Haynes School Health Office

Lisa Nigrelli, BSN, RN, NCSN

Haynes School Nurse

lisa_nigrelli@sudbury.k12.ma.us

978-443-1093 x1204

ABOUT SCHOOL NURSING

"A child must be healthy to learn and a child must learn to be healthy." (Massachusetts Department of Public Health)

"School nursing, a specialized practice of public health nursing, protects and promotes student health, facilitates normal development, and advances academic success. School nurses, grounded in ethical and evidence-based practice, are the leaders that bridge health care and education, provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potentials." (National Association of School Nurses 2016)

The mission of the school nurse is to promote the safety and wellness of students and staff during the school day in order to optimize learning.

School nurses:

  • Provide nursing assessment, diagnosis, and care for students who are ill or injured, or have chronic medical conditions
  • Develop individual health care plans in collaboration with students, parents/guardians, and physicians for students with asthma, diabetes, life-threatening allergies, seizures, and other chronic and acute health issues
  • Collaborate with Sudbury Dept. of Public Health on school-wide health issues
  • Conduct state-mandated annual vision, hearing, postural, and BMI screenings
  • Review physical exams and immunizations as required by state law
  • Communicate to the school community regarding urgent health issues and changes in state laws affecting health in the schools
  • Compile data and submit reports to the district and MA department of public health
  • Educate students individually and in the classroom on a variety of topics, including infection control, hygiene, human growth and development, normal anatomy and physiology, nutrition
  • Participate in Special Education Team meetings and Section 504 meetings as needed
  • Provide annual flu vaccine clinic to staff

EPI PEN UPDATE

To address the current EpiPen shortage, the FDA has extended the expiration dates of select Pzifer EpiPens and its authorized generic version. This applies only to the 0.3mg version, NOT EpiPen Junior. Please see the links below for more information and lot numbers:

IMMUNIZATION REQUIREMENTS

  • Annual Physicals are required upon start of kindergarten and grade 4. Please remember to send in your Physical and Immunization Records for your children.
  • There are two situations in which children who are not appropriately immunized may be admitted to school:

1) a medical exemption is allowed if a physician submits documentation attesting that an immunization is medically contraindicated; and

2) a religious exemption is allowed if a parent or guardian submits a written statement that immunizations conflict with their sincere religious beliefs. Medical and religious exemptions need to be renewed annually, at the start of the school year.

MEDICATION ADMINISTRATION

Medication administration is an important issue in schools. Some students require medications at school in order to survive. Others need medications in order to learn. Occasionally, students require antibiotics during the day following a bacterial infection.

The goal of your School Nurse is to administer only those medications that are absolutely necessary during the school day. All other medications should be given at home either before or after school.

State law requires a written order by a licensed prescriber and written parental permission before any medication can be administered to students, including over-the-counter medications. All medication MUST be in the original labeled container and labeled with the student’s name. The School Nurse will NOT administer the following: expired medications, medications delivered in unlabeled containers, and medications in inappropriate containers such as zip-loc bags.

For the safety of all students, no medications are to be carried to school by students. Parents must transport ALL medications

For short term prescription medications (i.e. those requiring administration for 10 school days or less), the pharmacy-labeled container may be used in lieu of a licensed provider's order. Written parent permission is required. Complete the Medication Care Plan below

SPS MEDICATION FORMS

Both forms below need to be completed with signature from MD on prescription medication form

MEDICATION CARE PLAN: https://docs.google.com/viewer?a=v&pid=sites&srcid=c3VkYnVyeS5rMTIubWEudXN8c3BzLW51cnNpbmd8Z3g6M2QxMTViOWExNjRmYzBlMg

PRESCRIPTION MEDICATION FORM: https://docs.google.com/viewer?a=v&pid=sites&srcid=c3VkYnVyeS5rMTIubWEudXN8c3BzLW51cnNpbmd8Z3g6NjJjNjFiNTk2OTc3MjhkYQ

FAQs

When should I keep my child home from school?

Fever: Fevers are generally a sign of illness/infection. Your child should stay home if his/her TEMPERATURE is 100 F or above. He/she should not return to school until their temperature has been normal (97 - 99 F) for at least 24 hours without any fever-reducing medication.

Cold, Cough, Sore Throat: Most children can attend school with cold symptoms as long as they do not have a fever. If your child has a cold with a fever over 100 F, he/she should be kept at home and your healthcare provider should be consulted. Your child should also stay home if they have greenish nasal discharge or cough production. A sore throat with a fever, swollen glands, headache, stomachache, or rash may indicate strep. You should consult your child's doctor for evaluation. If strep is confirmed, your child may return to school after 24 hours of antibiotics, if they feel better.

Stomachache, Vomiting, Diarrhea: A child with vomiting and/or diarrhea should be kept at home until symptoms have resolved for 24 hours. Your child also needs to be able to eat and drink normally before returning.

Red Eyes: Your child should stay home if he/she has red eyes that itch and/or have a crusty discharge.Consult your doctor for evaluation of possible conjunctivitis. Your child may return to school after 24 hours of antibiotic treatment.

Rash: A rash is usually a sign of a viral illness. It also may be a reaction to medication, plants, or chemicals such as soaps or detergents. If your child has an unusual rash or it is associated with a fever, contact your doctor.

Please remember a sick child belongs at home.

What should I do if my child has been hospitalized or out of school for a prolonged time?

Please provide the school nurse with the hospital discharge summary and treatment plan. Contact the school nurse and guidance to help with transition back to school

What should I do if I find a tick on myself or my child?

The tick should be carefully removed as soon as possible. The longer an infected tick remains attached to a person or animal, the higher the likelihood of disease transmission. Use fine point tweezers to grip the mouthparts of the tick as close to the skin as possible. The tick should not be squeezed or twisted, but pulled straight outward with steady, gentle pressure. You should not apply kerosene, petroleum jelly, nail polish, or a hot match tip to remove the tick; these measures are not effective and may result in injury. Notify your health care provider if you have been bitten by a deer tick, or if you develop a rash or other flu-like symptoms following a tick bite.

What should I do if my child has been diagnosed with a concussion?

Please provide the school with the documentation and restriction order from the MD. The school will need documentation from the MD (Post sports related head injury medical clearance and authorization form) to be cleared to resume activities in gym and recess.

https://crls.cpsd.us/UserFiles/Servers/Server_3045299/File/athletics/forms/Post_Concussion_Form.pdf

What do I do when my child needs to limit gym activity or recess?

A doctor's order is required for both.

What if my child needs OTC medications?

For over the counter medications (ie Tylenol, Motrin, Benadryl) the health office carries these medications and can administer with parental permission. Parents give permission when on their child's ASPEN acct.

State-Mandated Screenings

VISION: Grades 1 through 5

HEARING: Grades 1 through 3

POSTURAL (SCOLIOSIS): Grades 5

GROWTH (BMI): Grades 1 and 4

The Flu

What is the flu?

Influenza (the flu) is an infection of the nose, throat and lungs caused by influenza viruses that are constantly changing. Flu causes illness, hospital stays and deaths in the United States each year. Flu can be very dangerous for children. Each year about 20,000 children younger than 5 years old are hospitalized from flu complications, like pneumonia.

How serious is the flu?

Flu illness can vary from mild to severe. Flu can be especially dangerous for young children and children of any age who have certain long term health conditions, including asthma (even mild or controlled), neurological conditions, chronic lung disease, heart disease, blood disorders, endocrine disorders (such as diabetes), and weakened immune systems due to disease or medication. Children with these conditions, and those receiving long-term aspirin therapy, can have more severe illness from the flu.

How does the flu spread?

Most experts believe that flu viruses spread mainly by droplets made when people with the flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might get the flu by touching something that has flu virus on it and then touching their own mouth, eyes or nose.

What are the symptoms of flu?

Symptoms of flu can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue and sometimes vomiting and diarrhea. Some people with flu will not have a fever.

How long can a sick person spread the flu?

People with the flu may infect others from 1 day before getting sick to 5-7 days after. Children and people with weakened immune systems can shed virus for longer, and might still be contagious past 7 days, especially if they still have symptoms.

Can my child go to school, daycare or camp if he or she is sick?

NO. Your child should stay home to rest and to avoid giving the flu to other children or to caregivers.

When can my child go back to school after having the flu?

Keep your child home until at least 24 hours after their fever is gone, without using fever-reducing medications, like acetaminophen (Tylenol) or ibuprofen (Motrin or Advil). A fever is defined as 100.4°F (38°C) or higher.

Much more information is available at:

WHAT TO DO WHEN YOUR CHILD HAS LICE

Pediculus Humanus Capitis, or as they are more commonly referred to head lice strikes fear in the hearts of parents of school age children. Each year approximately six million children are affected, and every parent dreads the call from the school nurse informing them that their child's’ head has become the host for a family of insects. Head lice have been around for hundreds of years.

Cleanliness or personal hygiene have no bearing on whether head lice will affect your family. In fact, they seem to prefer clean, healthy heads. Please do not be embarrassed to notify the health office as well as parents of your child's playmates if you discover your child has head lice. Parental cooperation will help prevent the spread to others.

Head lice cannot jump or fly. They are spread by direct head to head contact, or by the sharing of hairbrushes, pillows, hats or headbands. Close family members are at risk for contracting lice and must be checked as frequently as the affected child. Head scratching is the most common symptom of head lice.

A louse is one bug, lice are plural. Nits are the lice eggs. Lice are wingless insects that range in size from as small as a pencil point to the size of a small ant and range in color from tan to dark brown. Because of their color and speed, they aren’t easy to find. NIts are tiny, beige colored eggs shaped like a sesame seed. They are found on individual hair shafts approximately 1/4-1/2 inch from the scalp. Favorite spots are behind the ears, at the crown of the head, or the nape of the neck. An adult female louse will lay an average of 125 eggs during her 30 day lifecycle. These are attached to the hair shaft with a glue like substance. Unlike dandruff or lint, they will not wash off or blow away, but need to be manually pulled off. Diagnosis is usually made due to the presence of the eggs, or nits.

It is a good idea to screen your children’s heads often, in a well lit area, especially at the start of the school year and after school vacations. If your child attends camp in the summer, they will most likely be checked upon arrival, and you should check them upon their return home.

Checking the hair involves lifting small sections of hair away from the scalp and examining it carefully. This is best done in sunlight or with a magnifying light. Hair clips are helpful in sectioning hair. If your child does have head lice, treatment is a two step process involving the use of a lice treatment shampoo and nit removal. Contact your physician for recommendations on which lice treatment shampoo to use. Follow product directions carefully when using the shampoo. NO TREATMENT CAN AVOID THE PAINSTAKING MANUAL REMOVAL OF NITS. This is the most important part of the treatment process, and involves using a special fine tooth metal nit comb to comb through small sections of hair. The comb will pull the nits from the hair shaft, or you can use your thumbnail and finger to pull the nits off.

Treatment of personal items and the environment is also necessary. All washable clothing and linens must be washed in hot water and dried in a hot dryer. Careful vacuuming of rugs, furniture, car seats and mattresses should be done.

Combs, brushes, etc. can be soaked in hot (boiling) water for 15 minutes. Articles that cannot be washed or dried can be sealed in a plastic bag for 2 weeks. Change bed linens often. Keep in mind however, that lice depend on human blood for survival and typically die within 24 hours without a human host, i.e. human head.

While treating head lice can be a time consuming and an emotionally draining experience, be assured that lice do not spread disease. With the cooperation of all parents we can work together to treat an outbreak and prevent additional cases. If caught early, it is much easier to treat.

https://www.cdc.gov/parasites/lice/head/parents.html

https://www.webmd.com/children/ss/slideshow-lice-overview


There are also professional lice removal services available, for more information contact:

www.lice.aunties.com/

www.liceinfo.net

LiceTreatmentCenter.net/Boston

www.thenit-picker.com

http://www.thelicecompany.com/

http://www.compassionnitmoms.com/

Nits and adult lice.

Health Office Wish List

  • socks
  • underwear
  • boy and girl sweat pants or other stretchy pants in various sizes

I have a small supply of clothing for the occasional accidents. If your child has been the recipient of these clothes, please return washed for the next person.