Student Health Care Policies and Procedures

Health Care packets are disseminated to all parents at the beginning of the school year. It is a comprehensive packet identifying the Plan of Action for the most common disabilities. It is solely the parental responsibility to alert the school of their child’s disability and complete all given paperwork.

In addition to, all parents must provide an official action plan by the student’s physician. All medication provided by the parent must be approved by the physician with a prescription label and the proper bottle encasement, if applicable. The school’s Registered Nurse will secure and label all medications until needed. All staff is alerted of the student’s disability so they can follow the emergency plan for that given disability in case of an emergency.

Policy Title: Acute Conditions, Emergencies, or injuries Requiring Immediate First Aid or Early Medical Attention

Policy No. 1001

Policy Statement: It is the policy of the District of Columbia School Health and Nursing Program to facilitate the provisions of emergency care for acute conditions, emergencies or injuries requiring immediate first aid, or early medical attention.

Purpose:

To delineate roles responsibilities for managing acute conditions, emergencies, and injuries.

The Common Disabilities are:

Allergies – Anaphylaxis is an extremely serious condition. It is an over exaggerated response by the body to a substance to which a person is allergic.

  • Modification of the student’s environment should be made as much as possible without unduly restricting the child’s activities (i.e., if a student has severe peanut allergies, effort should be made to remove peanut products from the child’s educational environment).

Asthma is the leading chronic disease that affects students. It is one of the most common reasons for hospitalization, particularly for children.

Asthma is a Lung Condition that affects the airways (the windpipes) is super sensitive or “twitch” (hyperactive). Asthma is also a chronic condition. When asthma occurs, there are usually three problems:

  • Hyperactivity of the airways, so the airways spasm; Squeezing of the muscles around the airways (bronchi constriction) so the airway becomes narrower than normal; and/or swelling and increased mucus inside the airway (inflammation), which also makes the airway narrower than normal.
  • This series of events can make it hard to breathe or may cause excessive coughing. Asthma is also called Reactive Airway Disease (RAD).

Hypoglycemia (Low Blood Glucose) impairs cognitive and motor functioning. A student may be aware that he/she needs to eat, but may not be able to problem solve how to get the food, or may not have the fine motor skills to remove the juice lid or open a cracker package. Some students may become combative and/or verbally abusive. Hypoglycemia can often be mistaken for misbehavior.

Hypoglycemia is one of the most frequent complications of diabetes. If recognized and treated early, an emergency situation can be avoided. Most hypoglycemic episodes respond within 10-15 minutes after the student eats a quick acting snack (i.e., juice, crackers, etc.). If an adverse reaction occurs, the school staff will follow the student’s action plan and always have appropriate foods accessible.

Sickle Cell
(SCD) is a genetic disease of the red blood cell  characterized by vaso-occlusion and hemolysis.

  • Occlusion of small vessels leads to impaired oxygen delivery to tissues
  • Pain crises often occur in the same areas of the body
  • Older children can often discern ‘sickle pain’ from other pain

Prevention & School Concerns 

  • Avoid triggers: cold, getting chilled, dehydration
  • Avoiding triggers cannot prevent all crises
  • Goal is early detection and treatment

Diabetes is a chronic condition that prevents the body’s ability to use food (i.e., glucose) properly. Food is converted into energy for the body with the help of the hormone insulin. The student with diabetes usually has a pancreas that makes little or no insulin or the body (i.e., cells) develops resistance to the insulin. As a result, the body cannot properly use the food for energy, and blood sugar levels rise.

Policy Title: Administration of Medication

Policy No. 1301

Health services provided by the District of Columbia School Health Nursing Program do not routinely include medical treatment or medication except for minor first aid in the case of accidents and in emergency situations.

District law, however, authorizes licensed registered nurses and practical nurses to administer medication in the school setting under certain circumstances. District Law 17-1707 authorizes school employees who have been trained to administer medications during hours when the licensed nurses are not in assigned schools. It also allows students, who have been authorized by their parents and licensed practitioner, to carry and self-administer inhaler asthma medication and auto injectable epinephrine to self-manage their asthma or anaphylaxis or both conditions during the school day.

Policy Title: The Responsibility of Administration of Medication by Licensed Nursing Personnel and Trained School Employee

Policy No. 1302

The Plan of Action

The need for assistance for the aforementioned disabilities care tasks will vary from student to student. The licensed nurse or designated medication administer are mandated to follow the physician’s Action Plan for that student and the physicians explicit orders documented when dispensing medication.

Richard Wright Public Charter School’s Action Plan, Step One: 

The Registered Nurse, if available, will handle all medical crises. If the Registered Nurse is not available, the Head of School will direct the certified authorized medication administer to assist the student.

Richard Wright Public Charter School Emergency Protocol, Step Two:
Call 911 immediately if any of the following symptoms occurs:

  • Shortness of breath, difficulty breathing or not breathing
  • Chest pains
  • Seizures or twitching
  • Loss of consciousness or non-responsive
  • Head or neck injury
  • Possibility of broken or dislocated bone(s)
  • Choking on a foreign object

Communication:

  • Call 911 immediately
  • Notify the Head of School or Designee
  • Call the telephone covering nurse or nurse manager
  • Call the student’s Parent or Guardian

Policy Title: Implementing Specific Medical Procedures/Treatments

Policy No. 1303

Policy Statement: Licensed nurses and trained school personnel performing a specific medical procedure/treatment must adhere to the policy and procedure guidelines. The procedures set forth will assist the nurse and trained school personnel to effectively and safely implement the Specific Medical Procedure/Treatment Policy.

The Purpose:

To provide guidelines for the performance of specific medical procedures/treatments.

When the procedure/treatment has been terminated, document medical procedures/treatments administered or provided on the specific medical procedure/treatment form (#1303A and #13038B).  File this form in the student’s permanent health record.

Policy Title: Reporting Requirements for the District of Columbia School Health Nursing Program

Policy No. 1304

Policy Statement: Data reported monthly is collected and submitted as statistical data for the District of Columbia School Health Nursing Program.

Purpose:

To provide a record of medication and dosage, as well as monitoring dates of trained school personnel and remarks to nurse manager and statistical reporting.

Under the FARE Student Disability Act Disclosure:

  • Students with asthma, sickle cell, diabetes, hypoglycemia, and allergies should be encouraged to participate in all usual student activities including parties and field trips.
  • Regular class attendance should be expected. Recurrent illnesses are to be carefully evaluated by the student, parents, school staff, and physician or health care team.