Schoharie Nursing Guidance - Schoharie Central School District

The following is our complete health screening policy for the Elementary School:

The Schoharie Central School District will be using the Capital Region BOCES COVID-19 electronic application as its health screening tool. For anyone who cannot access the BOCES COVID-19 electronic application, a paper form of the screening questionnaire will be provided. Daily health screening procedures will include:

Daily temperature check and completion of the BOCES COVID-19 screening questionnaire for all staff, contractors, vendors, and visitors at least 15 minutes prior to arrival at the school.
- Staff: BOCES COVID-19 screening questionnaire to be completed by 7:15 am
- Report of staff who have not completed screening questionnaire will be provided at 8:40 am to Principals and designated office staff for follow-up
Daily temperature check and completion of the BOCES COVID-19 screening questionnaire for all students attending in-person learning at least 15 minutes prior to scheduled transportation pick up or arrival at school if self-transported.
- Jr/Sr High School: COVID-19 screening questionnaire to be completed by 7:30 am
- Elem School: COVID-19 screening questionnaire to be completed by 8:30 am
Designated school staff will review the incoming health screening questionnaires daily.
If the BOCES COVID-19 health screening questionnaire is not completed electronically or in paper form, student will be screened by the School Nurse or other trained school staff.
Transportation staff, as well as the School Nurse will be notified of students who require health screening upon arrival at school.
If health screening is needed upon arrival at school:
- Student will be dropped off at the health screening tent located at ES Main Office entrance behind the white wall area.
- Mental Health Staff will supervise students who are waiting their turn to ensure social distancing is maintained.
- Appropriate PPE will be worn by School Nurse or other trained school staff during health screenings, to include at minimum, an acceptable face covering or mask, and may also include gloves, gown, and face shield.
- Upon negative health screening completion, student will join their classroom/cohort group at their building entry area or go directly to their classroom/cohort using the Elementary School Main Office entrance.
- Any student, who screens positive for COVID-19 symptoms or exposure, will immediately be taken to the designated isolation area. Protocol: COVID-19 Care of the Symptomatic Student will be followed.
If staff or students develop symptoms during school hours:
- Staff will notify the Elem School Nurse by telephone, ext. 1321060, if they develop symptoms or if their answers to the health screening questionnaire change during the school hours. In addition, staff will be required to notify the Elem School Nurse by telephone, 518-295-6660, if they begin to experience symptoms or there has been an exposure to a confirmed case of COVID-19 outside of school hours.
- Students will be instructed to inform school staff if they begin to feel ill during school hours. School staff will be trained on COVID-19 symptoms, behavior changes and signs that a student may not be feeling well. Staff will need to notify the Elem School Nurse by telephone, ext. 1321060, that student requires assessment. Procedures: COVID-19 Sending Student to the Health Office for Assessment/Care will be followed.
- Parents will be required to notify the Elem School Nurse by telephone, 518-295-6660, if and when their responses to any of the health screening questions change, such as their student begins to experience symptoms or there has been an exposure to a confirmed case of COVID-19. This includes during or outside of school hours.

The following is our complete health screening policy for the Jr./Sr. High School:

Daily temperature check and completion of the BOCES COVID-19 screening questionnaire for all staff, contractors, vendors, and visitors at least 15 minutes prior to arrival at the school.
- Staff: BOCES COVID-19 screening questionnaire to be completed by 7:15 am
- Report of staff who have not completed screening questionnaire will be provided at 8:40 am to Principals and designated office staff for follow-up
Daily temperature check and completion of the BOCES COVID-19 screening questionnaire for all students attending in-person learning at least 15 minutes prior to scheduled transportation pick up or arrival at school if self-transported.
- Jr/Sr High School: BOCES COVID-19 screening questionnaire to be completed by 7:30 am
- Elem School: BOCES COVID-19 screening questionnaire to be completed by 8:30 am
Designated school staff will review the incoming health screening questionnaires daily.
If the BOCES COVID-19 health screening questionnaire is not completed electronically or in paper form, student will be screened by the School Nurse or other trained school staff.
Transportation staff, as well as the School Nurse will be notified of students who require health screening upon arrival at school.
If health screening is needed upon arrival at school:
- Student will be dropped off at the health screening tent located at ES Main Office entrance behind the white wall area
- Staff will supervise students who are waiting their turn to ensure social distancing is maintained.
- Appropriate PPE will be worn by School Nurse or other trained school staff during health screenings, to include at minimum, an acceptable face covering or mask, and may also include gloves, gown, and face shield.
- Upon negative health screening completion, student will join their classroom/cohort group at their building entry area or go directly to their classroom/cohort using the designated door entry.
- Any student, who screens positive for COVID-19 symptoms or exposure, will immediately be taken to the designated isolation area. Protocol: COVID-19 Care of the Symptomatic Student will be followed.
If staff or students develop symptoms during school hours:
- Staff will notify the Jr/Sr High School Nurse by telephone, ext. 1322034, if they develop symptoms or if their answers to the health screening questionnaire change during the school hours. In addition, staff will be required to notify the Jr/Sr High School Nurse by telephone, 518-295-6634, if they begin to experience symptoms or there has been an exposure to a confirmed case of COVID-19 outside of school hours.
- Students will be instructed to inform school staff if they begin to feel ill during school hours. School staff will be trained on COVID-19 symptoms, behavior changes and signs that a student may not be feeling well. Staff will need to notify the Jr/Sr High School Nurse by telephone, ext. 1322034, that student requires assessment. Procedures: COVID-19 Sending Student to the Health Office for Assessment/Care will be followed.
- Parents will be required to notify the Jr/Sr High School Nurse by telephone, 518-295-6634, if and when their responses to any of the health screening questions change, such as their student begins to experience symptoms or there has been an exposure to a confirmed case of COVID-19. This includes during or outside of school hours.

Procedures: COVID-19 Sending Student to Health Office for Assessment/Care

Elementary School

Students in need of assessment by the School Nurse due to illness or injury during school hours will be handled in the following manner, unless deemed an emergency:

Teacher or other school staff will call Health Office by telephone ext. 1321060 or radio device, to review student symptoms or injury that is requiring assessment by the School Nurse. This is necessary to allow School Nurse to make sure that the Health Office is prepared to accept student based on current capacity/circumstances, as well as allow time to determine that appropriate PPE and handling of symptoms is in place.
If student is symptomatic, they will be assessed in Health Office following Protocol: COVID-19 Care of the Symptomatic Student. Appropriate PPE will be worn by staff and student.
If student injury can be assessed and managed in the classroom cohort area, School Nurse could make decision to go to the student vs. student coming into Health Office. This will allow for less movement of students throughout the school building.
Each classroom/cohort hallway will have a room that is vacant and able to be used for assessment and treatment of injury.
Student that is assessed in Health Office and deemed appropriate to remain in school, will return to their classroom cohort.

Students who require daily medication administration during school hours will be handled in the following manner:

School Nurse will make medication administration rounds to all students who have doctor’s order for medication to be taken during school hours.
School Nurse will make medication administration rounds during the student’s scheduled lunch period, unless it does not coincide with doctor’s order for dosing time.
Each classroom/cohort hallway will have a room that is vacant and able to be used for medication administration.
School Nurse will handle medication administration on a 1:1 fashion to ensure confidentially.
This workflow will allow for less movement of students throughout the school building.

Students who require diabetic management during school hours will be handled in the following manner:

Students with diabetes require that their blood glucose levels be routinely checked prior to snack, any physical activity such as PE and recess, lunch, and dismissal. These students could also develop symptoms of low or high blood glucose levels requiring assessment and treatment with the School Nurse.
For routine blood glucose level checks (ie. prior to snack), teacher or other school staff should call Health Office by telephone ext. 1321060, to check the availability of School Nurse and Health Office prior to sending student.
School Nurse could make decision to go to the student vs. student coming into the Health Office.
Each classroom/cohort hallway will have a room that is vacant and able to be used for diabetic management.
For symptoms of low or high blood glucose levels, teacher or other school staff should call Health Office by telephone ext. 1321060 or radio device, to review student symptoms in order for School Nurse to make sure that the Health Office is prepared to accept student based on current capacity/circumstances.
Symptomatic diabetic student will be escorted to Health Office for assessment and management.
Once assessment, care and resolution of symptoms is achieved, student will return to their classroom cohort.

Procedures: COVID-19 Sending Student to Health Office for Assessment/Care

Jr/Sr High School

Students in need of assessment by the School Nurse due to illness or injury during school hours will be handled in the following manner, unless deemed an emergency:

Teacher or other school staff will call Health Office by telephone ext. 1322034 or radio device, to review student symptoms or injury that is requiring assessment by the School Nurse. This is necessary to allow School Nurse to make sure that the Health Office is prepared to accept student based on current capacity/circumstances, as well as allow time to determine that appropriate PPE and handling of symptoms is in place.
If student is symptomatic, they will be assessed in Health Office following Protocol: COVID-19 Care of the Symptomatic Student. Appropriate PPE will be worn by staff and student.
If student injury can be assessed and managed in the classroom cohort area, School Nurse could make decision to go to the student vs. student coming into Health Office. This will allow for less movement of students throughout the school building.
Student that is assessed in Health Office and deemed appropriate to remain in school, will return to their classroom cohort.

Students who require daily medication administration during school hours will be handled in the following manner:

Students who have doctor’s order for medication to be taken during school hours will be provided a scheduled time to report to the Health Office for their medication administration.
School Nurse will handle medication administration on a 1:1 fashion to ensure confidentially.
This workflow will allow for less movement of students throughout the school building and a controlled environment in Health Office.

Students who require diabetic management during school hours will be handled in the following manner:

Students with diabetes require that their blood glucose levels be routinely checked prior to snack, any physical activity such as PE, lunch, and dismissal. These students could also develop symptoms of low or high blood glucose levels requiring assessment and treatment with the School Nurse.
For routine blood glucose level checks, teacher or other school staff should call Health Office by telephone ext. 1322034, to check the availability of School Nurse and Health Office prior to sending student.
School Nurse could make decision to go to the student vs. student coming into the Health Office.
For symptoms of low or high blood glucose levels, teacher or other school staff should call Health Office by telephone ext. 1322034 or radio device, to review student symptoms in order for School Nurse to make sure that the Health Office is prepared to accept student based on current capacity/circumstances.
Symptomatic diabetic student will either be escorted to Health Office or School Nurse will go to student for assessment and management depending on severity of symptoms.
Once assessment, care and resolution of symptoms is achieved, student will return to their classroom cohort.

Protocol: COVID -19 Care of the Symptomatic Student

COVID-19 Description:

A novel coronavirus (COVID-19) is a new coronavirus that has not been previously identified. The virus that causes COVID-19 is thought to spread mainly from person to person through respiratory droplets produced when an infected person coughs, sneezes, or talks. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Spread is more likely when people are in close contact with one another (within about 6 feet). It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or eyes. People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People of all ages can be infected by the new coronavirus (COVID-19). Older people, and people with pre-existing medical conditions (such as asthma, diabetes, and heart disease) appear to be more vulnerable to becoming severely ill with the virus. There are no specific vaccines or treatments for COVID-19 available currently.

COVID-19 Symptoms

Fever (100.0 or greater)
Chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

*Note that the manifestation of COVID-19 in children, although similar, is not always the same as that for adults. Children may be less likely to present with fever as an initial symptom, and may only have gastrointestinal tract symptoms, which should be taken into consideration during the screening process.

Multisystem Inflammatory Syndrome in Children (MIS-C):

MIS-C is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. We do not yet know what causes MIS-C. However, we know that many children with MIS-C had the virus that causes COVID-19 or had been around someone with COVID-19.

Symptoms of MIS-C

Fever
Abdominal pain
Vomiting
Diarrhea
Neck pain
Rash
Bloodshot eyes
Feeling extra tired

*Not all children will have all the same symptoms.

The following steps should be taken if a student exhibits any of the above symptoms.

School Health Professional (Professional Registered Nurse) to conduct initial assessment and review of past medical history for chronic conditions that could explain presenting symptoms, ie. allergies, asthma. Standard and transmission- based PPE to be worn by School Health Professional.
If no chronic condition noted in health chart, student to be placed in visually supervised isolation area until departure from school with parent/guardian. Supervising staff will maintain social distancing and wear appropriate PPE.
Symptomatic student will wear mask at all times, unless unable due to breathing difficulty or other medical condition.
Parent/guardian notification of symptoms exhibited, and pickup arrangements made.
Reassessment of symptomatic student every 15-30 minutes by School Health Professional until departure.
Upon parent/guardian arrival, student escorted out of building to parent/guardian by School Health Professional.
COVID- 19 checklist of symptoms reviewed with parent/guardian; instruction provided to parent/guardian that student requires medical evaluation by health care provider. If needed, parent/guardian will be provided location of nearest health clinic or testing site.
Parent to be instructed to contact School Health Professional with outcome of student’s medical evaluation.
Following student departure, cleaning and disinfecting of all contaminated areas will be performed by custodial staff according to CDC guidelines.
Depending on student diagnosis, notification to Schoharie County Health Department.

Symptoms of COVID-19/MIS-C requiring immediate attention and ambulance transport to emergency rooms

Respiratory distress
Persistent pain/pressure in chest
New confusion
Inability to wake or stay awake
Bluish lips or face
Severe abdominal pain

Protocol: COVID-19 Student Return to School after Illness/Infection or Exposure

If a student is not diagnosed by a healthcare provider (physician, nurse practitioner, or physician assistant) with COVID-19 they can return to school:

Once there is no fever (100.0 or greater), without the use of fever reducing medications, and they have had no symptoms for 24-hours;

If they have been diagnosed with another condition and have a healthcare provider written note stating they are clear to return to school.

If a student is not evaluated by a healthcare provider per School Nurse recommendation, they should not be at school and should stay home until:

It has been at least 10 days since the student first had symptoms;
Student has been evaluated by a healthcare provider for appropriate diagnosis.

If a student is diagnosed with COVID-19 by a healthcare provider based on a test result OR their symptoms,

they should not be at school and should stay at home until:

It has been at least 10 days since the student first had symptoms;
It has been at least three days (3) since the student has had a fever (100.0 or greater) without using fever reducing medications; and
It has been at least three days (3) since the student’s symptoms improved, including cough and shortness of breath.
School Health Professional (Professional Registered Nurse) will work in collaboration with local health department to ensure contact tracing procedures are followed in accordance with the NYS Contract Tracing Program. School will assist local health department by:
- Keeping accurate attendance records of students and staff;
- Ensuring student schedules are up to date;
- Keeping a log of any visitors which includes date, time, and where in the school they visited
School Health Professional (Professional Registered Nurse) will work in collaboration with local health department to ensure that the student diagnosed with COVID-19 has completed the appropriate home isolation period and that the student is cleared to return to school.

If a student has been exposed to a confirmed case of COVID-19, they should not be at school and stay at home until:

Requirements for home quarantine of any student who was exposed to a confirmed case of COVID-19, will be established, and followed in coordination with the local health department.
Depending on exposure level, local health department will determine the length of home quarantine period:
- General guideline: If student has had close or proximate contact with a confirmed case of COVID-19 for a prolonged period of time AND is not experiencing COVID-19 related symptoms, the student may return to school upon completing 14 days of home quarantine.
- Home quarantine period will be determined by local health department and communicated to School Health Professional (Professional Registered Nurse).
School Health Professional (Professional Registered Nurse) will work in collaboration with local health department to ensure contact tracing procedures are followed in accordance with the NYS Contract Tracing Program. School will assist local health department by:
- Keeping accurate attendance records of students and staff;
- Ensuring student schedules are up to date;
- Keeping a log of any visitors which includes date, time, and where in the school they visited

School Health Professional (Professional Registered Nurse) will work in collaboration with local health department to ensure that the student exposed to a confirmed case of COVID-19 has completed the appropriate home quarantine period and that the student is cleared to return to school.

*Note:

CDC recommendations for discontinuing home isolation in persons known to be infected with COVID-19 could, in some circumstances, appear to conflict with recommendations on when to discontinue home quarantine for persons known to have been exposed to COVID-19. CDC recommends 14 days of home quarantine after exposure based on the time it may take to develop illness if infected. Thus, it is possible that a person known to be infected could leave home isolation earlier than a person who is home quarantined because of the possibility they are infected.

Resources:

NYSDOH Reopening New York, Guidelines for In-Person Instruction at Pre-K to Grade 12 Schools Summary Guidelines; https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/P12_EDU_Summary_Guidelines.pdf

NYSDOH Interim Guidance for In-Person Instruction at Pre-K to Grade 12 Schools During the COVID-19 Public Health Emergency, Master Guidance, dated 7/13/2020; https://www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/Pre-K_to_Grade_12_Schools_MasterGuidence.pdf

New York State Department of Health Novel Coronavirus (COVID-19) Website https://coronavirus.health.ny.gov/

New York State Education Department Coronavirus (COVID-19) Website http://www.nysed.gov/coronavirus

CDC Symptoms of Coronavirus, https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

NYSED Reopening Guidance, http://www.nysed.gov/common/nysed/files/programs/reopening-schools/nys-p12-school-reopening-guidance.pdf

New York State Department of Health Novel Coronavirus (COVID-19) Website https://coronavirus.health.ny.gov/

New York State Education Department Coronavirus (COVID-19) Website http://www.nysed.gov/coronavirus

Centers for Disease Control and Prevention Coronavirus (COVID-19) Website https://www.cdc.gov/coronavirus/2019-ncov/index.html