Current through September 24, 2024
(1) Each local board of education shall adopt
policies and procedures that provide for the administration of medications that
treat adrenal insufficiency in compliance with these rules.
(2) For purposes of this rule the following
definitions are applicable:
(a) "Adrenal
crisis" means a sudden, severe worsening of symptoms associated with adrenal
insufficiency, such as: severe pain in the lower back, abdomen, or legs;
vomiting; diarrhea; dehydration; low blood pressure; or loss of
consciousness.
(b) "Adrenal
insufficiency" means a hormonal disorder that occurs when the adrenal glands do
not produce enough adrenal hormones.
(c) "IHP" means Individualized Healthcare
Plan.
(d) "LEA" means Local
Education Agency.
(e) "Nurse
practitioner" means a nurse practitioner licensed under T.C.A. title 63,
chapter 7.
(f) "Physician" means a
physician licensed under T.C.A. title 63, chapter 6 or 9.
(g) "School personnel" means any person
employed by a Local Education Agency (LEA).
(3) Training.
(a) If an LEA has been informed by a parent
or guardian that a student in a school of the LEA has adrenal insufficiency,
the LEA shall train school personnel at the school who will be responsible for
administering the medication for the treatment of adrenal crisis.
(b) Trained personnel shall be available to
each student identified as having adrenal insufficiency whose parent or
guardian has provided the medication for treatment of adrenal crisis.
(c) An LEA shall provide training to any
school personnel who volunteer to receive the training and to be responsible
for the administration of the medication for the treatment of adrenal
crisis.
(d) Training on the
treatment of adrenal insufficiency shall be coordinated by the LEA and shall be
conducted under the supervision of a physician or nurse practitioner or by any
other health care professional licensed under T.C.A. title 63 as delegated by a
supervising physician or nurse practitioner.
(e) The training shall include, at a minimum,
the following:
1. General information about
adrenal insufficiency and the dangers associated with adrenal
insufficiency;
2. Recognition of
the symptoms of a person who is experiencing an adrenal crisis;
3. The types of medications that are
available for treating adrenal insufficiency;
4. Proper administration of medications that
treat adrenal insufficiency; and
5.
LEAs shall maintain a written record of all school personnel who have completed
such training.
(f) A
person who has successfully completed training in the treatment of adrenal
insufficiency may possess the medication and necessary paraphernalia for
administration of medication. Trained school personnel may administer the
medication to the student for whom the medication is prescribed if the student
is suffering an adrenal crisis when a school nurse or other licensed health
care professional is not immediately available.
(g) Trained school personnel shall:
1. Be familiar with the IHP for each student
with adrenal insufficiency in the school and become familiar with:
(i) The student's baseline activity level,
attitude, and behavior;
(ii) The
conditions that place additional stress on the body (such as illness or injury)
that may trigger an adrenal crisis;
(iii) The student's past history with adrenal
crisis; and
(iv) The medication and
administration route that is prescribed to the student from his or her
physician to use during an adrenal crisis.
2. Understand the symptoms of adrenal crisis
including unconsciousness, extreme lethargy, or nausea and vomiting.
3. Understand the student's 504 Plan,
Individualized Education Program, or other education plan, if
applicable.
4. Practice universal
precautions and infection control procedures.
5. Comply with all state and federal privacy
laws.
(h) An LEA shall
not require school personnel who have not received appropriate training to
administer medication.
(4) If it is determined a student is
suffering from an adrenal crisis and the school nurse or other licensed health
care professional is not available, the trained school personnel shall:
(a) Instruct someone to call 911 and the
student's parent or guardian.
(b)
Administer the medication and wait with the student until help arrives. Do not
leave the student unattended.
(c)
Turn the student on his or her side and monitor the student's
breathing.
(d) Give the empty vial
to the Emergency Medical Responders when they arrive.
(5) Medication shall be stored safely and in
a location that is readily available and in close proximity of the
student.
(6) School transportation
and activities such as field trips or other out-of-school functions shall be
taken into account in the LEA policy regarding treatment of adrenal
crisis.
(7) The student's IHP team
may consider allowing a student to carry his/her own medication in certain
circumstances. The IHP team shall take into account the student's age and
maturity when making this determination.
Authority: T.C.A. §
49-50-1603.