Bulletin One 2012 2013 Final.pdf - Fort Worth ISD

VII. Herbal medications, dietary supplements and other nutritional aids not approved as medication by
the FDA may not be administered at school.
VIII. A Medication Log shall be maintained to record the administration of all medication. The
Medication Log will record the following information:
A. The name of the student.
B. The name of the physician.
C. The name of the medication.
D. The prescribed dosage of medication.
E. The date the medication was administered.
F. The dosage administered.
G. The time of day the medication was administered.
H. The name and signature/initials of the person administering the medication.
3.11 Specialized Health Care Procedure
I. In order to provide continued health care for students who need specialized health care during
school hours, the following provisions shall be met:
A. The student’s physician/health care provider shall complete the Specialized Health Care
Procedure Authorization Form authorizing the administration of these procedures at school.
B. The Specialized Health Care Procedure Form shall include the following information:
1. Student’s name and school;
2. Name of procedure to be performed;
3. Time schedule, duration and/or instructions for treatment precautions, possible
untoward reactions, and recommended intervention; and
4. School staff authorized to perform the procedure as indicated by the physician.
C. The parent or guardian shall sign a request form to have the specialized health care procedure
performed during school hours. The following information shall be included on the form.
1. Student’s name, D.O.B. and phone number;
2. Name of Procedure; and
3. Signature of Parent(s)/Guardian(s).
D. The principal shall designate school personnel to administer specialized health care procedures
in the absence of the school nurse and when otherwise appropriate (ex: suctioning of student).
These persons shall have orientation, instruction and practice appropriate to the task from the
school nurse assigned to the school.
II. The parent or guardian of a student who will seek care for diabetes while at school or while
participating in a school activity, and the physician responsible for the student’s diabetes
treatment, shall develop a diabetes management and treatment plan (DMTP).
A. The DMTP must:
1. Identify the health-care services the student may receive at school;
12-13 SY Bulletin Number One 53 Revised: 10/9/2012