Version 10.0
July 2008

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HEALTH SERVICES

• Clinic

• Medication Policy

• Prescription Medication

• Over-the-Counter Medication

• Diabetic Care for Students with Diabetes

• Immunizations

• State Mandated Health Screenings for students

• Bloodborne Pathogens Exposure Control Plan

• Automatic External Defibrillators – AEDs

• Also check on the Internet at www.irvingisd.net/health

Clinic

The clinic is under the supervision of the school nurse. The school nurse provides assessment for acute illness or injury, emergency first aid, provides medical procedures for medically fragile and chronically ill children, provides referral and follow-up for student’s with injury or illnesses requiring medical intervention, provides state mandated health screenings with referral and follow-up, connects parents with community resources to support healthy initiatives, supports campus wellness programs, provides classroom instruction for health related topics, and monitors student’s compliance with state mandate for immunization compliance. 

The clinics are to be used for the care and management of student’s and staff’s health concerns.  If a student becomes too ill to remain at school, the parent or designated person must be notified. Facilities are such that the clinic cannot be used as rehabilitation or resting place.

If a student is noticeably ill or injured, teachers should fill out a corridor pass to send with the student to the clinic.  Discretion should be used to determine when a student is too ill or injured to be sent to the clinic alone.

The approved procedure for students to go home when they are too ill to remain in school is for the student to report to the school nurse for evaluation of the problem. Students who do not follow this procedure and call a parent/guardian from the hall or classroom phone will be required to see the grade level vice principal for permission to go home.

Students must have a written pass to come to the clinic stating full name, date, time, and reason for clinic visit.

Parent/guardian or designated person must be notified before a student can be dismissed from school.

Medication Policy

Medications shall be brought to the clinic or office area where they shall be kept in a locked container or cabinet. Students shall not possess any form of medication while at school other than to transport such to the designated location for proper storage. Medication will be refrigerated only if such storage instruction is printed on the label. At the end of the school year all medication left at school shall be returned to the parent or destroyed.

Prescription Medication

Designated employees of the District may administer medication to a student provided:

1. The District has received a written request to administer the medication from a parent, legal guardian, or other person having legal control of the student. (form # 5.2)
2. Prescription medications must be in the original container, bearing a prescription label in English that includes the student’s name, the name of the medicine, directions concerning dosage, mode of administration, the name of the prescribing physician, the name of the pharmacy filling the prescription, and the date the prescription was filled – within the past year.
3. Prescription inhalant medications and/or “anaphylaxis medicine” if properly labeled, may be carried by the student for self administration if directed in writing by the physician and parent and the student has demonstrated to the school nurse appropriate skill level and self responsibility for self administration.  A written statement from the physician must state the student has asthma or is subject to anaphylaxis and is capable of self-administering the prescription medicine. This request must be filed in the school clinic.
4. All physician’s sample medication must be accompanied by a written authorization from the physician.

No district employee will be required to give medication above the daily recommended dosage by the Federal Drug Administration.

No medication will be dispensed for a missed dose unless written authorization is received from the parent/guardian for each dose missed.

Hypodermic injections may be given by the school nurse on an emergency, life-saving basis. This does not include routine injections such as allergy shots, vitamins, hormones or antibiotics.

In accordance with a student’s individual health plan for management of diabetes, a student with diabetes may be permitted to possess and use monitoring and treatment supplies and equipment while at school or at a school-related activity.  See the school nurse or principal for information.

Over-the-Counter Medication

Designated employees of the District may administer over-the-counter medications to students if the following conditions are met: (Labels on over-the-counter medication designate contents as MEDICATION.)

1. The District has received a written request in English, to administer the medication, from a parent, legal guardian, or other person having legal control of the student.
2. The written request of the parent/guardian must indicate the dosage, frequency of need, reason for the medication, and the date(s) to be administered. (Form # 5.3)
3. The medication must be stored in the original container. Dosage must be within recommended amount for the age of the student. Medication may not be given for longer than 5 school days unless directed by a physician. All over-the-counter medications should be picked up on Fridays.
4. For secondary students all Over-the-Counter medications must be in original unopened container.

The student shall report to the clinic to take the medication. Exceptions to the clinic being the location for administering medication may be made for eligible special education students if such change is recommended by an ARD committee.

Home visits are made upon request for excessive absences and to evaluate illness.

School nurses are available and willing to teach health concepts upon invitation from the classroom teacher.

Diabetic Care for Students with Diabetes

The 79^th legislature HB 984 allows students with diabetes to have access to diabetic care and disease monitoring via self monitoring and self administration as needed according to the Individual Health Plan developed for the student with diabetes.  A Diabetes Management Plan must be submitted by the physician providing a statement indicating the student has diabetes and is capable of self-monitoring and self-administering the prescription medicine. Physician, parent and school nurse must agree with the skill level of the student and self responsibility to provide self care.  The Individual Health Plan must be completed and signed by the physician, parent and school nurse and retained in the clinic.  The Individual Health Plan must be updated annually.

Immunizations

Proper verification of immunization against Diphtheria/Tetanus, Pertussis, Poliomyelitis, Rubeola, Rubella, Mumps, Haemophilus Influenzae Type B (H.I.B.), Varicella (chickenpox) Hepatitis A, Pneumococcal Conjugate and Hepatitis B is required for the enrollment of all children in Texas public schools.  Exclusions from compliance are allowable for medical and religious reasons on an individual basis and evidence must be submitted for exclusion from compliance as specified in Texas Education Code 1.09. 

Texas law requires immunizations for all students to be enrolled in school.

State Mandated Health Screenings for students

Spinal Screening

The annual, state-required, spinal screening will be conducted for 5^th & 8^th grade students.  The purpose of this program is to identify the students who may have spinal problems and to inform their parents so the student may have a complete examination by their own physician.  Pupils are checked individually by the school nurse.  All students must remove their shirt for this exam.  For this reasons, we request that girls wear a halter top, tube top, sports bra, or a two-piece swimsuit underneath their shirt on exam day.  Parents will be notified of the results of the screening only if professional follow-up is necessary.

Acanthosis Nigricans Screening

Acanthosis Nigricans (AN) is a skin condition that signals high insulin levels in the body.  Insulin is produced by an organ called the pancreas. Insulin helps “carry” the glucose or sugar to the cells in the body.  High insulin levels indicate that the body is resisting the insulin that is being produced.  As a result, the pancreas produces more insulin than needed, and through time, it can stop producing enough insulin to carry the glucose to the cells in the body.  Acanthosis Nigricans screening can help identify students who may run the risk of developing diabetes in the future. In compliance to Texas legislative mandate for Acanthosis Nigricans screening Irving ISD conducts screening during 3^rd, 5^th and 7^th grade vision and hearing screening.  Parents will be notified if their child is found to have this skin marker for professional follow-up.

Vision and Hearing Screening

In compliance with Texas Health & Safety Code Chapter 36 the Irving ISD has established a screening program to identify students with vision and hearing disorders.  Early detection and treatment will provide students with the opportunity to reach academic and social status through adequate educational experience and training.  Vision and Hearing screenings are conducted in the 3^rd, 5^th, & 7^th grades.  Parents will be notified of failed vision and/or hearing screenings for professional follow-up as necessary.

Bloodborne Pathogens Exposure Control Plan

The district exposure control plan is located in the clinic on each campus or in the office of the building administrator if there is not a clinic. The purpose of the exposure control plan is to eliminate or minimize work related exposure to Bloodborne pathogens, particularly the HIV and the Hepatitis B virus (HBV).

The plan identifies two categories of employees. Those employees whose job routinely involves exposure to blood, body fluids, tissues, or other contaminated material include: nurses, clinic assistants, athletic trainers, and specific special education teachers and aides. This group receives extensive pre-service training, hepatitis B vaccine, and annual refresher training.

All other employees will receive annual in-service on standard blood and body fluids precaution to avoid Bloodborne pathogens. The plan also includes a post exposure plan in the event an exposure incident occurs.

Automatic External Defibrillators – AEDs

When available at a school an Automated External Defibrillator (AED) may be used by trained emergency response members to treat victims who experience sudden cardiac arrest.