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School Nursing: Guide to Practice
Rebecca Doran, MSN, RN, PEL SN, NCSN
Wellness Department
August 7, 2023
Equity ● Quality ● Collaboration ● Community
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What guides a school nurse's practice?
▪ Illinois School Code
▪ Related Rules, Administrative Code
▪ Nurse Practice Act (applicable to school nurses)
▪ District Policy
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Links for School Code
• Illinois School Code
– Administering medications
• 105 ILCS 5/10-22.21b
– Anaphylactic policy for school districts
• 105 ILCS 5/2-3.190
• Model Anaphylaxis Response Policy for Illinois Schools
– Self-administration and self-carry of asthma
medication and epinephrine injectors, administration
of undesignated epinephrine injectors, administration
of an opioid antagonist, administration of
undesignated asthma medication
• 105 ILCS 5/22-30
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Links for School Code
• Illinois School Code
– Home hospital instruction
• 105 ILCS 5/14-13.01
• Medical Certification for Home/Hospital Instruction (ISBE
Form 34-58)
• Home-Hospital Instruction FAQ
– Endorsement on licenses
• Professional Educator License School Support Personnel
• PEL School Nurse
– Job description and responsibilities
• 105 ILCS 5/21B-25
– Psychotropic or psychostimulant medication,
disciplinary action
• 105 ILCS 5/34-18.25
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Links for School Code
• Illinois School Code
– Required health exams
• Physical fitness and professional growth
(employee physical exam, other tests)
• 105 ILCS 5/24-5
• Institutes or in-service day shall include
instruction on prevalent student chronic
health conditions
– 105 ILCS 5/3-11
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Required health exams
• Illinois School Code 105 ILCS 5/27-8.1
Health examinations and immunizations
– Exclusion if not in compliance
– Illinois State Board of Education
• Public Health Code Section 665
– Requirements
– Intervals
– Components
– Illinois Department of Public Health
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Health Condition Links in School Code
• Care of Students with Diabetes Act
– 105 ILCS 145/5
– Delegated care aide
– Diabetes Care Plan basis for 504 Plan
– Accommodations
– Training
– Permits undesignated glucagon
• Seizure Smart School Act
– 105 ILCS 150/1
– Delegated care aide
– Accommodations
– Training
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Health Exam Requirements
School Code
• Required health exams
– Child Health Exam and
Immunizations
– Eye Exam
– Dental Exam
• Dates to be submitted to
school
• Consequences of non-
compliance
Public Health Code
• Components of exams
• Timetable
• Report forms
• Proof of examination
• Basic
immunizations/proof of
immunity/boosters
• Keeping list of non-
immunized attendees
• Exemption or objection
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• Physical within one year and that meets Illinois requirements written in Public Health Code.
• Illinois form or out-of-state form that has required components may be accepted for first entrance to
Illinois school.
• Immunizations according to the Immunizations for School Attendance table.
• Eye exam at kindergarten or first entrance to Illinois school.
• Illinois kindergarten eye exam should follow with permanent school records.
• Dental exam at required grade levels (kindergarten, second, sixth, or ninth)
• If student enters at a different grade, not due until NEXT required grade level.
• Out of country same as out of state
• Exchange students
• There are health requirements from sponsoring organizations. Work with student and host family to
obtain copies.
What to do if a student is new to Illinois?
This Photo by Unknown author is licensed under CC BY-SA.
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Health Exams
–Child Health Exam and Immunizations
• Pre-K
• Kindergarten
• Sixth Grade
• Ninth Grade
• Immunization Data Entry Worksheet
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Health Exams
– Eye Exam
• Kindergarten
• First entrance into an Illinois School [105 ILCS 5/27-8.1 (1.10)]
• Waivers per Illinois Department of Public Health (IDPH)
• Eye Examination Data Entry Worksheet
– Dental Exam
• Kindergarten
• Second Grade
• Sixth Grade
• Ninth Grade
• Waivers per IDPH
• Dental Information Data Entry Worksheet
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Actions if Not Submitted
•Shall exclude from school
attendance (School Code)
Child Health
Exam and
Immunizations
•May hold report card
Eye Exam
•May hold report card
Dental Exam
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Reporting Dates to Remember
ISBE Student Health Data Important Dates
Immunization/Health Examination
Students submit to school by
October 15 annually
or an earlier exclusion date
set by the district
IWAS system becomes available for data entry
September 1 annually
Must be submitted in IWAS to be considered
complete BY
November 15 as written in School Code
Eye Examination
Students submit to school by
October 15
IWAS system becomes available for data entry
September 1
Must be submitted in IWAS to be considered
complete by
June 30 at 11:59 p.m.
Dental Examination
Students submit to school by
May 15 annually
IWAS system becomes available for data entry
May 16 at midnight
Must be submitted in IWAS to be considered
complete by
June 30 at 11:59 p.m.
This table lists annual dates. Systems become available on that date and data must for completion must be submitted before the end date..
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Knowledge of Agencies
IDPH
School Health Programs
Communicable Disease
Chronic Health Conditions
Vision and Hearing Programs
Illinois High School Association
Illinois Elementary School Association
Illinois Department of Human Services
Division of Mental Health
Illinois Department of Children and
Family Services
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Additional Health Requirements
• Communicable Disease Code Section 690
– Infectious disease
– Notifications
– Susceptibility
– School Health Listing of Communicable Disease Chart
– Illinois Department of Public Health
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Vision and Hearing Screening
• Vision and Hearing Test Act (410 ILCS 205)
• Hearing screening: 77 Ill. Admin. Code 675
• Vision screening: 77 Ill. Admin. Code 685
– Illinois Department of Public Health
**Hearing and vision screening reports are due to IDPH by June 30
th
of each year
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ISBE Rules Currently in Effect
• Joint Committee on Administrative Rules
• ISBE.net
– Rules Currently in Effect Webpage
• 1 Public Schools Evaluation, Recognition and Supervision
– 1.520: Home and Hospital Instruction
– 1.530: Health Services (policy and procedures relative to injury or
sudden illness of students and staff)
– 1.540: Use of Undesignated Epinephrine, Asthma Medication,
and Naloxone
– 1.760: Standards for Student Support Personnel (Sections b-h,
school nurse)
• 23 Standards for School Support Personnel Endorsements
• 25 Educator Licensure
– 25.432 Short-term Approval School Support Personnel
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ISBE Rules Currently in Effect
Joint Committee on Administrative Rules
• 375 Student Records
– Permanent record
– Temporary record
• 226 Special Education
– ISBE rule 226.800: Personnel required to be qualified (nursing interventions)
– ISBE rule 226.860: Qualifications of evaluators
– ISBE rule 226.160: Medical review: performance of health evaluation for
student for Individualized Education Program (IEP)
» Non-PEL Registered Nurse IEP Designation
• Job description and responsibilities
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Nurses Working in Schools
• Licensed Practical Nurse
– Able to report to
the IEP team
subjective and objective
data about interactions
with student
– Job
description and responsibil
ities
• Registered Nurse
– Work in the school health
office
– Day-to-day encounters
with students
– Provide direction for LPN
Licensed
Practical Nurse
Registered
Nurse
Non-PEL RN IEP
Designee
PEL School
Nurse
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Nurses Working in Schools
• Non-PEL RN IEP Designee
– RN (2014; 2016 and
after) minimum
education requirements of
bachelor's degree in nursing,
education, or a related field
• Has completed ISBE-
sponsored medical
review course
• Able to participate in
IEP team assessment
through evaluation
• PEL SN
– RN with graduate level
education in specialty of
school nursing
• Able to participate in IEP
team fully (assessment
through evaluation)
Licensed
Practical Nurse
Registered
Nurse
Non-PEL RN IEP
Designee
PEL School
Nurse
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Thank you!
• Wishing a healthy 2023-24 school year!
• Questions may be directed to:
schoolnur[email protected]