Health Services – Holten Richmond Middle School

Students are not permitted to transport medications to school.

Our school nurses are available for students, parents, and teachers every day. Our school health services are NOT a substitute for the parental responsibility for medical care, but they do serve to supervise and inform parents of student needs.

Parents must present full and complete health records before enrolling a student in school. The school nurse will notify students in need of immunization update. As required by law, all students must be immunized for certain diseases. Questions regarding immunizations may be directed to the school nurses. Effective September 1, 1999, the Commonwealth of Massachusetts REQUIRES all students entering 7th grade to receive a complete physical examination by a physician and receive a list of immunizations. These immunizations can be downloaded on our MEDICAL FORMS link.

Per the policy of the Danvers School Committee, students whose inoculations or physicals are not up to date will not be allowed in school in order to insure the health of all.

Screenings for vision, posture, and hearing are completed each year to ascertain any problems that may hinder student learning. Students failing any of these screenings will receive a letter from the school nurse.

Immunization Requirements

Effective September 1, 1999, regulations issued by the Commonwealth of Massachusetts REQUIRE that all students entering seventh grade as well as others who are 12 to 13 years old, submit documentation of all required immunizations and updated physicals. Please keep the following immunizations in mind when scheduling your child’s physical appointments.

By seventh grade (or age 12 – 13), all students should have had:

- 2 doses of varicella vaccine or a physician-certified reliable history of

- chicken pox

- 2 doses of the MMR (measles, mumps and rubella) vaccine

- 3 doses of the hepatitis B vaccine

- Vaccinations for polio

- Vaccinations for Haemophilus influenzae type B (Hib)

- a Tetanus, Diphtheria, Pertussis booster within the last 5 years

- a Physical Exam within the last year

Please do not assume that your Doctor will forward this information to the schools. It is your responsibility to see that the immunizations are given and to provide a copy of the physical examination and the vaccination documentation to the schools. We sincerely appreciate your cooperation and assistance with this State mandate.

Tylenol/Acetaminophen Protocol

Indication: Analgesic/antipyretic agent, to be administered subsequent to the assessment of the student, by the School Nurse, for the relief of minor pain or reduction of fever. Students with a temperature of greater than or equal to 100 degrees will be dismissed per current School Physician Standing Orders.

Middle School and High School students may receive 1-2 tablets of regular strength Tylenol/Acetaminophen (325 mgm.) every 4-6 hours as needed.
Elementary School students may receive 15mgm/kg/dose of Tylenol/ Acetaminophen every 4-6 hours as needed.

The Middle School/High School nurses will provide regular strength (325 mgm/tablet) Tylenol/Acetaminophen. Elementary nurses will provide Tylenol/Acetaminophen “Chewables” (160 mgm/tablet, as well as regular strength (325 mgm/tab) Tylenol/Acetaminophen.

Nursing Action

A completed, signed “Parent Authorization for Medication Administration” form must be on file before medication will be administered.
The nurse will evaluate pain and pain source and, where necessary, measure the student’s temperature.
For student safety, prior to the administration of the Tylenol/Acetaminophen, the nurse will contact the student’s parent/guardian. This will allow the nurse to ascertain the time of the last dose (if any), check to see what other medication (if any) is being given concurrently, to re-check allergies to medication and to inform the parent/guardian of the dose, time and circumstances surrounding medication administration. The nurse may also, at this time, request that the parent come to dismiss the student.

Following direct parent/guardian contact, the nurse:

Where applicable, (given the above parameters) will administer the appropriate dose.
Will document medication administration per established school protocol.

Adverse reactions: Hemolytic anemia, neutropenia, leukopenia, severe liver damage, jaundice, rash, hives, hypoglycemia

Contraindications:

Allergy or hypersensitivity to Tylenol/Acetaminophen
Not to be given with other Tylenol or Acetaminophen-containing products
Not to be given concomitantly with non-steroidal anti-inflammatory medication

Cautions: In case of overdose, contact health care provider or Poison Control Center immediately (1-800-222-1222). There is potential for hepatic (liver) toxicity. If sensitivity occurs, discontinue drug.

Medication Policy

We are obligated to adhere to the policy of the Danvers Public School which states that: no medication, prescription or *over-the-counter, is to be administered unless accompanied by written authorization from both the physician and the parent(s) (for students under 18 years of age).

Required information: name of the medication, dose, time to be administered, duration of medication administration. The same information is required for all medication, whether prescription or over-the-counter.

Medication must be brought to the Nurse’s Office by a parent or another adult designated by the parent. Only the School Nurse will accept medication. Medication will be counted, when necessary, and locked in the medication cabinet.

Medication administered at school must be in a prescription bottle, with label attached or, if not prescription, in the original container. ** Medication that is not properly labeled and is unidentifiable will not be accepted.

In the case of inhaled medication for asthma, glucose monitoring and insulin injection for diabetes and Epi-Pen injection for allergic reactions: with the required physician documentation and parent consent, students may be allowed to carry equipment and medication to self-administer. Prior to self-administration, and subsequent to completion of the Self-Administration Checklist, the student must demonstrate competency in self-administration to the School Nurse and a medication plan must be in place. Ability to carry and self-administer any medication will be determined on an individual basis after the safety of the student and the school community is assessed by the School Nurse.

With the exception of emergency Epi-Pen administration (by trained faculty/staff), no one but the School Nurse, acting within the above protocol, may administer any medication to students. However, students who do not meet the criteria for self-administration may use inhalers, prescribed for the treatment of asthma, under staff supervision. Staff will log inhaler usage into health log.

If a student requires medication on a day when no nurse is available, parents will be requested to make their own arrangements for administration of their child’s medication.

* Examples of over-the-counter medications include Tylenol, Advil, Midol, and cough drops.
**Medication in plastic bags, plastic containers, etc.

ADDITION
SCHOOL PHYSICIAN’S STANDING ORDERS

Following the nurse’s assessment, students who demonstrate understanding of parameters of glucose levels and proficiency in self-testing for blood glucose may test in the classroom or other appropriate location. Student, parent and nurse will agree on the most appropriate manner of disposal of sharps, with regard to D.P.H. and OSHA guidelines. Manner of disposal will appear in the Individual Health Care Plan and/or Medication Administration Plan. Classroom glucose testing will require parental consent.

Staff

Meghan Paul R.N., B.S.N. Tel: 978-774-8590 x3052 Email: meghanpaul@danvers.org

Amanda Piraino, R.N. Tel: 978-774-8590 x3053 Email: amandapiraino@danvers.org

HRMS Nurses' Office Fax: 978-762-8332

Nursing Action

Following direct parent/guardian contact, the nurse:

Staff

Forms for Parents

Forms for Doctors

Resources

Contact

Schools

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