Nurse

Parent/Guardian Medical Guidelines for Rolling Hills Elementary School Clinic 

Safety, Respect, & Responsibility

CCSD Health Services Website

School Accidents or Illnesses 

The school nurse provides emergency care and emotional support when a student has an accident or becomes ill during school hours. However, if a student meets the exclusions guidelines below, requires provider care or a restful home environment, it is critical that they stay home that day or they are picked up from the clinic as soon as possible if they are already in school. Therefore, changes in emergency contact information should be updated as soon as possible in the parent on-line form located on the my.cherrycreekschools.org website.  Accurate/current phone numbers in the correct priority order are essential.

Absences

School attendance is important for a successful student. Nevertheless, the exclusion guidelines below can help ensure a safer environment for students. It can be difficult deciding when a child is too ill to attend classes.  Please remember, the best way to prevent the spread of infection is through good hand washing and avoiding touching your T zone (eyes, nose, mouth).  

Exclusion Guidelines for Children and Staff 

Excluding (defined as keeping a child from attending the child care or school setting) a child who has an infectious disease from attending child care or school may decrease the spread of illness to others. The decision to exclude is typically based on the disease, and should be made in conjunction with the school nurse or the child care health consultant, the state or local public health agency, health care professionals, and/or parents/guardians.

In situations in which a child does not have a diagnosed disease/condition, but has signs or symptoms indicative of a potentially infectious disease, exclusion may also be warranted. Generally, if any of the following conditions apply, exclusion from child care or school should be considered:

• The child does not feel well enough to participate comfortably in usual activities.
• The child requires more care than the child care or school personnel are able to provide.
• The child is ill with a potentially contagious illness, and exclusion is recommended by a health care provider, the state or local public health agency, or these guidelines.
• The child has signs or symptoms of a possible severe illness, such as trouble breathing. 

In cases in which unvaccinated children are exposed to a vaccine-preventable disease (such as measles, mumps, rubella, and pertussis), the state or local public health agency should be consulted in order to determine if exclusion of unvaccinated children is necessary.

The guidelines below list common symptoms that could possibly be related to an infectious disease. The chart indicates whether it is recommended to exclude a child exhibiting a particular symptom from child care or school. If a child is excluded based on symptoms (and not a diagnosed illness), the child should be allowed to return to child care or school once symptoms have subsided, or a health care provider clears the child or determines the illness is not communicable, provided that the child can participate in routine activities.

 
Symptom Exclusion Guidelines

• Cough - Exclusion is recommended if the child is experiencing severe, uncontrolled coughing or wheezing, having difficulty breathing, becoming red or blue in the face, making high-pitched whooping sounds after coughing, or vomiting after coughing.
• Diarrhea, defined as stools that are more frequent and looser than usual - Exclusion is recommended if any of the following conditions apply: the child has other symptoms along with the diarrhea, such as vomiting, fever, abdominal pain, jaundice, etc., the diarrhea cannot be contained in a toilet, there is blood or mucous in the stool, or the child is in diapers. 
• Earache  - No exclusion is necessary.
• Fever, defined as a temperature over 101 degrees F orally - No exclusion necessary, UNLESS the child has symptoms in addition to the fever, such as a rash, sore throat, vomiting, diarrhea, behavior changes, stiff neck, difficulty breathing, etc.
• Headache - No exclusion is necessary, unless the headache is severe and accompanied by additional symptoms, like vision problems, stiff neck, or behavioral changes.
• Jaundice or unusual color of the skin, eyes, stool, or urine - Exclusion is recommended until a medical exam indicates the child does not have hepatitis A.
• Mouth Sores - Exclusion is recommended if the child is drooling uncontrollably.
• Rash - Exclusion is recommended if the child has symptoms in addition to the rash, such as behavior change, fever, joint pain, or bruising not associated with injury, or if the rash is oozing or causes open wounds. Contact the school nurse for additional information on rashes.
• Stomach Ache or Abdominal Pain - Exclusion is recommended if the pain is severe, if the pain appears after an injury, or if the child had symptoms in addition to the stomach ache, such as vomiting, fever, diarrhea, jaundice, etc.
• Swollen Glands - Exclusion is recommended if the child has symptoms in addition to the swollen glands, such as difficulty breathing or swallowing, fever, etc.
• Vomiting - Exclusion is recommended if the child has vomited more than two times in 24 hours, if the vomit appears bloody, if the child has a recent head injury, or if the child has symptoms in addition to the vomiting, such as fever, diarrhea, etc.

Medication Policy

Medication must be in the original container appropriately labeled from the pharmacy, and should be brought to the clinic by a parent accompanied by the prescription medication permission form. This form requires a health provider’s signature as well as a parent’s/guardian’s signature and should be dated. If your child needs a non-prescription medication on a schedule, you will be responsible for providing this medication to the clinic. Non-prescription medication must be brought in the original container and will be administered if accompanied by an over-the-counter medication form signed by a parent/guardian.

Allergies and Asthma

If your child has asthma, an allergy, or other medical condition, please note this when registering your child in the on-line Parent Forms.  If the student requires an Allergy & Anaphylaxis Action Plan Form, it must be signed and dated by a health provider and parent/guardian. This form is required when administering an antihistamine and/or epinephrine/EpiPen for mild to severe symptoms. Colorado State Asthma Care Plan forms must accompany measured dose inhalers (MDIs) for those diagnosed with asthma. These Care Plans must be signed and dated by a healthcare provider and a parent/guardian, too.

Medication Forms and Immunization Information

Forms can be found at the CCSD Health Services website.  Medical forms and immunization information can be found towards the bottom of the Health Services page.  Please contact me if you have any questions or concerns.

5th Grade Students with Measured Dose Inhalers (MDIs)

One of the health goals for 5th grade students with MDIs is preparing them to carry their inhalers when entering middle school. The nurse will be happy to work with the parents/guardians and student in order to achieve this goal.

Valerie J. Hines, BSN, RN, NCSN
Rolling Hills School Nurse
Supporting Student Success with Innovative School-Based Health Services
vhines@cherrycreekschools.org
Direct Line: 720-886-3405
Fax Line: 720-886-3488