titer (IgG, Serology, etc.) * Date * -----**MUST** enter the Collection Date, if it is on the document * ----------Also called Specimen Date, or Draw Date * -----If collection date is NOT on the document: * ----------Result Date * ----------Report Date * ----------Received Date * ----------Date next to or directly above titer name or result **Different Kinds of Titers** **Titer Testing** -There are generally 2 different **Types of Titers** * **Antibody** Titer * **Antigen** Titer -**Antibody Titers** measure protection to a certain disease * This is the Titer we look for most often! * Majority of Items that allow Titers ask for this -**Antigen Titers** measure the infection level of a certain disease * This is the Titer we **avoid** most often! * A few Items will **specially** ask for Antigen Titers -Antibody Titers might be labeled as: * **ABT** * **AB** * **Surface AB** * **sAB** * **IGG / AB IGG** * **Serology** -Titers to avoid! * **Antigen, AB IGM,** or **Core AB** are generally **NOT ACCEPTABLE** (unless the Item asks for it specifically) -Items will specify what Titer is needed! * **Remember – ALWAYS go with what the Item requires!** **Understanding Titer Results** **Titer Testing – Results** -**Titer results** will show in different ways: * A **Qualitative** Result uses a **word** for the result * -----**Examples:** Negative or Positive * A **Quantitative** Result uses a **number** for the result * -----**Examples:** 1023.4, 350, >150, or <1.5 -**Quantitative** Results are preferred! * Watch Admin Notes carefully, some **require** numerical results -Titers that have numerical results usually need a **reference range!** * The reference range tells us if the numerical results are positive, negative, or equivocal * Find the numerical result & **compare!** -**What the results mean:** * **Positive** = the Student is immune or protected * **Negative** = the Student **IS NOT** immune or protected! * **Equivocal** = Indeterminate -**By default, a titer is acceptable even if it is negative or equivocal. The student will not become compliant until they follow the school's next steps.** -**Acceptable Qualitative terms:** * **Positive = Immune, Protected, Reactive, (+) sign** * **Negative = Non-Immune, Not Immune, Nonreactive, Not Protected, (-) sign** * **Equivocal = Borderline, Grayzone, Indeterminate** **Specific Titers** **Varicella Titers** -**DO NOT TAKE** * Shingles * Herpes Zoster * Zoster alone (does not indicate Varicella) **MMR Titers** -**MUST** be listed separately * Measles * Mumps * Rubella * NOT "MMR" * Review whichever specific items were assigned to you **Hep B/Hepatitis B Titers** -Document **MUST** indicate **immunity** * If it is not listed as a surface antibody titer, the result **MUST** state immune or non-immune * -----**NOT** positive or negative * **CANNOT** indicate pre/post HBIG infusion **Hep C/Hepatitis C Titers** * **ONLY** titer where we can accept IgM by default * Hep C items are checking for infection ________________________________________________________________ (May 25 - 29) ========== Day 6 ==== Tuberculosis ========= **What is Tuberculosis** **Tuberculosis in the Clinical Setting:** -Tuberculosis, also known as **TB**, is a bacterial infection * `Most commonly found` in the **lungs** -Due to the extremely infectious nature of TB, Schools & Healthcare Facilities **screen** for this on a regular basis * **EVERYONE** is screened, not just Clinical Intern Students! * Most people in the US **do not** get the TB vaccine! * The vaccine always makes you test **positive**! -During TB screening & testing, **testing positive** is not the end of the story! * If the TB bacteria is detected, **more tests** will need to be done * Your healthcare provider will then `determine` if the TB infection is **Active** or **Inactive** * This is normally done with a **chest x-ray** **Vaccine for Tuberculosis (TB)** **Tuberculosis Vaccine – BCG Vaccine:** -In other countries, children receive vaccinations against TB * Receiving the BCG vaccine will cause you to test positive for exposure when receiving a skin or blood test * Because of this, TB vaccines are rarely accepted, and typically require a student to also submit further documentation **Testing for Tuberculosis (TB)** **Tuberculosis Testing Options:** -In general, there are **3 ways** to test for TB **-Skin Testing** * Purified Protein Derivative (**PPD**) * Mantoux * TST (TB Skin Test) **-Blood Testing** * QuantiFERON (**QFT** or **QFT Gold**) * T-Spot * IGRA (Interferon Gamma Release Assay) * BAMT (Blood Assay for M. Tuberculosis) **-Chest X-Rays** * Will not be the **actual** x-ray * It will be a **doctor's interpretation** of the x-ray * **NOT** acceptable as a TB Clearance Letter **Testing for Tuberculosis – Skin Testing** **Tuberculosis Skin Testing:** -One of the most popular & cheapest ways to test for TB is **Skin Testing** -First, the Student visits their healthcare provider & a small amount of testing serum is **placed** under the skin * This is called the **"placement date"** -Then, usually **48-72 hours later**, the Student returns to see if there was a skin reaction to the serum * This is called the **"read date"** -The skin reaction is **measured** to determine if the Student is positive or negative * ANYTHING above 0mm must include physician interpretation * 0mm is always **negative** **Testing for Tuberculosis – Skin Testing Submissions** **Skin Testing Submission Options:** -Items could ask for one or more of the following Skin Test options: * **1-Step Skin Test** * **2-Step Skin Test** * **Annual Testing** -A 1-step skin test should have **2 dates!** * 1 Placement Date, 1 Read Date, & 1 Result -A 2-step skin test should have **4 dates!** * 2 Placement Dates, 2 Read Dates, & 2 Results -Annual testing will change depending on the institution. Be sure to pay close attention to the Student Note on your item. **Testing for Tuberculosis – Skin Testing Submissions** **1-Step Skin Test Submissions:** -`Generally`, a 1-step skin test **should** have 2 dates & a test result * At a minimum, we **must** have at least the read date & a result * If the placement date & the read date fall outside of the 48-72 hour window, we must **Reject** -2 dates are `required` only if the Admin Note or Center Panel ask for both! * The Admin Note may ask for it directly **OR** a field may be present in the Center Panel that requires it -There **MUST** be `48-72 hours` (2-3 days) between the placement date & the read date * **Reject** the test if there is less than 2 days or more than 3 days between placement & read dates **Testing for Tuberculosis – Skin Testing Submissions** **2-Step Skin Test Submissions:** -This is **two 1-step tests**, often completed **1-3 weeks apart!** -`Generally`, a 2-step skin test **should** have 4 dates & 2 test results * At a minimum, we **must** have at least the 2 read dates & 2 test results * If you are reviewing the 2nd step item, Complio will alert you if the date is out of scope -Pay close attention to **Admin Notes!** * Sometimes, Schools will ask for **different** amounts of time between tests **Testing for Tuberculosis – Skin Testing Submissions** **Annual Testing Submissions:** * Annual Testing is PPD that the school wants `submitted` once a year * May require a 1-step OR a 2-step annually * Exact `timeframes` will be set by the school * May be a single item that is `submitted` to every year, or may be multiple items `submitted` to in consecutive years Testing for Tuberculosis – Skin Testing Standard Standard for PPD: * Basic Requirements PLUS Result * We are specifically looking for the read date. Testing for Tuberculosis – Skin Testing Results Skin Test Results Interpretation: -Skin test results are often called "induration" * If you don't see the word "Result" on a document, look for the word "Induration." -Skin test results will show in different ways: * A Qualitative Result uses a word for the result * -----Examples: Negative or Positive * A Quantitative Result uses a number for the result * -----Examples: 15mm, 10mm, 3mm or 0mm * ANYTHING above 0mm must include a qualitative interpretation * 0mm is ALWAYS Negative! * "No Induration" means Negative! **Testing for Tuberculosis – Blood Testing** **Tuberculosis Blood Testing:** -Another way to screen for TB is testing a **blood sample** for the TB bacteria * There are different kinds of blood tests! -Types of blood testing: * **QuantiFERON (QFT or QFT Gold)** * **T-Spot** * **IGRA**(Interferon Gamma Release Assay) * **BAMT** (Blood Assay for M. Tuberculosis) * **TB Blood Test/Screen** * **TB Blood Assay** -This involves the Student providing a blood sample at a clinical collection site * It's only one visit for the Student, not multiple visits as with skin testing **Testing for Tuberculosis – Types of Blood Testing** **Blood Testing Options:** -There are 2 **Trademarked Name Brand** options: * **QuantiFERON** (**QFT** or **QFT Gold**) * **T-Spot** -Generic testing options may appear as: * **IGRA** (Interferon Gamma Release Assay) * **BAMT** (Blood Assay for M. Tuberculosis) * **TB Blood Test/Screen** * **TB Blood Assay** -If the Admin Note asks for **one specific Name Brand**, no other blood test is Acceptable! -If the Admin Note allows **BOTH** name brands OR asks for a generic test, **ANY** TB blood test is acceptable! Testing for Tuberculosis – Blood Testing Results **Labwork:** ========== -Admin Notes may require blood test results to be provided as **Labwork** * **Labwork** = Printed Document (handwritten signatures ok) * **No hand-written** results, dates, or other test information * **MUST** include a collection date **OR** a reference range -If no collection date, we can accept other dates, but the document **MUST** include a reference range -Collection Date could be written in different ways: * Collection Date * Specimen Date * Draw Date **Testing for Tuberculosis – Blood Testing Results** **IGRA/Quantiferon/T-Spot:** ======================= -Admin Notes may require blood test results to be provided as **standard for the basic requirements PLUS (Result)** * Information can be hand-written or typed * EXCEPTION: Provider name **must** be typed or stamped -If no collection date, we can accept other dates. -Collection Date could be written in **different ways:** * **Collection Date** * **Specimen Date** * **Draw Date** **INH Treatment** **Standard for INH Treatment:** -If a student has had an active TB infection, they may be required to submit documentation of completing INH Treatment -Basic Requirements * Service Name: INH or isoniazid * Service Date: Completion Date Testing for Tuberculosis – Chest X-Rays ============================= **Chest X-Ray Results:** -Some schools will have items for clear **Chest X-Rays** * This is to ensure the Student does not have **Active** TB * Most people that have TB, have **Inactive** TB – the chest x-ray can **prove** it is Inactive * Some schools require students who have received the BCG Vaccine to submit chest x-rays -There are two standards you may see in these items * **Standard for Chest X-Ray** * -----Basic standards and a result * **Standard for Radiology Report** * -----Basic standards and a result * -----**MUST** indicate **"Radiology"** or **"Imaging"** * -----**MUST** indicate number of views taken or previous comparison * -----**MUST** clearly indicate **"Impression"** or **"Findings"** **Chest X-Ray Results Continued:** **-Reason for Exam** * Document is not required to say the reason for the exam is TB screening * The document **CANNOT** exclude TB screening as a reason for the exam (ex: Reason for Exam: Lung Cancer) * **"Reason for Exam"** might also be called **"History"** or **"Indication"** -Results * Normal * Negative * No Active Disease * Within Normal Limits -If there is no overall **"negative"** result, but the document includes a section for observation: * As long as that section shows no findings, the chest x-ray can be considered normal. * If it has a potential finding, the document **MUST** have an overall result. **Chest X-Ray Results Continued:** * **Positive Chest X-Rays are NEVER Accepted!!!!!!** * If a student submits a positive chest x-ray, that means they have active TB! Skip review and send a note to your supervisor so that we can alert the school. **Testing for Tuberculosis – TB Assessment Forms** **TB Clearance Letter:** -There are **two types of clearance letter**, the student can submit either one * **Questionnaire** - The student must indicate any symptoms that they do have * -----If student answers "no," we can accept. If "yes," we need to ask for the reason. * **Letter/Note** - A document declaring that a student has "no signs or symptoms" of TB **-Clearance Letter Standard:** * **Basic standards** * **MUST** indicate that the student shows no signs or symptoms of Tuberculosis ________________________________________________________________ DAY 7 ===== • Cardiopulmonary Resuscitation (CPR) ============================= **CPR in the Clinical Setting:** -The **overwhelming majority** of healthcare workers are required to know CPR! * Even a Nursing Student could be called on to **save a life!** -There are several different kinds of CPR training **types** * The type of healthcare a Student is studying often determines the kind of CPR training they need -There are also several different **Issuing Agencies** of CPR training * Many Schools & Clinical Sites that Students attend prefer certain Agencies • **Understanding CPR Training** **CPR Training Issuing Agencies:** -The 2 most **popular Agencies** of CPR Training in the US: * **American Heart Association (AHA)** * **American Red Cross (ARC)** -There are many other **Agencies** to watch out for: * National Safety Council (NSC) * Emergency Care & Safety Institute * ProCPR * Military Training Network – **conducted by American Red Cross** * ASHI - American Safety & Health Institute * National CPR Foundation • **Understanding CPR Training** **Common CPR Types:** -The most common type of CPR Training is **"Basic Life Support"** -**Also referred to as:** * BLS / BLS Provider * Health Care Provider (AHA and ASHI only) * CPR/AED for the Professional Rescuer (ARC) -Those terms **ALL** mean the same thing! * If the item name requires **Basic Life Support** – the above types are **Acceptable** -This is the most **common type** `required` • **Understanding CPR Training** **Specific Types of CPR Training: ACLS** -Advanced Cardiac Life Support **(ACLS)** is a certification for healthcare workers only * Deals with the cardiovascular unit, including electrocardiogram info & emergency pharmacology -Item Name will mention this type **specifically** -Some cards use the term **"Advanced Life Support"** * Advanced Life Support = **ACLS** -**Not Acceptable** for BLS Requirements! **• Understanding CPR Training** **Specific Types of CPR Training: PALS** -Pediatric Advanced Life Support **(PALS)** is a certification for those that work in healthcare with infants & children * Deals with CPR & first aid techniques needed to treat infants -Item Name will mention this **specifically** -American Red Cross also calls this type **"Pediatric Advanced Life Support"** * Pediatric Advanced Life Support = **PALS** -**Not Acceptable** for BLS Requirements **• Understanding CPR Training** **First Aid & Basic CPR Types** -First Aid Certifications are `generally the` **lowest level of CPR type** -Will sometimes appear as: * Basic CPR & First Aid * Lifeguard / First-Aid / CPR / AED * K-12 * Heart Saver -**Rarely** required by the item name * Avoid these unless **specifically named** by the item! -These are **NEVER Acceptable** for BLS Requirements! **• Understanding CPR Training** **RQI Advancement** -Resuscitation Quality Improvement **(RQI)** is a skills improvement course that can be added on to any American Heart Association CPR Card * Think of this as a **"Level Up"** to an existing type the student already has -If a type has an **RQI badge**, it's still Acceptable * **Example** = BLS RQI is Acceptable for regular BLS **Instructor Cards** * An **Instructor Card** `indicates` that the holder can **teach & train**, as well as administer CPR! * Instructor Cards are **NOT** acceptable unless the Admin Note specifically says that they are. **• Another RQI Example** **RQI Advancement** -Sometimes, the Student will give us an **eCredential certificate** along with the **eCard** * Notice the **different** expiration dates * **Both** are Acceptable alone -If **both** are submitted, use the dates from the **eCard** since it gives more time! • Reviewing CPR **Completing CPR with RQI Items – Dates:** RQI Cards are acceptable for AHA BLS, HOWEVER, they do not always expire after 2 years like other cards. They may last anywhere between 3 months and 2 years, which means accepting the Issue Date may make the student Compliant after it is expired. **• Understanding CPR Training** **AHA HeartCode** -HeartCode is a **2-part Course** option offered by the American Heart Association * The HeartCode option is offered for most AHA Courses -Allows AHA **Course instruction** to be broken up: * Part 1 is offered online * Part 2 is an in-person skills test -Must have **BOTH** parts submitted together to be Complete * Part 1 is often submitted alone – must **REJECT** **• Common CPR Submissions** **Reviewing CPR Items:** -**Item Name** will specify what **issuing agencies** are allowed & what types are needed * Accepting the wrong agency and/or type are **common errors!** -By default, both **eCards** and **physical cards** are acceptable. * Physical cards are becoming less and less common -Some **Categories** may have multiple **items** for different CPR types. **• Common CPR Submissions** **CPR Submissions: eCards** -eCards are **ALWAYS** Acceptable **-ADB Standard for CPR:** * Training **Issuing Agency** * -----Logos **alone** are NOT Acceptable! * **Type** Name * Student **Name** * Issue Date * If eCard, must have the eCard code and/or a QR code **• Common CPR Submissions** **CPR Submissions: Physical Cards** -Physical cards (or **"wallet cards"**) are `generally Acceptable` * These are becoming **rare** submissions! -Admin notes may have `additional` **document standards** for physical cards – **read carefully!** * **"Front and back are required"** * **"Card must be signed"** * -----Card needs to be signed even if there is no signature line * **eCard submissions** `don't` need these extra requirements, EVEN if they are in the admin note **• Common CPR Submissions** **CPR Submissions: Temporary Certifications** -A letter or certificate confirming completion of the Course * Normally given by the Instructor at time of completion * Proves the course was complete * Used until the actual Card or Certification arrives -Only Acceptable if allowed by the **Guidelines!** -Normally only Acceptable for 30 days – Set **Renewal Date** for 30 days (1 month) * Only Acceptable **once!** * **After 30 days**, we need the eCard or physical card • Reviewing CPR – Attributes Multiple CPR Card Submissions -Sometimes, the Student will give multiple cards in the same submission -If multiple cards are REQUIRED – use the dates from the OLDEST card provided * We need to report the card that will be the first one to expire! -If multiple cards are NOT REQUIRED – use the dates from the MOST RECENT acceptable card provided * We use the card that gives the Student the most time! • CIT: IDs and Licenses ============ • Photo Items ========== Some schools will have items requiring a Photo, or a Photo ID. -Photo -ADB Standard for Photo * Student's face is fully visible * Only one person in the photo * NO sunglasses or hats -Photo ID -If the item name specifies "Photo ID," It can be ANY photo ID, as long as: * It includes a photo of the student * Student name matches -Driver's License -If the item name specifies "Driver's License," It must be a driver's license • Driver's License ============= **Driver's License:** -Many Students `are required to` travel to a Clinical Site; therefore, the School must ensure they are legally able to do so -A Student's Driver's License must be **valid** and **NOT temporary** -The photo should be `somewhat **clear**` * Watch for completely faded photos * Watch for dark or completely blacked out photo * Need to be able to tell `it's` a person 😃 -**Check Center Panel fields closely** * Different schools will require different information • RN & Other Professional Licenses ========================== **Professional Licenses in the Clinical Setting:** -Many Students, especially in higher level healthcare education programs, will already have some kind of Professional License * Students may have to attend a higher-level program to increase their license level -There are many types of **Professional Licenses:** * **RN** – Registered Nurse (This is the most common) * **CNA** – Certified Nursing Assistant * **LPN** – Licensed Practical Nurse * **ARRT** – American Registry of Radiologic Technologists * **EMT** – Emergency Medical Technician * **CPT** – Certified Pharmacy Technician * And more! **• Reviewing Professional License Items** **Standard for Professional License:** **-Issuer** * State Name * (State Name) Board of Nursing * "Board of Nursing" or "BoN" * Nursys **-Student Name** * Must match Complio **-Expiration Date** **-Type** * If the item name `indicates` a specific type of license, that type is `required` * -----Ex: "RN License" or "LPN License" **• Reviewing Professional License Items** **Reviewing Professional License:** -Some Admin Notes require a License to be **Unencumbered** * **Unencumbered** = No restrictions or stipulations * **Needs to say "Unencumbered"** -Some Admin Notes require a License to be **"Multi-State"** status * Multi-State may also show as **Compact** * A **Compact License** is a multi-state license Some Center Panel fields `require` more information * Check fields carefully! * Ex: State name, license number, issue date, etc. -If the Admin Note, Item Name, or Center Panel field `indicate` a specific state, that state name **MUST** appear on the document • Reviewing Professional License Items Reviewing RN Licenses: * Registered Nursing **(RN)** Licenses are the most common submissions * **Advanced Practice Registered Nurse (APRN)** Licenses can also be accepted for RN items, but RN licenses **CANNOT** be accepted for APRN items. • Reviewing Professional License Items **Interchangeable Terms:** **-LVN, LPN, VN, PN** * All of these abbreviations mean the same thing **-Other terms are NOT interchangeable, like LPN, RN, and NP** **• Common Professional License Submissions** **RN Licenses – Nursys:** -Registered Nursing (**RN**) Licenses may also be reported from the **Nursys** website * **Nursys** is a web service integrated with US State Nursing Agencies -If the item requires a specific state, the submission **must** still list that state. -**REMEMBER!** If the Admin Note, Item Name, or Center Panel fields mention a state, the document must list that state. • CIT: Insurance Categories =============== **• What is Health Insurance? (No One Really Knows)** **Health Insurance in the Clinical Setting:** -Health Insurance provides coverage for **medical expenses** * There are `different kinds` of coverage plans * There are many different companies that provide Health Insurance -While Students attend **Clinical Rotation**, they are at risk of getting sick or injured * A hospital or clinic, and those that work there, are constantly exposed to medical dangers -Due to the nature of these risks, many schools require their student body to be covered by Health Insurance while on site **• Reviewing Health Insurance** **ADB Standard for Health Insurance:** **-Insurance Provider** * May be an insurance company or a state name **-Student Name** * Student's last name must match at least If a specific type of document (card, letter, etc) is required, it will be listed in the item name. If the item name is just "Health Insurance," any type of document is acceptable **• Reviewing Health Insurance** **Health Insurance Dates:** **-Typically, we will enter the `submission date` of the document into the "Date" field in the Center Panel** * Complio will then automatically set the `expiration` date for one year -There are 2 situations where we would not use the submission date** * If the item specifically says to use a different date * If the document expires in less than 1 year, enter one year before `expiration` **• Health Insurance Carriers** **Health Insurance Carrier Examples:** * aetna * Anthem * Cigna * MetLife * Humana * AARP * ASSURANT * PROGRESSIVE * USAA * KAISER PERMANENTE * UnitedHealthcare **• Common Health Insurance Submissions** **Health Insurance Carriers – Tricare:** -Members of the military are covered through **Tricare** for Health Insurance -Students covered under Tricare may provide a **Military ID** as proof of coverage * **Refer to date standards** **• Common Health Insurance Submissions** **Health Insurance – VA Coverage:** -Retired members of the military are covered through **Veterans Affairs (VA)** * Sometimes referred to simply as **"The VA"** -Students covered under the VA may provide a **VA ID** or **letter of eligibility** as proof of coverage **• Non-Acceptable Documents** **Documents that are NOT Acceptable** The following documents are **NOT acceptable alone:** * **Accident Coverage** * **Dental Coverage** * **Prescription Card** * **Health Savings Account (HSA)** If an actual health or medical insurance document has a section with any of the above information, that is ok. **• Common Health Insurance Submissions** **Documents to Avoid!** * US **Tax Documents** – Form 1095-A / 1095-B * Tax Documentation is **NOT ACCEPTABLE** * -----This proves previous year coverage, not **current coverage** * **Reject** & ask for current proof of coverage **• Common Health Insurance Submissions** **Documents to Avoid!** * Explanation of Benefits (**EOB**) Documents * An EOB is **NOT ACCEPTABLE** * -----This only proves that a Student might have been covered at the time of a medical incident * **Reject** & ask for current proof of coverage **• Common Health Insurance Submissions** **Documents to Avoid!** * **Health Share Plans** or **Cost Share** * These types of plans are not **legally** considered Health Insurance • CIT: Professional Liability Insurance Requirements ================================= **• What is Professional Liability Insurance?** **Liability Insurance in the Clinical Setting:** * **Professional Liability Insurance** covers healthcare workers while in the Clinical Setting * -----In the event of an accident while practicing medicine, liability insurance pays money to those impacted by a mistake or wrongdoing * Sometimes referred to as **Medical Malpractice Insurance** * Given the nature of risk in the Clinical Setting, schools require students to be covered by some kind of liability insurance while on site **• Reviewing Professional Liability Insurance** **Professional Liability Insurance Documentation:** * Liability Documentation **most often** appears as: * Liability Insurance Coverage letter * Certificate of Insurance * ADB Standard for Liability Insurance * Provider name * Must say "professional" liability * Student name * Issue date * Expiration date **• Reviewing Professional Liability Insurance** **Professional Liability Insurance Documentation:** **-Some Schools Require:** * **Coverage Limits** (in Dollars) * -----This outlines how much damages the policy will cover in dollars * -----**Per Occurrence** = The amount that will be paid per single occurrence * -----**Aggregate** = The maximum total amount over the life of the policy * -----**Example** = $1 Million per Occurrence - $3 Million Aggregate * -----Coverage Limits can always be **MORE** than what the Admin Note requires – can never be less * **Specialty** or **Medical Specialty** * -----What type of person the policy will cover * -----**Example** = RN Student • Auto Insurance ============ **ADB Standard for Auto Insurance:** * Must show insurance for a vehicle * Must show `expiration` date • Insurance Recap - Dates ===================
ItemDate Center in Panel
Health InsuranceSubmission Date
Liability InsuranceIssue Date or Expiration Date (Center panel will indicate which)
Auto InsuranceExpiration Date
____________________________________________________ DAY 8 ===== What is a Physical Exam? =================== **Physical Exams in the Clinical Setting:** * Students are required to get a **Physical Exam** to ensure they are healthy & fit enough to perform the required duties * -----Most healthcare jobs are **physically demanding!** * The Physical Exam a Student undergoes is much like an examination we would receive during a doctor's office visit * -----Thinking about this will help you identify Physical Exams during the Review process * Many Schools require Physical Exams to be documented on a **School Form!** **Reviewing Physical Exams** **Standard for Physical Exam:** -Basic Requirements -Service Name – **NO** other names accepted * Physical * Physical Exam * Medical Exam * General Health Exam * Annual Exam * Routine Health Exam What are CPFs? ============ **About Client Provided Forms:** -Many Schools create their own **documents** that they require Students to complete+ -Some examples include: * Student Handbook acknowledgment * Declination or Waiver forms * Physical exams & other health assessment -Schools give us the **document** & we load it into the Category * This allows the Student to download the blank form * Also allows us to see an example of the document when we review **Looking At Example CPFs: Detective Work** **Look For Clues!** * If all else fails, we might have to do some **detective work!** * Look at the **School logo** * Look for document **titles** * When in doubt, reach out! **N-95 Masks & Other Respirator Mask Fit Tests** ===================================== **What's the Deal with Masks?** -The N-95 is a type of Respirator Protective Mask * Other types exist & may be required * N-95 is the most popular in the Clinical Setting -Students need to be fitted for a mask to ensure it functions properly while in the Clinical Setting -A Fit Test determines the type of mask as well as the mask size * Fit Tests are often submitted on a card or a fillable form * Normally conducted by someone at the School or other verified 3rd party provider **N-95 Masks & Other Respirator Mask Fit Tests** **Standard for Mask Fit Tests:** -Complio does not have a **"Standard for Mask Fit Test."** You will see one of these options: * Standard for CPFs * Standard for Documentation Read carefully and review accordingly! Some schools will ask for more information, like model, manufacturer, size, etc. But this is only `required` if it is specifically mentioned in the Item Name, Admin Note, or Center Panel field. Certificates ======== Some schools will require their students to obtain certifications for various courses, like HIPAA and OSHA. The Admin Note will specify either: **Standard for Certification:** * Provider Name * Service Name * Student Name * Admin Note **may** have a sample document, but that is optional Standard for CPFs: * **MUST** match the sample CPF * Student Name * Date * -----If there is a Center Panel field for any information, it is **required**. With CPFs, it is normally the date. ---------------------------------------------------------------------- DAY 10 ====== * **complio@disahealthcare.com** - written agents email * **ds@disahealthcare.com** - email to be used for advising customer to reach out the **Drug Screening Team** to change their site location * **fpticket@disahealthcare.com** - not for changing site or location. can advise student to send their fingerprint result to this email if their package is expired * **liberty@disahealthcare.com** - **Call History** * Student called in to renew BGCK, DS. Assisted the student to place a new order for Initial BGCK. * Student called in for their locked account. Assisted in unlocking the account since it wasn't locked by the admin. * Student called in for their issue regarding placing order for DS because it keeps on loading. Replicate the student's issue and selected multiple locations until one went through. * Student called in to create new account in Complio because they don't know how to * Student called in because they want to change the location for their site collection. They stated they contacted ds@disahealthcare.com last week and today but received no response. Informed them that the DS Team response time is uncertain. Offered callback once there is a response. * Student called in because they already did multiple times the fingerprint but most got rejected (1st and 2nd mails got rejected by the school). They got frustrated because they don't want to pay for another FP package for the new rolled fingerprint. Transfer to the higher supervisor.