Policy and Procedure Manual

The

Policies and Procedures

of

The Cherokee Elementary School Nurse

 

 

Table of Contents

 

 

Health and Medical Division
Cherokee School Clinics

SUBJECT: Abuse and Neglect Reporting

PURPOSE: Compliance with North Carolina General Statutes on Child Abuse and Neglect (7A-157).

STAFF GOVERNED BY THIS POLICY: School Nursing Staff

EFFECTIVE DATE: July 2000

DATE REVIEWED OR REVISED: November 5, 2003

DISTRIBUTION: Nursing Staff

POLICY:

Any member of the Cherokee High School Nursing Staff that has cause to suspect child abuse or neglect (as defined by NCGS 7A-157) should immediately notify the following: (1) School Principal (2) Director of Department of Social Services in the county where the juvenile resides (3) Medical Supervisor

PROCEDURE:

  1. The report can be made orally, by telephone, or in writing.
  2. If a written report is made or a follow-up report is sent to the school by DSS, the original report will be kept in a confidential file in the office of the school principal and a copy of the report will be filed with the school nurse.

Health and Medical Division
Cherokee School Clinics

SUBJECT: Communicable Disease Prevention and Control

PURPOSE: (1) To insure that preventative measures are in place to protect the health status of all students and staff. (2) To provide for immediate care of students or staff who develop a potentially communicable illness.

STAFF GOVERNED BY THIS POLICY: School Nursing Staff

EFFECTIVE DATE: July 2000

DATE REVIEWED OR REVISED: November 5, 2003

DISTRIBUTION: Nursing Staff

POLICY: Students are excluded from school in cases of communicable diseases.

PROCEDURE:

When a student is suspected of having one of the following communicable diseases, it is the responsibility of the parent to take the child to the local health department, treatment facility (Cherokee Indian Hospital or Qualla Youth Health Center), or family physician for verification and treatment before that student can return to school.

  1. Chicken Pox : Student is excluded for at least five (5) days after the rash appears or until all blisters have formed scabs.
  2. Measles (Rubeola/Rubella): Student is excluded until physician’s approval is given and student is no longer contagious.
  3. Pediculosis (Head Lice): Student is excluded until: (1) Pediculosis shampoo is completed and all nits have been removed in accordance with the CISD “NO NIT” policy. (2) The parent or guardian must return with the Elementary School Students to the school nurse for clearance to return to class. Middle School and High School students report to the school nurse for clearance.
  4. Scabies: Student is excluded until one (1) treatment with prescription medication for 12 to 24 hours is completed.
  5. Conjunctivitis (Pink Eye): Student is excluded if any of the following are present:
    1. Eye(s) is(are) severely red and somewhat swollen.
    2. There is a yellow (purulent) discharge.
    3. Child excessively rubs the itching eye(s).
    4. Condition lasts more than three (3) days.
    5. There is an epidemic in the school or it appears that cases are being transmitted from one student to another. *Student is allowed to return to school on approval of physician.
  6. Impetigo: Student is excluded from school if he has more than three to four sores and until seen by a physician and treated with a prescription antibiotic for 24 hours.
  7. Streptococcal and Staphylococcal Infections: Student is excluded from school until treated with a prescription antibiotic for 24 hours.

 

 

 

Health and Medical Division
Cherokee School Clinics

SUBJECT: Emergency Care for Injury and Sudden Illness

PURPOSE: To ensure for the safety and well-being of students and staff during the hours of school attendance, while on school property and during school sponsored activities.

STAFF GOVERNED BY THIS POLICY: School Nursing Staff

EFFECTIVE DATE: July 2000

DATE REVIEWED OR REVISED: November 05, 2003

DISTRIBUTION: Nursing Staff

POLICY:

Emergency information will be kept on every student (see attached medical consent form) The information will be updated on an annual basis.

PROCEDURE:

  1. Assess the patient for nature of injury and level of consciousness.
  2. Refer to North Carolina School Health Program Manual for specific injuries.
    Section E 4.30 (First Aid)
  3. Notify the parent/ guardian whether to pick up the child at school or to meet the child at the hospital.
  4. If the parent/ guardian cannot be reached, the student will be transported per our local EMS to designated hospital. Efforts to notify the parent/guardian will continue until they are completed.
  5. The school nurse will inform the Principal immediately of any serious injuries suffered by students or teachers. A report of the injury will be filed in the school clinic.

 

 

 

 

Health and Medical Division
Cherokee School Clinics

SUBJECT: Hearing Screens

PURPOSE: The State Department of Public Instruction Guidelines propose hearing screens as one of the recommended procedures used to identify children with handicapping conditions in need of special education and/or related services as required by Public Law 94-142.

STAFF GOVERNED BY THIS POLICY: School Nursing Staff

EFFECTIVE DATE: July 2000

DATE REVIEWED OR REVISED: November 05, 2003

DISTRIBUTION: Nursing Staff

POLICY:

As recommended by the American Academy of Pediatrics and the State of NC, hearing screens will be done on the following grades: All Elementary School age children, grades 7th, 9th, 11th, and all exceptional students or when indicated.

PROCEDURE:

  1. All hearing screens will be coordinated by the school nurse and the audiologist with each new school year.
  2. All screening results will be maintained as part of the school health record.
  3. All referrals and follow-ups will be completed by the audiologist.

 

 

 

 

Health and Medical Division
Cherokee School Clinics

SUBJECT: Medication Administration: Prescription and Non-Prescription

PURPOSE: To define the policy and procedure for administering and securing medications at school.

STAFF GOVERNED BY THIS POLICY: School Nursing Staff

EFFECTIVE DATE: July 2000

DATE REVIEWED OR REVISED: November 05, 2003

DISTRIBUTION: Nursing Staff

POLICY:

To meet the needs of students who require medication during school hours to maintain and support their continued presence in school.

PROCEDURE:

  1. Parents can either come to school and administer medications to their child as prescribed or provide a written/oral request for school personnel to administer the OTC or physician prescribed medication.
  2. Prescription and Over-The-Counter medication must be brought to the nurse’s office for dispensing.
  3. The medication should be in the original container with parent/guardian note that provides the following information: name of child, name of medication, date prescribed, dosage, how and when the medication is to be given, special instructions about the child or the medication, how long the medication is to be given at school, and the name of the health care provider.
  4. The school nurse will dispense all medication. If the school nurse is not available, a designated school representative (trained and supervised by the school nurse and with physician approval) will administer and document the medication.
  5. Proper storage space will be provided to ensure that all medications are secure. Some medications can not be locked, such as those that students need to carry with them at all times (asthma inhalers). Elementary school student asthma inhalers may be kept in the class room and administered by teacher prior to physical activity. Security for these medications must be planned on an individual basis.
  6. Records of all medication administered at school should be maintained. All written medical logs and records should be on file as long as the student is enrolled in the school system plus three (3) years past the time the child reaches age 18. (See attached medication records)
  7. Parent information regarding school policy on medication should be provided through student handbook, individual letters and forms as needed.
  8. Some medications may be given by the school nurse in accordance with the School Nurse Standing Orders per physician / medical director.

 

 

 

 

Health and Medical Division
Cherokee School Clinics

SUBJECT: Pregnancy Tests

PURPOSE: To define the policy and procedure for pregnancy tests.

STAFF GOVERNED BY THIS POLICY: CHS Nursing Staff

EFFECTIVE DATE: July 2000

DATE REVIEWED OR REVISED: November 5, 2003

DISTRIBUTION: Nursing Staff

POLICY:

Whereas the CMS/CHS clinic serves the adolescent population which are considered high risk for teen pregnancy, confidential testing is available.


PROCEDURE:

  1. If a student presents at the CMS/CHS clinic and requests a pregnancy test, or if the Nursing staff deems necessary, one will be performed.
  2. Pending the results of the test, the following options will be available.
    1. Negative Results:
      1. The Nursing staff will provide education/information on teen sexuality, pregnancy prevention, STD awareness, and reproductive health as per individual student needs.
      2. The student will be encouraged to visit the Qualla Youth Health Center for a pelvic/pap exam and information on birth control.
    2. Positive Results:
      1. With the student’s consent, an appointment will be made at the Qualla Youth Health Center for coordination of continued services.

Health and Medical Division
Cherokee School Clinics

SUBJECT: Standing orders for RN

PURPOSE: To define standing orders for the RN in the school setting

STAFF GOVERNED BY THIS POLICY: School Nursing Staff

EFFECTIVE DATE: July 2000

DATE REVIEWED OR REVISED: November 05, 2003

DISTRIBUTION: Nursing Staff

POLICY:

In accordance with the North Carolina State Board of Nursing, the staff RN may follow a set of standing orders that are written and signed by the Medical Director.

PROCEDURE:

  1. A set of standing orders will be written and updated annually for the school nurse to follow.
  2. See attached copy of current standing orders.
  3. The RN may also receive verbal/ telephone orders from a Medical Doctor or mid-level provider.
  4. The RN may only follow standing orders when functioning in the school setting.

 

 

Health and Medical Division
Cherokee School Clinics

SUBJECT: Vision Screens

PURPOSE: To identify possible vision problems that require professional care.

STAFF GOVERNED BY THIS POLICY: School Nursing Staff

EFFECTIVE DATE: July 2000

DATE REVIEWED OR REVISED: November 05, 2003

DISTRIBUTION: Nursing Staff

POLICY:

As recommended by the American Academy of Pediatrics and the State of NC, vision screens will be done on the following grades: All Elementary School age children, grades 7th,9th,11th, and all exceptional students or when indicated.

PROCEDURE:

  1. Vision screens will be completed each new school year.
  2. The school nurse will implement the vision conservation program.
  3. At least two certified screeners (Prevent Blindness of NC) should be present to maintain and utilize standardized guidelines for screening throughout the State.
  4. All vision results will be maintained as part of the school health record. A copy will be sent to Prevent Blindness of NC.
  5. All students who fail to meet the guidelines as outlined by Prevent Blindness of NC will have a referral (see sample form) sent to their parent.
  6. The school nurse will follow up on all vision referrals.