EMERGENCY NURSING SERVICES GUIDELINES



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MONONA GROVE SCHOOL DISTRICT Board Rule 453.1 EMERGENCY NURSING SERVICES GUIDELINES A. School Nurse Certification and Duties 1. The name and educational preparation of the School Nurse shall be provided to the building principal by August 1 of each year. 2. The School Nurse shall be responsible for assuring that he/she is currently licensed in the state of Wisconsin and shall confirm this in writing to the building principal. 3. The School Nurse may function as a resource to designated persons, serve on the emergency review committee and identify areas of the emergency care plan in need of improvement. B. Medical Advisor Each school year, the Superintendent shall arrange with a physician to serve as the medical advisor for emergency nursing services. C. Health Room 1. The health room for each building shall be identified to all staff at the beginning of each school year. 2. Readily accessible equipment and supplies adequate for emergency nursing services shall be stored in the health room of each school building. This room shall include the following: Equipment Accident report forms Accessible hot and cold running water Supply cabinet One or more cots Two blankets per cot Readily accessible telephone Supplies Cake or liquid soap Adhesive tape (non-allergenic, 1 inch) Band aids (assorted sizes)

D. First Aid Kits Sterile gauze squares (2x2 and 4x4) Gauze roller bandage (Kling is recommended; 1, 2, 6 ) Triangular bandages (small, medium, large) Cotton or gauze for cleansing Scissors (blunt or bandage) Tongue blades (medium) Rubbing alcohol (70%, swabs) Non-adherent dressing (e.g., Telfa; assorted sizes) Paper cups Tissue Wash basin Paper towels Emesis basin Flashlight Thermometer Tweezers Icebag or cold chemical packs Disposable gloves (non-latex) Large sterile dressings (one or two for large burns) Cardiopulmonary resuscitation (CPR) face shield ACE wraps Red Cross first aid manual Sanitary napkins (optional) 1. There shall be traveling first aid kits for each trip away from school. Staff should contact the health office if additional kits are needed. Traveling first aid kits shall include: Current Red Cross first aid manual ( First Aid Fast ) Sugar packets 4 Gauze bandages (4x4) Bandage tape Band aids Triangular bandage 2 Instant ice packs Soap wipes Scissors 2 Ace wraps 2 Pair gloves (non-latex) Tweezers 2 Large size dressings CPR face shield Current health concerns list

Alcohol wipes 2 Splints Student emergency contacts and phone numbers (found on parent permission forms for field trips) Sanitary napkins (optional) Money for phone call (optional) First aid kit supply list 2. Classroom first aid kits shall include: Band aids (assorted sizes) Sterile gauze pads (2x2) Disposable gloves (non-latex) E. Emergency Notification Form Employees The notification card for emergency or illness for each district employee shall be updated annually. It shall be filed in the District Office personnel file. Students 1. The notification card for emergency or illness for each student should be completed by the first day of class. For students entering during the school year, it is to be completed by the parent/guardian at the time of registration. 2. The emergency phone numbers shall be filed in the office and shall be readily available for use by appropriate school personnel during the school day. 3. In the event of extracurricular events and field trips, the person designated as responsible for emergency services shall have ready access to the emergency phone numbers of students (e.g., place the emergency phone numbers into the traveling first aid kit). F. Emergency Nursing Services 1. The building principal shall assign staff to provide direct emergency care during the school day. These persons shall maintain CPR and first aid certifications or their equivalent. 2. During the school day, direct emergency care shall be provided by assigned staff. Consultation and advice shall be available from the School Nurse when designated staff have questions. Arrangements shall be made by the building principal or designee for the provision of emergency services at all

school-sponsored events involving students. 3. The building principal may require and assign a person who has current CPR and first aid certification to be present and provide emergency care at any schoolsponsored event involving students. The following shall be taken into account: a. Whether the activity has high potential for injury. b. Whether a large number of people are expected to attend the event. c. Whether the trip is to a remote area. 4. When the extent of a student s injury/illness has been assessed and it is the opinion of the emergency caregiver that the student should go home, the following shall apply: a. The caregiver should discuss the assessment with the student s teacher and the school secretary. b. The student s parent/guardian or designated other shall be contacted to inform him/her of the nature of the illness/injury and what has been done by the caregiver. If a student is suspected of having a communicable disease, he/she should not be allowed to remain in the classroom while waiting to contact his/her parent/guardian or the designated other or waiting for him/her to arrive. c. No student shall be sent home unless parent/guardian contact is made and in no case shall a student be sent to an unsupervised home without parent/guardian permission. d. School staff shall learn who will be coming to pick up the student and how soon he/she will arrive and shall instruct the parent/guardian or designated other where the student will be waiting. No student shall be left unsupervised while waiting for his/her parent/guardian or designated other to arrive. G. Calling an Ambulance 1. The number for calling an ambulance shall be posted in the health room and be readily accessible in the school office area. All staff shall be advised regarding this number at the beginning of the school year. 2. If it is determined by the emergency caregiver that the illness/injury is life threatening and immediate medical attention is needed, he/she shall remain with the student or staff member to provide first aid.

3. A second adult shall be instructed to call an ambulance and then the student s parent/guardian, if applicable. The adult shall give the ambulance personnel the name and address of the school and where the ill/injured student or staff member is located. If possible, the adult shall wait for ambulance personnel to arrive and direct them to the student or staff member. 4. If there is sufficient time, the second adult shall check the emergency form to determine which hospital the parent/guardian or staff member has indicated that he/she prefers. The ambulance staff shall be given this information. However, the ambulance staff shall make the final decision regarding where to transport the student or staff member. 5. Once the care of a student or staff member has been turned over to the ambulance crew, the emergency caregiver shall notify the school office. If the ill/injured person is a student, the caregiver also shall notify the teacher. H. Inservice 1. Emergency procedures shall be reviewed with the entire staff at the beginning of each school year and with any new staff members added during the school year. 2. A meeting shall be held annually for staff assigned to provide direct emergency care to update them in basic first aid and CPR and the district s current policies and procedures related to emergency nursing service. 3. The School Nurse shall meet as deemed necessary with designated staff to review areas of concern or interest. The School Nurse also shall meet with staff on an individual need basis when appropriate. I. Student Special Health Needs 1. All students, prior to enrollment in the district, are strongly encouraged to have a physical and dental examination. In addition, each student entering kindergarten is asked to provide evidence that he/she has had his/her eyes examined by a licensed optometrist or evaluated by a licensed physician. Parents/guardians of students with identified special health needs may be contacted for further information to plan for any special health care and to promote optimal level of wellness. 2. The building principal shall ensure that nursing procedures for students with special health care needs are provided when students are active participants in or members of school-sponsored activities. 3. At the beginning of each school year, the school staff assigned to the health room shall consult with the School Nurse and provide a health concerns list identifying students with known problems that could develop into an emergency

situation such as diabetes, asthma, seizure disorders and severe allergies. This shall be made available to faculty and staff working with these students. Confidentiality standards are to be maintained with respect to this information. (Other health concerns such as vision concerns, hearing loss, etc., may be found in the cumulative health record or on the emergency card located in the building office.) J. Emergency Services Log 1. A daily log shall be kept by staff providing emergency services to students. Information to be recorded may include date, student s name, grade, teacher, reason for care, brief account of observations and service given, whether parents/guardians were notified and disposition. 2. The School Nurse shall review the logs regularly (i.e., utilization of service, types of illnesses and injuries treated and adequacy of care). 3. Emergency services logs may be reviewed annually at the emergency nursing services committee meeting. K. Student Personal Data Health Record 1. Parents/guardians shall be provided with a health update form at the beginning of each school year. (This may be combined with the notification card for emergency or illness.) In addition to completing the health update, parents/guardians have a responsibility to inform school authorities of all physical impairments and medical concerns that a student has that may interfere with his/her participation in a complete school program, as soon as practicable. 2. A cumulative physical health record shall be filed for each student. The record shall include basic health information about the student, including the student s immunization records, an emergency medical card, a log of first aid and medicine administered to the student, an athletic permit card, a record concerning the student s ability to participate in an education program, the results of any routine screening test, such as for hearing, vision or scoliosis and any follow-up to such test and any other basic health information as determined by the State Superintendent of Public Instruction. Such record shall be forwarded to another school or school district in accordance with state law. L. Liability Insurance The Superintendent and the Board of Education shall be responsible for assuring liability coverage for all designated school employees.

M. Annual Review of Emergency Nursing Services A review meeting shall take place annually. The agenda shall include a review of emergency nursing policies and procedures, a report from the Safety Coordinator and review of the frequency and types of accidents and illnesses treated by health room staff. Any suggested changes in policy and procedure must be approved by the Board prior to their adoption. BOARD APPROVAL: August 18, 2004