These are great questions and definitely questions school nurses need to have clarification. There are great resources.
The National Association of School Nurses has a position statement on IHPs
Individualized Healthcare Plans: The Role of the School Nurse - National Association of School Nurses
There is also a document on the DSHS School Health Services page about IHPs
School Health Services - School Nurse Notes
An IHP is a nursing care plan and a nursing document and not a document ever placed in a 504 or IEP. Components of the IHP can make up the Action Plan which can be given to teachers or placed in 504 and IEP.
1. The IHP does not replace doctor orders as this is a nursing document.
The doctor does not sign the IHP. You can develop the IHP with the parent and parent can sign acknowledging nursing care and goals for their child.
2. IHPs must be formulated by the RN and can have input from the LVN. This comes down to Scope of Practice with our NPA scope of practice. Texas Administrative Code Title 22, Part 11, Chapter 217, Rule 217.11
3. We are legally required by the state under (LEGAL) Policy FFAF to have an IHP on students with Diabetes. However, the RN can decide what students might need an IHP based on a few questions. A guide for this can be found on the Texas School Nurses Organization website in the community library that can be accessed by members. If you are not a member, please feel free to contact me and I can get that document to you.
4. Not every student with a reported health issue requires an IHP. Again, the guide is very helpful for the RN to determine that. IHPs do not need to be complicated. And the big book on Individualized Healthcare Plans mentioned earlier is a great book AND very expensive- so maybe one per district if you are small.
The IHP needs to be a useful and easy to follow plan that you actually follow to determine course of care for your student such as skills to learn, education and safety measures you are implementing, etc. If it is too lengthy and complicated or you never look at it again during the school year, then it serves no purpose.
5. There are several documents that your Diabetics require
Medical Management Plan from the doctor (totally different from an IHP)
IHP developed by the RN
Emergency Action Plan that can be shared with teachers and a 504 or IEP
UDCA authorization by parent
Documented list of the person(s) assigned to be an UDCA by your Principal
Training they received (knowledge and skills)
The only ridiculous questions are those not asked ;o)