Exclusion Policies

[NurseMrn]

Please tell me your school policies for exclusion of:

Fevers
Vomiting
Diarrhea

And the requirements for return to school.

We have a very high rate of absence right now (18%), and I believe some of it is due to children returning to school and still being contagious. I understand not all vomiting is illness related (I have several of those kiddos). But our policy is so gray about these issues. Curious if you have some concrete rules regarding these things, and if you base it off of your state DHHS or if it is just per your district. Thanks so much!

[beachynurse, ASN, BSN]

Our division policy is 24 hours fever free without the use of medication, 24 hours without vomiting or diarrhea. It's based off our division guidelines. I only wish parents would follow it...

[pedi_nurse]

Fever: 100.0, sometimes I still have parents come pick up if it's close to that and siblings are sick at home with the flu or something.
Vomiting: Technically any vomiting. Personal policy is it has to be witnessed by staff, occasionally I have them stay if there is an obvious, non-contagious reason it happened.
Diarrhea: Technically any. Personal policy, it really depends, since this one is hard to verify. I always tell parents to keep their kid home though if it's more than 2 loose stools a day.

Requirements for return are symptoms free for 24 hours. At our school, we just exclude the whole next day.

Give me a minute and I'll upload our policy.

[pedi_nurse]

Exclusion from School for Health Reasons

To protect all children from communicable illnesses, students infected with certain diseases are not allowed to come to school while they are contagious. Students should be symptom-free for 24 hours before returning to school. Contact your campus nurse if you are un sure whether or not your child should return to school.

The guidelines below have been developed for the exclusion of students who have communicable or contagious diseases. These regulations are in compliance with the requirements of the local health authority, ISD Administrative Guidelines, and the Board of Trustees’ appointed medical officer.

A student with any of the following symptoms will be excluded from school until such time as the student is free of symptoms, has been satisfactorily treated, or submits a signed physician’s statement that he/she is not contagious.

Temperature of 100 degrees or more. Student must be fever free for 24 hours, without medication, before re-entry.

Nausea, vomiting or diarrhea. Student must be symptom free for 24 hours without medication before re-entry.

Pain and/or swelling at angle of jaw.

Undetermined rash over any part of the body.

Undiagnosed scaly patches on the body or scalp.

Red, draining eyes.

Intense itching with signs and symptoms of secondary infection.

Open, draining lesions.

Jaundice

The Principal or his/her designee, in collaboration with the school nurse, will notify parents that the student must be excluded for medical reasons.

It is the responsibility of the parent or guardian to transport the student from school to his/her home in a timely manner.

For readmission, some diseases may require a statement from the student’s physician affirming that the student is not contagious.

[JenTheSchoolRN, BSN, RN]

If we kept home every student with 1 instance of diarrhea, our absence rate would be huge! I find this symptom is common with the amount of junk food and caffeine students consume (I work with the older ones in MS/HS).

Vomiting more than x1, unable to eat and/or hold food down are factors for vomiting for me. I'm working on revising policies this year.

Temp is 100+ plus, and student must remain fever free for 12 hours without the aid of medication.

As for rashes, the rule is more determined by location of rash and if it can/cannot be covered. Again, older kids, so my guidelines and though process may be different with the elementary crew.

[theksmom, ADN, BSN]

Our district follows the CDC guidelines. If the student vomits once, does not have a fever and is able to keep liquids down, I tend to let them stay at school. Of course, if they vomit again, then they go home. Sometimes test taking, a presentation, or something in class causes a nervous stomach. Once whatever is over, or they vomit, they tend to feel better. I try to courtesy call parents to let them know. If they chose to go ahead and pick them up, I let them know that it is not an excuse absence and they would have to follow district policy for excusing and unexcused absence.

Hope this helps.

[Keeperofbandages, LPN]

Our policy is fever over 100.0, vomiting, diarrhea, lice, eye infections and rashes of unknown origin are sent home.

Students must be fever free for 24 hours without the use of medication

Vomiting and diarrhea is also 24 hours without anymore episodes of vomiting and diarrhea

Lice: student must come back through the health room for a recheck before being admitted to class. If nits/bugs are still present in the hair then the student is sent back home and the process repeats

Rashes of unknown origin and eye infections require a doctor's note allowing the student to return to school and a statement that they are not contagious must also be on the note.

[RN4kids18]

Google emoji sick chart...I’m a new school nurse and have been thinking of using this. What do you all think?