Helping Belton ISD Helping Belton ISD Students Stay Safe & HealthyStudents Stay Safe & Healthy

What Every BISD Staff Needs to Know About:What Every BISD Staff Needs to Know About:

Helping Belton ISD Helping Belton ISD Students Stay Safe & HealthyStudents Stay Safe & Healthy

What Every BISD Staff Needs to Know About:What Every BISD Staff Needs to Know About:

Belton ISDBelton ISDHealth ServicesHealth Services

2013-20142013-2014

• Responding to Emergencies (Mr. MERT) • Health Conditions: What Do I Do?

• Field Trip Process: Health Needs

• Communicable Disease Prevention Updates: Lice

• Blood Borne PathogensSEVERE

LOWBLOOD

GLUCOSE

Is it an Emergency?Not responding?

What you see What you do• They are not

moving or responding when you tap their shoulders and yell:

“Hey, are you Ok?

• Yell for help• Tell someone to call a MR. MERT

(Medical Emergency Response Team) to your location. Remind them to bring the AED

• If no one is with you and you are alone, go call 911 and get the AED

• If it looks like they are not breathing : Place the AED and give CPR if you know how

Automatic External Defibrillators (AEDs)

Open the case and pull the handle Voice prompts will tell you:•Place the pads on the bear chestJust like the picture on the pad•Do not touch the person if the AED tells you a shock is needed•Push the flashing orange button when it tells you to•Start CPR if the AED tells you to and leave the pads on

Safe & Healthy

• Health Conditions: What Do I Do?

Safe & Healthy

Asthma Emergency Plan

Safe & Healthy

Food Allergy

Food Allergy

Severe Allergy Emergency Plan

Safe & Healthy

Teacher/Coach Responsibilities

•Review the Emergency Plan for Severe Allergy plan with the school nurse, if available, and with the student and his/her parent/guardian. •Keep the student’s plan accessible in the classroom and available for a substitute•Ensure that an adult accompanies a student suspected of having an allergic reaction or ask the nurse to come to the student•Notify the school nurse at least 48 hours before a field trip so that emergency plan and EPIPEN administration procedures can be reviewed with one to two staff going on the field trip.•Educate classmates to avoid endangering, isolating, stigmatizing or harassing students with food allergies•Ensure other staff, students and their parents comply with any risk-reduction strategies.

Food Allergy

Risk Reduction Strategies•No food sharing•No utensil sharing•Avoid serving food without appropriate ingredient labels•Hand washing before and after eating snacks/meals. Soap and water are best.•Avoid cross-contamination of food by wiping down eating surfaces before and after eating. •Designate allergen safe zones, such as designated tables/seating areas•Consider eliminating or limiting foods in the classroom, buses, after-school activities which may cause a life-threatening reaction to a student in a class•Avoid or use caution when using food for classroom activities, such as for crafts, science projects, holiday celebrations, etc.•Use non-food items as rewards instead of food•Avoid high-risk areas for field trips, i.e. corn fields,

exposure to latex balloons or seafood, etc. Food Allergy

Field TripsMedications/Procedures/Supplies

• Oral medications• Epipens• Inhalers• Diabetic supplies• Other equipment• Other emergency

meds• Basic 1st Aid supplies

Emergency Care Plans

• Asthma• Bleeding Disorder• Cardiac Condition• Diabetes• Seizures• Severe Allergies• Other special

conditions or procedures

Medication Administration on Field Trips

Illness PreventionExamples of When a Student Would be Excluded from School:

• Possible Fever > 100°• “Wet” Rash that cannot be covered• Signs & Symptoms of a contagious disease, like

pertussis, mmps, chickenpox, “pink-eye”

Communicable Disease Prevention

Illness Prevention Tips:

• Wash Hands• Cover Cough• Stay Home if Sick- See Your Dr. • Get Flu Shot

Head Lice UpdatesNew Texas Law: No School Exclusion for Head LIce

Research & Recommendations from:•American Academy of Pediatrics•National Association of School Nurses•Texas Department of State Health Services

Communicable Disease Prevention

Head Lice Guidelines Reviewed By:• Belton ISD School Health Advisory Committee• Belton ISD Administration

Head Lice: Prevention

• School Nurses provide Parental Education about identification, treatment and prevention in person & in writing, including on BISD website

• Teachers avoid classroom activities that increase head to head contact (naptime)

• All staff remind students about not sharing caps, hats, scarves, hairbrushes, combs

• All staff avoid practice of having students pile coats, backpacks, etc. )Use separate hooks, cubbies)

Communicable Disease Prevention

Head Lice: Identification & Referral

•Refer those exhibiting signs (itching, visible nits or lice)•Check only those with possible close head to head contact- at discretion of nurse and principal•No head checks in the classroom

Communicable Disease Prevention

Head Lice: Management of Confirmed Case

• Nurse calls parent to inform of case and educate on treatment , encouraging parent to treat

• Student may remain in class, but discouraged form close head to head contact

• Head Lice Notice to Class sent only at discretion of nurse and principal with several cases

Communicable Disease Prevention

Head Lice: Exclusion?

• Student with > 2 cases in same week can be excluded at discretion of nurse & principal until free of live lice

• Nurse will re-examine student before allowing to return

• Nurse should collaborate with CIS staff to offer extra extra help for students with excessive absences due to head lice

Communicable Disease Prevention

Head Lice: Educate!

• Head Lice, American Academy of Pediatrics, published July, 2010

• Pediculosis Management in the SCHool Setting, National Association of School Nursing, August 2010.

• Managing Head Lice in School Settings, Texas Department of State Health Services, December, 2012.

• Lice Management: Staff Information, Belton ISD Health Services, BISD website, 2013.

Communicable Disease Prevention

Belton ISDBelton ISDHealth ServicesHealth Services

2013-20142013-2014

Helping Belton ISD Helping Belton ISD Students & StaffStudents & Staff

Stay Safe & HealthyStay Safe & Healthy

What Every BISD Staff Needs to Know About:What Every BISD Staff Needs to Know About:

Helping Belton ISD Helping Belton ISD Students & StaffStudents & Staff

Stay Safe & HealthyStay Safe & Healthy

What Every BISD Staff Needs to Know About:What Every BISD Staff Needs to Know About:

Blood borne Pathogens

BBP

Why do I need this training?Your job duties may put you at risk of exposure to

blood or other potentially infectious material (OPIM)

Breaking up fightsAssisting with nose bleeds, cutsAssisting diabetic studentWorking with combative students including

those who bite and break the skinProviding swallowing therapy BBP

What are bloodborne pathogens?

Viruses, bacteria, and other microorganisms that are carried in the bloodstream and can cause serious diseases

The most common BBP are:Human Immunodeficiency Virus (HIV)Hepatitis B Virus (HBV)Hepatitis C Virus (HCV)

These disease can lead to problems like cirrhosis, liver cancer, liver failure, aids and

death.

Many Symptoms appear months after exposure and HEP B can survive outside of the body for up to a week

How do BBPs enter your body?

Direct contact with blood or other body fluids of an infected person through:

Open cuts, wounds, skin abrasionsBlood splashing into your eyes, nose, or mouth

BLOOD + ENTER BODY

Belton ISD Provides the Hepatitis B vaccine to :Staff working in special-ed self-contained classroomsStaff working in the school health clinics Staff whose school duties placed them at risk to frequently

come in contact with blood or other potentially infectious material

3shots: 1-2 months apartNotify the BeltonISD School Health Coordinator immediately

if you have not received the vaccine (See Hep B form)• Most insurances do not charge. Belton ISD will provide if your

insurance does not cover the vaccine

Best Practice: Universal Precautions“All Blood is the Same”

When you take Universal Precautions you act like all human blood may be infectious and treat everyone the same. You will take

precautions with everyone’s blood.

• Best Practice: Wear Gloves

• Wear gloves when you might be coming in contact with someone’s blood or body fluids.

• Wear goggles or gowns if needed.

Best Practice: Wash Hands

• Wash hands with soap and water before eating, after any contact with blood, body fluids, or soiled objects, After using the toilet, after assisting with personal hygiene, after the removal of gloves

Best Practice: Proper Cleaning

• Belton ISD trains staff to clean up blood & body fluids properly using the right cleaners and the right method.

• Waste such as bloody tissues should be disposed of in a plastic-lined trash and after being double-bagged, can be thrown in the dumpster

Best Practice: Sharps Containers

Use sharps containers if you are diabetic and will be checking you blood sugar or give yourself injections at school and make sure students are using them as well. They are located in the health clinics, and we can make sure they are also available in staff lounges if needed.

Best Practice: Report Exposure

When blood or body fluids gets in through non-intact skin or mucous membranes, or if you are poked with a needle, do the following:•Wash the exposed area with soap and water, or irrigate the eyes with water •Report the incident to the Health Services Coordinator for investigation and proper referral•The district will provide for additional medical evaluation and treatment if needed•Health Services: Charlotte Smith, RN 215-2510

BBP: INFORMATION ACCESS

Annual Training

Web Access: Staff Training Tab of School Health Service Page

Written Access:

BBP Exposure Control Plan @ the school health office of each campus or department in the district

Belton ISDBBP

ExposureControl

Plan BBP

Questions or Comments?References & Resources

Emergency:• American Academy of Pediatrics (AAP). (2008) Disaster planning for schools. Pediatrics, 122 (4) pp. 895‐ 901.

doi:10.1542/peds.2008‐2170• Cole, V., Henry, B., Tyson, D., Fitzgerald, R., Hopkins, R. (2007). In the face of danger: Comprehensive emergency

preparedness and response for schools. Penn GSE Perspectives on Urban Education, Retrieved from http://urbanedjournal.org/archive/Vol.%205%20Iss.%202%20Order%20in%20Schools/Articles/Article_ 2_In%20the%20Face%20of%20Danger.html

• Doyle, J., & Loyacono, T. (2007). Disaster preparedness guidelines for school nurses. Silver Spring, MD: National Association of School Nurses.

• Fitzpatrick, B. (2006). Emergency management, crisis response and the school nurse’s role. In J. Selekman (Ed.) School nursing: A comprehensive text. (pp. 205‐ 233). Philadelphia: F.A. Davis Company.

Diabetes• Care, 34(Supp 1), S70‐S74.• American Association of Diabetes Educators (AADE). (2008). Position statement: Management of children with

diabetes in the school setting. The Diabetes Educator, 34(3), 439‐443.• American Nurses Association /National Association of School Nurses (ANA/ NASN). (2011). Scope and standards of

practice: School nursing, 2nd ed. Silver Spring, MD: Nursebooks.org.

Food Allergy• American Academy of Allergy, Asthma and Immunology Board of Directors (1998). Position Statement-Anaphylaxis in

schools and other child-care settings. Journal of Allergy Clinical Immunology: 102(2), 173-175.• Food Allergy Network (2001). Information about anaphylaxis: Commonly asked questions about anaphylaxis.

www.foodallergy.org.• Mudd, K. E. & Noone, S. A., (1995). Management of severe food allergy in the school setting. Journal of School

Nursing: 11(3), 30-32• National Association of School Nurses (2000). Position Statement-Epinephrine use in life-threatening emergencies.

Scarborough, ME: Author.

Questions or Comments?References & Resources

Medication• Belton Independent School District Board Policy (2012). FFAC Legal and Local: Wellness and Health Services: Medical Treatment: Administering Medication. Retrieved June 22, 2012 from

http://pol.tasb.org/Policy/Code/164?filter=FFAC

• Belton Independent School District Board Policy (2012). FFAF Legal: Wellness and Health Services: Individualized Health Plan. Retrieved June 22, 2012 from http://pol.tasb.org/Policy/Search/164?filter=FFAF

• Texas Department of State Health Services (2011). Texas School Health Guidelines: School health Manual: Chapter 5, 208. Retrieved June 22, 2012 from http://www.dshs.state.tx.us/schoolhealth/pgtoc.shtm

• American Academy of Pediatrics. (2009). Policy statement guidance for the administration of medication in school. Pediatrics 124, 1244‐1251.

• American Nurses Association / National Council of State Boards of Nursing (ANA/NCSBN). (2006). Joint statement on delegation. Retrieved from https://www.ncsbn.org/Joint_statement.pdf

• American Nurses Association (ANA). (2005). Principles of delegation. Silver Springs, MD: Author.• Canham, D.L., Bauer, L., Concepcion, M., Luong, J., Peters, J., & Wilde, C. (2007). An audit of medication administration: A

glimpse into school health offices. Journal of School Nursing, 23, 21‐27. doi: 10.1177/10598405070230010401• Clay, D., Farris, K., McCarthy, A.M., Kelly, M.W., Howard, R. (2008). Family perceptions of medication administration at school:

errors, risk factors and consequences. Journal of School Nursing, 24, 95‐102. doi: 10.1177/10598405080240020801• Gursky, B. S., & Ryser, B. J., (2007). A training program for unlicensed assistive personnel. Journal of School Nursing, 23, 92‐97.

doi: 10.1177/10598405070230020601

BBP http://www.dir.ca.gov/dosh/dosh_publications/expplan2.pdf

http://www.odh.ohio.gov/ASSETS/BF89785CAD2F478BB75134D8219D2A5F/bbpath.pdf

http://www.setonresourcecenter.com/safety/written/pdf/bbpschools.pdf

Contact info: Belton ISD Health Servicescharlotte.smith@bisd.net