Non-compliance procedure

  1. So we just got SNAP (had Health Master) and we are doing immunizations and are finding non-compliance in a lot of students all over the District. The Supervisor would like us to call to MD's office and clarify the record, and if required, tell them that student will need a booster etc.. Then the MD's office gets hostile with you and ignores your request. Then we have to contact the parent and let them know, and in some cases (with the live vaccines), tell them we have to exclude them from school until it is completed (mind you, this is for all grades). This obviously takes a tremendous amount of time we don't have.

    We want to just send a letter to the parent stating they are non-comp and leave it up to them to contact their MD. I'm tired of being the immunization cop, my name is not stamped on the physical saying everything is up to date.

    Just curious how some of you handle the process.

    Thanks!
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    About mattfd37, ASN, BSN, RN, EMT-B

    Joined: Jan '09; Posts: 162; Likes: 50
    School & ER RN
    Specialty: 5 year(s) of experience

    19 Comments

  3. by   BeckyESRN
    We send notice to the parents only. I have, on a few occasions, contacted the doc. for an updated record. Our immunizations laws changed this year, so our exclusion date was very early.
  4. by   JenTheSchoolRN
    Quote from BeckyESRN
    We send notice to the parents only. I have, on a few occasions, contacted the doc. for an updated record. Our immunizations laws changed this year, so our exclusion date was very early.
    Same. I only contact the doctor's office after I get nada from a parent and suspect their kids is actually up to date and request the immunization report. 9/10 they are and I get the paperwork and I'm done.
  5. by   LikeTheDeadSea
    I'd request parents contact their MD. For non-compliance that is because the kid got it 2 days before their birthday, I'll let the parent know that I can accept "a letter from the MD stating that the child is adequately immunized." and attach the record. If they choose to give it again, just the new paperwork.

    SNAP lets you generate non-compliance letters. Definitely reach out to a SNAP rep if you can. Sometimes it's the way they're entered in from past years, (I can't remember which one specifically, but there was something with putting in "varicella" vs "varciella: Varivax" that would flag it as non-compliant, despite being in correct dates.) The rep can tell you all of those types of things.
  6. by   mattfd37
    Yea it's with the Influenza shot I believe. All letters to parents have to be approved by the BOE! SMH
  7. by   kidzcare
    From a parent standpoint, it would be really bad form to immediately exclude based on new found information. I think administration should give some leeway. Like, alert parents not that there is an issue that was just found and give them until the first day of next school year to be in compliance.
  8. by   Farawyn
    I hardly ever contact the doc.
  9. by   ruby_jane
    Most of mine don't have a medical home and go to the health department.

    You should contact the parent....not the provider. It's the parent's responsibility.

    Good luck!
  10. by   Amethya
    I hear you.

    I usually just inform parents, and it's their decision to talk to their doctor about this. Sometimes I talk to the doctors or sometimes I call them myself, if I have an inkling I can get a copy from them.

    But my methods are, check front office flies, check my files, check Immtrac (State immunization website, can look up students)

    As of now, from 549, I only got 4 out of compliance in the whole school.
    Last edit by Amethya on Dec 20, '17
  11. by   Eleven011
    I always just go to the parents. It's their responsibility. The only time I've ever called a doc (well a clinic) was when the parent insisted they got their child the shot at our local clinic, but our States immunizations website wasn't showing it. Clinic was very helpful (they saw the same thing on the website) and discovered the child had two records due to a name discrepancy ( De La Name vs. DeLaName). Otherwise, I don't have to call doc's at all.
  12. by   NurseBeans
    I let parents know because it is their responsibility. I can and have called doctor's offices and know one local peds office will fax me records and two others will not. They don't feel as though I am a provider caring for the child and feel like it is a privacy violation to send me immunization records.

    I feel like the peds offices should know what is required to register for the local schools. They do not. For me the issue arises with lead testing. Our state says we need proof of a blood test, surrounding states say a risk assessment is good enough. The peds around here all seem to think a risk assessment is enough. They say the kids are good to register, the school nurse says no...you can see how this conversation usually goes with a parent.
  13. by   grammy1
    I'm the Immi Cop at our school. They don't start the first day of school if they're not complete. If I find someone out of compliance during the school year I check the state database, if it's not in there I send a letter to the parents giving them 30 days to get the shot and get me a certified copy of the immunization record, or little precious will be excluded from school. I try to send a reminder at 3 weeks, and if the 30 days passes they are not allowed to return. If they show up, they come and sit in the clinic till someone picks them up. New students who are military or homeless are by state law, given 30 days to comply. I let the parents know up front and send a reminder letter at 3 weeks. If they don't comply, they are also excluded from school.

    It always amazes me that they are given a full month and 90% of them get their immi on day 31 or 32. YOU HAD A MONTH TO DO THIS!! Also, any days missed due to lack of immis are unexcused.
  14. by   MrNurse(x2)
    Quote from grammy1
    YOU HAD A MONTH TO DO THIS!! Also, any days missed due to lack of immis are unexcused.
    Had this issue with one family this year. My first time being this close to the deadline. I kept telling them to tell the pediatrician they were going to be excluded and they would make an exception. After a month they still didn't have them done, despite weekly reminders, and were panicking. I told them they could go to urgent cares to do it. Mom was ticked this was happening, but she didn't do anything. I called and found the urgent care she could go to. She got them done, but it wasn't over yet, they got ticked they had to pay a copay because it was an urgent care. Amazingly, they were quick about getting us to write a letter for the insurance company to cover their costs and kept calling us and bugging us about this letter.

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