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Pupil Illness and Medication Policy

Reviewed and approved by Board of Management: 1st October 2018

Introduction

The school has a duty of care to all its pupils and members of staff. This policy aims to set out procedures to be followed when children become unwell, to ensure that they are well cared for and that, where the cause is of an infectious nature, others are not exposed needlessly. Procedures regarding the administration of medicine during the school day are also outlined.

In matters of pupil health, staff at St Joseph’s work closely with the ChildVision Nursing Team. The Nursing Station is based in close proximity to the school on the ChildVision campus. Neither the school nor the Nursing Station has a ‘sick bay’ where a child who is unwell can stay during the school day.

Illness or Infection at School   

Responsibility of Parents/ Guardians

When children should be kept at home:   

Parents are asked not to send their child/ren to school if any of the following apply:

  • The child has symptoms of an infectious illness that is mentioned in the list of ‘Common Ailments requiring Pupils to Stay at Home’ at the back of this policy (Appendix 1) or in HSE Publication: ‘Management of Infectious Diseases in School – 2014’, Chapter 9. http://www.hpsc.ie/a-z/lifestages/schoolhealth/File,14304,en.pdf
  • The child does not feel well enough to participate in the normal programme of curriculum activities.
  • The child requires more care than the classroom team is able to provide without affecting the health, safety and schoolwork of the other pupils.
  • If antibiotics are prescribed for a contagious illness or infection, the child should not attend school until 24 hours after treatment has begun and must be showing signs of improvement.
  • If headlice or ringworm is noticed, the child may not come to school until treatment has begun. See the end of Appendix 1 at the back of this policy.

If a child has been sent to school and is clearly unwell, as described above, a parent or guardian will be asked to collect him/ her from school as soon as possible.

Pupil Absence – Informing the bus escort

If a pupil becomes ill overnight or at the weekend and is unable to attend on the next school day, the parent/ guardian should contact the bus escort so the school bus need not come unnecessarily to the house. The evening before a pupil returns to school, the parent/ guardian should phone the bus escort to ensure their son/ daughter is collected in the morning.

Pupil Absence – Informing the school

As well as contacting the bus escort, the parent/ guardian must also contact the school office, stating the reason for the child’s absence.

This is very important for the following reasons:

  • If a child has an illness which is recognised by HSE as an infectious disease, staff, other parents/guardians or the authorities may need to be notified. It is vital that information about an infectious disease is passed to the school as soon as possible.
  • National Educational Welfare Board requires the reason for absence to be recorded
  • Child absences may affect how staff members are assigned during the school day.

Returning to school

A pupil who has an infectious ailment, e.g. diarrhoea, vomiting, heavy cold, should remain at home until they are no longer infectious. The length of time before return will depend on the ailment and on the treatment. Guidelines in Appendix 1 at the back of this policy, or in ‘Management of Infectious Diseases in School’ (Chapter 9), should be followed. For some infectious diseases, the school may require a doctor’s ‘fitness to return’ note before the child is allowed to come back to school.

Collecting child when ill

If a ChildVision nurse and/ or the Principal contacts a parent/ guardian to say that their child has been examined and is not well enough to be at school, or travel home on school transport the parent/ guardian must arrange to collect the child as soon as possible. This is primarily for the well-being of the child who is unwell. In the case of infectious diseases, it is also very important for the well-being of the other pupils and the school staff. Classroom staff will aim to keep the child as comfortable as possible while waiting for a parent/ guardian to arrive. The parent/ guardian will be handed a ‘Return to School’ Slip (See Appendix 7 at the back of this policy) where an infectious illness is present or suspected. This slip is to be completed and sent in with the child on his/ her first day back at school.

Responsibility of School

If a child feels unwell or appears unwell, on arrival at school or during the school day, the procedures at the back of this policy, in Appendix 2, will be followed for the well-being of the child who is sick and of all members of the school community.

On an ongoing basis, St Joseph’s aims to promote good hygiene practices that will help prevent transmission of infection. These practices will be taught as part of the SPHE curriculum and will be consolidated throughout the school day. They will include:

  • Teaching and implementing effective handwashing throughout the school, with staff leading by example
  • Teaching and implementing respiratory hygiene and cough etiquette, e.g. to turn away when coughing or sneezing, etc.
  • Facilitating the Schools Immunisation Programme
  • Provision of gloves, aprons, suitable sanitising cleaning products and cleaning equipment for staff who are in contact with bodily fluids when caring for a child.

Administration of Medication in School

In St Joseph’s School, medication is administered by the ChildVision Nursing Team rather than by school staff. At present, the one exception to this is the prescribed emergency regime for epilepsy management. At the start of each school year, all members of staff are trained to administer epilepsy medication in the case of an emergency, when a ChildVision Nurse is unavailable within the necessary time frame. For further information, please refer to the Accident and Injury Policy. As the medical needs of our pupils change, the Board of Management and school staff may need to respond to requests for administration of other types of similar medication e.g. epi-pen.

 Administration of Infrequent Medicines

 Responsibility of Parents/ Guardians

If a child has been prescribed a short-term antibiotic, or requires ’over the counter’ medication when in recovery, the parent/guardian should attend to the following:

  • ensure the medicine is in its original container, is clearly named and dated and has clear instructions about administration; this is required by the Nursing Team. If the medication is prescribed by a doctor, the prescription should be enclosed.
  • ask the bus escort to pass the medication to the teacher in the morning and to bring it back in the afternoon, unless the child is availing of ChildVision Residential Services.
  • inform the class teacher about the child’s need for medication through a note in the child’s communication diary. This will allow the teacher to liaise with the Nursing Team about the practical arrangements.
  • supply the ChildVision Nursing Team with any other information they need to safely administer the medication, either through a note in the communication diary, in an enclosed letter or by phone

Responsibility of School

When a class teacher receives a child’s medication from a bus escort and notification in the communication diary regarding the need for the administration of this medication during the school day, she/he should contact the ChildVision Nursing Team as soon as possible. The teacher should make arrangements with the nurse regarding the storage of the medication, and the time and place for the medication to be administered. At the end of the school day, the teacher will hand the medication to the bus escort or to the relevant ChildVision Care Staff member, if the child is availing of Residential Services.

Administration of Regular Medication 

If a child requires medication during the school day on a regular or an ongoing basis, parents and guardians must notify the Principal in writing as soon as possible, i.e. on application, or as soon as the medication has been prescribed. The Principal will liaise with the ChildVision Nursing Team and a nurse will make contact directly with a parent/ guardian.

In order for the administration of the medication to begin, the parent must provide the Nursing Team with:

  • a valid medical prescription
  • medication in original packaging with the pharmacy label intact
  • written consent

A ChildVision nurse will agree on an individual medication plan with the class teacher to ensure medication is given as prescribed with minimal disruption to the child’s school day. Relevant details will be recorded in the pupil’s Personal Care Profile.

Self-Administration of Regular/ Long-Term Medication

If an older child requires non-oral medication on a daily basis, e.g. eye drops or inhalers, parent/s and the ChildVision Nursing Manager may agree, at some point, that the child is capable of the responsible self-administration of this medication under supervision. In this case, the parent/s or guardian/s should:

  • obtain written approval from the child’s consultant or GP for supervised self-administration on Appendix 3 Form
  • write to the Board of Management on Appendix 4 Form, requesting the Board to authorise an SNA or teacher to supervise this self-administration and providing all requested details. Parents may ask the ChildVision Nursing Team to assist when making this application.

The Board of Management will consider the matter and may authorise an SNA or teacher, if willing, to undertake the supervision of the self-administration. In this instance, the Board will follow the procedures in Appendix 5 at the back of this policy. The Principal will liaise with involved parties regarding the regular review of self-administration arrangements, and nursing staff will periodically review the self-administration procedure. Frequency of reviews will be, at a minimum, at the start of each school year.

Medical Procedures during the School Day

 The ChildVision Nursing Team

If a child is likely to require a medical procedure to be carried out during the school day on an ongoing basis, parents and guardians must notify the Principal in writing as soon as possible, i.e. on application, or as soon as the procedure may become necessary. The Principal will consult with the ChildVision Nursing Team and a nurse will make contact directly with a parent/ guardian.

Non-Nursing School Staff

If a child is likely to require a medical procedure to be carried out on school transport or during the school day by a non- nursing staff member of St. Joseph’s Primary School, the parent/s or guardian/s should:

  • obtain written approval from the child’s consultant or GP for the procedure to be carried out on Appendix 3 (b) Form
  • write to the Board of Management on Appendix 4(b) Form, requesting the Board to authorise an Escort/SNA or Teacher to carry out the procedure and providing all requested details. Parents may ask the ChildVision Nursing Team to assist when making this application.

The Board of Management will consider the matter and may authorise a bus escort, an SNA or a teacher, if willing, to undertake the procedure, following appropriate training. In this instance, the Board will follow the steps outlined in Appendix 5 at the back of this policy. The Principal will liaise with involved parties regarding the regular review of the policy on medical procedures. The performing of medical procedures will be periodically reviewed by the nursing staff. Frequency of reviews will be, at a minimum, at the start of each school year.

Return to School following Surgery/ Hospitalisation

 At times, children attending St. Joseph’s may need to attend the acute hospitals for either planned or emergency surgery/treatment. If, to ensure a safe return to school after surgery or treatment, the child would need support from ChildVision nurses or therapists (ChildVision MDT), it is important that a parent or guardian is aware of the procedure outlined in Appendix 8 of this policy and in ChildVision’s ‘Return to ChildVision Services following Surgery and Hospitalisation’ Policy.

Appendix 1

Common Ailments requiring Children to Stay at Home or to Visit GP
CHICKEN POX: The child should not attend school until all scabs are dry and crusted. This is usually 5-7 days after appearance of rash.

DIARRHOEA: When your child has had diarrhoea due to infection, he/ she should only return to school once 48 hours have passed following the last loose bowel movement. For example, if your child has his/her last loose bowel movement at 11 am on Sunday morning, he/she cannot return to school until Wednesday morning.

VOMITING: As in the case of diarrhoea, the child should remain at home until 48 hours have passed since last episode of vomiting due to infection.

FEVER: The normal body temperature is 36.5 to 37.2 C. If the child develops a temperature, she/he should remain at home until 24 hours after the fever has passed.

HEAVY COLD SYMPTOMS OR FLU LIKE SYMPTOMS: e.g. large amount of yellow-green nasal discharge, sleepiness, ear pain and/or fever. The child should be kept at home until these have subsided and the he/ she is able to participate in the normal school curriculum.

MILD COLD SYMPTOMS: If a child’s mild cold symptoms would prevent him/ her from participating in normal school curriculum, e.g. significant weariness at onset, streaming watery discharge from nose, persistent cough, he/ she should be kept at home.

CONJUNCTIVITIS: inflammation of the lining of the eye and eyelid, causing sore or red eyes; can be highly contagious if bacterial or viral. Children with red eye/s and a watery or sticky discharge must be evaluated by a doctor, who will advise about return to school – at least 24 hours after start of treatment, perhaps until fully recovered.

IMPETIGO: The fluid inside the blisters is very infectious. The child should be taken to the doctor who will advise about return to school, usually when blisters have dried and healed or a minimum of 24 hrs after commencing antibiotics,

Common Conditions requiring Immediate Treatment

HEAD LICE: It is important to avoid contact between an affected child and others. If parents/guardians notice head lice, or are advised that they have been noticed in the child’s hair at school, treatment must begin before the child returns to school. So long as the treatment begins before bed-time, the child may attend school the next day.

RINGWORM: A child with suspected ringworm should be taken to their GP and, if ringworm is confirmed, treatment should begin as soon as possible. Once parents/guardians attend to this, the child may return to school.

Appendix 2

Internal School Procedures when Child is Unwell

  • If a class teacher is concerned that a child is unwell, she/ he will inform the Principal.
  • The Principal or the class teacher will contact the ChildVision Nursing Station to request that a nurse would examine the child.
  • Sometimes the nurse will examine the child in the classroom. At other times, an SNA will bring the child to the ChildVision Nursing Station. In this case, the class teacher will ensure that the Principal is informed and that ‘sign out’ procedures are followed.
  • Having examined the child, the nurse will advise the Principal as to whether or not the child is well enough to stay at school.
  • If the child needs to go home because he/ she has an infectious illness, or is too unwell to participate in school activities, the Principal and the nurse will agree how parents will be informed. Residential pupils may be returned to the care of the residential staff.
  • If the child is not infectious but may require ‘over the counter’ medication to alleviate symptoms while at school (e.g. Calpol for headache), the nurse will phone a parent/ guardian to discuss this. She will also document any treatment in the child’s communication book, and re-assess the child within an agreed timeframe.
  • In the case of a child who is unwell and is awaiting collection, staff will ensure that the child is supervised, reassured and made as comfortable as possible.
  • If the child has an infectious condition:
  • further contact with other children will be limited by moving the child to a separate space in the classroom or by removing him/ her from the classroom, if so advised by the nurse
  • all other necessary precautions will be taken to limit the spread of infection, i.e. careful hand-washing and use of suitable sanitising cleaning products, as required
  • the parent/ guardian will be handed a ‘Return to School Slip’ to be completed and sent to child’s class teacher on his/ her return
  • If advised by the ChildVision Nursing Team that a particular child has symptoms of an infectious disease which needs to be reported to staff and other parents, or to the HSE, the Principal will ensure this is communicated promptly.

Appendix 5

Self-Administration of Medicine 

Procedures to be followed by Board of Management

The Board of Management of St Joseph’s School for Children with Visual Impairment will aim to ensure that:

  • The authorised SNA /Teacher is aware that this is a voluntary role and that if they wish to withdraw at any point or have concerns about their role, that they should speak with the Principal.
  • The Principal and/ or Class Teacher has confirmed with the pupil that they would be comfortable to start self-administering their medication under supervision in school.
  • The SNA/ Teacher is fully informed of all self-administration details supplied directly to the Board by the parent/guardian and the GP/ consultant.
  • The SNA/Teacher has been trained by the ChildVision Nursing Team to supervise the pupil’s self-administration of the medicine; this supervision will involve monitoring, recording on Appendix 6 Form, informing parents when medication is running low and checking with the Nursing Team regarding any medical concerns.
  • A trained and willing substitute is appointed to supervise on occasions when the authorised SNA/ Teacher is absent
  • Suitable safe storage of the medication has been considered and agreed, e.g. in a locked container on high shelf in classroom. The key to this container will be held by the authorised SNA/ Teacher
  • Relevant details are recorded in the pupil’s Personal Care Profile
  • The school’s insurers are informed in writing of the agreed commencement of self-administration

Appendix 8

 Procedure on Return to School following Surgery/ Hospitalisation where ChildVision MDT support is required

(This procedure has been agreed between ChildVision MDT and St. Joseph’s.)

  • ChildVision MDT must have received correspondence/ confirmation from the child’s medical team of the procedure/illness and of any post-operative instructions, protocols and/or precautions, either directly or through the school.
  • The child must be comfortable and pain must be controlled.
  • The child should be medically well enough to participate in the normal programme of curricular activities (see ’Responsibility of Parents’ section of this ‘Pupil Illness and Medication Policy). In some post-surgery/ post-treatment cases, the school may, by agreement with the parent, be able to accommodate some short-term modifications in school activities. However, if the child requires more care or equipment than the class team is able to provide without affecting the health, safety and education of the other children, then he/she will have to remain at home.
  • ChildVision MDT will arrange for relevant therapists/ nurse to meet with the child and parents for an assessment of the following needs, as required: training, transport, seating, equipment and medication.
  • The school and ChildVision MDT will agree a date for return on the understanding that a parent will collect the child from school if, on the child’s return, they are not managing.
  • The school and ChildVision MDT may initially advise a shorter day for the child. Parents will have to provide the transport to accommodate the shorter day.
  • It is acknowledged that attending school is more demanding than recuperating at home. Therefore, should the child’s needs change on return to school, a review assessment and meeting may need to be carried out to ensure the child continues to be well, safe and supported optimally.
  • If a child returns to school requiring ChildVision services without following the policy outlined above, parents will be contacted and asked to collect the child.