STUDENT SAFETY AND WELFARE DIABETES MANAGEMENT IN SCHOOLS POLICY CODE: J 5.9

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1 POLICY CODE: J 5.9 The London District Catholic School Board is committed to the safety and well being of all students. It recognizes the importance of maintaining a balance in blood glucose levels through carefully planned meal and snack times, communication and planning for sports and extracurricular activities and providing opportunity for (and where medically advised) assistance with blood glucose testing. All students have the right to a safe environment in which to learn and have a right to participate fully in opportunities to share the school experience that all students enjoy. In order to ensure that schools are safe places for those with life threatening medical conditions and diabetes, the Board empowers the Director of Education to create detailed regulations and procedures. Adopted: June 22, 2009 Page 1 of 7

2 REGULATIONS SCOPE: The London District Catholic School Board is committed to the creation and maintenance of a safe and healthy environment for students. The appropriate monitoring of food intake, exercise and blood glucose is essential for short and long-term health for students with diabetes. This presents a serious challenge for all schools attended by students with Type 1 versus Type 2 Diabetes. For students with Type 1 Diabetes, specific precautions are required. Parents shall identify students with Diabetes at the time of registration or as soon as the student is diagnosed with diabetes. Each student s needs are different and specific to their type of diabetes. Knowledge about Type 1 and Type 2 Diabetes, the signs of hypoglycemia and hyperglycemia and the appropriate responses are essential to a student s health and their ability to be successful at school. The more realistic and practical the intervention, the greater the likelihood of support from everyone involved. 1.0 INFORMATION GATHERING 1.1 The Principal, or designate, shall ensure that, upon registration, parents, guardians and/or students shall be asked to supply information on Type 1 and Type 2 Diabetes. 1.2 When a student develops diabetes the parents, guardian or student shall supply this information as soon as possible upon diagnosis of diabetes. 1.3 In the case of Type 1 Diabetes, the principal shall create a file for the student (If required, students with Type 2 Diabetes, will receive required supports by completion of the form: Request for Administration of Medication and/or Assisted Test at School ). The parent(s), guardian or student, will provide the following specific information to assist the principal in completing the Personal Health Care Plan (PHCP) for all Type 1 Diabetes: General information on Diabetes and specifics associated with the student (appropriate blood glucose range, etc.) Symptoms of hyperglycemia and hypoglycemia Instructions for responses to hyperglycemia. Insulin injections and/or medical judgement will not be undertaken by the principal or board staff Blood glucose level targets for individual student and a strategy for communication Insulin delivery (injection or pump), forms of glucose, blood glucose testing requirements. DRAFT Page 2 of 7

3 Simple table of adjustment to be used prior to physical activity, i.e., for example, usually 15 grams of carbohydrates are given for an hour of extra exercise and this varies with each child Emergency contact information. 1.4 In cases where assistance with blood glucose testing is required as per physician s instruction, parents, guardians or student shall provide the following to the school: A signed statement authorizing and directing assistance with blood glucose monitoring. (See Request for Administration of Medication and/or Assisted Test at School ) Adequate supplies including blood glucose meter, blood glucose test strips, lancets and emergency treatment, for example, juice, etc A waist pouch or other container to be with the student on field trips complete with a source of emergency glucose/juice, blood glucose testing kit and emergency contacts Demonstrated encouragement for student to wear some form of emergency medical identification and reminders to student of proper disposal of sharps (Biohazard waste containers are available at all schools). 2.0 SCHOOL PROCEDURES The Principal, or designate, in cooperation with the student and family, shall 2.1 Inform staff and students of the presence of students with diabetes. 2.2 Invite health related experts to address/inform classes generally on diabetes. 2.3 Establish a Personal Health Care Plan (PHCP) for each student with Type 1 Diabetes. The Personal Health Care Plan should be posted in the classroom, staff room, office area, health room, or any other designated room (i.e., Attendance Office) one copy should be located close to the storage area for testing equipment and a supply of juice. All teachers and other staff members who may be involved with the students should be made aware of the details (i.e., copy in staff daybook or planning book, occasional teacher packages etc.) 2.4 Complete annually an Personal Health Care Plan (PCHP) to include: The student s name and picture. Page 3 of 7

4 Type of Diabetes, testing procedures, academic implications, table of adjustments and directions from the student s physician and symptoms characteristic of the student Symptoms of hypoglycemia and hyperglycemia Listed forms of glucose and testing kit with location Action to be taken Parent s/guardian s home number, work number and other emergency contact information. 2.5 Create a file for each student with diabetes to include: Current treatment Copy of any medications and instructions for administration from the student s physician Current emergency contact list Copy and proof of delivery of letter notifying parents of non-compliance with policy. 2.6 Obtain consent from parents/guardians to implement treatment in emergency situations including off-site excursions. Information to parents/guardians must ensure understanding that school will not act outside physician s direction or engage in medical judgements. 2.7 Ensure students are made aware that food is not to be consumed in common areas of the school such as libraries, gymnasiums, school yards, music rooms, etc., and students are encouraged to eat in designated areas where possible. These provisions may be waived as part of the Personal Health Care Plan. 2.8 Ensure student is aware of what to do if treats are brought into the school or classroom. 2.9 Provide an immediately accessible and safe storage space for medication and testing equipment that is clearly identified and its location shall be communicated to all school staff including occasional teachers and volunteers Provide opportunity for student, upon request, to test blood glucose as required by the physician s directions, in a comfortable, convenient location, as agreed upon including before exams/performance/tests to ensure proper range to reduce chance of cognitive impairment due to hypoglycemia or hyperglycemia. Page 4 of 7

5 2.11 Review blood glucose targets and communicate with parent(s)/guardian(s) as per instructions in the Personal Health Care Plan Assist with blood glucose level recording and/or direct student as per plan for assistance with blood glucose testing and recording. 3.0 CLASSROOM PROCEDURES The teachers shall 3.1 Post the Personal Health Care Plan form in the classroom and any other designated areas in the school as necessary. 3.2 Discourage the practice of trading or sharing food. 3.3 During classroom celebrations or parties, where possible, communicate with parents in advance and/or follow simple table of adjustments in Personal Health Care Plan. 3.4 Where possible, communicate with parent after unplanned exercise or extracurricular activity or special unplanned treat days. 3.5 On excursions, ensure that the glucose testing kit, a supply of glucose, medication (if needed) and the Personal Health Care Plan form are immediately available, in a waist pouch or other suitable container, for the student with diabetes. 3.6 Providing opportunities for eating, drinking and washroom breaks outside of regular time may be required. 3.7 If student becomes unresponsive at any time or if their condition requires medical judgement, immediately contact the office to call TRAINING and INSERVICE 4.1 The Principal shall arrange training for all staff members directly responsible for the proper administration or assistance of blood glucose testing. Inservice for teachers, arranged by the principal, shall occur during the instructional day. 4.2 This training and inservice shall be completed annually, preferably at the beginning of the school year or the beginning of each semester or as new circumstances arise. Page 5 of 7

6 4.3 The training and inservice shall include but is not limited to; General awareness of types of diabetes and treatment and potential challenges within the school environment Awareness of the Board Diabetes Management Procedure Signs, symptoms, recognition of hypoglycemia and hyperglycemia, and appropriate responses and proper administration of blood glucose testing Personal Health Care Plan. 5.0 SCHOOL BUS PROCEDURES 5.1 School Principal (or designate) will give a copy of Personal Health Care Plan to the Bus Company. 5.2 Bus Company will assign a driver who has had training to recognize symptoms of both hypoglycemia and hyperglycemia. The Bus Company dispatcher will be aware of Board Policies and Procedures dealing with Emergency Protocols. The Bus Company will: Keep a copy of the Personal Health Care Plan, so a new/replacement driver will have information readily available Be aware that a supply of glucose as provided by parent/guardian will be carried by the student to be used when necessary Inform dispatcher immediately if child is displaying any abnormal symptoms and follow any instruction on Personal Health Care Plan. Page 6 of 7

7 PERSONAL HEALTH CARE PLAN Diabetes (Type 1) J E Name of Student: Teacher: Emergency Contact: Healthy Blood Sugar Range: Location of Test Kit: Phone: HYPOGLYCEMIA (Low Blood Sugar <4) Management: Give 175 ml juice or 3 teaspoons sugar or 1 tablespoon of honey. Common Symptoms: Headache/ stomach ache to sleepy/erratic behaviour with slurred speech and confusion to uncooperativeness, inability to swallow. Causes: Too much insulin or too little food. Look for: Skipped meal/snacks, unplanned exercise/activity. HYPERGLYCEMIA (High Blood Sugar >15) Management: Contact parent and/or 911. Student requires insulin. Common Symptoms: Increased thirst/ hunger/urination to stomach cramps/pain, vomiting, difficulty breathing. Causes: Too much food/too little insulin/decrease in activity. Look for: Unplanned treats/snacks/meals, cancelled activity/recess, stress, missed insulin. Routine 1. Blood Sugar Checking My child can independently check blood sugar/read meter My child need supervision to check blood sugar/read meter Management Parent please check appropriate routine blood sugar checking times: Before Morning Break ( time ) Before Lunch ( time ) Before Afternoon Break ( time ) Healthy blood sugar range. Instructions for contacting parent/guardian: l 2. Nutrition Breaks 1. Student must be able to eat on time. 2. Student must be able to eat all of the required food prepared by parent/guardian at each break. 3. Supervision may be required. 3. Insulin My child does not take an insulin injection at school My child takes insulin at school by injection by insulin pump Insulin is given by child parent/guardian nurse 4. Exercise Plan (Table of Adjustments) (To help prevent a low blood sugar) * Communication with parent/guardian is required if child does not eat required food. Yes No Insulin by injection / insulin pump to be administered at the following times Before Morning Break ( time ) Before Lunch ( time ) Before Afternoon Break ( time ) Note: Educators do not give injections or operate insulin pumps. Please indicate what your child must do prior to exercise to help prevent a low blood sugar (i.e., take juice) 1. Before exercise: 2. During exercise: 3. After exercise: 30 minutes of moderate exercise = ml Juice or or 30 minutes of vigorous exercise = ml Juice or or Child s blood testing meter kit and fast acting sugar should always be on hand during exercise activities. 5. Illness 6. Supplies to be kept at school (responsibility of the parent) Call parent/guardian if student vomits. If parent/guardian is not reached within 30 minutes, call 911 to transfer to nearest hospital. Inform EMS, the student has Type 1 Diabetes. Fast acting sugar, carbohydrate snack in emergency (i.e., juice) low kit. Blood glucose meter and test strips, lancets, sharps disposal kit Insulin pen, pen needles or syringe, insulin (in case of pump failure). Location: This personal information is being collected, used and disclosed to school staff and volunteers in accordance with the Personal Health Information Protection Act, Municipal Freedom of Information and Protection of Privacy act, Education Act, for the purpose of addressing the needs of the student with Type 1 Diabetes. I agree that the school may post my child s picture, take emergency measures and share this information as necessary with the school staff and health care providers. Parent/Guardian Signature: Date: Page 7 of 7