sfast 2012 optional activity final

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Pre-test activity to help you practice your knowledge.

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Practice for your test by completing the following consent form review activity. Click on the form to begin.

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Flu Nasal Spray Consent Form Review Identify and click over problem areas on this form. Next

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Question #4 Parent answered “no” but side note indicates possible asthma/wheezing Notify the Group Supervisor/Clinic Manager. DO NOT administer LAIV Flu Nasal Spray Consent Form Review Identify and click over problem areas on this form.

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Flu Nasal Spray Consent Form Review The doctor’s address and student’s insurance policy number are not completed. Is this information required to be completed prior to vaccination? Yes No

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Right!! Flu Nasal Spray Consent Form Review The doctor’s address and student’s insurance policy number are not completed. Is this information required to be completed prior to vaccination? Yes No No. This information is not required. Next

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wrong Flu Nasal Spray Consent Form Review The doctor’s address and student’s insurance policy number are not completed. Is this information required to be completed prior to vaccination? Yes No

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Practice for your test by completing the following consent form review activity. Click on the form to begin.

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Flu Shot Consent Form Review Identify and click over problem areas on this form.

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Flu Shot Consent Form Review Did you find the two problems? If not, find them before moving on to the mini quiz. Next

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The patient did not answer question #3. Notify the Group Supervisor/Clinic Manager.

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Missing Legal Guardian or Parent’s signature and date. Notify the Group Supervisor/Clinic Manager.

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Flu Shot Consent Form Review There are 2 problems on this page. Test Question: The patient did not answer question #3. Should you notify the Group Supervisor/Clinic Manager? Yes No

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Flu Shot Consent Form Review Test Question: The patient did not answer question #3. Should you notify the Group Supervisor/Clinic Manager? Yes No Yes. When reviewing the student flu shot consent form, notify the Group Supervisor/Clinic Manager if any question #1 through #3 is marked ‘YES’ or left blank. Right!! Next

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Flu Shot Consent Form Review Test Question: The patient did not answer question #3. Should you notify the Group Supervisor/Clinic Manager? Yes No wrong

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Practice for your test by completing the following consent form review activity. Click on the form below to begin.

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01/10/55 Adult Consent Form Review Identify and click over problem areas on this form. Next

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01/10/55 Adult Consent Form Review Identify and click over problem areas on this form. There are a total of: 3 problems 4 problems 11 problems

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01/10/55 Adult Consent Form Review Identify and click over problem areas on this form. Doctor’s name and address are recommended, but not required.

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01/10/55 Adult Consent Form Review Identify and click over problem areas on this form. PROBLEM Birth date indicates older than 50 but Question #4 says “NO” Verify Date of Birth If Date of Birth is correct, ask participant to change answer to question #4 and initial next to the change Do not administer LAIV Ask if person wants TIV as it is not contraindicated If yes, have person complete an adult TIV consent form.

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01/10/55 Adult Consent Form Review Identify and click over problem areas on this form. NOT A PROBLEM Insurance and Policy Number are recommended , but not required

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01/10/55 Adult Consent Form Review Identify and click over problem areas on this form. PROBLEM The signature date is missing. Ask the adult participant to date the form.

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01/10/55 Adult Consent Form Review Identify and click over problem areas on this form. PROBLEM Question #9 has been left blank. Notify the Group Supervisor/Clinic Manager if any question #1 through #10 is marked “yes” or has been left blank.

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01/10/55 Adult Consent Form Review Identify and click over problem areas on this form. There are a total of: 3 problems 4 problems 11 problems wrong

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01/10/55 Adult Consent Form Review Identify and click over problem areas on this form. There are a total of: 3 problems 4 problems 11 problems wrong

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01/10/55 01/10/55 Adult Consent Form Review Identify and click over problem areas on this form. There are a total of: 3 problems 4 problems 11 problems Right!! Next

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This concludes the optional pre-test activity. Please continue to the test. Questions? Email: Schoolflu.helpdesk@doh.hawaii.gov Phone: 808.586.8300