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Section Title

Students engaged

Student Health

Medications at School

If you or your student needs to take a medication at school. Please call the school office and ask to talk with the nurse. Enclosed are the required forms.

Health Manual

Section I: Purpose and Goal of School Health Program

Eight Components of a Coordinated School Health Program

Our department’s mission focuses on improving the health of students and staff by providing

coordination and resources in eight component areas of school health. The components are:

  • Health Education
  • Safe Environment
  • Health Services
  • Mental and Social Health
  • Physical Education
  • Staff Wellness
  • Nutrition Services
  • Family/Community Involvement

With all the components in place and working together, students will be healthier, in school, in class, and ready to learn.

Purpose of School Health Program

The purpose of the Rowan-Salisbury Schools’ school health program is to maximize student learning by the modification or removal of health related barriers to learning and by promotion of an optimal level of wellness. The program will promote cooperation between school health program personnel, students, parents/guardians, educators, staff members, and other community resources in an effort to help students reach their full potential. The school health program is designed to assure procedures are in place for those who become ill or injured while at school.

The school health program is not a substitute for the health care that parents/guardians should provide for children. Parents/guardians should be encouraged to use the services of private physicians, dentists, optometrists and other community health agencies whenever needed.


The goal of the Rowan-Salisbury Schools’ school health program is to help each child achieve

and maintain optimum health to assure physical, emotional, and intellectual growth.


  1. To identify health problems which may interfere with the child’s performance in school using the following methods.
    1. Teachers shall observe for signs or symptoms of illness, injury, nuisance disease (such as lice, scabies), or deviation from normal behavior, which might need some type of health intervention. (The teacher who sees the student daily and knows how he/she looks and acts, readily recognizes when he/she is not well.) Parents/guardians will be notified when the teacher has a concern.
    2. The school will distribute Kindergarten Health Assessment forms to parents at kindergarten registration.
    3. Emergency information sheet completed annually by parent.
  2. To assist in the prevention of communicable disease using the following methods.
    1. The school will inform parents of requirements and request immunization records.
    2. School staff will screen students for lice on the first day of the school year, on the first day after Christmas Break, and as indicated.
  3. To provide a comprehensive health education program to all school-age children using the following methods.
    1. School staff will formulate and implement a comprehensive health curriculum and contact resource people for assistance in health education activities. Any speakers in the area of family life education will be given a copy of the Family Life Policy and Regulations.
  4. To assure that the physical facilities and food handling practices do not endanger the health of students, teachers, other school staff, or others using the premises. To these ends we employ the following methods.
    1. Health Department Environmental Specialists will inspect wells and septic systems in each school according to state criteria.
    2. Health Department Environmental Specialists will inspect lunchrooms in every school according to state criteria.


Confidentiality of Health Information in Schools


Student health information, both written and oral, is confidential. The information should only be shared with those individuals who could enhance the educational process of the student by understanding an underlying health problem.

Traditionally, most school children have been healthy and have needed school health services primarily for basic screening procedures or communicable disease control. In addition to this focus on physical health, the health of school children now addresses psychosocial concerns such as behavioral disturbances, child abuse, stress, and substance abuse. Similarly, passage of PL 94-142 and PL 99-457 has meant that children with complex medical problems who formerly were served in acute care institutions are now being educated in classrooms across the nation. In order to provide for the safety and well being of these students during the school day, an understanding of existing health problems needs to be communicated to appropriate personnel.

It is essential to treat all information confidentially. There may be a need to know of an existing health condition in order to modify an education plan to meet health and safety needs of a student. In accordance with law, local policies, and professional standards, the registered school nurse has the specialized skill, judgment, and knowledge to determine which health information is educationally relevant and which school personnel would need the information. Sharing of confidential information for any other purpose would be inappropriate and unethical. Breach of confidentially could result in financial or civil liability.


(a) Each LEA shall make available a registered nurse for assessment, care planning, and on-going evaluation of students with special health care service needs in the school setting. Special health care services include procedures that are invasive, carry reasonable risk of harm if not performed correctly, may not have a predictable outcome, or may require additional action based on results of testing or monitoring.

(b) Care planning includes but is not limited to:

    1. identification of appropriate person(s) to perform the procedure;
    2. teaching those persons to perform the procedure; and
    3. identification of a mechanism for registered nurses or other persons qualified by state law to plan and implement such health to provide ongoing supervision to ensure the procedure is performed appropriately and monitoring the student's response to care provided in the school setting.

(c) To assure that these services are provided, LEAs shall have the flexibility to hire registered nurses, to contract with individual registered nurses, to contract for nursing services through local health departments, home care organizations, hospitals and other providers, or to negotiate coverage for planning and implementing these services with the licensed physician, nurse practitioner, or physician assistant prescribing the health care procedure.

(d) LEAs shall implement this Rule in compliance with the provisions of G.S. 115C-307(c).

History Note: Authority G.S. 115C-12(9)c.; 115C-81; 115C-307(c);

Eff. July 1, 1995.

Students with Special Health Care Needs

Consistent with the State Board of Education Policy #04A107 and 16 NCAC 06D.0402, the local LEA will make available a registered nurse for assessment care planning, and ongoing evaluation of students with special health care service needs in the school setting. The school nurse shall determine the level of personnel (licensed or unlicensed) needed to perform the care at school and, with the school administrator(s), will identify appropriate persons to provide care.


  1. Students with special health care needs, including those who are technology dependent, shall be referred to the school nurse. Parents, teachers, and administrators are responsible for notifying the school nurse when students with special health care needs enroll in school. At this time the school nurse shall obtain information to determine health needs that may occur at school.
  2. The school nurse, as the school staff member with the knowledge and expertise in health care management at school, shall develop a plan of care. This plan of care will describe the care that is needed to safely care for the student at school and will be based upon consultation with the student’s medical care provider(s), parents/guardians, and the student when applicable.
  3. The school nurse will be responsible for teaching and monitoring procedures performed and for evaluating the student’s response to care. The nurse will develop a system of documentation validating training, performance, and ongoing supervision of designated personnel. Designated school personnel shall keep a daily log documenting care given and student’s response to care.
  4. Students shall be instructed in self-care when appropriate to do so.

Section II: Immunizations and School Entry Physical Assessments

Student getting physical assessment

Frequently Asked Questions

What do I need to do to be ready for school?

Where can I see the most up to date information on NC required immunizations?

North Carolina General Statutes

What are the Immunization Requirements? 

North Carolina Immunization Guidelines

How do I prove my child has the right immunizations?

Ask your doctor for a Certificate of Immunization (vaccine record)

How long do I have to provide the Certificate of Immunization?

30 calendar days from the first day of attendance.

What circumstances can make my student except from immunization?

North Carolina Immunization Exemptions

If my student is already enrolled, are additional immunizations required?

Students who will enter the 7th grade this year must receive one dose of Tdap vaccine and one dose of Meningoccal (MCV) vaccine for individuals who have not already received those vaccines.

North Carolina Immunization Guidelines

Required Vaccines for all Students - Kindergarten through 12th grade

DTP/DtaP (Diphtheria, Tetanus and Pertussis): Five doses

The last dose must be after the fourth birthday If the 4th dose is given on or after the 4th birthday, the fifth dose is not required

Polio (IPV): Four doses

If the third dose is given on or after the fourth birthday, a forth dose is not required

HIB (Haemophilus Influenza Type b: If child is 5 or older, HIb is not required.

Hepatitis B: Three doses

The last dose of the vaccine series shall not be administered prior to 24 weeks of age.

MMR (Measles, Mumps and Rubella)

Measles: Two doses Separated by at lease 30 days. 1st dose on or after 1st birthday

Mumps: One or Two doses One dose on or after age 12 months for all students Two doses for students entering school for the first time on or after July 1, 2008

Rubella: One dose Administered on or after the first birthday

Varicella: Zero, One or Two doses

None for students born before April 1, 2001 One dose for students born on or after April 1, 2001 administered on or after 12 months of age Two doses for students entering kindergarten after July 1, 2015

Vaccines Required for Students Entering 7th Grade after July 1, 2015

Tdap (Tetanus/Diphtheria/Pertussis): One dose for student who have not previously received it

MCV (Meningococcal Conjugate Vaccine): One dose

Additional Information

HPV Vaccine

Flu Fact Sheet

MCV Fact Sheet

Diarrhea Fact Sheet

Section III: Communicable Disease Policies/Procedure

Section IV: Emergency Care/Illness

Automated External Defibrillator (AED) Guidelines

Updated: 10/09/08


  • An AED is a device that analyzes the heart’s electrical rhythm and, if necessary, prompts you to deliver a shock to a victim of sudden cardiac arrest (SCA)
  • This shock, called defibrillation, may help the heart to re-establish an effective rhythm.
  • Delivering an electrical shock with an AED disrupts abnormal electrical activity long enough to allow the heart to develop an effective rhythm on its own.
  • The sooner a shockable rhythm is identified and the defibrillation shock is administered, the greater the likelihood the victim will survive.
  • Defibrillation is not intended to restart a heart without any electrical activity. It treats the specific abnormal electrical rhythm, V-Fib.
  • Although current defibrillation equipment was designed for adults, it has been viewed by the scientific community as able to deliver the needed amount of electricity and accurately identify the rhythms in children 8 years and older.

Key points when using an AED

  • Do not use an AED and/or electrode pads designed for adults on a child under
  • age 8 or less than 55 pounds.
  • Do not touch the victim while the AED is analyzing. Touching or moving the
  • person may affect the analysis.
  • Do not touch the victim while the device is defibrillating. You or others could be
  • shocked.
  • Prior to shocking a person with an AED make sure that no one is touching or in contact with the person or the resuscitation equipment.
  • Do not use alcohol to wipe the victim’s chest dry. Alcohol is flammable.
  • Do not defibrillate someone when around flammable materials, such as gasoline or free-flowing oxygen.
  • Do not use an AED in a moving vehicle. Movement may affect the analysis.
  • Do not use an AED on a person who is in contact with water. Move victims away from puddles of water or swimming pools, or out of the rain, before defibrillating.
  • Do not use an AED on a victim wearing a nitroglycerin patch or other patch on the chest. With a gloved hand, remove any patches from the chest before attaching the device. Wipe off any medication left on the chest.
  • Do not use a mobile phone or radio within 6 feet of the AED. This may interrupt analysis.


  • Goal: To ensure an organized, efficient and effective response to life threatening emergencies requiring the use of an automatic external defibrillator (AED)
  • Any AED to be purchased for a school in the Rowan Salisbury School System must receive prior approval by the Director of Student Services to assure continuity of brand and to facilitate training of staff.
  • Any AED purchased for and installed at a school must comply with the Rowan-Salisbury Schools written policy regarding the installation and use of the AED on school property.
  • Each school that plans to purchase an AED will have a written Emergency Response Plan. This plan will be developed in collaboration with the school nurse. The plan is to be reviewed at the beginning of each school year and periodically throughout the year.
  • Each school will be offered yearly in-service for all staff by the school nurse. At this time staff will:
    • Have a brief training about the AED
    • Will be told the location of the AED and how to get it out of the cabinet
    • Will review the AED Emergency Response Plan
    • Will meet the AED Emergency Response Team members
  • Each school will have an AED Emergency Response Team. The AED Emergency Response Team will be made up of the following staff.
    • School Administrator
    • A minimum of 4 staff members who are currently certified in CPR/AED by the American Red Cross or the American Heart Association.
  • The AED Emergency Response team will begin each year with:
    • A review of the AED Emergency Response Plan
    • Each member must provide proof of current CPR/AED certification
  • All AED Incident Forms will be stored and maintained as follows:
    • Student related forms are to be stored and maintained with confidential health information and accident reports.
    • Employee related forms are to be stored and maintained with the employee’s personnel file or with risk management and a copy with accident reports.
    • Visitor related forms are to be stored and maintained with accident reports.
  • Monthly maintenance checks will be done. The school administrator will decide who is responsible for maintenance and paperwork relating to this.
  • All monthly check forms will be maintained for a minimum of three years at the school site in a safe location.
  • After an AED emergency response someone from the school will take the AED to Student Services Office. The AED will be connected to a computer to print a copy of the AED’s activity during the emergency. This will be stored with the AED incident forms.
  • After each AED emergency response, the team will meet to evaluate the emergency situation and make changes in the Emergency Response Plan if indicated.

Section V: First Aid Management & Emergency Care of Common Illnesses/Injuries

General Guidelines

NC Emergency Guidelines for Schools (2009 Edition)

Specific to Rowan Salisbury School System

  • Fever Rule for RSS:   Fever Rule
  • Epinephrine Auto-injector for the Undiagnosed Person

            RSS Policy:  Epinephrine Auto-injector for the Undiagnosed Person

            RSS Procedure:  Emergency Epinephrine Procedure    

Emergency Care

These are general guidelines and are not RSS policy or regulation.  If a student is experiencing urgent symptoms related to a known diagnosis and has a current plan of care or emergency action plan, follow the instructions on the plan. For questions, please call the school nurse assigned to your school.

Section VI: Screening in the Schools (Hearing, Lice, Vision)

Audio Metric Hearing Screenings

Hearing screenings are performed by the school nurses on an “as needed” basis.

Head Lice Screenings

Elementary Schools: The classroom teacher may screen every child on the first day of school and the first day after Christmas break.

Elementary, Middle, High Schools: The teacher may screen any student who shows symptoms of head lice infestation.

It may be advisable to screen siblings of a student with infestation. Obtain parent permission before screening siblings. If a parent declines the screening of a sibling, encourage the parent to check the sibling as well as all family members.

Vision Screenings

The school nurses perform vision screenings in grades 1,3, & 5 and for those students who are referred by their teacher, parent, or self-referral for possible vision problems.

The parent/guardian is notified of issues that warrant further evaluation by a healthcare provider.

In certain circumstances, school staff can be trained by the school nurses to perform initial vision screenings.



Rowan-Salisbury Schools Pilots State Renewal Program

The State of North Carolina passed HB 986 enabling qualifying school districts to become a renewal district. Currently only Rowan-Salisbury Schools district qualifies. On June 28th the RSS Board of Education elected to participate in this program. Click for details.