Where in the World do I find the laws for my state?

[Kaylee's Mommy]

I've been all over the internet.. I can't find what I want.. we are in NH.. I want to know if a nurse in the state can deligate the use of glucagon to someone else in the school.. and other laws.. so.. where do I go?:(

[MLH]

Try the New Hampshire Dept. of Education. That is where I found my stuff for NY. Good luck!

[Kaylee's Mommy]

I have looked under the state of nh for the school laws, and I have found the person to contact for questions regarding 504 plans (I kept that one in my favorites) but I want to see it written down too..

I'll keep looking, thanks:)

[Ellen]

At this website:
http://www.ed.state.nh.us/education/doe/organization/Instruction/HealthHIVAIDS/stateofnhresources.htm

NH diabetes school care plan
http://www.ed.state.nh.us/education/doe/organization/Instruction/HealthHIVAIDS/diabetes.pdf

At this page: http://www.ed.state.nh.us/education/laws/SchoolHealthServices.htm

Part Ed 311 (http://www.ed.state.nh.us/education/laws/SchoolHealthServices.htm) School Health Services
For more information (http://www.ed.state.nh.us/education/doe/organization/instruction/HealthHIVAIDS/SchoolHealthServices.htm)and questions contact Katherine Rannie krannie@ed.state.nh.us (krannie@ed.state.nh.us)

Ed 311.02 Medication During School Day .

(a) Any pupil, who is required to take during the school day a medication prescribed by a licensed physician, advanced registered nurse practitioner, licensed physician's assistant or dentist, shall be supervised in taking medication, by the school nurse who shall administer the medication.

(b) If the school nurse is not available the building principal or designee is permitted to assist students in taking required medications by:

(1) Making such medications available to the student as needed; and

(2) Observing the student as he/she takes or does not take his/her medication; or

(3) Recording the student did not take his/her medication.

(c) Upon receiving a request from the parent, guardian, or physician relative to a particular student's need for medication during school hours, the school nurse shall contact the parent, or guardian to discuss whether the student should remain at home, or whether the medication should be taken before, during, and/or after school. The nurse may also inquire about any other medical conditions requiring medications and any special side effects, contraindications and adverse reactions to be observed.

(d) Each local school board, with the advice of the school nurse(s) and school physician if available shall establish specific policy and procedures to give protection and controls to the matter of medications in schools.




(e) In order for prescription medications to be given at the school, the following shall occur:(1) The school nurse shall ensure that a written statement from the licensed prescriber containing the following be file in the student's health record: a. The student's name; b. The name and signature of the licensed prescriber and contact numbers; c. The name, route and dosage of medication; d. The frequency and time of medication administration or assistance; e. The date of the order; and f. A diagnosis, if not a violation of confidentiality; (2) The school nurse shall ensure that there is written authorization by the parent and/or guardian which contains: a. The parent and/or guardian's printed name and signature; b. A list of all medications the student is currently receiving, if not a violation of confidentiality or contrary to the request of the parent, guardian or student that such medication be documented; and c. Approval to have the school nurse administer the medication, the student to possess and self-administer and/or the principal or his designee assist the student with taking the medication; and (3) The school nurse shall ensure the authorization or other accessible documentation contains: a. The parent and/or guardian's home and emergency phone number(s); and b. Persons to be notified in case of a medication emergency in addition to the parent or guardian and licensed prescriber. (f) All prescribed injectable medication shall be administered by a registered nurse or others who are qualified under Chapter 326-B, Nurse Practice Act. Asthma inhalants and epinephrine auto injectors may be possessed and self-administered by a student.

(g) The school nurse shall develop a system of documenting and communicating significant observations relating to prescriptions, medication's adverse reactions, and other harmful effects, to the child's parent or guardian and/or licensed prescriber.

(h) The school nurse shall develop and implement procedures regarding receipt and safe storage of prescription medications.

(i) A parent, guardian or a parent/guardian-designated, responsible adult shall deliver all medication to be administered by school personnel to the school nurse or other responsible person designated by the school nurse as follows:

(1) The prescription medication shall be in a pharmacy or manufacturer labeled container; (2) The school nurse or other responsible person receiving the prescription medication shall document the quantity of the prescription medication delivered; and (3) The medication may be delivered by other adult(s) , provided, that the nurse is notified in advance by the parent or guardian of the delivery and the quantity of prescription medication being delivered to school is specified. (j) All medications shall be stored in their original pharmacy or manufacturer labeled containers and in such manner as to render them safe and prevent loss of efficacy. A single dose of medication may be transferred from this container to a newly labeled container for the purposes of field trips or school sponsored activities.

cont. on next post

[Ellen]

cont.

(k) All medication to be administered by the school nurse shall be kept in a securely-locked cabinet which is kept locked except when opened to obtain medications. Medications requiring refrigeration shall be stored in a locked box in a refrigerator maintained at temperatures of 38 degrees to 42 degrees. Emergency medications may be secured in other locations readily accessible only to those with authorization.

(l) No more than a 30-school day supply of the prescription for a student shall be stored at the school.

(m) Non-prescription medication shall be given only with the written authorization of the parent and/or guardian and if this is in accordance with school policy .

Ed 311.03 Physical Examination of Students . Schools shall accept documentation of a student's physical examination, provided:

(a) The examination has been performed within the past year; or

(b) If an examination has not been performed within the past year, the school shall accept documentation of an appointment for a physical examination with a licensed physician, advanced registered nurse practitioner or physician's assistant within a time determined by the school district for conditional enrollment.

[Kaylee's Mommy]

Thanks!

I had found the stuff that you posted Ellen, thanks.. I wish they'd put it in plan english LOL..

"f) All prescribed injectable medication shall be administered by a registered nurse or others who are qualified under Chapter 326-B, Nurse Practice Act. "

so, If I'm reading this right, only a nurse and registered nurse/dr. or such can give Kaylee her insulin injections, and glucagon?? I went and looked at the Nurse Practice Act and holy moly it was long.. and half of it was legal mumbo jumbo..

thanks! your a wealth of info:)

[Ellen]

I think you need to read what your local school board has in place - in our state it goes by the county.

I just saw this - you may have seen it already and it was updated in 2003

http://www.nh.gov/nursing/practice/SchoolNursing.htm

Can school nurses delegate the task of administering insulin and glucagon?
For nurses employed in public schools, the NHDOE administrative rule Ed 311.02 states that "All prescribed injectable medication shall be administered by a registered nurse or others who are qualified under the Chapter 326-B, Nurse Practice Act".

If you are employed as a school nurse for a private school, according to NHBON rule NUR 404.06 (b), any nurse who delegates a task must take into account factors such as the stability of the client's situation and whether the nursing needs of the client are changing. This rule greatly narrows the option of delegating administering insulin and glucagon as the person performing the injection must make clinical judgments about dosages and related issues. It is important to remember that the nurse must always act in accordance with the policies and procedures of his/her employer.

[Kaylee's Mommy]

Thanks Ellen, I've been searching for this!! So, according to the Nurse practice Act, the person HAS to have some sort of nursing liscense.. so the nurse may NOT deligate it to a teacher or other staff member.. am I correct?

I was reading the other questions, and it clearly said yes, the nurse may deligate, except for this one guestion.. so my guess is NO.. so there for The school that Kaylee will be going to needs a full time nurse? I know they had one other child on a pump last year, but she was also in the 4th grade, did most of her own care, and her mother volunteered at the school.. so they school got out of A LOT of stuff.. but Kaylee will be going into Kingergarten NEXT year.. and I feel she needs someone there.. at first I didn't.. I thought someone else could do it. but I really feel that a qualified nurse needs to be there.. my DH's cousin is a nurse in Washington state, she told me to look these things up because she is NOT allowed to deligate the insulin and glugagon to anyone, unless its another nurse.. she also said that they can choose to bus her to another area school that DOES have a full time nurse.. I don't know how the laws very from state to state, but I tried to beg her to come out this way instead of going back to Washington LOL.. :)

ahh.. I just found this
Question: Can public school nurses delegate the administration of epinephrine auto injectors to school staff or volunteers when a child has a prescription for this medication in the event that an RN or LPN is not available?

Background: Under the authority granted to the Board of Nursing, they have adopted rules that permit delegation under certain circumstances, including the delegation of injectables. However, the Department of Education rules for nurses employed in school districts indicate that "all prescribed injectable medication shall be administered by a registered nurse or others who are qualified under the Chapter 326-B, Nurse Practice Act" (Ed 311.02). Therefore, according to state policy, public school nurses shall not delegate the administration of epinephrine.


so, according to this, they may not delegate to anyone the admistrating of insulin and glucagon.. if they can't do an epi pen, then they can't do insulin or glucagon.. now.. does it matter that she's actually on a pump? its still giving insulin.. but they don't actually have to do the injections..

[Ellen]

Read this - I would make a case to the local school board to allow the same for glucagon. If it hasn't been done already, you may have to lead the campaign to make it law.

http://www.ed.state.nh.us/education/doe/organization/instruction/HealthHIVAIDS/schoolhealthserviceepinephrineautoinjectoradm.htm

Recommendation for Delegating Epinephrine Auto Injector Administration

Question: Can public school nurses delegate the administration of epinephrine auto injectors to school staff or volunteers when a child has a prescription for this medication in the event that an RN or LPN is not available?
Background: Under the authority granted to the Board of Nursing, they have adopted rules that permit delegation under certain circumstances, including the delegation of injectables. However, the Department of Education rules for nurses employed in school districts indicate that "all prescribed injectable medication shall be administered by a registered nurse or others who are qualified under the Chapter 326-B, Nurse Practice Act" (Ed 311.02). Therefore, according to state policy, public school nurses shall not delegate the administration of epinephrine.
Recommendation: While the Department of Education does not provide legal advice, we are not aware of any law that prohibits parents from delegating their care responsibilities to other people taking care of their children. As long as it is consistent with local school board policy, a parent may delegate the administration of epinephrine auto injectors to their child to a responsible and willing school official, teacher, staff, aide, or volunteer.
Such authorization should be obtained in writing. The parent may train the person(s) and describe circumstances for administration. In addition, school nurses may provide school personnel with training and support regarding recognition of anaphylaxis and epinephrine auto injector administration. When such training is provided by school nurses, it must emphasize that school personnel can only administer epinephrine auto injectors when the parent delegates this activity to school personnel.

In the event that parents are not willing or able to delegate the administration of injectables, there should be a meeting and/or discussion with the parent(s), school nurse, teacher(s) and other key school personnel to determine who may appropriately monitor (and administer as needed) epinephrine auto injectables to students. The school district is responsible for providing whatever resources are necessary (to include appropriately trained personnel) to ensure that students with a physical or mental impairment that substantially limits a major life activity (e.g., caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, working, and learning) can participate fully in all appropriate classes, courses, programs, field trips, and other extra-curricular activities with their classmates.
The Department of Education is available to provide technical assistance to local schools/districts to ensure that the necessary resources, personnel, procedures, and contingency plans (e.g., medical protocols) are in place. Questions and/or concerns may be directed to Katherine Rannie and/or Robert Wells at the address(es) below.

Katherine Rannie, RN, MSc
School Health Services Consultant
NH State Department of Education
101 Pleasant St., Concord, NH, 03301
Phone: (603) 271-3891
Fax: (603) 271-1953
Email: krannie@ed.state.nh.us (krannie@ed.state.nh.us)

Robert Wells, Ph.D.
Education Consultant
IDEA / SECTION 504/ADA / GIFTED EDUCATION
Bureau of Special Education
New Hampshire State Department of Education
101 Pleasant Street
Concord , NH 03301 -3860
Tel: 603-271-1536
Fax: 603-271-1953
rwells@ed.state.nh.us (rwells@ed.state.nh.us)

[Kaylee's Mommy]

HAHA, I have found that same thing.. and by my understanding, if they can't deligate (the nurse, not me) the use of the epi pens, insulin and glucagon, and I DON"T want to deligate anyone else.. they'd have to have a nurse there all the time? I actually emailed the lady at the end of that paragraph.. not sure if I'll hear back from her..

I am actually surprised to find more info on the epi pen than I am on the use of insulin and glucagon..

how do you interpret those statements (assuming I'm not WILLING to delegate the job to anyone else.. )..

I'm so glad your up late:)

and this is what I find on their website.. give me nothing :rolleyes:
Medication



Proper form must be filled out in order for school to administer ANY medication (prescription or over the counter).


lol. big help!:)

Kim

[Kaylee's Mommy]

now I'm kind of irritated, I've been looking for the policies for HOURS now.. trying to find something specific to our local school district.. and I find at the END of their sick day/emergency policy stuff, diabetes, AFTER bee stings, bites, animal (and human:eek: LOL), ear aches, tooth ache, throwing up, bit lip, knocked out tooth, bloody nose... .. on about the LAST page of their pamplet.. their policy for low blood sugar.. they can't even get it right..says if they are unconcious to not do anything, send someone to call 911.. ummm H E L L O GLUCAGON.. I can see I'm going to have to straighten this school system out!! :rolleyes: LOL