Chronic Health Conditions

Your child's health condition may affect their ability to learn. When you provide documentation from your health care provider, your nurse will write an Individual Health Plan (IHP) for your child. Each plan will be communicated to the appropriate staff and monitored throughout the year for effectiveness and updates. School nurses may provide care directly to the student, or train another school employee to give medication or assist the student in specialized health care procedures such as catheterization, or tube feedings. School health's goal is to make sure students' health care concerns do not become a barrier to their ability to learn.

Concussion

Diabetes

UCPS School Health understands that students with diabetes face many challenges in school. We provide a program of Individualized Health Care as well as comply with North Carolina law Diabetes Bill SB 911. SB 911 requires that we train Diabetes Care Managers for our students when the School Nurse is not available. To provide a comprehensive approach to care for your child with diabetes, we need you to make an appointment with your school nurse prior to your child's first day at school and have your doctor complete all the necessary paperwork. Once your child is enrolled in school, your school nurse needs to meet with you and your child and have updated paperwork from your doctor at the beginning of each school year.

Contact your school nurse or call the School Health Office at 704-296-0845 for additional information.

Forms Required for Students with Diabetes Annually

• Forms For Students with Diabetes

Food Allergies

UCPS does not serve food that contains nuts or peanuts, but they may have products that are manufactured in an environment that processes nuts. Cafeterias are not peanut and nut-free, because children are allowed to bring in these items from home. A nut-free area is available for your child to eat at.  Contact your school nurse, as each school provides this option in a different manner. If your student needs special arrangements in the classroom or cafeteria to prevent an allergic reaction, a report from your doctor is required to determine the extent of the allergy.  If your child needs a nut or peanut-free classroom, you have to have an evaluation by the 504 Accommodation team to have a classroom restrict eating snacks. Call your school's counselor to set up this meeting. 

The following steps are helpful to maintain your child's safety from allergic reactions to food at school.

1. Complete a request for Health Information Form.
   • Request for Health Information English
   • Request for Health Information Form Spanish
2. Have your medical provider complete the following forms:
   • Diet Order Form: Diet Order Form (English) or Diet Order Form (Spanish)    
   • Medication Consent: Medication Form (English) or Medication Form (Spanish)
   • Consent to Self-Carry Medication (Emergency Medication only *optional* )
     Consent to self-carry Medication (English)
     Consent to self-carry medication (Spanish)
3. Provide your school nurse with any other documentation from your health care provider to help determine the extent of the allergy and emergency care,  FARE forms are accepted.  

Additional Health Resources       

• American Academy of Pediatrics
• Center for Disease Control
• Mayo Clinic
• North Carolina Healthy Schools
• Union County Public Health 
• Oral Health UC Public Health

• Blood Borne Pathogens Manual

Each school must be prepared to respond safely and appropriately to any medical emergency that a student might experience on school grounds. This can include injuries such as severe lacerations, bone fractures, and head injuries. Also included are emergencies related to health conditions such as seizures, asthma attacks, anaphylactic reactions, and diabetic emergencies.

School Responsibility

1. UCPS has developed an emergency care plan that describes the school’s plan of response to medical emergencies.  This is included in the UCPS emergency handbook (red notebook located in every classroom).  Plans include procedures for medical emergencies, heart attacks, and a master emergency plan for field trip accidents.
2. The principal will designate the school personnel to serve on the Emergency Care Team (ECT) at every school.
3. The ECT members will:
   • Receive training in First Aid/CPR and renew training every two years.
   • Watch and review the UCPS Blood Borne Pathogens online annually. 
   • Be offered the Hepatitis B vaccine series.
4. In response to NC Senate Bill 911, all schools in North Carolina must provide diabetes education for all new employees. All employees have an annual review of diabetes in school through the Safe Schools Training.  In addition, every school must have at least two employees to serve as Diabetes Care Managers (DCM). They must complete the DCM training class provided by UCPS.  Training is once and as needed.

Nurse Responsibility

1. Assist the school in the development and implementation of an emergency medical plan.
2. Provide education to the members of the Emergency Care Teams. The UCPS nurses provide First Aid/CPR training several times during the school year.  School employees may contact the School Nurse Supervisor for class information.
3. Identify students who have a medical condition that puts them at risk for a medical emergency, write Individual Health Plans (IHP’s) for those students, inform team members that IHP’s have been written and instruct them as needed on the implementation of the plans.

COVID-19

UCPS nurses and staff will follow all North Carolina State recommendations for the safety and health of employees in the prevention of COVID-19 when school is in session. 

• Union County COVID-19
• CDC COVID-19

Influenza

UCPS school health and the CDC recommends that all staff and students get a yearly flu shot. Flu clinics are held by CVS yearly at schools for easy access to all staff members, and children over 12 years of age. 

Symptoms of the Flu

• Fever or feeling feverish/chills
• Cough
• Sore Throat
• Runny/stuffy nose
• Muscle or body aches
• Headache
• Fatigue
• Some people have vomiting or diarrhea, but this is more common in children 

Helpful Resources

• CDC Flu Information
• Flu Symptoms and Care
• Flu Symptoms and Care Spanish

Lice

Lice is a nuisance and not a disease. School Health realizes that when your child has lice, it can be frustrating and difficult to remove, but it is not a health concern. The Academy of Pediatrics does not recommend excluding children from school due to lice or nits. Union County Board of Education has developed a lice policy that requires that we notify parents if a student has live lice, and the student must be removed from school for treatment. Communication to classrooms where a staff member has seen live lice will happen in elementary schools only. UCPS staff is not responsible for inspecting children's heads, or communicating to other parents when lice is discovered by parents at home. See below for the complete UCPS Board of Education Policy.  

• UCPS Board of Education Lice Policy

In order to comply with North Carolina GS 130A-440, each child entering public school, grades K-12 for the first time must have a health assessment completed by their Health Care Provider. The Provider may be out of state but the results of the physical exam must be recorded on a North Carolina Health Care Transmittal Form. 

• Health Assessment Form (English)
• Health Assessment Form (Spanish) (Evaluacion De Salud En Carolina Del Norte)

Protocol

Students are seen throughout the day with illness and injury in the school's health room. A nurse may not always be present to care for the student, but designated personnel in every school are trained in first aid and CPR and they will assist with the student's health care needs, or call 911 if necessary.

Most illnesses and injuries that occur in school are minor, and may not require a phone call to parents. The student may call home themselves or the teacher may call from the classroom. If nurse or school care provider feels the injury needs followup, they will contact the parent or guardian by phone or in writing. If the nurse, office staff or Emergency Response Team member feels the illness or injury is an emergency, the school will try to notify the parent or guardian first by phone, then the emergency contact. If an ambulance is necessary, and a parent or guardian is not available the principal has the authority and will take responsibility for sending the student with a school employee to the hospital if needed.

We encourage students to stay in the classroom during the school day. If a student has frequent visits to the health room or calls home frequently during the school week the nurse may contact the parent or guardian to determine if there is a medical or psychosocial concern that should be addressed at home or at school. Nurses are consulted by both school staff and parents regarding frequent illness and absences and are available to help problem-solve these issues as needed.

Health Care Tips for the Classroom Teacher

• First Aid in the Classroom

• Letter to Parent Requesting Health Information (English)
• Request for Health Information Form (English)
• Letter to Parent Requesting Health Information (Spanish)
• Request for Health Information Form (Spanish) 

Medication Administration

All medications that can be given outside of school hours without adversely affecting the health of the student should not be administered at school during school hours. As a general rule, medications that are given three times a day or less can be administered at home. However, UCPS realizes that sometimes it is necessary to administer medications at school for the health of the student. When medication is to be administered at school, the parent or guardian should communicate with the teacher and school nurse about its administration.

*Medications may not be administered at school until appropriate consent has been received

The responsibilities of the parent or guardian are:

• Obtain and return to school a medication consent form (at bottom of this page) signed by the doctor and parent/guardian for each school year. (and when a student transfers to another school)
• Medication should be in original container with the student's name and dosage amounts clearly written.
• Contact the school nurse to discuss any long-term (daily) or emergency medications medication, preferably prior to administration at school.
• Inform teacher and school nurse of any changes in the medication immediately. A new consent form signed by the doctor is required for changes in dosages.
• Medication must be picked up after the 10-day period with no note from a doctor, or by the last workday of the school year. The school nurse will discard all medication left at school at the end of the last workday.
• Medication should be brought to school by a parent, not sent in with the student on the bus.

Emergency medication such as epi-pens and inhalers may be carried by the student or kept in a classroom. All other medication will be kept in a locked cabinet in the health room or classroom with permission from the nurse and principal.

• UCPS Medication Policy
• Medication Training

Tube Feedings, Colostomy Care, Tracheostomy Care and Other Special Health Care Procedures

If your child has need of a special health care procedure at school, your school nurse will work with you and your health care provider to provide this care, or train unlicensed assistive personnel in school to provide the care. Occasionally a child needs more care than a school nurse can provide, if this is the case, then the 504 Accommodation team at the school, lead by your school counselor will meet with you to determine the best way to meet your child needs. 

How to set up specialized health care for my child

1. Call the school your child is attending, and notify the school nurse that your child needs assistance with a specialized health care procedure at school.  
2. UCPS Parent Authorization for Specialized Health Care must be completed. 
3. A Plan of Treatment form completed by your health care provider is required for the procedure to be done at school.
4. A Release for information form is helpful to allow the nurse to speak to the doctor about any concerns they may have while giving care to your child.
5. A medication form will be needed in addition to the specialized health care form, if your child is going to need medication at school.
6. The nurse will review all pertinent health care plans/procedures/treatments with the school personnel and administration, and will decide if the care can be delegated to a non-licensed teacher assistant, or if the care must be done by a Registered Nurse.  

Training and Supervision  

School Responsibility

1. School personnel will be designated to perform long-term procedures (ie. catheterizations, suction and tracheostomy care, ostomy care, tube feeding, etc.).  The school nurse and the principal will work closely together to identify the most appropriate staff member to perform the procedure.
2. It is highly recommended that all care be put in place before a medically fragile student comes to school. The care cannot be given without the Plan of Treatment and Parent Authorization for Specialized Health Care form.  Your nurse may also develop and Individual Health Care Plan that will also be distributed to the staff. 

Nurse Responsibility

1. If the school nurse feels the care can be delegated to the designated school staff, that staff member will be trained by the school nurse to provide the care. 
2. The nurse will supervise the designated school staff in the performance of the specialized procedures until proficiency is demonstrated and review the care monthly or as needed.   A skills checklist will be used to show evidence of mastery of the required procedure(s).  The checklist will be filed in the student’s Individual Student Health Care Folder. 
3. Specialized health care procedures which may be performed by trained school staff include but are not limited to:
• gastrostomy tube feeding
• care and cleaning ostomies
• tracheostomy suctioning
• care and cleaning of tracheostomy and stoma     
• clean intermittent catheterization
• care of an external catheterization
• postural drainage and percussion therapy
• administration of tube or rectal medications
• intermittent temperature or blood pressure monitoring
• other

Parent Responsibility

1. To inform the school of changes in the student’s Treatment Plan and/or medications as they occur so that information can be updated and implemented.
2. Specialized health care procedures that are the responsibility of the parent and will not be done by school personnel or the school nurse include but are not limited to:

• Replacing gastrostomy tube feeding sites
• Changing malfunctioning insulin pump sites, continuous glucose monitoring sites, or pods in Omnipod/insulin pumps.

Forms Needed for Specialized Health Care

• Parent Authorization for Specialized Healthcare Procedure English and Spanish
• Plan of Treatment for Specialized Health Care
• UCPS Medication Consent Form
• Consent for Release of Information

The purpose of doing vision screenings at school is to identify possible visual problems that may be a deterrent to the student's educational performance in school, and to refer for appropriate diagnosis and treatment by an eye care professional.

Vision Screenings will be conducted annually in Union County Public Schools for all students in grades K - 5 and in grade 7. Students in grades 1 - 5 will be screened during the fall semester and at the kindergarten level by the end of February. Grade 7 will have a completed vision screening by the end of February as well. Additional vision screenings should be performed for all students, regardless of grade level, who are new to the UCPS system, in special education programs, demonstrate possible vision problems or are referred by teachers.

The school nurse can assist families who qualify for vision care programs in obtaining exams and/or eye glasses on an as-needed basis.

Prevent Blindness North Carolina