FASA Handbook Chapter 7 CONTAGIOUS, INFECTIOUS AND COMMUNICABLE DISEASES/AGENTS Purpose: The Health Services Department ensures compliance with Federal and State mandates for contagious, infectious and communicable diseases/agents. Additional Authority: Southern Nevada Health District (SNHD); Centers for Disease Control and Prevention (CDC); Nevada Revised Statutes (NRS), Nevada Administrative Code (NAC), Nevada State Board of Nursing (NSBN), National Association of School Nurses (NASN), Clark County School District Exposure Control Plan (PUB); First Aid/Emergency Guidelines for School Personnel (PUB) and Clark County School District Regulation 5150 Health and Welfare: Students. Scope: School Nurses, Specialized Procedure Nurses (SPNs), First Aid Safety Assistants (FASAs), Unlicensed Assistive Personnel (UAPs) Responsible Party: Director of Health Services Distribution: Health Services Coordinators, School Nurses, Specialized Procedure Nurses (SPN), First Aid Safety Assistants, Health Office Back-Ups, and Health Services Secretarial Staff 1.0 Policy Statement POLICY 1.1 Every health office should maintain a copy of the Exposure Control Plan, PUB-593 for reference. 1.1.1 PUB- 593 is updated annually and MUST be printed the first week of the school year.
1.2 School Nurses manage suspected and/or confirmed contagious, infectious, and communicable diseases/agents on an ongoing basis to protect the health and safety of students and staff throughout the school district. 1.3 It is important to limit any discussion of possible diseases to describing what is observed and NOT making a diagnosis. 1.4 All body fluids are handled as if a pathogen may be present. 1.5 A student suspected of having an infectious, communicable, or contagious disease/agent may not be allowed to attend school until the period of communicability has passed or until appropriate treatment has been obtained. 1.6 The Director of Health Services must be made aware of all cases of HIV/AIDS in the school settings. 1.6.1 The CCSD Director of Health Services is the superintendent designee for notification of cases of students with HIV. 1.7 FASAs should refer to the First Aid and Emergency Guidelines for School Personnel (PUB) for specific information and when to notify the School Nurse. 1.8 The FASA will continually communicate suspected and actual contagious, infectious, and communicable diseases/agents with the nurse in an ongoing manner. 1.9 Equipment Cleaning - The School Nurse or FASA may be consulted by staff for appropriate cleaning procedures. The School Nurse or FASA should direct staff to consult the Exposure Plan (PUB-593), Risk Management, or their own departmental procedure regarding standard cleaning procedure for equipment.
1.9.1 Student Medical Equipment - Many students use the same or similar brands of medical equipment. If care is not taken, this can lead to one student accidentally using another student s equipment. 1.9.2 Medical materials or equipment are not to be shared by students at any time. 1.9.3 Student testing equipment and supplies should be stored in individual, labeled containers. 1.10 Head Lice And Bed Bugs Refer to Health Services Policies/Procedures for information and documentation. 2.0 Procedure for Handwashing 2.1 In the health office, the most important safety precaution involves frequent hand washing. This is the single most important means of preventing the spread of infection. Wash hands between contact with students, before & after eating, drinking, or smoking, after bathroom use, after removal of gloves, and before assisting with medication. 2.1.1 Use pump soap 2.1.2 Scrub hands- using friction for at least 15 seconds 2.1.3 Rinse hands under running water 2.1.4 Dry hands well with paper towels and use paper towel to turn water off. 2.2 Gloves should be worn to avoid skin contact with blood, blood-soiled items, and body fluids, as well as exposure to contaminated surfaces, materials, and objects.
2.2.1 Gloves should be used only once, and then discarded before leaving the contaminated area. Proper hand washing techniques should be used after removing gloves. Wearing gloves does not replace hand washing. 2.2.2 If one glove is used, with two fingers of the opposite hand, grab the glove at the wrist level, touching only the inside of the glove, and pull slowly over and off the hand. 2.2.3 If two gloves are used, with two fingers of the opposite hand, grab the glove and pull slowly over and off the hand. Then slip the middle fingers of the free hand under the remaining glove, touching only the inside of the glove, and slowly peel off the glove. The gloves should be placed immediately in a plastic-lined container. 3.0 Procedure for Identification, Communication and Reporting of Diseases/Agents Contagious, Infectious, and Communicable Diseases/Agents Essential Steps 1. An contagious, infectious, and communicable disease/agent is suspected. Keystones/Precautions Refer to the Communicable Disease Chart for Schools and Child Care Centers. Refer to the First Aid and Emergency Guidelines for School Personnel (PUB) for exclusion criteria. 2. Observe student FASA should communicate suspected or actual cases with School Nurse. 3. If condition meets the exclusion criteria, notify the parent/guardian. 4. If condition meets the reportable disease criteria, notify Health Services Coordinator. Student must be sent home. Communication with the SNHD will be done under the direction of the Director of Health Services. All communication/letters from the SNHD must be approved by the Director of Health Services. 5. For conditions that are non-reportable, Informational sheets are obtained from
the School Nurse may initiate a medical referral and include appropriate informational sheets. 6. Separate student from other students in the health office as much as possible until sent home with parent/guardian. 7. Determine necessary length of absence per SNHD guidelines. www.southernnevadahealthdistrict.org under the direction of the School Nurse. May be transported by attendance officer if athome supervision is established and parent/guardian has no other means of transportation. Student is under appropriate medical treatment. Student is no longer contagious per LHCP. Written documentation may be required. 8. Inform parent/guardian of required length of absence under direction of the School Nurse. 9. If student returns to school with continued symptoms or condition is untreated, the School Nurse initiates a Student Health Suspension (CCF). Refer parent/guardian questions to SNHD or LHCP. Notify school administrator/designee, if issued. FASA may not initiate the Student Health Suspension (CCF). A copy is maintained in Communicable Disease section of FASA Notebook. 10. For absences that exceed 2 days that are related to the Student Health Suspension (CCF), the School Nurse should be notified. 11. The School Nurse should work with the FASA to ensure that proper documentation of suspected/confirmed communicable disease are recorded on the Communicable Disease Worksheet (HS) 12. The School Nurse will notify the parent/guardian of the student who is immunodeficient regarding confirmed communicable diseases in the classroom/school population. Based upon the individual needs of these students, an alternative educational placement may need to be considered. 13. The School Nurse will confer with the FASA regarding any outbreaks of Communicable Disease Worksheet (HS) is maintained in the FASA Notebook and should be made available for the Health Services Coordinator and SNHD as needed. A student who is immunodeficient may need to be removed from the classroom for their own protection when communicable diseases are occurring in the school population. Record this on the Communicable Disease Worksheet (HS) in the FASA Notebook.
chicken pox. The Chicken Pox letter (HS) should be sent home at the elementary level to parents/guardians of students in a class where there is a confirmed case of chicken pox. 14. In the event of an unusual number of students with similar symptoms, the FASA shall notify the School Nurse. 15. The School Nurse should notify the Health Services Coordinator or Health Services with any increased symptoms observed in the school. 16. In the event of an outbreak, unimmunized or under-immunized students may be excluded from school by the SNHD. Secondary distribution is determined on a caseby-case basis with the School Nurse, Health Services Coordinator, and school site administrator. Gather as much information as possible such as symptoms, affected classroom(s), and dates symptoms exhibited. The School Nurse should provide specific information gathered from school with Health Services. The SNHD determines when it is permissible for un-immunized or under-immunized students to return to school. 4.0 Documentation: 4.1 Document in Electronic Medical Record and the Communicable Disease Worksheet (HS). 5.0 References, Sources, Bibliography 5.1 CDC website http://emergency.cdc.gov/preparedness/quarantine/ 6.0 Authorizations Health Services Director (Print) Signature Date