How many students have IHPs?

[iggywench, BSN, RN]

I know this is a question that should have come up at the beginning of the school year, or perhaps my first year of school nursing, but with the little amount of training that I received, I feel like I am continuously learning how to do my job. I am still a little unclear on which students should have IHPs. In our district handbook, it does not specify any requirements, only that we should complete them.

I complete an IHP on my students who would require a procedure at school, or have a major medical condition (seizures, diabetes, sickle cell, cystic fibrosis, tube feeding, catheter, water bolus via G-button), but I started reading through the School Nursing text today (an optional book that I purchased), and it states that students with asthma, ADHD, and allergies should have an IHP. How realistic is that expectation, and how would it benefit the students who all have those conditions? I can only imagine how many of my 1000 9th-graders have asthma, ADHD, or allergies listed on their medical form, and having to write an IHP on each of them. I don't have medication or any interaction with most of those students. I give about 7-9 ADHD meds daily, and have no students with daily inhalers.

How many of you actually write an IHP for every student with a medical condition, and do you feel that it is beneficial? If there is a part of my job that I am not doing, I'd like to work on it for next year.

[iggywench, BSN, RN]

I forgot to add that I have district action plans for asthma and allergies from the parents who are willing get them completed; we have no standard form for students with ADHD beside the medication permission form.

[AdobeRN]

We have a generic IHP's for common illness - Asthma, ADD, Severe allergies, Diabetes, Seizures, etc - I just tweek as needed, they are very minimal. I do not complete them on everyone with these diagnosis - only those I see on a regular basis - basically my Diabetics, ADD kids that I administer daily medication and a few asthma kids. Everyone else is on a case by case basis - I have had a few bad concussion, TBI's and a severe burn where I needed to create one for them, but other than that I try to avoid them as much as possible.

My personal opinion is that they are not beneficial to anyone but maybe a sub nurse in my clinic. I think it is excess paperwork just setting the district up for possible lawsuits.

[Nurse in MT]

1150 Students pk-8th. All students with major medical problems and/or allergies have an emergency health plan (EHP), and those that ride the bus have a bus-specific one. ADHD/mental illness/behavioral kids do not have EHPs. Been working on updating the photos on EHPs for the 17/18 school year; we have 51 EHPs. All teachers and staff that spend any meaningful time with each student has a parent-signed copy in a red pocket folder.

[SassyTachyRN]

I do IHP's for all my seizure kids and CF kids. I do them for all my kids with epi. I will do them for any kid who might have had epi one year but doesn't now, or maybe a kid that went anaphylactic on me but I still don't have epi for. I send home a general IHP for kids with interesting diagnoses... chiari, heart conditions, cyclic vomiting, sickle cell that type of thing. If the parent doesn't send anything back, sometimes I will write a generic one, depending on what the diagnosis is. We don't write one for every kid with asthma. We will send home an asthma IHP for every kid who sends in an inhaler. If they send it back, they do. If they don't, they don't. I will write a generic one for my kids that I know are really, really bad and I didn't get ones back from the parents.

We also have a special procedure IHP for things like tube feedings, changings, skin checks, caths, etc. We don't write them for ADHD though. Oftentimes, kids have 504's for them if they are requesting anything special.

[iggywench, BSN, RN]

I just don't understand the benefit of writing them for a student with ADHD. I'm never going to see them for any symptoms, and besides giving them daily meds (for the 7 students who take it at school), there is no other care to be provided for them. Some of the students have 504 accommodations, but not all do. I don't have any students with uncontrolled asthma, and none on daily inhalers at school.

[Windchaser22]

I just don't understand the benefit of writing them for a student with ADHD. I'm never going to see them for any symptoms, and besides giving them daily meds (for the 7 students who take it at school), there is no other care to be provided for them. Some of the students have 504 accommodations, but not all do. I don't have any students with uncontrolled asthma, and none on daily inhalers at school.[/

If your assessment data indicates a need, then you would write the IHP.