Testing Snacks

[RNCourt]

My school hands out snack to all the students who undergo a standardized test. Testing usually goes from 8:30am-11:30am for the whole school (grades 6-12). I think it's a good idea that they have something to sustain themselves but can I just say, it is a huge pain in the behind for school nurses to go through and figure out all the allergies and make appropriate substitutions. Not to mention, my school chose poptarts and fruit juice as the snack. Not exactly the best brain food if you ask me.

Just wondering if any of your schools do the same. If so, how do you handle food allergies, diabetics, etc during testing?

[Wave Watcher]

Each class decides if they want to provide a snack during state testing. Every teacher is aware if a child in their class has a food allergy. It is up to them to provide the appropriate snack. I don't get involved unless a student brings the food down to me and asks if they can eat it.

The only problem that it causes is for my diabetics and making sure we cover carbs during testing.

[OldDude]

I am on the elementary level. At the beginning of each school year all of our staff, teachers and aides, undergo allergy and anaphylaxis training. I attempt to identify the students with food or other types of allergies. I then inform the teachers and appropriate staff who have these students and what their allergy is. Some of our grade levels still have snacks so I'll assist with parent informational letters, etc. At that point it becomes the individual teacher's responsibility to ensure the safety of their students. I am available when "what ifs" come up but generally I'm not involved in the day to day monitoring of what is eaten in the classrooms. We do have a rule that only store bought foods, with the ingredient label attached, is allowed at school. No home cooked foods (Elementary Level only). There is no way I can audit several hundred snacks eaten on my campus every day. Plus....just because you you do the work of identifying that a child needs a substitute snack, you can't guarantee the child will, or will not, eat the substitute or something else unless you sit there and watch him/her. Again, the teachers are responsible for the safety of their students. Don't take on that responsibility for them; especially on that 6 to 12 grade level.

[Flare, ASN, BSN]

the classes don't generally hand out snacks during testing, but the diabetic students are encouraged to bring a snack and stash it in the testing room (usually on the teacher's desk since the rules are strict as to what can be in the room) and are also encouraged to bring their spare meters if they are capable of testing independently and interpreting the results (which all of my students are capable of). Teachers are advised to check with students regularly to determine if they feel like they need to test or have a snack. It works out pretty well, but parents would also have the option of having a 504 written for children to be given "frequent breaks" if needed. The downside is that they would have to be put in the same testing room with the other children needing frequent breaks and the testing may take them much longer than it may have normally taken them due to children that work at a lower level or slower pace. Most parents don't opt for the 504 when they find that their diabetic child can just have a snack stashed that they can eat or a juice they can drink quickly.

[griffabilly]

The issue that occurs at my school, is they decide to do a food celebration and then ask me to identify which children can't have said snack and decide what snack they should have. This happens repeatedly through the year, with cookies for holiday parties, ice cream socials, and pizza parties. It is so difficult to be responsible for what is fed to 700+ children, especially with the vast variety of food allergies! This is one of the biggest frustrations I deal with. I do supply each teacher with food allergy lists, plus each child has a marker near name on computer to identify medical needs.

[JenTheSchoolRN, BSN, RN]

I can't police snacks during testing. We give them out as well, and they are usually donated. The only rule is that they must be peanut and nut free as we are a peanut/nut free school. Since I work with the older kids, my diabetics self-carry their meters and no how to check and cover. The time between snack and lunch is only about 70 minutes, so if they are uncertain, they will reach out to me at lunch when they stop into my office to check sugars in front of me and we adjust accordingly. But most snacks we provide are between 15-25 carbs and I talk snack coverage during testing at the beginning of the year.

I do make the allergy list available to the necessary staff and they do a great job policing it in their individual classrooms. I also have an allergy action plan printed and posted in each classroom and lead an Epi-Pen training for staff at the beginning of the year.

[RNCourt]

I guess my concern now is I thought it was a HIPPA violation to make lists of students and their allergies and give them to their teachers. With the diabetics who self test in classrooms, do they carry a sharps container of some sort with them?

[ChristineN, BSN, RN]

I guess my concern now is I thought it was a HIPPA violation to make lists of students and their allergies and give them to their teachers. With the diabetics who self test in classrooms, do they carry a sharps container of some sort with them?

Why? If they have a lancet pen and an insulin pen they can just dispose of the needles after class

[OldDude]

I guess my concern now is I thought it was a HIPPA violation to make lists of students and their allergies and give them to their teachers. With the diabetics who self test in classrooms, do they carry a sharps container of some sort with them?

My stand on the HIPPA things is yes, it would be a violation if you just posted a list of students with medical issues for the public to read. But...providing the information to relevant staff who are responsible for the student's safety and well being, however, in my opinion, would fall into that need to know group of caregivers; since that information is relevant to preventing them from experiencing an adverse medical event.

[JustBeachyNurse, LPN]

HIPAA doesn't apply but FERPA does. ask me how I know.

If you want a product that is healthy and doesn't contain the big 8 allergens (nuts, tree nuts, dairy, wheat/gluten, soy, etc) and they have some great educational materials regarding food allergies. I know they often send out samples to professionals and were willing to send some to my son's school nurse is Enjoy Life products. BRB with website.

The food is actually pretty tasty per my son & myself. May not help for this year but could going forward especially if you need to do staff education regarding allergies.

http://www.enjoylifefoods.com/

[OldDude]

HIPAA doesn't apply but FERPA does. ask me how I know.

.....OK, how do you know ?

[JustBeachyNurse, LPN]

Schools do not bill insurance so they do not meet the second "test" as to whether HIPAA applies. FERPA applies to school records as well as school health records. I had an issue with a school and learned that although HIPAA does not apply FERPA offers similar protection of confidential educational information as well as confidential school health records. (The school was still required to obtain my written consent to release confidential health/medical information to a third party. The school nurse knew this, the principal did not and thus got into hot water as he not only did not have the right to release information but he didn't have any business accessing the information. The BoE took action) The schools in my area now have a statement that when you release health & medical to school there is no HIPAA protection as FERPA takes over.

Basically if the school does not bill insurance for services rendered, FERPA not HIPAA applies.

http://www.hhs.gov/ocr/privacy/hipaa/faq/ferpa_and_hipaa/