Conjunctivitis -how long to exclude

[momnurse23]

Hi all,

I am sure this has been discussed before and I found a few threads on pink eye, but my question is not when to send home but when can they return? I have had a few cases this year where the student is being treated but the eye is still red and draining, sometimes still thick drainage. Typically I would say 24 hours after treatment has begun even if the eye is still red, but it's the drainage that's confusing me. What if this is viral instead of bacterial and the MD gave drops "just in case".... I know - not my call to make regarding the diagnosis, but I still want to do the right thing as far as keeping them home. Should I be requiring a doctor's note saying treatment has been prescribed it's OK to return on xyz date? So far, I've just been going on the parents word that they are treating. I've done a quick internet search and got conflicting recommendations - some say 24-48 hours after starting antibiotic drops but some say after drainage has stopped. As far as I can tell we don't have a black & white policy regarding this and 99% of our "send home" is up to the nurse. (the only exceptions I can think of are fever >100.0 and live lice - the lice is supposed to be up to the nurse but very frowned on by admin if a student is kept with live bugs) so this is really up to me. It's great, usually, but in cases like this I want to be consistant and smart and it'd almost help to have a policy, ya know?

Ok I feel like I've rambled but hopefully you found my question in there somewhere and can offer some advise.

Thanks for your help.

[smily nurse, BSN, RN]

check CDC website... under a-z look up pink eye... all addressed :redpinkhe

[Purple_Scrubs, BSN, RN]

The policy is in my district is that they can be readmitted with a doctor's note, so I insist that the doctor's notes state a date that the student may return to school. If they have a note but it does not state a date, I call or have the parent call the doctor. Occasionally I have readmitted without a note when all symptoms are resolved completely...but I would not readmit with any continuing symptoms unless I have a doctor's note to cover myself!

[Artistyc1]

My school district does not exclude at all for conjunctivitis. Most cases are caused by the same viruses that cause the common cold, and we don't exclude for colds. Of course, if the child is very uncomfortable, rubbing their eyes,have pain or photophobia and the eyes are sticky and nasty, we call the parent for the soonest physicians appointment they can get! Still, if the child is old enough to be told to wash their hands frequently, and not to touch their eyes, exclusion, according to our district physicians, is neither necessary or desirable.

When a child is seen by a physician, any type of conjunctivitis is likely to be deemed "pinkeye", and antibiotic preparations will be prescribed, (just in case!) even if they are of no benefit to either the allergic or viral types of conjunctivitis.

[momnurse23]

Thanks for the replies.