SCHOOL NURSING LAW- What you need to know to stay out of hot water!!!

1. SCHOOL NURSING LAW-What you need to know to stay out of hot water!!! Rachel Gallagher, R.N., A.P.N.P. School Nursing Consultant Wisconsin Department of Public Instruction 125 S. Webster St. Madison, WI 53707 (608) 266-8857 Rachel.gallagher@dpi.wi.gov

2. Why is it important to know the LAWS?

3. Overview • Wisconsin Statute Chapter Section 121.02(1)(g) • PI 8.01 - Emergency nursing service • Chapter 118.29 Administration of Medication and Emergency Care • Delegation and Chapter 441 Nurse Practice Act/N6 Standards of Care

4. Overview Continued • Asthma Law • Child Abuse Reporting Law • Reporting requirements for Sexually Active Teens • Sharing of health information • Human Growth and Development

5. Wisconsin Statute Chapter 121.02(1)(g) • “Provide for emergency nursing services” • One of the twenty standards • State Law

6. Standard G or PI 8.01(2)(g) • Administrative Code • How to provide emergency nursing services Emergency nursing policies – Policies for accidental injury, illness and medication administration Medical advisor Nursing services at ALL school sponsored events ER card, supplies and facilities Review and evaluate annually http://dpi.wi.gov/sspw/pdf/snemergency.pdf

7. Policy development resources National Association of School Nurses • Quality Nursing Intervention in the School Setting, Procedures, Models and Guidelines • Responding to Student Injury and Illness • Available at: https://nasn.networkats.com/members_online/members/createorder.asp?

8. Wisconsin State Chapter 118.29 • Administration of Drugs to Pupils and Emergency Care -OTC Medication -Prescription Medication -Emergency Medication – Glucagon/Epinephrine -Civil Liability Exemption -DPI-approved medication training – rectal, injectable, inhaled or gastrostomy access -Written Policies – record keeping, obtaining forms, storage. -School personnel-oral medication http://www.dpi.wi.gov/sspw/pdf/sndrugs.pdf.

9. Wisconsin State Chapter 441 • Nurse Practice Act -Professional Nursing Definition -Education Standards for the Schools of Nursing -Requisites for examination -Examination rules and test questions -Fraudulent representation of a nurse -Renewal requirements -Disciplinary proceedings

11. Wis. Adm. N6 Standards of Practice – Delegation • No list of nursing tasks that you can delegate • Delegation decisions should be based on the predictability of the outcome, complexity of the task, knowledge and skill of the person assuming task • If there is any assessment or decision making needed to perform the task • Cannot delegate assessment, diagnosis or evaluation

12. N6 Standards of Practice • Administrative Rule -Nursing Process -Delegated Medical Acts 1. Protocols, written or verbal orders 2. Competent 3. Consult if suspect harm 4. Perform under general supervision

13. N6 Standards Continued -Supervision of Direction of Delegated Nursing Act 1. Task – educational preparation and skills 2. Provide direction and assistance 3. Observe and monitor the activities 4. Evaluate the effectiveness http://dpi.wi.gov/sspw/pdf/snpracticeact.pdf

14. Board of Nursing White Position Paper on Delegation • Some Schools – limited nursing capacity • Nursing owns - evaluation of staff for competency to perform the duty • Authority for administration of medication flows from the physician to the parent and ultimately to the delegate in those settings. • http://drl.wi.gov/board_docview.asp?docid=69&boardid=42&locid=0

15. Wisconsin State Chapter 118.291 • Asthmatic Pupils; possession and use of inhalers for prevention or treatment of symptoms May possess and used a metered dose inhaler if the following are true 1. Inhaler to prevent and alleviate symptoms 2. Written approval from medical provider and parent 3. Pupil must provide a copy of approval to principal

16. Wis. Stat. sec. 118.292 • While in school, at a school-sponsored activity or under the supervision of a school authority, a pupil may possess and use an epinephrine auto-injector if all of the following are true: • Student uses the epinephrine auto-injector to prevent the onset or alleviate the symptoms of an emergency situation. • Student has the written approval of the pupil's physician and, if the pupil is a minor, the written approval of the pupil's parent or guardian. • Student has provided the school principal with a copy of the approval. • No school board, school district, private school, or tribal school, or any employee of the foregoing, is civilly liable for an injury incurred. • Stock supply of medication

17. Wisconsin State Chapter 48.981(2) • State law • Abused or Neglected Children Reasonable cause to suspect that a child seen by the person in the course of professional duties has been abused or neglected or who has reason to believe that a child seen by the person in the course of professional duties has been threatened with abuse or neglect and that abuse or neglect of the person will occur, must report to a child protection agency or law enforcement. • Mandated Reporter • Exception is due to poverty

18. Wisconsin State Chapter 48.981(2m) • Health care provider and service – School Nurses Maintain confidentiality if the following are not true. 1. Intercourse or contact with caregiver 2. Child with mental illness or deficient 3. Age and immature – consequences 4. Child was unconscious or physically unable to communicate 5. Participant was or is exploiting the child Any reasonable doubt regarding child’s willingness – report Reporting Requirements for Sexually Active Adolescents: http://dpi.wi.gov/sspw/pdf/rrfsaa.pdf

19. Wisconsin Statute 118.125(3)(p) and FERPA 99.36 • Sharing Health Care Information – FERPA Licensed staff with legitimate educational and safety interests • Emergency situations may share health care information

20. Human Growth and DevelopmentWis. Stat. sec. 118.019 (2011 SB 237) Provision in the law: • Age appropriate – suitable for a particular age group based on cognitive and emotional capacity and consistent with adolescent development and community standards. • Medically accurate – scientifically based and published in peer reviewed journals and textbooks. • Instructional topics are recommended but not required. • Importance of abstinence only effective form of contraception.

21. Human Growth and DevelopmentWis. Stat. sec. 118.019 (2011 SB 237) Provision repealed in law: Instructional material and methods must not promote bias against student of race, gender, religion, sexual orientation or ethnical or cultural backgrounds or against sexually active student with disabilities

22. To take required post-assessment: • Close course window by clicking on the red X in the right hand corner. • Go to the TRAIN home page by clicking on Home in the green ribbon. • Look at My Learning Record in the right hand blue box. • Click on My Learning. • Select the M (Manage) to the right of the title. • Select completed. • Select assessment. • You must answer 5 out of the 5 questions correctly to complete the course. • To get a certificate: • — Go to TRAIN home page. • — Go to My Learning Record and click on certificate in right hand column and print.

23. Any comments regarding this webcast? Any suggestions on future school nursing topics? Contact: Rachel Gallagher (608) 266-8857 E-mail: rachel.gallagher@dpi.wi.gov