IHPs

[BunnyBunnyBSNRN, ASN, BSN]

Can we have an honest discussion about IHPs for a minute.  When I started school nursing, about 100 years ago, we didn't write IHPs.  Now, we're supposed to write them for every student with asthma, food allergies, diabetes, etc.  Why?  And what do we do with them once they're written?  We can send them home for parent signature, we can talk to kids about their triggers and when to see the nurse, but, in all honesty, it's not like we have time to meet with every student on the regular to update them through the year.

[drvncrazy, BSN]

This is the criteria we use. So no, not every asthmatic, food allergy etc student needs one.

ihp criteria.pdf

[k1p1ssk, BSN, RN]

Yeah, if I wrote an IHP for every student whose doctor identified "asthma" or "adhd" on a health history, almost 90% of our student population would need one.

At a conference last year, a large school district cited this problem in developing a criteria, since our state says that we need one for any student who carries these diagnoses. They basically were able to narrow it down to those students who require frequent intervention beyond your typical medication or treatment orders, their rationale being that the kids with med orders are also getting a med admin plan, which is essentially what their ihp would be, So if it is an asthmatic who uses their inhaler once or twice per year, they don't need an IHP, since it is managed well. However, the asthmatic who is using their inhaler daily, takes prophylactic doses of their rescue med before gym, and is STILL struggling to get through the day - may need extra care and attention.

Using this ideology, I only have 2 students in my building with an IHP & EHP - 1 is because he has food allergies, asthma, ASD and ODD, the other because the family loves having "extra precautions" and it makes them feel better. 

[NutmeggeRN, BSN]

drvncrazy said:

This is the criteria we use. So no, not every asthmatic, food allergy etc student needs one.

ihp criteria.pdf

This is awesome!

[iggywench, BSN, RN]

In my building of almost 3400 students, I have about 750 students this year with some sort of medical condition (as reported by their parents).  I don't write an IHP unless they have a rare condition, something that I might have to deal with at school this year, or the 504 coordinator/diagnostician asks for it.  I feel like the action plans provided by the doctor are sufficient in most cases.

I will say that I have learned to use ChatGPT to write IHPs for me, and it puts out some pretty good ones.  I will copy and paste it into Google Docs, then edit it as I see fit.  I like the background info that it gives for different conditions.