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Food Allergies: Building the Coordinated Care Plan
A coordinated care plan ensures that care is safe, reliable, continuous and effective.
Your child's IHP and 504 Plan provide the information, guidelines and standards that promote both your child's health and educational goals while avoiding unnecessary risk, restriction, stigma, illness and absences. It establishes a basis for ongoing teamwork, communication and evaluation.
An Individualized Health Plan (IHP) is your child's health security plan.
A licensed school nurse develops the IHP in collaboration with the student's parents in accordance with applicable laws and standards of practice for nursing in the school setting. (See the National Association of School Nurses www.nasn.org.)
An IHP is based on the student's physician's documentation of the student's diagnosis and recommendations for the student's health and safety in all locations and during all activities during the school day.
The school nurse ensures that the plan for comprehensive health management, safety and emergency response is safe, reliable, continuous and effective in all school settings and activities.
In addition, a 504 plan defines and coordinates roles, responsibilities, guidelines, policies and practices for all school staff to enable your child to access and benefit from all elements of his/her educational program.
The IHP and the 504 plan provides school personnel with the necessary information and authorizations to make appropriate decisions, the family's and staff's concerns are addressed, roles and responsibilities are clear. (What if......?)
Administrative/Staff discuss...
- How do school routines, policies, staff roles and responsibilities fit student's needs? What adjustments or changes are necessary?
- What is the teacher/administrator's/ school nurse's relationship with student's physician(s)? Who is the parent's school contact?
- How will medication/treatment be administered? health monitored?
- When should the teacher/school nurse call the parent or physician(s) with a question or a concern?
- What special emergency provisions are necessary? What planning should be done with local rescue team? nearest emergency treatment center?
- What places, materials, supplies, events or situations require special caution or guidelines to ensure preventive measures are implemented and that staff have appropriate knowledge of child's needs?
The Emergency Plan
- identify first responders, back ups, chain of command
- develop sequential action lists
- require full participation in drills
- post steps in every classroom.
- conduct drills at intervals throughout the year
- document the drills (who, what, where, when)
Medication - Epinephrine is available at all times.
- The school nurse will train all personnel to recognize the signs of an allergic reaction, to act promptly, and to summon emergency help.
- All personnel must know where an EpiPen is at all times, and how to use it.
Training, Updates
The school nurse documents training dates, topics, names of instructors, outlines or texts of presentations, tests or other means of verifying attendees understanding of the material, copies of all handouts, and signed attendance sheets. (Training is required for any change in staffing or school routine, and after each incident.)
Incident Documentation, Reports and Analysis
- name, date, time, place
- name of teacher present
- names of witnesses
- type of incident
- description of incident
- steps taken, treatment administered
Learn from Experience. Revise guidelines. Replace old copies!
Evaluation and Communication. (parent/school, school/child, child/parent, student/student).
Teachers: Precautions and Practical Issues/ Best Practices
- Recognize students' limited self-report skills.
- Develop and rehearse cues, signals, key words to ensure child can communicate needs.
- Develop Food Safety plan. Include monitoring of food products, guidelines for storage, hygiene, handwashing protocols
- Reminders for children and staff.
- Provide substitute snacks, emphasize healthy choices.
- Reduce temptation.
- Always give preference to the universal option.
- Food handling - develop, post and enforce guidelines to prevent cross contamination.
- Emphasize importance of personal hygiene (frequent hand washing) and environmental hygiene.
- Clarify expectations for supervision. Report conditions when appropriate vigilance by staff is compromised by overcrowding, activity demands, etc.
- Communicate expectations and win cooperation by educating peers, peers' parents, and auxiliary staff.
- Communicate confidentiality guidelines to staff and families.
- Know what to do in case of an emergency.
Educational links
- Restrictions are also opportunities for altruism, building peer support (students and parents), teaching peer refusal skills
- Orientation: emphasize optimism
- Ingredient substitutions presented as challenges, problem solving, categories, math sets
- Placement, seating, monitoring - structuring activities
- Labeling foods, color codes, substitutions (art, science) ingredients (math, science)
- Labeling safe areas - reminders (learning strategies, art)
- Health education goals
Respecting different food choices for a variety of reasons, i.e., allergies, diabetes, high blood pressure, medications, weight control, taste preferences, religion (kosher), cultural choices
Health and hygiene practices
washing hands
cleaning up spills
safe storage, latches and locks
fire safety, stranger danger
reporting illness and injury
Planning to Promote Developmentally Appropriate Self-Care
- speech and language development, group skills
- negotiation skills
- peer refusal skills
- ability to delay gratification
- consumer education skills
Promoting Resiliency and Self-esteem
- validating needs and feelings: you are the expert; everyone needs help once in a while; a lot of people have allergies; no one can eat anything they want all the time...
- respecting/acknowledging challenges - staff/students/community
- providing advance notice, process time, options/control
- having appropriate expectations (independence/dependence)
- trust building - believe the child
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