Faculty/Staff In-service 2011-2012

School Nurse

Karen Dobbs BSN, R.N.

Blood Borne Pathogens-Online District Presentation Child Abuse-Online District Presentation

DNR Screenings

Confidentiality AED’s Health Initiatives General Clinic/Medication Info Health Concerns:

Diabetes – Level I Diabetic TrainingSeizures

Severe Allergies/Epipen Asthma

Field Trips, Overnight Field TripsHealth and Safety

Confidentiality• Student confidentiality is of utmost concern. Please do not be offended

if we cannot give you certain information about a student’s medications or medical condition. We will provide you with information only on a need to know basis and this information should not be shared with others.

• Please do not discuss a student’s medication or illness in front of the class, other students, or staff.

• The same confidentiality is given to staff.

State Mandated Screenings7th Grade– Vision– Hearing– Acanthosis NigricansDuring 7th Grade Science classesstarting mid September

8th Grade– SpinalDuring 8th Grade English classesStarting in October

Nurse will schedule with teachers

Acanthosis Nigricans

is a roughening and/or darkening of the skin at skin folds such as the back of the neck, armpits, elbows, back of knees, and at knuckles. It a sign that insulin levels are high and the person may at risk for developing Type II Diabetes.

Acanthosis Nigricans

• Acanthosis Nigricans

Do-Not-Resuscitate (DNR) Orders

• Out-of-Hospital DNR Order • Legally binding directives that indicate life-sustaining

treatments should not be initiated • These include but not limited to:

· Advanced Airway Management · CPR · Artificial Ventilation

• DNR Orders · Apply to Health Care Professionals · School Nurses

• Refer requests/parents to School Nurse. All requests must go through health services.

AED’s

• Automated External Defibrillators• Eisenhower has 2 units • Locations:

– Clinic– Boy’s Gym

Trained Staff: Nurse, Clinic Assistant, Coaches

If you suspect that a student is “under the influence” :

• Call for an Administrator or Police Officer• do not “send” the student alone or with

another student (If they have anything on them, this may give them a chance to “dump it ”.)

• the administrators will have the nurse

do an assessment if they feel

it is needed

Confidential Student Health Information

• I will be emailing you information on confidential student health concerns.

• Print two (2) copies of these emails and attachments. Keep a copy for yourself and place the additional copy in your sub folders.

• When something is updated, the old one needs to be shredded.

• Never throw any health related info in the trash.

Sub Instructions

• Please leave instructions for your subs regarding student health concerns/needs.

Student Clinic Referrals We have gone electronic.

Everything goes into the new computer documentation program. This includes all student and staff clinic visits.

The clinic referrals have changed. It is now only a ¼ sheet. Students will only return with the bottom portion.

Please print your name legibly on the referral, who the student was sent by must be entered into the computer. You can put your name on a bunch of them ahead of time, to save time later. Put some in your sub folder. Subs need to print their names on the referral.

Always send students to the clinic with a clinic referral. (Tardy students sometimes come by the

clinic with a complaint, hoping they will get a nurse referral to use as a reason for being late). We will send students to get a referral if they don’t have one (unless it is an emergency).

You can IM me or my assistant with further information if needed. Keep in mind though, I am not always at my computer.

Please do not send a sick or injured student on to their next class for a clinic referral.

If you have a student that frequently asks to go to the clinic during your class, please discuss this with the nurse.

Student Clinic Visits

• Always allow a diabetic or asthmatic to come to the clinic upon request. Unless they are coming for a scheduled check, snack, or med. time, do not send them alone. Send with a teacher, assistant, or another student. The other student will be sent back to class right away.

• Do not send a student alone with complaints of dizziness, or any type of head injury. Treat all head bumps as head injuries. They need to be evaluated.

• In case of an emergency, please call for the nurse. Be sure to state who and what the emergency call is for, so that I know how to respond and what meds to bring if applicable.

• While vomiting is obviously distressing for the student (and the teacher), it is usually not an “emergency”. Please send them to the clinic.

• Please have students bring their books with them when they come to the clinic.

Medication• Do not, under any circumstance, give a student

medication from your personal supply.• Students may not carry or have any medication on their person, in their backpack, lunch, purse, or locker. • If you see a student with medication, please escort them to

the clinic or office immediately or call for an administrator. • State law provides the following exceptions for emergency

medications. - With proper physician orders and district requirements met, students with asthma (inhaler), severe allergies (epi-pen or key chain meds), and diabetes (supplies and medication) may be given authorization to carry and self manage their care. There are protocols that need to be in place and followed for any of these to occur. When approved, these students will have documentation of this authorization. The administrators and the appropriate faculty and staff will be notified of this authorization and the individualized healthcare plan for that student.

Medication Times

• Many students take their medications during their lunch period. They will be given a pass for any other medication times.

• Students generally do not need to be dismissed early from class for scheduled medication unless they have a clinic pass indicating this or the nurse has notified you. (The exception is our diabetics)

• Medications must be given within 30 minutes of the scheduled medication time.

• If students do not come in on time, we must send for them.

• If students are frequently missing class time because they come to the clinic late for their medication or we have to send for them, please discuss this with the nurse.

Misc.Parent-Teacher Conferences

If a health concern comes up in a parent conference, please let me know. I may not be aware of it. If you would like me to be involved

in a parent conference, please let me know.

Elevator Pass/Extra Time Students will have a written pass if they need special privileges like

leaving class early, needing a book buddy, elevator, etc.If you suspect a student no longer needs, or is abusing the privileges, please see the nurse. Friends and book buddies are not to be on the elevator.

Do not provide a student with crutches or any other assistive devices.

Schedules/Room ChangesPlease notify the clinic, attendance, and the office of any

schedule/room changes and leave a note on door so that we can locate students.

Science Teachers, Custodians, etc: If there is any type of

chemical exposure, please send the MSDS to the nurse immediately.

Campus Health Initiative

Prevention, Prevention, Prevention

• More info will be coming on benefits the district will be offering this year

• We want your ideas for staff and student health initiatives

• The more we educate….the more we prevent... the higher the attendance rates for students and staff

Chronic Health Problems Diabetes, Asthma, Severe Allergies, & Seizures

These are chronic health conditions that can be managed, but can also have life threatening implications. This is not meant to alarm you, but to make you aware of the seriousness of managing these conditions.

Students with these conditions should have the same opportunities as their peers.

Please place emergency information regarding students with these conditions in your sub folder. You will receive this information from the nurse.

Asthma• Asthma is a chronic lung disease

characterized by acute episodes or attacks of breathing problems such as coughing, wheezing, chest tightness, and shortness of breath.

• These symptoms are caused by airway swelling, blocked airways, and increased responsiveness of the airways to a variety of stimuli or “triggers”. The triggers that cause an asthma episode vary with individuals.

• Common Asthma Triggers– allergens such as pollen, animal dander, dust mites,

and molds– irritants such as cold air, weather changes, strong

odors, cigarette smoke, perfumes, and aerosols– upper respiratory infections such as cold or flu– physical exercise

• Asthma Can Be Controlled With Effective Management

Asthma is one of the leading causes of absence for illness.

• Effective management of asthma at school can help:- promote a supportive environment for students with asthma- reduce absences- reduce disruption in the classroom- provide the necessary support in the event of an

emergency

• On Air Quality Alert Days, outdoor activity should be limited.

Types of SeizuresTonic Clonic (Grand Mal)

Fall, rigidity, muscle jerks, shallow breathing, bluish skin, loss of bladder/bowel control

Absence (Petit Mal)Blank stare, rapid blinking, chewing-like motion, appear to be daydreaming

Complex-PartialBlank stare, random or no activity. Unaware, unresponsive, may pick at objects, remove clothing, may run or appear afraid, may speak randomly

Simple PartialJerking in one area of the body, no loss of awareness. May feel sad, fearful, or angry. May have nausea or funny feeling in stomach or smell something odd.

Atonic (Drop attack) Fall, collapse

MyoclonicBrief muscle jerks in all or part of the body

If a person has a seizure:• Remain calm • Remove objects from around the person and try to protect the

person’s head • DO NOT RESTRAIN the person• If the person walks during the seizure, close the door and stay near • Do not put anything in the person’s mouth• If a person is laying down, turn person on side following the seizure• Call for the nurse • If a person has a grand mal seizure and you are unaware of a

seizure disorder, this should be treated as a medical emergency.• A seizure lasting over 5 minutes or followed by another seizure

should also be considered an emergency.• We have had students that have seizures several times a day. The

teacher may be asked to monitor and document the seizures on a seizure log.

• A person may have a seizure because of a seizure disorder/epilepsy or due to other instances such as drugs, fever, head injury, etc.

• The nurse has a video that shows the different types of seizures.

Seizure Information for the nurse:• When the seizure started, did the person lose consciousness?• How long did the actual seizure last?• Did you see any abnormal movements of the person’s eyes,

mouth, face, head, arms, or legs?• Did the movements involve the whole body or specific parts of

the body?• Did the person’s eyes roll back or turn in a specific direction?• Could the person talk and respond to questions or requests?• Did the person display any unusual behaviors? • Did the person lose bladder or bowel control?• Did the person bite his or her tongue or the inside of the

cheek?• After the seizure, did the person appear confused, tired? For

how long?• After the seizure, were the person’s speech and body

movements normal?

SEVERE ALLERGY• Common Types of Allergies: LATEX, INSECT STINGS, FOODS, MEDICATIONS, & OTHERS

• A severe allergic reaction can also be referred to as an anaphylactic reaction. This is a life threatening situation. Anaphylactic reactions can be sudden, severe, spontaneous, and potentially fatal. Some people with an allergy may start out with a local, non-life threatening reaction, but develop more symptoms each time they are exposed.

• It is very possible for someone that has not been diagnosed with an allergy to have an allergic reaction to something. There is always a first time.

• The nurse will notify the team, elective teachers, counselors, and administrators if they have a student with a severe allergy.

• If you have a student that is having a reaction, call for the nurse immediately, be sure to state for whom and why.

• A district food allergy plan has been put in place, which includes, but not limited to a student with food allergies to be allowed to sit where the allergen is not present, such as a “peanut-free” table, cleaning table with certain cleaners before a student with food allergies sits there, etc. This plan will involve everyone from the nurses, administration, custodial staff, cafeteria staff, and teachers to minimize the risk of exposure.

SIGNS AND SYMPTOMS OF ANAPHYLACTIC REACTION

• SKIN: Hives, Itchy red rash, Eczema• STOMACH: Cramps, Vomiting, Diarrhea• RESPIRATORY: Itchy eyes, Stuffy nose, Sneezing, Cough,

Itching, Swelling of lips, tongue, and throat, Changes in Voice, Difficulty swallowing, Tight chest, Wheezing, Shortness of breath, Throat clearing

• HEART: Low blood pressure, Increased heart rate, Shock• NEUROLOGICAL: Sense of doom, Weakness, Numbness or

tingling of lips or extremities

• EPIPENS AND TWINJECTS ARE EMERGENCY INJECTIONS USED TO TREAT AN ANAPHYLACTIC REACTION. EMS(9-911) MUST ALWAYS BE CALLED, IF AN EPIPEN IS USED. SYMPTOMS ARE LIKELY TO RETURN IN 5-30 MINUTES.

• Students with a severe allergy may have an EPIPEN in the nurse’s office. There may be instances where a student has authorization to carry his/her Epi-pen. It will be sent on field trips and requires training. All teachers will be trained on Epi-pen administration. Twinject has an available 2nd dose in the syringe.

• If a student has a Twinject, the team will be trained on this also.• Students may have an epipen, an antihistamine, or both.

Diabetes

• Diabetes is a chronic disease that impairs the body’s ability to use food properly. The hormone insulin, which is produced in the pancreas, helps the body convert food to energy. With diabetes, either the pancreas doesn’t make enough insulin or the body cannot use insulin properly. Without insulin, glucose (the body’s main energy source) builds up in the blood. Diabetes cannot be cured, only managed. This is done by carefully balancing food, medications, and activity.

There are 2 types of Diabetes

Type I• Pancreas does not

produce insulin• Must receive insulin

through injections or a pump

• Most common type affecting school-age children

Type II• Insulin is not used

properly in the body• May be able to control

the disease with diet and exercise

• May require oral medications and/or injections

• Obesity is a high risk factor

Hyperglycemia• Hyperglycemia: occurs when blood

glucose levels get too high Causes: too much food, too little insulin or diabetes medicine, illness or stress

Onset: gradual-not immediately life threatening, may progress to ketoacidosis or diabetic coma

Signs and symptoms include:

Extreme thirst, frequent urination, hunger, dry skin, blurred vision, drowsiness, nausea blurred

Hypogylcemia• Hypoglycemia: May be life threatening - occurs when

blood glucose levels get to low(Causes: too little food, too much insulin or diabetes medicine, or

extra activity)Onset: sudden, may progress to insulin shock

Signs and symptoms include:Shaking, fast heartbeat, sweating, anxious, dizziness, hunger,

impaired vision, weakness, fatigue, headache, slurred speech, irritability, inability to concentrate, daydreaming, sleepiness/tiredness, personality changes

Hypoglycemia is treated with a carbohydrate snack, glucose tablets or gel, and in severe cases, Glucagon.

Glucagon is an emergency injection given for severe hypoglycemia in which a student may be unable to swallow or has become unconscious. Call 911 anytime glucagon is given.

House Bill 984 Upon receiving a student’s diabetes management and treatment plan

from the physician, an IHP (Individualized Health Plan) will be developed for the student with diabetes while at school or while participating in a school activity.

Levels of Required Diabetes Education Training:Level I – All school based staff (brief diabetes in-service) Level II – All school based staff who have direct contact with a student who has diabetes -teachers, counselor, bus driver, cafeteria monitors, etc.

(In-depth diabetes in-service)Level III – (Student specific diabetes education/in-service with skills testing). UDCA’s-Unlicensed Diabetic Care Assistants An UDCA is trained by the nurse, to assist or monitor a student requiring blood glucose monitoring or insulin administration during school or school activities. The UDCA may be one of the diabetic students’ teachers and if in extracurricular activities, also a coach, or sponsor. On field trips, the diabetic management will be administered or monitored by the UDCA.

Diabetes Management/HB 984The physician may • provide permission for the student to provide

self-care.• state that the student requires the supervision or

assistance of a designated adult

If student is given physician permission to provide self care, they may carry their monitoring supplies and insulin. They can manage their care in the clinic, in the classroom, at a game, on the bus, at lunch, etc. They will be expected to follow their IHP.

NEISD FIELD TRIPMEDICATION SAFETY REQUIREMENTS

These requirements relate to field trips occurring during the school day.

(Requirements for travel and overnight trips, extracurricular activities, work study programs, etc. are addressed separately.)

Preparation of Field Trip MedicationsField Trip and Extracurricular Activity Medication ProtocolsAnd Safety Requirements:

• The RN will conduct faculty training at the beginning of each school year to review the Field Trip and Extracurricular Activity Medication Protocols and Safety Requirements.

• Each faculty member will sign a Faculty Training Record to indicate that they have received this information.

• The Field Trip and Extracurricular Activity Medication Protocols and Safety Requirements pertain to field trips taken during the school day.

• Prior to each field trip, the teachers/team will meet with the RN to review and sign the Field Trip Medication Safety Review Sheet.

• Field trip medications will be limited to scheduled oral medications, inhalers, and emergency medications that are student specific (e.g., EpiPen®/Twinject®, Key Chain Medications, Glucagon, Diastat®). Other medications prepared for a field trip will be at the discretion of the RN and/or student’s parent/guardian on a case-by-case basis.

• It is strongly recommended that teachers provide a list of students participating in field trips/extracurricular activities to the RN at least two weeks before the date of the trip. This is necessary to allow the RN sufficient time to accurately prepare the medications, discuss medication with faculty, and to provide for student safety.

Field Trips• All medications will be administered by the student’s assigned, authorized,

and trained teacher.• Substitutes, student teachers, instructional assistants, parent volunteers,

and any other staff members are not authorized to administer medications. (The only exception is that a parent may administer medication to their own child.)

• Parents who are currently licensed in the State of Texas as RNs, LVNs, MDs, Physician’s Assistants (PAs), or pharmacists may administer medications on field trips and during extracurricular activities. The RN will train these individuals according to NEISD protocols. To verify training, parent volunteers will sign the Field Trip and Extracurricular Activity Medication Protocols and Safety Requirements.

• Trained and authorized teachers and parent volunteers are never to administer medication from their personal supply to students. (The only exception is that a parent may administer medication to their own child.)

• Medication side effects, special precautions and special instructions will be discussed by the campus nurse and the teacher prior to departure on the field trip.

Field Trips• All medications will be carried in medication fanny packs

and/or back packs. These packs are to be worn at all times by the trained and authorized teacher; or the trained RN, LVN, MD, PA, or pharmacist, parent volunteer. The packs will not be removed, hand carried, or set aside for any reason.

• The following supplies will be included inside the medication fanny packs and/or back packs:

waterless hand cleanser; disposable medication cups; disposable cups for water; writing pen; anda copy of the Field Trip and Extracurricular

Activity Medication Protocols and Safety Requirements.

Oral Medications• Wash hands or use waterless hand cleanser prior to administering

medication• Designate a private area to administer medication – medication

administration is confidential.• Medicate students one at a time; remove medication envelopes from fanny pack/back pack one at a time; never leave envelopes unattended.• Medication must be given within 30 minutes of the time indicated on the

envelope; if this does not occur, do not give medication and notify RN and/or parent to obtain further instruction.

• Verify the following: (1) right student (always ask student to tell you his/her name; if student

unable to effectively do this, other methods of verifying identity must be in place)

(2) right medication (3) right dose (4) right time (5) right route (6) right documentation

Oral Medications• Tear open envelope along dotted lines; shake medication into a medication cup being careful to not touch medication nor drop it. • Make sure all medication is removed from envelope and amount in

cup coincides with the amount indicated on the envelope.• If trained and authorized teacher or parent volunteer has

questions/concerns re: medication and/or instructions regarding administration, DO NOT administer without conferring with the RN.

• Make sure that student has swallowed oral medication; offer additional water if necessary.

• Immediately document date and time medication was given; and sign the Medication envelope.

• Upon return to campus immediately return medication fanny packs/back packs with empty medication envelopes and additional medications (inhalers and Emergency medications) to the RN.

Inhalers

• Inhalers and spacers are to be placed in clearly labeled baggies with proper identification and instructions enclosed. The inhaler and spacer may be placed in same baggie.

• A short-term medication card or Field Trip Medication Calendar may be completed by the campus nurse and enclosed in baggie with inhaler and spacer.

• The card or calendar will remain in labeled baggie and suffice for documenting inhaler use on field trips the entire school year.

Emergency Medications• Emergency medications such as Glucagon, EpiPen®/Twinject®,

Key Chain Medications, and Diastat® are to be placed in clearly labeled baggies. Plastic containers such as pencil boxes may also be used. A copy of Physician’s orders, instructions for use, emergency care plan, and parent contact information must be included.

• When an emergency medication is administered, EMS and the student’s parent must becontacted immediately. The only exception to calling EMS may be the administration of KeyChain Medications (refer to student specific MD orders).

• Health Services and the campus RN must be notified as soon as possible. • Documentation must include the time the medication was administered and the times calls were

made.• Any error in giving medication or omission of a scheduled medication must be reported

immediately. In the event of a medication error or omission, immediately call EMS if thestudent’s health and safety could possibly be at risk. Immediately notify the parent, RN, andprincipal. The RN will notify the physician and Health Services. Document the date and timethey were contacted. A medication incident report will be completed upon return to the school.

• No student may have any medication (prescription/non-prescription) on their person except asdescribed below:

Students who are authorized to carry and self-administer their emergency medications during the regular school day may also do so on field trips/extracurricular activities. They will follow the same rules pertaining to self-administration established for the regular school day on campus.

Print Name _________________________________________________ _________________________________________________ _______________ Signature Date

FIELD TRIP MEDICATION SAFETYREVIEW SHEET

To be reviewed and documented prior to each field trip after the annual training.__• ___________Teacher/parent volunteer responsible for student requiring medication/supplies will

carry all medication supplies on his/her person at all times.• ___________Prior to administering each medication, the authorized and trained teacher/parent

volunteer will check the Six Rights of Medication Administration. 1) Right Student 2) Right Medication 3) Right Dose 4) Right Time 5) Right Route 6) Right

Documentation• __________ Immediately after administering medication, the authorized and trained

teacher/parent volunteer will document the time medication was given and sign the medication record (calendar, envelope, card).

• ___________All medication records are to be returned to the RN.• __________ Medications/supplies will be returned to clinic by the authorized and trained

teacher/parent volunteer immediately upon return to school. Medicationsare not to be given to students to hold or transport for any reason.

• Check as appropriate for specific field trip:• __________ Demonstrates understanding of Epi Pen®/Twinject® Injection.• __________ Demonstrates understanding of blood glucose testing.• __________ Demonstrates understanding of insulin administration (injection or pump).• __________ Demonstrates understanding of Glucagon injection.• __________ Demonstrates understanding of Diastat® administration.• __________ Demonstrates understanding of Key Chain Medication administration.• ________________________________ ____________________________ _________• Teacher/Parent Volunteer Printed Name Signature Date• ________________________________ ____________________________ _________• RN Printed Name Signature Date

Overnight Field Trips• 1. The RN will conduct an annual inservice for faculty

who take students on overnight field trips. This inservice will be done prior to any overnight field trips and will review Overnight Field Trip Medication Protocols. These faculty members will sign a Faculty Training Record to indicate they have received and reviewed the information. Prior to each overnight field trip, the RN will meet with the teachers/team responsible for the students to review protocols and discuss the medications, administration, and documentation procedures.

• 2. It is strongly recommended that teachers provide a list of students participating in overnight field trips to the RN at least two weeks before the date of the trip. This list should be updated periodically and finalized at least 48 hours before the trip. This is necessary to allow the RN ample time to accurately prepare the medications, discuss medications with the faculty, and to provide for student safety.

Overnight Field Trips• 3. Parents who are currently licensed in the State of Texas as RNs, LVNs, MDs, PAs,

or Pharmacist may administer medication on overnight field trips. The RN will meet with these parents prior to an overnight field trip to review NEISD Medication Protocols, Overnight Field Trip Medication Protocols, medication administration, and documentation procedures. Parents will sign to indicate they have reviewed and received these protocols and agree to abide by them.

• 4. Substitute teachers, student teachers, instructional assistants, volunteers, parents, or any other staff members or persons are not authorized to administer medications.

• 5. The only exception to the above is that a parent may administer medication to their own child.

• 6. All medication must be delivered to the RN by a parent/guardian. All medication must be in the original properly labeled container or prescription bottle. If the students depart at a time when the RN is not on duty, the medication may be given to the teacher/sponsor by a parent/guardian. Whenever possible, medications should be delivered to the RN. Medication sent in plastic wrap, foil, baggies, envelopes, etc. will not be given. Only medication authorized by a physician/parent will be given. Only necessary amounts of medication needed for the trip will be accepted. All medication must be in the original container.Homeopathic preparations will not be accepted or administered. Expired medications will not be accepted or administered.

• 7. All medication must be accompanied by a note from the parent with specific directions regarding dose, frequency, times of administration, and any other student specific information. Doses of medication exceeding the prescription label instructions or the manufacturer’s recommended dose will not be administered. Medication will only be administered at the frequencies on the prescription label or according to the manufacturer’s recommended dosing intervals.

Overnight Field Trips• 8. All medication administered during the overnight field trip must be

documented. Medications are to be administered to each student at the designated times. The trained and authorized teacher or parent volunteer must document the medication administration by noting the date and time of administration and signing the official NEISD Travel Medication Record. The Travel Medication Record will be provided by the RN or Health Services.

• 9. All medications are to be secured in safe and locked locations at all times. Medications should never be accessible to students and should not be exposed to extremes of heat or cold.

• 10. To protect student confidentiality when administering medications, designate a private area for this purpose. The administration of all medication at school and on school trips is a confidential issue and must be handled as such. Any discussion concerning the student and/or their medication should be kept to a minimum and should only involve those who have a legitimate need to know.

• 11. Privately request students and take them to the designated area for medication administration individually and one at a time.

• 12. Verify the name of the student and the name on the medication container and ensure the medication container matches the student’s name. This step is to be repeated with each student and each time a medication is administered.

Overnight Field Trips• 13. Ask the student to state their name to verify identity and to ensure the correct

medication will be given to the correct student. If the student states questionable information, other reliable methods of verifying identity must be established. Adequate measures must be taken to establish correct identity. This step is to be repeated with each student and each time a medication is administered.

• 14. Double check the dose, the time the medication is scheduled to be given, and the current time prior to administering the medication. This step is to be repeated with each student and each time a medication is administered.

• 15. If there are any questions or concerns or if the identification or instructions are unclear, DO NOT administer the medication without getting clarification from the parent/RN/Health Services.

• 16. Ensure that oral medication is swallowed by the student by asking the student for a verbal reply and offering more water if necessary.

• 17. Immediately document the date and time each medication is administered and initial/sign the Travel Medication Record. DO NOT wait until later to complete this documentation. For confidentiality reasons, all medication records should be kept in a folder/binder that is not accessible to students and others without a need to know.

• 18. Inhalers and spacers are to be placed in clearly labeled baggies with proper identification and instructions for administration enclosed. The inhaler and spacer may be placed in the same plastic bag.

• 19. Emergency medications such as glucagon, Epi Pen ®/Twinject ®, Key Chain Medication, and Diastat ® syringes are to be placed in clearly labeled baggies. Indications for administration and instructions for use must be included in the bag along with a copy of the student’s Emergency Care Plan and parent contact information.

Overnight Field Trips• 20. When an emergency medication is administered, EMS and the student’s parents

must be contacted immediately. Health Services and the RN should be notified as soon as possible. Documentation must note the time the medication was administered and the times calls were made. The only exception to calling EMS would be the administration of Key Chain Medications (refer to parent/MD documentation).

• 21. Any error in giving medication or omission of a scheduled medication must be reported immediately. In the event of a medication error or medication omission, immediately call EMS if the student’s health and safety could possibly be a risk. Immediately notify the parent, physician, RN, and principal and document the date and time they were contacted. A medication incident report will be completed upon return to the school.

• 22. All medications are to be returned to parents upon the student’s return. Under no circumstances are medications to be given to students to take home.

• 23. All Travel Medication Records are to be returned to the RN upon the students return to the school.

• 24. Trained and authorized teachers and parent volunteers are never to administer medication from their personal supply to students.

Overnight Field Trips• 25. No student may have any medication (prescription/non-prescription) on their

person except as described below.Students who are authorized to carry and self-administer their inhaler, Epi-Pen®/Twinject®, glucagon kit, insulin and/or diabetic supplies during the regular school day may also carry and self-administer these medications on overnight field trips. If requested, written permission from a parent/guardian and the student’s physician may be given for a student to carry and self-administer the following medications for a specific overnight field trip: inhaler, EpiPen®/Twinject®, Glucagon kit, insulin, and diabetic supplies. With written permission from a parent/guardian and the student’s physician, female students are authorized to carry labeled prescription oral contraceptives (birth control pills) during overnight field trips. An authorized and trained teacher must be informed of any student who is authorized to carry and selfadminister their medications during the trip.An authorized and trained teacher or authorized and trained parent (RN, LVN, MD, PA, Pharmacist) will administer ALL medications not authorized for self-administration.

• 26. These protocols will be reviewed and signed by trained and authorized parents each school year prior to any overnight field trips. Trained/authorized teachers sign the Faculty Training Record.

• I have read, understand, and will follow all of the above-stated NEISD Overnight Field Trip Medication Protocols.______________________ ________________________ _________________Printed Name Signature Date_____________________ ________________________ _________________RN Signature Date3 8/11

OVERNIGHT FIELD TRIPMEDICATION SAFETY REVIEW SHEET

• *To be signed prior to each overnight field trip after attending annual training.• __________ All medication is properly labeled and is accompanied by a parent/physician• note.• __________ All medications will be stored in a safe and secure location.• __________ Prior to administering each medication, the authorized and trained• teacher/parent volunteer will check the Six Rights of Medication• Administration:• 1.) Right Student 4.) Right Time• 2.) Right Medication 5.) Right Route• 3.) Right Dose 6.) Right Document• __________ Immediately after administering each medication, the teacher/parent• volunteer will document the time medication given and sign the Travel• Medication Record. All Travel Medication Records will be returned to the• RN.• __________ MEDICATIONS ARE NOT TO BE GIVEN TO STUDENTS TO• TAKE HOME. Upon the student’s return, medication will be returned to• parents only.• Check as appropriate for specific trip:• ___________ Demonstrates understanding of Epi Pen®/Twinject® injection.• ___________ Demonstrates understanding of blood glucose testing.• ___________ Demonstrates understanding on insulin administration (injection or pump).• ___________ Demonstrates understanding of Glucagon injection.• ___________ Demonstrates understanding of Diastat® administration.• ___________ Demonstrates understanding of Key Chain Medication administration.• __________________________________________________________ _____________• TEACHER/PARENT VOLUNTEER SIGNATURE DATE• _______________________________________________________________________________________ ____________________• RN SIGNATURE DATE

More On Overnight Field Trips

• Additional forms are required for overnight field trips. We will go over them if you are planning a trip.

The Clinic is also your resource.

• Providing health information or resources• Monitoring of health needs such as blood pressure and weight.• Gloves or band aids• Come in if you are not feeling well or have a health need or concern• If you have emergency medications, please talk to me about

keeping one in the clinic (inhaler, epipen, etc). Must have RX label.• The clinic staff cannot provide any medications for staff in the clinic

or elsewhere. Please plan accordingly.

Thanks for your cooperation, support, and all that you do.

Don’t forget take care of yourself!!!!!

Health/Clinic Sign Off• Watch the electronic presentations on

Blood Borne Pathogens and Child Abuse

on Intranet, under August 2011 Leadership.• Read the Field Trip protocols carefully (This applies anytime you take students off campus)

• Review any of this power point that you need to. (It will be in staff shared under Clinic and I will also email it to everyone)

• Sign the Health Services Faculty Training Record and turn it into the nurse.

HAVE A GREAT YEAR!!!!