| Description of good practice: |
Yokohama City defines support for these children as follows: “giving considerations for students requiring daily medical care at school, and supporting the elementary and junior high schools they belong to through medical care provided by nurses at these schools”.
It is based on the following criteria: Among all students of elementary and junior high schools providing compulsory education in Yokohama City, those requiring daily medical care at school; those regarded as being able to attend general schools, but requiring medical care at school by their doctors, with their parents understanding the relevant support program and requesting medical care provided by nurses, and the principal and school committee agreeing with the provision of such care; and those defined as children requiring medical care at the Medical Care Coordination Meeting from specialized perspectives. The necessity of support is re-examined annually at the Medical Care
Coordination Meeting. Care procedures performed at school include: Suctioning sputum in the oral cavity and suctioning rhinorrhea in the nasal cavity, suctioning sputum in tracheal cannulas, gastro- or enterostomy tube feeding, and nasal tube feeding. Among these, the city covers suctioning sputum in the oral cavity (not including the management of artificial respiration or oxygen therapy in any case), suctioning rhinorrhea in the nasal cavity, and suctioning sputum in tracheal cannulas. Depending on the operational situation, the scopes of suctioning rhinorrhea in the nasal cavity and suctioning sputum in tracheal cannulas may be expanded in the future.
Schools can be equipped with medical devices, but their management, such as cleaning,
replacement, and replenishment, should be performed by parents. Yokohama City also provides counseling for parents. The principal of each school confirms the conditions of the relevant children and their parents during health examinations on admission. When a school has decided to support a child, it sends an application to the Section of Health Education at the request of the child’s parents. Based on this application, the Section of Health Education holds a Medical Care Coordination Meeting to examine the necessity of support. Medical Care Coordination Meetings are held with the Section of Health Education and Section of Special Support Education as secretariats. Representative school doctors (medical association), principals (principals’ association), nurse-teachers, and those involved
participate in the meetings to discuss approaches to care, and the details of the equipment and personnel support, and develop future perspectives on medical care in Yokoyama City. When they decide to support the child, with methods to support him or her determined, the Section of Health Education forms contracts with home-visit nursing facilities belonging to the medical association. These facilities are closed on weekends and national holidays, in principle, but their services may also be available on these days (e.g., during an educational school trip) depending on the agreement.
In addition to the above-listed approaches, the Section of Special Education Support Consultation provides school enrollment counseling for parents as necessary. The section provides and shares information with relevant schools, and adopts actions based on the results of examinations. It also shares information and collaborates with the Section of Health Education. |
