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The Iowa school nurse is a registered nurse holding current licensure recognized by the Iowa board of nursing who practices in the school setting to promote and protect the health of the school population using knowledge from the nursing, social, and public health sciences.
The school nurse ensures students receive health services for physical and mental health conditions that permit school attendance so they may equally access education as their peers and assist parents or legal guardians to reasonably meet compulsory regulations of attendance for their child pursuant to Iowa Code 299.
All health services provided to students that constitute nursing or any activity representing nursing in the school setting is a regulatory responsibility of the state board of nursing. The student, as a healthcare consumer, has the right to nursing care that meets the legal standards of healthcare regardless of the practice setting (Nation Council of State Boards of Nursing [NCSBN], 2005). The school nurse retains accountability to practice nursing following regulations from the board of nursing to provide consumer rights of protection when needing nursing care and safe parameters to work (Iowa Administration Code 655 Chapter 6).
“The school nurse is the leader in the school community to oversee health policies and programs. The school nurse serves in a pivotal role to provide expertise and oversight to the provision of health services and promotion of health education. Using clinical knowledge and judgment, the school nurse provides health care to students and staff, performs health screenings and coordinates referrals for students to the medical home or private healthcare provider. The school nurse serves as a liaison between school personnel, family, community, and healthcare providers to advocate for the student’s health and health of the school environment” (American Nurses Association & National Association of School Nurses [ANA & NASN], 2011).
Iowa law requires any person who regularly examines, attends, counsels, or treats adults or children in Iowa to complete the training requirements on abuse education and/or dependent adult abuse using a course that has been approved by the Iowa Department of Public Health to maintain licensure (Iowa Board of Nursing [IBON]).
Following the completion of this 3-hour, approved training (#2032) and evaluation (Survey Monkey), registrants will receive a certificate of training completion via email that will be good for 5 years from the date of the training.
Practice and Regulation of School Nurses - This 2014-08-19 Memorandum addresses the scope of practice allowed of the Licensed Practical Nurse (LPN), Registered Nurse (RN), and Advanced Registered Nurse Practitioner (ARNP) in Iowa schools.
Intersection 504 and IHP - The memorandum is to remind school officials and school nurses about the relationship between Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794 (as well as the Americans with Disabilities Act) and Individualized Health Plans as of March 11, 2015.
Health Requirement: The statewide Voluntary Preschool Program for four year old learners was established in May, 2007 (Iowa Code Chapter 256c). Programs that receive funding from the Iowa Department of Education follow Iowa Quality Preschool Program Standards [IQPPS] to meet Program Standard 5.1-Health pursuant to the Department of Human Services [DHS] IAC 441 Chapter 109
Requirements for Program Standard 5.1 can be located in the IQPPS Guidance on page 12.
Vision Student Card: Schools are required to give all enrolling preschool students’ parents or a legal guardian a student vision card to all registering kindergarten students pursuant to IAC 280.7A. To order Student Vision Cards, please go to: iowaoptometry.org
Immunization Requirement: An immunization record is required to enroll in Kindergarten pursuant to Iowa Department of Public Health [IDPH] 641 Chapter 7. The school nurse collaborates with local public health, whom audits admitting official’s compliance with IAC 641 Chapter 7. To access the administrative rules, the certificate of immunization form, provision form, and exemption forms go to: Iowa Immunization Requirements
To access the Immunization Registry Information System [IRIS] to track immunization records for Iowa students, please go to: Immunization Registry Information System
Dental Screening Requirement: All children enrolled in Kindergarten are required to have a dental screening pursuant to IDPH 641 Chapter 51. The school nurse collaborates with regional public health designee, I-Smile Coordinators, whom audit the admitting school official’s compliance with IAC 641 Chapter 51. There is no school exclusion with this mandated health screening. A school nurse may complete the Kindergarten Dental Screening. To access the certificate of dental screening form, exemption form, dental screening flyer, and link to find your community’s regional I smile Coordinator go to: School Dental Screenings
Lead Screening Requirement: All children enrolling in Kindergarten are required to have at least one lead test. The school nurse collaborates with school personnel to complete a Kindergarten excel spreadsheet containing enrolling student demographic information that is returned by email to IDPH that is compared to the state Lead database. IDPH will audit the list of enrolling kindergarten students and return to the school a list of students whom did not meet the requirement and school admitting official’s compliance with IAC 641 Chapter 67. To access the kindergarten spreadsheet, instructions for data entry, the administrative rules, certificate for exemption, and parent resources go to: Mandatory Lead Testing Program
Vision Screening Requirements: Each public or accredited nonpublic school shall forward to the Iowa Department of Public Health evidence of each Kindergartner’s valid vision screening performed no earlier than 1 year prior to enrollment and no more than 6 months after the date of the child’s enrollment. The school nurse can collaborate with community providers or conduct the screening themselves. School nurses may enter the screening results into the IRIS to provide proof that school officials are in compliance with IAC 641 Chapter 52 or by mail/fax. To access Vision training resources, certificate of vision screening, IRIS enrollment information at: Immunization Registry Information System.
Schools are also required to give a student vision card to all registering kindergarten students pursuant to IAC 280.7A. To order Student Vision Cards, please go to: iowaoptometry.org
Vision Screening Requirements: Each public or accredited nonpublic school shall forward to the Iowa Department of Public Health evidence of each Third Grader’s valid vision screening performed no earlier than 1 year prior to enrollment and no more than 6 months after the date of the child’s enrollment. The school nurse can collaborate with community providers or conduct the screening themselves. School nurses may enter the screening results into the IRIS to provide proof that school officials are in compliance with IAC 641 Chapter 52 or by mail/fax. To access Vision training resources, certificate of vision screening, IRIS enrollment information at: Immunization Registry Information System.
Tetanus, Diphtheria, Pertussis (Tdap) Vaccination Requirement: Beginning the 2013-2014 school year and thereafter, students entering 7th grade and above if born on or after September 15, 2000, shall have a one-time dose of tetanus, diphtheria, acellular pertussis (Tdap) vaccine.
Dental Screening Requirement: All children enrolled in Kindergarten are required to have a dental screening pursuant to IDPH 641 Chapter 51. The school nurse collaborates with regional public health designee, I-Smile Coordinators, whom audit the admitting school official’s compliance with IAC 641 Chapter 51. There is no school exclusion with this mandated health screening. To access the certificate of dental screening form, exemption form, dental screening flyer, and link to find your community’s regional I smile Coordinator go to: School Dental Screenings
Abuse - Sample Policy on Identifying and Reporting Child Abuse and Sample Policy and Rules on Procedures for Investigating Allegations of Abuse of Students by School Employees (Chapter 102 Level I Investigator Manual) - The manual deals with mandatory reporting of suspected child abuse to DHS and with reporting and investigating alleged abuse of students by school employees.
Allergies - The Food Allergy and Anaphylaxis Management Act, a part of the food safety act (FAAMA), passed by the U.S. Congress and signed into law, January 2011, requires the U.S. Secretary of Health and Human Services to develop and make available to schools a voluntary policy to manage the risk of food allergy and anaphylaxis in schools and provide for school-based food allergy management incentive grants to support implementation of food allergy management guidelines in public schools. The Food Allergy and Anaphylaxis Network’s (FAAN) School Food Allergy Program and the National School Boards Association, Safe at School and Ready to Learn: A Comprehensive Policy Guide for Protecting Students with Life-Threatening Food Allergies are recommended for use in Iowa schools.
Allergies - Allergy resources and recommendations include a school team identifies student needs and may provide an individualized health plan, emergency plan, allergy action plan, and 504 plan as appropriate to provide the student with an allergy safe and healthy school environment. The Peanut Allergy Institute recommendation, ‘Concern over peanuts in public places has led to some schools calling for peanut bans. However, bans, which can never be fully enforced, may lead to a false sense of security and put the child at greater risk. There is no evidence supporting the effectiveness of this practice. A more effective solution is to educate students, schools, and foodservice professionals and set up a food allergy management plan. When it comes to school peanut bans, FAAN does not advocate them. They recommend parents, doctors and school officials work together to develop a plan that best fits their situation’.
Americans with Disabilities Act Amendments Act (ADAAA) 2008 and the Iowa School Nurse - The ADAAA, effective January 1, 2009, impacts school nursing. The document and presentation provide information regarding the ADAAA law and its applications to school nursing.
Bed Bugs - While an annoyance, bed bugs have not been found to carry disease; however have been found to cause panic. With the increased number of reported cases of bed bugs in our communities, it is recommended schools make available to the community information on bed bugs and the school plan.
Bloodborne Pathogens: OSHA-Occupational Exposure - The United States Department of Labor, Occupational Safety and Health Act (OSHA), Occupational Exposure to Bloodborne Pathogens Regulations and Standards, adopted by the Iowa Division of Labor, Occupational Safety and Health Bureau purpose is to end and reduce employee exposure to blood and other potentially infectious materials. The laws require Iowa schools and education agencies, as employers, to develop an occupational exposure to bloodborne pathogens program.
Clinical Laboratory Improvement Amendments (CLIA-Federal law U.S.C. 42 §263a, 42CFR Part 493) - Requires a certificate of waiver for schools to examine materials from the human body to provide information for diagnosis, prevention, or treatment of any disease, impairment, or assessment of health (for example, blood glucose, urine testing, throat swab). The law applies to a school nurse or other qualified school personnel, following health care provider orders and manufacturer's instructions, administering these tests at school and in school activities. The Iowa Department of Education has a CLIA Certificate of Waiver to meet the requirement for each Iowa school under the jurisdiction of the Iowa Department of Education to carry out these tests. Additional CLIA information and good laboratory practices.
Concussions and other Brain Injuries - Protection of Students Key provisions of the new Iowa 'Brain Injury' law, effective fall 2011, include:
- Annually, every student (grades 7-12) and their parent/guardian must receive, sign, and return a concussion and brain injury information sheet signatures before student may participate in interscholastic sports, cheerleading, and dance in any way (practice or competition).
- Students must be immediately removed from participation (practice or competition) in an extracurricular interscholastic sport, cheerleading, dance if coach or official observes signs, symptoms, or behaviors consistent with concussion or brain injury.
- The student, to return to participation (practice or competition), provides the school with a signed evaluation/clearance to return by a licensed health care provider trained in the evaluation and management of concussions and other brain injuries.
The Iowa High School Athletic Association (IHSAA) and Iowa Girls High School Athletic Union (IGHSAU) developed guides and forms located on their websites including signature sheet, "Heads Up: Concussion in High School Sports." Use this form beginning fall 2011 for interscholastic sports, cheerleading, and dance. Students cannot practice or compete until this form is signed and returned to school. The parents/guardians keep the concussion and brain injury information sheet for reference and return the sheet signature portion to school. The acknowledgement of receipt statement may be included as part of the general forms parents and students sign.
The IHSAA and IGHSAU Concussion Management Protocol complies with the legislation. The 'Return to Participation Protocol Following a Concussion' is required to be on file at school signed by a "licensed health care provider" (a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board) for the student to return to practice or competition.
The IHSAA and IGHSAU websites link to a free, 20-minute concussion course. Mick Koester MD hosts the recommended course for school administrators, coaches, and sports officials. Contact: Alan Beste, Assistant Executive Director, IHSAA, PO Box 10, Boone, IA 50036-0010, 515-432-2011.
Delegation and the Iowa School Nurse - Iowa school nurse delegation, decision making, and documentation.
Emergency-School Health Planning - The emergency school health plan in each school building provides for a safe and healthy learning environment for students and school personnel considering the total and individual population needs.
Evaluation for the School Nurse Example - Provides a side by side listing of the Teaching Standards and Criteria, Nursing Standards, School Nursing Standards, and School Nurse Competencies for School Nurses evaluated on the teacher evaluation.
Exclusion from School Due to Illness - Basic criteria/planning for student illness temporary exclusion from school.
Family Educational Rights and Privacy Act (FERPA) - The School Nurse practices FERPA to protect the privacy of student health information. The following presentation and transcript reviews FERPA definitions, consent exceptions, relationship to other laws, notifications, education program, and resources:
Iowa Students with Special Health Needs - Information on Students with Special Health Needs including laws, school nurse and school health services assessment and planning, and service implementation in school and school activities.
Connect pro meeting: Iowa Students with Special Health Needs, 56 minutes at (link)
- Number of Public LEA School Nurses and AEA Special Education Nurses in selected years.
Guidelines for the Management of Chronic Conditions in Iowa Schools Guidelines for the Management of Chronic Conditions in Iowa Schools
Individual Health Plan (IHP) - Iowa Student Individual Health Plan: School Nurse Interpretive Statement - Detailing the student's needs for school nurse and school health services and example IHP form.
Individualized Education Program (IEP) - Statewide AEA Special Education Procedures Manual and AEA Special Education Documentation Guide
Influenza The Iowa Department of Public Health (IDPH) information for schools and community colleges to assist in influenza prevention and planning.
Laws - Iowa School Health Legal Reference Summaries - The Law summaries are not a substitute for the actual laws. For further clarification, refer to the legal references full text.
Licensed Practical Nurse in Iowa Schools - Iowa School Health Services and the Licensed Practical Nurse in the School - Lists the laws on LPN Practice in Iowa Schools.
Mailing List is a communication tool for Iowa School Nurses. The mailing list is the Department of Education link with school nurses allowing the Department and Nurses to communicate via email messages. Iowa School Nurses can use the mailing list to request information, advice, share news and initiatives, and receive news. School nurses joining the mailing list add their email address to the online school nurse mailing list and can send messages to all members at any time. When messages are posted, the message automatically goes to everyone on the list. Joining the mailing list is free.
Medicaid Presumptive Eligibility - Medicaid Qualified Entity (QE) for presumptive eligibility. The school nurse, in a Medicaid approved provider school, can become a QE to make the presumptive determination about a child's Medicaid eligibility based on the family's income self declaration statement for the child to receive immediate medical care. More in Informational letter 978 (http://www.ime.state.ia.us/docs/978_PresumptiveEligibilityforChildren.pdf).
Medication Administration and Management
- Medication Administration Course - This basic online Iowa medication administration course is available to unlicensed school personnel, by the Iowa Department of Education, whom school nurses have requested to certify and delegate medication administration. A blank certificate will be generated when an individual obtains 100% completion and passing scores on all modules/quizzes. The certificate will be valid after a hands on skills check to demonstrate competency in medication administration is completed and documented by the school nurse on the certificate. To access the course please go to: http://training.aeapdonline.org and fill in all required fields. If you do not know your district password, contact your school administrator or email to: firstname.lastname@example.org.
- Student Medication Administration Record Sample
- Medication Error Report Sample Form
- Iowa School Medication Waste Guidance - Created in collaboration with the Iowa Department of Education, Iowa Department of Natural Resources, and United States Department of Justice’s Drug Enforcement Administration, this document provides clear and accurate information regarding medication disposal for public school districts and accredited nonpublic schools. The guidance for safe disposal of medications and infectious waste can prevent drug diversion and protect the environment.
- Medication Management in Iowa Schools Manual - Resources to support the health and safety of students and staff. Contents include laws, policies, procedures for medication administration, roles, responsibilities, education for qualified designated personnel, example forms, glossary, resources, and references.
- Medication Administration Toolkit - Contains resources to build a skills observation kit, skills checklist, special checklists, example forms for assistive personnel documentation, training-supervision-monitoring record, course evaluation, and emergency plan.
- Accessing Iowa Mental Health Services - Serving Children and Youth in their Homes, Schools, and Communities. Laura Larkin, LMSW, Program Planner, Division of Mental Health and Disability Services, Iowa Department of Human Services. January 2011, webinar contents: Identification of knowledge or service gaps; Review of national and state data on children’s mental health needs; Overview of outpatient, wraparound, system of care, remedial, and children’s mental health waiver programs; and Service funding.
- Iowa Outpatient Mental Health Services - Designated County Community Mental Health Centers and Waiver Mental Health Providers.
NEWS: School Nurse and School Health Services - Iowa Department of Education newsletter.
- August 2015
- May 2015
- February 2015
- November 2014
- August 2014
- May 2014
- February 2014
- April 2012
- January 2012
- August 2011
School Health Council
Guide to Community-School Health Councils: Promoting Healthy Students, Schools, and Communities - This presentation describes an effective structure and process for partnerships between the community and school to promote and support the improvement of student health and how to use the community-school health council to meet the health needs of all the differing school populations.
School Health Records
- Student Cumulative Record Retention - List of ideas on the length of maintaining health records.
- School Nurse Special Issue Documentation - School Nurse documentation of sensitive health information.
School Screenings - The Federal Protection of Pupil Rights Amendment (PPRA) and State requirements and interpretation govern the provision of school screenings.
Status Epilepticus and Midazolam - Provides status epilepticus information including definition, etiology, morbidity, mortality, prevention, and treatment. Presented by Dr. Charuta Joshi, Clinical Associate Professor, Division of Pediatric Neurology, UIHC, May 5, 2009.
Promoting Healthy Youth, Schools and Communities: A Guide to Community-School Health Advisory Councils - Guidance for schools planning to form a Community-School Health Advisory Council to promote coordinated school health.
Center for Disabilities and Development - University of Iowa Hospitals and Clinics resource for healthcare services, training, research, and information for people with disabilities. Consulting services and a Disability Resource Library are available for both professionals and families.
hawk-i - Information on the Iowa health insurance for uninsured children.
Health Education - Information and guides for health education.
Iowa School Nurse Organization - Professional Organization supporting school nurses in the delivery of health services to improve student's health and academic success.
Medline Plus - Information on prescription and over the counter medications and links to other health topics.
School Health - School Health programs promote health and healthy behaviors in the lives of students, staff, families, and the community.
Special Dietary Needs - US Department of Agriculture. (2001). Accommodating Children with Special Dietary Needs in the School Nutrition Programs: Guidance for School Food Services Staff. USDA, Washington, DC.