HIPAA, FERPA and how do you inform teachers about the health concerns in their class?

[cmomrn]

Hi everyone,

I am a new school nurse this year. The previous nurse told me that she never gave teachers a list of students with health concerns because she was "too worried about privacy" and "the teachers always leave those lists lying around", but as far as I can tell she never really told them at all.

I am trying to figure out a good way to tell the teachers about allergies, asthma, seizures, etc... in their classrooms. What do you guys do? Am I allowed to email a list to each teacher? Or is that not private enough.

Also, do you give them a copy of the student's IHP or emergency plans, so they know what the student and their responsibilities are? I am also interested in how all types of schools handle this (I am the nurse for a whole district), as I can imagine this problem would play out differently in the middle and high schools over the elementary schools.

Any advice?

[coughdrop.2.go, BSN, RN]

I create an IHP for that student and email it to the student's teachers (I'm at a high school). I do not make any list and I do not tell them about a health concern without giving them an IHP. I have a little "disclaimer" at the end of my emails explaining that the info is confidential and needs to be shared with a sub or intern. Also, they may make their own list, but cannot share that list with anyone. If you aren't the student's teacher, coach, or an admin, they don't need to know. My PE teachers wanted a list of all the Diabetics. I said no. If they are in your class and I know about it then you will no. You're welcome to print it out and give them copies with maybe a little confidential cover letter, but too much ink and paper. My District is cheap.

You can make your own list of student health concerns for your own records, but you cannot share that list. Do you have an IHP template for all your health concerns?

[cmomrn]

Thanks so much kenderella.

I am in California and the have a book of templates for all the major concerns. I have just been using that. It works out well. I am trying to navigate through a little bit of an unorganized mess that the last nurse left here. Unfortunately she is still coming in 1 day per week to "train" me, so I feel weird about doing a complete overhaul of the organization system (there really isn't one) right now.

Do you give each teacher a quick training on emergency steps for the student, or just let them read it from the IHP/ECP?

[coughdrop.2.go, BSN, RN]

Thanks so much kenderella.

I am in California and the have a book of templates for all the major concerns. I have just been using that. It works out well. I am trying to navigate through a little bit of an unorganized mess that the last nurse left here. Unfortunately she is still coming in 1 day per week to "train" me, so I feel weird about doing a complete overhaul of the organization system (there really isn't one) right now.

Do you give each teacher a quick training on emergency steps for the student, or just let them read it from the IHP/ECP?

I'm in California too! With the emails I include links to YouTube videos I find for quick explanations on asthma, allergies, diabetes, etc. If it's something more complicated I leave it up to them to read the care plan. I'm working on a "quick-review" sheet for my basic health concerns. The Care Plans I use are a bit long, even for Asthma and ADHD, but the info is very through. I'm wondering if you use the Green Spiral book? (Or red spiral book if you have an older version).

[mycsm]

We have parents fill out an emergency card (#'s addresses etc) and they can check off a box regarding the health issues. . Health office only OR can share with school faculty. if I can share, i do not seek out the teachers, they see an icon on the student home page and they ask me.

[schooldistrictnurse]

Medical alerts are imbedded in our computer system. Teachers have access only to their own students, click on the icon and an alert is visible. We review and update the alerts annually. Our system is PowerSchool. Not terribly friendly for health room visits, but useful for medical alerts and immunization tracking. The system also does attendance, grades, report cards, etc.

[AdobeRN]

Medical alerts are inputed in our system also - we use Eschool. I know the teachers can see thier students but I don't know if they can access all in the school. Medical info is updated yearly at the beginning of year and as I get new info during the school year.

I am in elementary and the kids switch classes between thier own grade level and switch out for Art, PE, computers, library etc - I have mixed feelings about the health info - yes it is private but I think the more teachers know about the problems the better it is for all of us in an emergency situation.

As I get health info I input it in the system and depending on the condition I will contact the teacher (diabetics, seizures, life threatening allergies, etc) just so we are on the same page about when the students need to see me immediately. At the beginning of the year at our first staff meeting I usually let all staff know who are diabetics are, who are the kids that need to carry own epi pens & I have a few with serious conditions that I think everyone just needs to be aware of.

As far as training teachers for emergencies - just depends on the condition. This year our district had staff watch videos on diabetes and how to admin Epipen for allergic reactions as part of required training. For those teachers with Diabetics - I print out info regarding lows/highs, I leave juice or whatever the parent decides to use for treatment of lows with the teacher. Severe allergies - I review quickly how to use the epipen, let them practice with the trainer pen. Seizures - review basic info.

[cmomrn]

Thanks everyone! This is very helpful. I am working on care plans for all of our asthmatics and allergy kids right now (at least the ones that reported it on their registration card).

Kenderella, we don't have the actual green book at our district, but the nurse training me keeps calling it that. We have the CD-ROM with the updates. It is annoying though because under diabetes and seizures it doesn't have any of the templates for IHPs etc... Just information on what the recent news is regarding diastat and insulin. Where in California are you? Are you planning on going to the CSNO conference in March in Sacramento? My district is sending me and I am hoping that I will be able to get a lot out of it.

[coughdrop.2.go, BSN, RN]

Thanks everyone! This is very helpful. I am working on care plans for all of our asthmatics and allergy kids right now (at least the ones that reported it on their registration card).

Kenderella, we don't have the actual green book at our district, but the nurse training me keeps calling it that. We have the CD-ROM with the updates. It is annoying though because under diabetes and seizures it doesn't have any of the templates for IHPs etc... Just information on what the recent news is regarding diastat and insulin. Where in California are you? Are you planning on going to the CSNO conference in March in Sacramento? My district is sending me and I am hoping that I will be able to get a lot out of it.

Okay not that Greenbook this one: Computerized Classroom Health Care Plans for School Nurse It has a CD with pretty much any and all health conditions you can think of when it comes to kids. There's only been a few times I've had to make one from scratch, but I definitely use this as a guide. This is where all my Care Plans come from and it's easy to make alterations as needed. Wonderful investment!

I live in SoCal and I'm really going to try and make that conference! I'm not sure if my District will pay for it, but I'll try. Otherwise I'll just pay out of pocket.

[Meemsx3]

I just purchased the Large blue book of Individualized Healthcare plans for the School Nurse and I see it as a big help, but not appropriate information to give to teachers. It would be extremely confusing. Do you create a more simple version of an IHP for the teacher to use?

[JenTheSchoolRN, BSN, RN]

We have an internal file server. I work at a small charter without a cafeteria; students eat in classrooms and any teacher could be covering a classroom for lunch. Therefore, I have a list of food allergy students (if parents have allowed me to share information) in a folder marked health/safety up there. I sent an email to teachers pointing it out and asking that it not be printed for privacy reasons. I do Epi-pen training at a staff meeting for everyone.

I also developed a general allergic reaction plan, seizure action plan, and asthma action plan (one page) and posted in every classroom. I reviewed those with staff at a staff meeting as well.

For teachers who teach a specific student with more specific health needs (diabetics or sickle cell, for example), I reach out for specific teaching.

[Flare, ASN, BSN]

i'm a lucky duck, my school uses a program which allows me to put health concerns into a secure area which can be accessed by teachers as needed. Meaning that Mrs Jones can see Mrs Jones class, Mr Clark can see his class and the PE teacher may be able to see everyone since he teacher everyone. It's not flawless, though. My biggest complaint is that I can't run a report on the aforementioned health concerns to give to people that I feel need a list (IE the lunch lady - she knows the kids by sight I feel safer with her knowing who has allergies)