Health Office
A student’s health status is directly related to his or her ability to learn. Children with unmet health needs have a difficult time engaging in the educational process. The school nurse supports student success by providing health care through assessment, intervention, and follow-up for all children within the school setting, addressing the physical, mental, emotional, and social health needs of students and supporting their achievement in the learning process.
Health Records
The school nurse is responsible for maintaining health records for each student. Information concerning the following must be given to the nurse:
- Physical examination record prior to enrollment in school, before entry into middle school, and annually prior to participation on a school athletic team (JLCA).
- Record of illness, injury, hospitalization, allergy and / or special needs
- Results of vision or hearing tests that are done outside the school setting
- Immunization record satisfying current NH statute (required at entry by RSA 200:38)
- Transfer students must provide a copy of the cumulative health record from their previous school
Immunizations
All school-aged children must have immunization records on fi le in the health office. All students who have less than the minimum requirement must have either a medical or religious exemption, or a physician-approved schedule for reaching those requirements.
Students who have not been fully immunized will not be in compliance with the law. Failure to comply with this provision may result in exclusion from school for the child. A child may be “conditionally” enrolled when the parent/guardian provides documentation of at least one dose for each required vaccine AND the appointment date for the next dose of required vaccine. The appointment date shall serve as the suspension date. If the parent/guardian fails to keep the scheduled appointment, and suspension shall continue until acceptable immunization status is attained.
The following outlines the New Hampshire School Immunization Requirements for 2024-2025:
Vaccination and Requirements
Vaccination | Requirements |
---|---|
Diphtheria, Tetanus, and Pertussis DTaP DT/DTP Tdap/Td |
6 years and under: 4 or 5 doses with the last dose given on or after the 4th birthday 7 years and older: 3, 4, or 5 doses with the last dose given on or after the 4th birthday Grades 7-12: 1 dose of Tdap is required for entry into 7th grade |
Polio | Grades K-8: 3 or 4 doses with the last dose given on or after the 4th birthday and the last 2 doses separated by 6 months or more |
Hepatitis B | Grades K-12: 3 doses at acceptable intervals |
Measles, Mumps and Rubella, MMR | Grades K-12: 2 doses; the first dose must be administered on or after the 1st birthday |
Varicella (Chicken Pox) | Grades K-11: 2 doses with the first dose administered on or after the 1st birthday OR laboratory confirmation of immunity. |
Medications
All medications are to be administered or assisted with under the supervision of the school nurse, designated UAP (Unlicensed Assistive Personnel), or principal as prescribed. Over the counter medications will be administered as recommended by the manufacturer unless the student’s physician, APRN, PA, or dentist has provided different instructions.
(JLCD).
Parent/guardian authorization is required for all medication administered to a student during the school day. In addition to parent/guardian authorization, for any prescription medication from a licensed physician, APRN, PA or dentist, there must be written documentation from the prescriber which specifies the student, medication, dose, route, time, frequency, and purpose. The school day includes any day, afternoon, or evening hours when the student is attending a school or other school sponsored activity. Medications must be renewed each school with the appropriate documentation.
A parent/guardian or designated responsible adult shall deliver all medications to the school nurse. The medication must be in the original pharmacy container. The label shall include the student’s name, dose of medication, route, and time of administration, and any specific instructions regarding administration. Over the counter medications are to be in their original manufacturer’s container.
Students may carry and self-administer epinephrine auto injectors and asthma inhalers with authorization in writing of both the parent/guardian and the prescriber (RSA 200:42-200:47). Any student who has to use an epinephrine auto injector shall obtain help from the nearest supervising adult. A call to 911 will activate emergency services for further care of the student. The nurse may delegate authority to students with diabetes to self-carry and self-administer glucose tabs and insulin with parent/guardian and prescriber authorization. Students shall not possess any medication, with the exceptions of epinephrine, inhalers, or diabetes medications. Students shall not share any medication.
Health Screenings
Height, weight, vision, hearing, and spinal (scoliosis) screenings may be done for certain grades by the Nurse, according to the recommendations of the National Association of School Nurses (NASN), to determine if a child needs to be referred to a specialist for a thorough evaluation. If a parent/guardian prefers that their child NOT be screened at school, please notify the Nurse in writing, if a parent has any concerns about the growth and development of a child, the Nurse will gladly screen your child sooner, upon your request.
Exclusion Criteria
Students will be excluded when illness requires a level of care that is greater than the staff can provide without compromising the health and safety of others in acute situations. The following conditions should be treated at the end of the program day and readmitted after completion of the first treatment:
- Lice
- Scabies
- Ringworm
There is no exclusion for the following infections/diseases:
- Rash without fever and without behavioral change
- Common cold
- Thrush
- Fifth disease
- Conjunctivitis (pink eye)
- HIV
- MRSA (as long and active lesions can be covered
The following table lists some symptoms and the exclusion procedures:
Symptom | Exclusion Procedure |
---|---|
Fever (greater than 100.4F) | Return when fever free for 24 hours without the use of fever reducing medications |
Vomiting (2 or more times in the preceding 24 hours) | Exclude for a minimum of 24 hours |
Persistent new-onset abdominal pain (more than 2 hours) | Exclude until pain is resolved or evaluated by a provider |
Diarrhea (more than 2 abnormal stools or stools containing blood or mucus) | Exclude for 24 hours after last episode |
Influenza | Exclude until the above criteria have been met |
RSV | Exclude until the above criteria have been met |
COVID symptoms | Exclude until the above criteria have been met |
Streptococcal Pharyngitis (strep throat) | Exclude until fever free and 12 hours after treatment has been initiated |
Oral lesions (if unable to control drool) | Exclude until lesions resolve |
Skin lesion (is weeping and unable to be covered) | Exclude until lesion may be covered or have crusted over |
Impetigo | No exclusion if treatment has been initiated and lesions on exposed skin are covered |
Measles | Exclude for 4 days after the beginning of rash or in an outbreak setting 21 days if unvaccinated or if decline immunization after onset of rash. |
Mumps | Exclude 5 days after onset of parotid swelling |
Rubella | Exclude for 7 days after onset of rash or in outbreak setting 21 days if unvaccinated after onset of rash |
Varicella | Exclude until no new lesion for 24 hours and all lesions are crusted |
Pertussis (Whooping Cough) | Exclude until completion of 5 days of antibiotics or for 21 days if antibiotics refused |
Any questions or concerns please reach out to the health office.