Health Service Policies

Communicable Disease

The Arkansas School Health Services Manual and Shiloh policy provides guidance for excluding students with either suspected or known communicable disease or incomplete immunization status. As a general rule, a student whose temperature is 100.0 F degrees or greater and/or experiences vomiting or diarrhea will be excluded from school, as will students with an undetermined body rash, significant eye inflammation, or other signs or symptoms of a potentially communicable disease. Moreover, students requiring antibiotic therapy must follow the guidelines of their private provider before returning to school. This usually includes resolution of acute signs and symptoms, to include free of fever without medication for 48 hours and 1-2 days of antibiotics. The school nurse will apply private provider instructions, current Arkansas Department of Health guidelines, and the best interest of the school and individual in making the final decision for exclusion from school.

In an effort to prevent the spread of seasonal flu in our community, all associated with Shiloh are encouraged to consider flu vaccination for themselves and their family this year. Watch the local media for when you can access this important preventive care.

Parent Notification of Health Room Visits

Time constraints limit the nurse?s ability to directly notify secondary parents of routine health interventions not resulting in disposition home and/or immediate referral.

Medications

Many medications, including antibiotics and most allergy and behavioral medications, are best given at home. For instance, antibiotics that are prescribed for three times per day are most beneficial and tolerated by taking at or near regular intervals while awake at home, such as at breakfast, after school, and before bed. In the rare instance when home administration of prescribed medication is not possible, or the need for a stand-by rescue medication or protocol exists, medication administration can be requested as follows.

1. The parent or legal guardian must provide a written request for the administration of a prescribed medication. This request should include the medication name, dosage, administration time, parent's printed name, signature, and best contact number. Pre-printed request forms are available from the Nurse by email or visit. .
2. This request must accompany the medication in its original container with the original label that includes the provider's name and date, patient name, drug name and dosage and clear administration directions. Upon request, many pharmacies will split a prescription to assist with this requirement.
3. Medications containing narcotics cannot be administered in the school setting. These medications are highly regulated and the School Nurse office is not set up to comply with these regulations. The School Nurse is also prohibited from administering non-FDA approved medications, to include herbal preparations.
4. Arkansas law and current practice allow for the responsible student to carry their own rescue medications (e.g. Act 1694, "Alex's Law"). This includes prescribed Auto-Injectable Epinephrine, Asthma Inhalers, and diabetic medications. Per law, the need for this must be documented by a private provider and reviewed by the parent, school nurse, student, and if indicated, select faculty, coaching staff, and/or peers. Parents may provide the School Nurse Office with back-up rescue medications for their student.

Immunizations

Arkansas state law and associated rules and regulations state that "no infant or child shall be admitted to a public or private childcare or school facility that has not been age-appropriately immunized . . . ." It is the parent?s responsibility to consult with their local private provider and/or the public health department to coordinate appropriate immunization, keep school records updated, and immediately respond to any discrepancy notice.

Arkansas state law does allow for parents to request an annual exemption from state immunization requirements by contacting:

Director of Communicable Disease Immunization Division
Arkansas Department of Health 4815 West Markham Street, Slot 48 Little Rock, AR 72205
Phone: 1-800-235-0002

The parent must notify the School Nurse when an exemption request is in process and provide a copy of approval when processing is completed.

Minimum Immunization Requirements:

• Kindergarten (K5) through 12th grade students must meet the following to be admitted and/or to continue attending school in Arkansas:
• Diptheria/Tetanus/Pertussis (DTP): Minimum of 3 doses (the last must be on/or after the 4th birthday). Arkansas has added a pre- adolescent/adolescent booster requirement this school year (i.e.,Tdap marketed as Adacel or Boosterix). Local providers are offering this starting at age 11 or 12 years old. Students ages 11- 18 are encouraged to catch-up with this booster.
• Polio (OPV or IPV): Minimum of 3 doses (the last must be on/or after the 4th birthday).
• Measles/Mumps Rubella (MMR): Minimum of 2 doses for Measles (both must be on/or after the 1st birthday).
• Chicken Pox Vaccine (Varivax): Two (2) doses are required for kindergarten students. History of the disease will no longer be accepted in lieu of the vaccine. Two doses will also be required for 7th grade students if no prior doses have been received.
• Hepatitis B: complete series before the end of the school year for all kindergarten, 7th grade, and transfer students.

Additional Immunization Recommendations:

The nation's Center for Disease Control has updated recommendations for childhood immunizations. This includes the tetanus/pertussis and chicken pox boosters referenced above, and immunizations for protection against bacterial meningitis, Hepatitis A, and others. For guidance specific to your child, contact your private provider or health department for an immunization review and/or wellness visit. For general information, see: http://www.cdc.gov/vaccines/ or http://www.nasn.org/Portals/0/resources/boost_teen_vaccincations _english.pdf