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DSHS Update: Focus on Food Allergy Guidelines

DSHS Update: Focus on Food Allergy Guidelines. Anita Wheeler, RN, MSN School Health Coordinator/School Nurse Consultant Anita.wheeler@dshs.state.tx.us 512-776-2909. The Learner will be able to:

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DSHS Update: Focus on Food Allergy Guidelines

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  1. DSHS Update: Focus on Food Allergy Guidelines Anita Wheeler, RN, MSN School Health Coordinator/School Nurse Consultant Anita.wheeler@dshs.state.tx.us 512-776-2909

  2. The Learner will be able to: 1) Evaluate the impact of the TX Food Allergy Guidelines for care of students at risk for anaphylaxis related to food allergy on the policy/procedures of the nurse’s school/district. 2) Evaluate the impact of revised communicable disease rules for schools related to exclusion/re-entry procedures for the nurse’s school/district. 3) Analyze the impact of increased federal accountability and decreased state funding on student immunization access. Learning Objectives

  3. Texas Food Allergy Guidelines Texas Style

  4. Corn Wheat Milk Nitrites (and an aversion to fish) Breanna- Age 4 Bryan- Age 6

  5. Key Deadlines of the Bill • December 1, 2011 • May 1, 2012 • August 1, 2012 Senate Bill 27 Texas Education Code Chapter 38, Section 38.0151

  6. Review of National Guidelines Review of Other State Guidelines Review of National Organization(s) Resources Review of Evidence-based Practice Texas Guideline Development

  7. Identification of Students Development of IHPs, 504 Plans, ECPs Reducing the Risk of Exposure Training of Staff Evaluation of Food Allergy Policies and Procedures Central Themes

  8. Identifying Students • House Bill-742, 82nd Legislative Session • Amends Texas Education Code, Chapter 25, • by adding Section 25.0022 • “On enrollment of a child in a public school, a school district shall request, by providing a form or otherwise, that a parent or other person with legal control of the child…. • (1)  disclose whether the child has a food allergy or a severe food allergy….. • (2)  specify the food to which the child is allergic and the nature of the allergic reaction.

  9. Student Handbook (TASB Policy) Emergency Care Form Specific Form for Food Allergies Pre-K and K Round-up and Early Registration Events Other ideas ??? Suggested Strategies to Identify Students

  10. Food Allergy Action Plan (FAAP) Emergency Action Plan (EAP) Individualized Healthcare Plan (IHP) Section 504 Plan (504) Development of Care Plans

  11. Developed by the healthcare provider • Includes information about: • Specific Student’s Allergy • Specific foods • Signs and symptoms • Treatment and Medications • Emergency Contacts • Other information to support the student FAAP and EAP

  12. IHP-Developed by Registered Nurse (LVN can assist but not develop as per Scope of Practice) • 504 Plan-Developed by district 504 committee IHP and 504 Plans

  13. Identifying “high-risk” areas • Limiting, reducing food in classrooms • Notifying staff and parents • Reviewing classroom activities • Developing procedures for: • Snack time • Cleaning • Classrooms • Field trips • Buses • Hand Washing Reducing Risk of Exposure

  14. Awareness Training • Overview of Food Allergies • Signs and Symptoms • Treatment of Anaphylaxis • Comprehensive Training • Strategies for Identifying Students • Signs and Symptoms of Anaphylaxis • Implementing FAAPs and EAPs • Development of IHPs and 504 Plans • Communication Procedures for Emergency Response • Environmental Control Strategies • Coordinating with Local Emergency Medical Services • Post Anaphylaxis Debriefing and Management of the Food Allergy Management Plan for the School Staff Training

  15. Policy and procedures should be reviewed: • At Least Annually • After An Allergic Reaction • When the Science Changes in the Care or Treatment of Anaphylaxis Post Anaphylaxis Reaction Review of Policies and Procedures

  16. Development of the Individualized Healthcare Plan

  17. Student Outcomes

  18. National Association of School Nurses Research, Resources and Guidance Documents

  19. Comprehensive Research based Reflects current clinical practice Easy to use (Domains, Classes, Interventions, Activities all have definitions) Uses language that is clear and meaningful Continually updated Field tested Nursing Intervention Classifications (NIC)

  20. Allergy Management Anticipatory Guidance Asthma Management* Calming Technique Caregiver Support Crisis Intervention Delegation Documentation Emergency Care Emotional Support Family Involvement Promotion Health Education Health Screening Medication Administration Medication Management Nutritional Counseling Parent Education Referral Self-efficacy enhancement Teaching: Individual Telephone: Consultation Vital Signs Monitoring Wound Care Nursing Interventions for School Nurses

  21. Developed inductively and deductively Grounded in clinical practice and research Uses clear, useful language Helps in organizing outcome measures Outcomes can be shared by all disciplines Optimizes information for evaluation of effectiveness. Funded by the National Institute of Nursing Research Nursing Outcome Classifications (NOC)

  22. Asthma Self-management Compliance behavior- diet and medication Diabetes Self-management Immunization behavior Knowledge: Asthma, Diabetes, Diet, Weight Management * Neurological Status Nutritional Status Personal Autonomy Physical Fitness Respiratory Status Risk Control: Alcohol, Drugs, Sun Exposure, Tobacco Use Self-Esteem Sensory Function: Vision/Hearing Social Interaction Skills Social Involvement Student Health Status Vital Signs Nursing Outcome Measures for School Nurses

  23. National Association of School Nurses Food Allergy Tool Kit http://www.nasn.org/ToolsResources/FoodAllergyandAnaphylaxis

  24. QUESTIONS?

  25. DSHS Communicable Disease Chart

  26. Communicable Disease Chart Updated Chart Due for Dissemination January/February 2013 Rules posted 8/24/2012 for 30 day Comment Period

  27. Definition Temperature 100° F Definition Diarrhea 3 or more loose stools in 24 hour period Definition “Fever Free” Head Lice- No longer excludable condition Proposed Changes to the Rules/Chart

  28. Amebic meningitis and encephalitis; • anaplasmosis; • babesiousis; • Chagas’ disease; • shiga-toxin producing Escherichia coli infection; • novel influenza; • poliovirus infection, non-paralytic • Hepatitis E (Proposed)-New Reportable Conditions

  29. Changes to “Who Shall Report” • Adds language related to an Influenza Pandemic Other Proposed Changes

  30. QUESTIONS?

  31. Immunization Update

  32. -Increased Accountability to use vaccines for designated population in VFCP. (Federal Program) -Decrease in state funding -Affordable Care Act Changes to Immunization Availability

  33. QUESTIONS?

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