In this Chapter
The School Health Nurse
School Health Advisory Committee
- School Health Room Aide
- Major Duties of the Health Aide
- Teachers/Other School Staff
Medical Services - Florida Statute Provisions and Restrictions
The recommendations in this manual do not necessarily indicate an exclusive course of treatment or standard of practice but serve as a guideline based on careful research of the most current medical, nursing, educational, and legal advice.
These guidelines are written to assist the school district in establishing a safe environment for all children who attend Sarasota County schools.
The School Board of Sarasota and the Florida Department of Health in Sarasota County are legally responsible for the school health program (Florida Statutes (F.S.), section (s) 381-0056). Health services are a part of the total school health program that is carried out to appraise, protect, and promote the health of students. School health services are designed to encourage parents to devote attention to their child’s health, to recognize health problems, and to utilize the services of their physician, dentist, and community health agencies. The Florida Department of Health in Sarasota County and the School Board of Sarasota County, in conjunction with the School Health Advisory Committee, work together to assure provision of optimum health services for school children in Sarasota County. A School Health Services Plan is updated biennially outlining the provisions and responsibilities to provide mandated health services in all public schools. For this manual, licensed health care professionals are persons designated as such in their job description.
The School Health Nurse (RN/LPN)
Nurses (referred to in this manual as the school nurse) are employed by the Florida Department of Health in Sarasota County or the Sarasota County School Board. The nurse acts as a resource person and consultant to the principal and other school personnel. Nurses will visit assigned schools to assist personnel in identifying the physical, social, and emotional needs of students. Conferences to discuss issues relating to children’s health will be initiated by teachers, parents, or by the nurse. The ultimate goal of school nursing practice is to support students’ optimal state of health to promote student’s capacity for successful learning. School health services may include but are not limited to, interpretation of medical records, assessment of students’ symptoms, troubleshooting technical medical devices, health appraisals, health education, active listening, case management, direct care, counseling, advocacy, and health screenings.
The duties and responsibilities of school nurses in the schools include, but are not limited to:
- Providing health appraisals for the identification and management of actual or potential health problems, which include, but are not limited to nursing assessments, nutrition assessments, vision, hearing, scoliosis, and growth and developmental screenings.
- Providing health consultations for students, parents, staff, and physicians regarding referral and follow-up of suspected or confirmed health problems.
- Assisting with an operational plan for the management of emergency health needs in each school. Including creating a High-Risk list and a Medical Concerns list.
- RN ONLY - Create and implement an Individualized Health Care Plan if necessary. LPN - may work with and add to the IHCP.
- Assisting through consultation to implement health education and curriculum.
- Ensuring the establishment of a Cumulative School Health Record on each student and documentation of identified health problems and corrective measures are taken. A separate professional treatment record shall be used to document confidential health services.
- Conducting ongoing quality assurance and quality improvement activities.
- Providing health-related information on students seeking placement or reevaluation of placement in exceptional student programs.
- Ensuring appropriately trained individuals provide medical services (invasive procedures).
- Developing a procedure for assisting students in the administration of medications during school hours.
- Monitoring staff designated by the principal to administer medications.
- Work with DOH to ensure that no student will be admitted or attend any public or non-public school without proper documentation of Florida Certification of Immunization or Florida Certification of Immunization Exemption (DH Form 680) as required.
- Ensuring that all students entering Florida schools for the first time, including Pre-K, have a health examination within the past twelve months.
- Work with the DOH to ensure that all students entering Florida schools for the first time, including Pre-K, have a health examination within the past twelve months.
- Working with families for referrals, linkage to services, and advocacy
School Health Advisory Committee
The Sarasota County School Health Advisory Committee is an interdisciplinary coalition of health and education professionals and community members that advise the health department and the local school board. The members of the advisory committee ensure that community standards are represented in the school health decision-making process. The committee advises ways to offer age and developmentally appropriate health education and health services in the educational setting to maximize the potential for all students to take their places as productive and healthy citizens.
Florida Statutes (F.S.), section (s) 381-0056 provides that the principal assists in implementing the annual School Health Services Plan, which has been jointly approved by the Sarasota County School Board and the Florida Department of Health in Sarasota County.
School Health Aide
School aides are properly trained and work under the administrative supervision of the principal and have the guidance and direction of the school nurse on health-related issues. School health aides assist in the implementation of the school health services program. Their input and contribution to the management of the health needs of children are a major component of delivering health services to students. The school health aide performs services within the school health services program according to the written policies and procedures in the School Health Services Manual.
The School Board of Sarasota County coordinates the continuing education of school health aides.
Knowledge, Skills, And Abilities
Possess effective communication and interpersonal skills for interaction with students, parents, school personnel and public health personnel. Ability to file and keep legible records. Ability to accept supervision from the Principal and guidance from the school nurse. Possess technology skills necessary to complete assignments. Ability to organize and prioritize activities. Possess secretarial and telephone skills.
Major Duties of the Health Aide:
- Provide emergency and supportive care to students with sudden illness and injury and document care.
- Maintain accurate records on students who visit the health room or receive care for a sudden illness or injury.
- File all health paperwork including health files after clerk/school nurse review.
- Provide follow-up services and make appropriate referrals to the school nurse.
- Serve as liaison with the school nurse in providing information and materials on health education programs.
- Assist in and/or conduct screenings.
- Communicate with parents/staff regarding student health needs and maintain confidentiality. Inform the school RN when children with health needs are identified as well as any changes in current identified student health conditions.
- Assist in the implementation of the Annual School Health Services Plan.
- Assist in the administration of prescribed medication by students and maintain required records.
- Maintain health room and supplies.
- Participate in annual OSHA training and practice effective infection control procedures following OSHA and Center for Disease Control & Prevention guidelines.
- Perform, as necessary, those medical procedures (invasive as well as noninvasive) allowed by law, after receiving student-specific training by a registered nurse/LPN.
- Follow instructions in the Individual Health Plan (IHP).
- Maintain an annually updated emergency card file for all students.
- Develop and maintain high risk and health concerns lists of students with potential emergency needs. These lists are to be given to the school nurse for review and distribution instructions.
- Compile and maintain a current list of school personnel who are certified in CPR and/or First Aid and post as outlined in Emergency Health Needs.
- Participate in annual health services online training and updates.
- Perform other duties as assigned by the principal.
Teachers/Other School Staff
Teachers and other school staff are often the first to notice that a student may have a health problem. If staff observe changes in a student’s behavior or appearance, the student should be sent to the health room to identify potential health problems. The health room staff will evaluate, communicate with family and make referrals for appropriate services as needed.
Medical Services - Florida Statute Provisions and Restrictions
F.S. 1006.062 addresses the provision of medical services and restrictions:
Non-medical school district personnel shall not be allowed to perform invasive medical services that require special medical knowledge, nursing judgment, and nursing assessment. In accordance with F.S. 1006.062, procedures include, but are not limited to:
- Sterile catheterization
- Nasogastric tube feeding
- Cleaning and maintaining a tracheostomy and deep suctioning of a tracheostomy
Non-medical personnel shall be allowed to perform health-related services upon successful completion of child-specific training by a registered nurse/ LPN, a physician, or a physician assistant. The parent/guardian must complete an Affidavit - Medical Release Form before the service/procedures may be performed. The school nurse shall monitor all procedures periodically. These procedures include, but are not limited to:
- Clean intermittent catheterization
- Gastrostomy tube feeding
- Monitoring blood glucose
Note: To ensure the availability of emergency intervention, training should be given to at least three people, to include the health room aide and his/her relief. The training must be provided by a licensed health professional, as listed above, and should include recognizing symptoms, monitoring the student, and plans for emergency treatment.