What to do instead of a health alert list?

[mrsnurseblogger]

So, we're not allowed to send health alert lists to teachers due to confidentiality students. How do you get health information out to teachers without names? One of my coworkers said she sends out a general "watch for" list including symptoms of asthma and allergies, but when I asked to see what it looked like, she won't share...I'm wondering if anyone has some samples or suggestions on how to do this in a condensed and informative matter that would be of use to teachers - and be a good "CYA" thing for me! Thank you!

[JenTheSchoolRN, BSN, RN]

Do you have an allergy action plan? With so many kids with peanut allergies, we have one at my school and have it posted in every room. I just revised it and used that as an opportunity to discuss the symptoms of a possible allergic reaction and anaphylaxis. We have another Seizure Action plan that is posted in the same places.

I've been debating myself creating info one sheets to cover other areas like asthma and diabetes. You don't have to name names, but say something like these are common, let's review. Here is a great link about Asthma Action plans in the school setting - I'm thinking about circulating the flyer included to the staff at my school: http://www.lung.org/lung-disease/asthma/creating-asthma-friendly-environments/asthma-in-schools/asthma-friendly-schools-initiative/about-asthma-friendly-schools-initiative/asthma-action-plan.pdf

Confidentiality is a struggle in the school. HIPPA vs. FERPA. My brain sometimes hurts trying to balance it!

[Sudsy]

I wish I had input, but this is more of a "me too" post.

My school is age 2 through grade 8, and the practice that was in place before I got here was that the preschool has a list up in all classrooms of every preschooler with allergies or asthma. We have never had a parents complain about confidentiality issues (and we have a TON of parents who are doctors and advanced-practice RN's). I think it makes sense for this age b/c they are too young to know about/tell about their allergies. Whether it's legal, though, well that's a different story.

For the older grades, eek, it's so difficult. I ask parents for permission to tell their child's teachers about the issue and our practice is that every class that has a severely allergic child in it has the child's epipen in the middle drawer of the teacher's desk. I always worry, though....

[mc3, ASN, RN]

We send a "Health Alert Letter" via email with the student's school ID# and initials only directly to his/her teacher, other ancillary teachers that may have the student, and the cafeteria (if appropriate). They can look up the student's ID on the computer and get the name. It describes the child's diagnosis, what to watch for, and what to do in case of an emergency until the nurse can get there. We send them out for all asthma and allergy students (food and other), seizures, diabetes and any misc. needs. They keep these in a binder in their rooms, and are asked to keep a copy of this letter in their Substitute teacher in case they are out.

I'm told this is all going to be on our mainframe computer this fall...only time will tell. BTW, the alert only goes to those on a "Need to Know" basis. Otherwise you'll be in violation of both HIPPA and FERPA.

Generally, if we communicate anything about a student online, we just use the initials and ID#. Emails can be subject to public scrutiny (i.e. news outlets) so again, you must be very careful.

Hope this helps!

[Wave Watcher]

So what happens on field trips? If a child needs to carry their inhaler or epi? Do you just give them to the teacher and tell them to guess which one it belongs too? I think if a child has a sever allergy with epi pen or sever asthma with inhaler then that is NEED TO KNOW for the teachers.

[mc3, ASN, RN]

If you read my post, I started out by saying the Health Alert letter goes "to his/her teacher, other ancillary teachers that may have the student, and the cafeteria (if appropriate)."

If the child's parent does not go on the field trip..they don't have to.....we train the teacher how to administer the Epipen or inhaler if needed, followed by a 911 call. Has always worked with no problem for us.

Sarcasm wasn't necessary, was it?

mc3:cat:

[Wave Watcher]

Mc3.....No, I did not read your post nor was I responding to your post. My comment was in reply to the Original poster who states that she can NOT send out health alerts to teachers. I also was being sarcastic as you call it towards the policy her school has in place which she has no control over. Don't assume because someone posts after you that they are responding to what you said. Flattery isn't necessary is it?

[mc3, ASN, RN]

Mc3.....No, I did not read your post nor was I responding to your post. My comment was in reply to the Original poster who states that she can NOT send out health alerts to teachers. I also was being sarcastic as you call it towards the policy her school has in place which she has no control over. Don't assume because someone posts after you that they are responding to what you said. Flattery isn't necessary is it?

I rest my case......................now back to the original topic.......

[ERRNDeans]

I just emailed a list of kids to a teacher with their health concerns asthma/allergies. I know it's not legal but seconds count with anaphylaxis. I am brand new this year, still trying to make my way. This job is stressful because of the legality aspect. I am not sure I will do this again next year. I always put the action plan in their mailboxes with a note on top stating this is confidential, etc.

I tried a list with "code S" for seizure and "code A"for asthma. The teacher wasn't cool with it.

Our PE teacher has 700 students. She has NO time to look up all of the alerts. She needs to know. Wouldn't you want your child's teachers (all of them) to know about a severe allergy or asthma?

If we have access to epi pens, benadryl and inhalers in the school, shouldn't the teachers, who spend the majority of the day with students know who has what concern?

I am not sure I will be a school nurse next year, going to make it through this year and then decide.

[fetch, BSN, RN]

In our district, we have the Alert List in the substitute nurse binder and in the principal's office, but for each classroom instead we just do a single sheet per student. The teacher NEEDS TO KNOW that Student A has asthma and Student B has peanut allergy - so instead of one sheet of paper with everyone's name and health alert, each teacher gets a stack of papers. "Student A has asthma: here's what to watch for, here's when to send her to the clinic, she has meds at school." Then a separate sheet of paper saying "Student B has a peanut allergy: here are the warning signs, here's a "Nut Aware Classroom" sign to hang on your wall," etc.

That way confidentiality can be maintained per FERPA -- the teacher doesn't have one list with every name and alert. But the teacher CAN know who has what issues and needs.

[Jennifer Campbell]

Our Charter school system is allowing the nursing team to provide training to teachers/staff on critical topics. We plan to create short powerpoint presentations via their school emails, with basic information, easily remembered. They will include a link to a YouTube video that is short and appropriate to the topic. They will also have a Survey Monkey Quiz for the teachers/staff to take.

Our topics are: 1. When to call 911. 2. What an Asthma Attack looks like. 3. What an allergic reaction looks like. 4. How to use an EpiPen. 5. How to help during a seizure. 6. Diabetes info: Glucagon use.

Statistics say that the FIRST allergic reaction a child has may happen at school. You can't rely on a list. And it's against the law to distribute it. Better to teach the teachers what to look for, and when to get help fast. They are teachers. They can learn. :) Good luck!

[coughdrop.2.go, BSN, RN]

The Nurse before me always created a health concern list and distributed to school staff every year. So it was a pretty big deal this year when I started this August and refused to do the same even though I explained how it was a violation of FERPA. When I create a care plan for a student with a health concern I send an email to that student's teachers (I'm a High School Nurse) and CC it to the Vice Principal, head of security, Cafeteria clerk (if food allergy), and whoever else needs to know like their coaches. I have a little template that I use to format my emails with a little confidential disclaimer reminder and a pleasant Thank You for helping to keep students safe. I think I'm going to start including a statement about lists and that each individual person may make their own list for their personal use/reference, but they are not allowed to distribute such list to others even if it's another teacher for that student otherwise it would violate FERPA. All health concern disclosures should go through me unless they are talking to EMS personnel and I am not available. I also include a link to awesome YouTube videos that go in to more detail than my care plans.

I would love to do an in-depth health in-service for all my teachers and staff (I have PowerPoints galore ), but I have created a shorten PowerPoint with the main points to present at staff meetings. I'm also trying to see if the District will allow me to become a CPR/First Aid Instructor to get my District employees certified.

A lot of staff, especially PE teachers, feel it's unfair to not give them a list of all my student health issues. I explained to them that if the student is not in their class, then they don't need to know. Staff also got irate when I explained that if a student or staff member has HIV and they DO NOT need healthcare services provided at school they cannot get a list of names. One of the reasons I stress the importance of Universal Precautions. If they don't pay attention to the yearly training it's on them not a list.