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1008-H.a HEALTH OFFICE POLICIES |
CONFIDENTIALITY POLICY Adopted: 4/14/2003 Orig. 2003 Revised: _________________ Purpose: To ensure confidentiality is maintained at both the staff and student level. Policy: • Health office staff will not discuss student health issues with other staff. The exceptions would be as follows: Student food allergies will be shared with the food service. Student health concerns will be shared with pertinent staff, only if there is a need for them to know (i.e. condition may affect student’s classroom performance. Persons may include classroom teacher, playground supervisors, coaches, school age child care workers, bus drivers.) Student medication information will only be shared with pertinent staff, on a need to know basis (i.e. student needing to leave class early or arrive late because of taking medications in health office.) • Staff who does not follow the confidentiality policy of the district will be dealt with accordingly. COUGH DROP USE POLICY Adopted: 4/14/2003 Orig. 2003 Revised: _________________ Purpose: To ensure safe use of cough drops by students. Policy: • The school nurse reserves the right to limit cough drop use by students if necessary. The school nurse may also use different guidelines on a case-by-case basis. • General Guidelines are as follows: Bonner Elementary: All students must have written parent permission to use cough drops. All cough drops must be kept in the health office, or with the students’ teacher. Central Intermediate All students must have written parent permission to use cough drops. All cough drops must be kept in the health office, or with the students’ teacher. Middle School All student cough drops must be kept in the health office. High School Parent discretion of whether student may carry own. DIABETIC TESTING/INSULIN ADMINISTRATION IN THE SCHOOL SETTING Adopted: 1/3/2006 Orig. 2006 Revised: 9/25/06, 8/13/2007_________________ I. PURPOSE • To provide guidelines to school staff for the management and coordination of care for the students with diabetes in schools. • To enable a student with diabetes to attend school regularly and fully participate in educational programs. • To provide for the immediate safety and long term health needs of students with diabetes. • To minimize the possibility of diabetes related emergency situations. . II. GENERAL STATEMENT OF POLICY • Testing is different than treatment. The student tests their blood sugar level and if the blood sugar is in normal limits no treatment is necessary. If the blood sugar is low the student takes a tablet to raise the sugar level or will drink juice, etc. to raise the sugar level. If the blood sugar is high, insulin administration is conducted to lower the blood sugar. Insulin administration will only be conducted in the classroom by students with a pump. III. REQUIREMENTS The following criteria should be considered when the certified school nurse-teacher is assessing a student’s candidacy to self-management in the classroom: • The student must demonstrate independence in the use of the glucometer and deemed responsible to dispose of used lancets and strips properly. A sealed container for sharps is necessary. • The student must have the cognitive ability to interpret and act on the information which monitoring provides. For example a student must be able to treat hypo and hyperglycemia. • The student must reliably keep a record (logbook, electronic record in the meter, etc.) of monitoring results. • Monitoring results will be assessed by the certified school nurse as necessary. • There should be agreement among the child, parent, diabetes care provider, certified school-nurse, and school staff regarding whether the child meets the established criteria. • An Individualized Health Care Plan will be developed by the certified school nurse for each diabetic student in the school setting. • Students with diabetes should be taught and encouraged to independently care for their disease to the best of their ability, based on age, developmental stage, skills performance and input from the diabetic care team (school staff and medical professionals). Students who are able to self test, self administer insulin, and to manage their diabetic care must be allowed to do so in the classroom or other appropriate place(s) if the student and diabetic care team deem that this is appropriate. A physician’s order will be on file to address accommodations including, but not limited to, diabetic self care in the various school settings. • All diabetic students will be allowed to consume snacks in the classroom or other appropriate location, such as the bus. Students will also be able to use the bathroom and water fountain as needed. • Supervision will be provided on extracurricular events/ field trips based on the individual health plan or 504 plan. 1. Prior to testing in the classroom a physician’s letter or school nurse assessment will verify his/her ability to: – Demonstrate hand hygiene: – Act accordingly to any low or high blood glucose levels, as outlined in the student’s health care plan, without the assistance of health office staff. Also, the student must use correct technique when testing one’s blood sugar and administering insulin. – Properly dispose of test strips, lancets, cotton balls, tissues, or any items that have come into contact with blood. – Ensure any blood smears on hard surfaces that he/she causes are cleaned up. The student may clean up a smear with an approved disinfectant for blood. A bottle of disinfectant will be provided in the classroom that the student normally tests in. If time doesn’t allow the student to clean up a blood smear, the student will notify the teacher and the teacher will ensure the smear is cleaned up. The student should carry disinfecting wipes or notify the teacher of any blood smears that occur in other classrooms so that they may be appropriately disinfected. – The student will be given a reminder if a violation occurs as soon as possible and the parent will be notified within 24 hours. 2. For testing in the classroom the student should: – Develop a nonverbal signal with the teacher to give notice that they will be testing. – Find an appropriate area within the classroom to test on a regular basis that will minimize distraction to other students and provide the diabetic student with a level of privacy that he/she is comfortable with. – Test responsibly in the designated area using universal precautions, proper blood clean up, hand hygiene, and waste disposal. – The teacher will notify the student of any violations as soon as possible and also notify the health office. The health office will notify the parent within 24 hours. 3. The student will meet with the school nurse at the beginning of each school year to assess their understanding of the policy. * If the student is not acting responsibly or fails to meet any of the previously mentioned criteria, as documented by the classroom teacher, the testing will be confined to the health office for testing for a 5 trial period. Failure to act responsibly and meet the criteria three times in a semester will result in the student waiting until the next semester to be allowed to begin the testing in the classroom process again. 4. Parameters that would indicate that the student should come to the health office or that health office staff should be summoned: – A low blood glucose level that has been treated once and has not gone back within the student’s desired blood glucose range. – A high blood glucose level, based on the child’s health plan, the student will then proceed to health office. * Health office staff will not be held responsible for treatment of any blood glucose levels that they are unaware of. * An up to date copy of the student’s diabetic plan must be on file at the health office. * The parent will be responsible for notifying the health office of any changes to the health plan. * The student/parent will be responsible for providing and restocking necessary supplies throughout the school year. *Only diabetic students in grades 6-12 are eligible for diabetic testing/insulin administration in the classroom. An exception to this policy may be made based on doctor, parent, and school nurse input in the health care plan. *The policy must be signed by all parties to be considered in effect. HEAD LICE POLICY Adopted: 4/14/2003 Orig. 2003 Revised: _________________ Purpose: To prevent the spread of head lice. Policy: • Staff will identify children with Head Lice in an individual, confidential manner. • Parents must notify Health Office when their child has Head Lice/Nits. • Children cannot attend school if Lice or excessive number of Nits are present. Parents must pick up child immediately once notified. • When a child is identified with Head Lice, all siblings in the School District will be checked. • Parent Education will be provided by the Health Office. • Treatment by parents is mandatory before child may return to school. Health Office Staff will not treat children at school. • Students must be checked by the Health Office before returning to class. • Student will be checked by the Health Office a minimum of 3 times per week or as needed, and will be checked for two weeks after the last episode of Live Lice is seen. • All Elementary classrooms will be checked for Head Lice in early fall, and Health Office reserves the right to do random checks when exposure is suspected. • With families experiencing chronic Lice cases, the School Nurse will communicate with Health Providers (i.e. Public Health) to ensure that agencies are coordinating services. • Staff must follow the Procedures for Head Lice. IMMUNIZATION POLICY Adopted: 4/14/2003 Orig. 2003 Revised: _________________ Purpose: To ensure all students are in compliance with the State of Minnesota Immunization Law. Policy: • All students (enrolled students, and home school students) must be in compliance with the State of Minnesota Immunization Law. • All new students have 30 days to produce their written immunization record to the school health office. • Students entering grades in which a new immunization is required (currently Kindergarten, 7th grade), must be current on their immunizations. If they are not, they will not be permitted to attend classes. Schedules will be held until written documentation of required immunizations has been turned in to the school nurse. • All immunization records received from the parent/guardian must be on an official document (i.e. clinic printout, MN immunization record, etc.) No phone messages or parent handwritten notes will be accepted. • Parents may choose to exercise their right to refuse immunizations, but they must follow the proper procedure. See school nurse for paperwork. MEDICATION POLICY Adopted: 6/11/2007 Orig. 2003 Revised: _________________ STUDENT MEDICATIONS [Note: The necessary provisions for complying with Minn. Stat. § § 121A.22, Administration of Drugs and Medicine, 121A.221, Possession and Use of Asthma Inhalers by Asthmatic Students, and 121A.2205, Possession and Use of Nonsyringe Injectors of Epinephrine are included in this policy. The statutes do not regulate administration of drugs and medicine for students age 18 and over or other nonprescription medications. Please note that §121A.22 does not require school districts to apply the administration of medication rule to drugs or medicine used off school grounds, drugs or medicines used in connection with athletics or extra-curricular activities, and drugs and medicines that are used in connection with activities that occur before or after the regular school day.] I. PURPOSE The purpose of this policy and subsequent procedures is to set forth the provisions that must be followed when administering any medication (prescription, over-the-counter, and complementary, holistic) to students at school during regular school hours. II. GENERAL STATEMENT OF POLICY It is generally recognized that some students may require medication for chronic or short-term illness or health conditions during school hours. This medication enables students to remain in school and participate in their education. Although the school believes that medication should be given outside of school hours whenever possible; the district will provide administration of medication for any student if the parent/legal guardian is willing to comply with requests for authorization and provision of information. The school district’s licensed school nurse, trained health aide, or other trained school employee will administer all medications in accordance with law and school district procedures. Self-administration of medication may be allowed if certain conditions are met. III. REQUIREMENTS A. The administration of all medication or drugs (prescription, over-the-counter, complementary, and holistic medications) at school requires a completed signed request from the student’s parent and the student’s physician or licensed prescriber. An oral request must be reduced to writing within two school days. 1. Licensed prescribers’ include; physicians, advanced practice nurses (CNS, NP, CRNA, nurse midwifes), Physician’s Assistant under the direction of a physician, Dentist, Podiatrist, Osteopath, Psychiatrist. B. A “Medication Authorization” form must be completed annually (once per school year) and/or when a change in the prescription or requirements for administration occurs, this includes discontinuation of a prescribed medication. C. Prescription medication must come to school in the original container labeled for the student by a pharmacist in accordance with law, and must be administered in a manner consistent with the instructions on the label. Parents or guardians are responsible for their child’s supply of medication. D. Over the counter medications must be presented in their original container, with student’s name written on it. No baggies, or other containers will not accepted. E. The school nurse may request to receive further information about the prescription, if needed, prior to administration of the substance. F. All student medications, prescription and non-prescription, are to be kept and administered with-in the Health Office unless self-administered by the student, assigned to other district staff for administration, subject to exceptions listed in paragraph N 1-5, medications administered as noted in a written agreement between the school district and the parent or as specified in an IEP (individualized education program), Section 504 plan, or IHP (individual health plan). All medications, with the exception of approved self-administered, will be stored securely in the Health Office of each building G. The school must be notified immediately by the parent or student 18 years old or older in writing of any change in the student’s prescription medication administration. A new medical authorization and container label with new pharmacy instructions shall be required immediately as well. H. For drugs or medicine used by children with a disability, administration may be as provided in the IEP, Section 504 plan or IHP. I. The licensed school nurse, or other designated person, shall be responsible for the filing of the “Medication Authorization” form. The licensed school nurse, or other designated person, shall be responsible for providing a copy of such form or information from the medication authorization form to the principal and to other personnel designated to administer the medication. J. Planning for students with conditions that require medication on field trips during the school day will be done prior to the day of the field trip. It is the teacher’s and parent/guardian’s responsibility to inform the Health Office in advance of a field trip. The teacher or trained school employee may carry and administer the medication on the field trip as necessary, following district procedure. K. The Health Office will record and review any identified medication error. The review of a medication error will be used to identify corrective steps that may need to be implemented to ensure medication safety for students. L. Procedures for administration of drugs and medicine at school and school activities shall be developed in consultation with a school nurse, a licensed school nurse, or a public or private health organization or other appropriate party (if appropriately contracted by the school district under Minn. Stat. § 121A.21). M. Delegation of Medication administration may only be done by the LSN/RN/PHN. Delegation is a nursing function that is “transferring to a competent individual the authority to perform a selected nursing task in a selected situation. The nurse retains accountability for the delegation.” (According to the National Council of State Boards of Nursing (1997). N. Specific Exceptions: 1. Special health treatments and health functions such as catheterization, tracheostomy suctioning, and gastrostomy feedings do not constitute administration of drugs and medicine; 2. Drugs or medicine provided or administered by a public health agency to prevent or control an illness or a disease outbreak are not governed by this policy; 3. Drugs or medicines that are prescription asthma or reactive airway disease medications or emergency nonsyringe epinephrine autoinjector pens can be self-administered by a student if: a. the Health Office has received a written authorization (completed Medication Authorization for Self-Administration form) from the student’s parent and physician permitting the student to self-administer the medication; b. the medication is properly labeled for that student; and c. the parent has not requested school personnel to administer the medication to the student, except in emergency situations when the student is unable to self-administer. d. the student completes and signs the Self-Administration Contract. e. the licensed school nurse has met with the student and assessed their knowledge and skills to safely possess and use an asthma inhaler or Epipen in a school setting and completes and signs the Self-Administration. The parent must submit written authorization for the student to self-administer the medication each school year. The parent or guardian is responsible for maintaining the supply of asthma or reactive airway or Epipen medications. The school district may revoke a student’s privilege to possess and self administer these medications if the school district determines that the student is abusing the privilege. 4. Medications: a. that are used off school grounds; b. that are used in connection with athletics or extracurricular activities; or c. that are used in connection with activities that occur before or after the regular school day are not governed by this policy. 5. School Districts retain the authority to govern the administration of Investigational drugs and CAM’s (Complementary or Alternative Medicines). These medications will be considered on a case by case basis. Legal References: Minn. Stat. § 13.32 (Student Health Data) Minn. Stat. § 121A.21 (Hiring of Health Personnel) Minn. Stat. § 121A.22 (Administration of Drugs and Medicine) Minn. Stat. § 121A.221 (Possession and Use of Asthma Inhalers by Asthmatic Students) Minn. Stat. § 121A.2205 (Possession and Use of Nonsyringe Injectors of Epinephrine; Model Policy) Minn. Stat. § 151.212 (Label of Prescription Drug Containers) 20 U.S.C. § 1400 et seq. (Individuals with Disabilities Education Improvement Act of 2004) 29 U.S.C. § 794 et seq. (Rehabilitation Act of 1973, § 504) Cross References: MSBA/MASA Model Policy 418 (Drug-Free Workplace/Drug-Free School) MDH-Minnesota Guidelines for Medication Administration in Schools SICK CHILD POLICY Adopted: 4/14/2003 Orig. 2003 Revised: _________________ Purpose: To maintain a healthy learning environment. Policy: Sick Child • Only the health office staff or school principal will determine when a child needs to go home sick. • If a student has been absent from school for an extended amount of time (greater than 3 days continuous, or 10 days in a semester), the school nurse may request a doctor’s note from the child’s health care provider. Reasons children will be excluded from school: When they can come back: • Fever of greater than 100.0 F • Must be fever free for 24 hours. Taking medication to control fever does not count for fever free period. • Vomiting • When symptoms subside • Diarrhea • When symptoms subside • Loose stools which can not be contained by child (or contained in diaper) • When stools resume normal consistency • Strep Throat • 24 hours after beginning medication (Antibiotic) • Continuous or uncontrollable coughing • When symptoms subside • Mattery eyes • Needs to be evaluated for pink eye. If positive, need to stay home until on medication for 24 hours. • Active Lice • When no live lice are present • Other • See health office for complete listing. Infectious Disease • If a child is diagnosed with a contagious disease, parents must notify the school within twenty-four hours. • Parents must keep the Health Office updated with emergency contact information, and keep the school up to date with home and work phone numbers. Emergency Situations • If a student requires emergency care (either due to illness or injury), health office personnel will attempt to contact the parent, guardian, or other designated emergency contact. • If parent or specified contact is unavailable, and the school nurse deems an ambulance is necessary, designated school personnel will arrange transport to the hospital, as listed on the student information card. If no hospital is specified, students will be taken to St. Mary’s Hospital, Rochester. |
