Student Health Services

Major goals of our Student Health Services program include:

• assisting with access to primary health care.
• providing a system for dealing with crisis medical situations.
• providing mandated health screening and immunization monitoring.
• identification and care of student health concerns.
• promotion of comprehensive and appropriate health education.
• promoting a healthful and safe school environment that facilitates learning.
• providing a system of evaluation of the effectiveness of the school health program.

Student Health Services staff strive to create and maintain a safe and healthy environment for all students. We request that parents notify us of any health condition that may affect their child’s educational progress, especially any that may result in an emergency or require our assistance during the school day. Our staff is available to assist students and their families in planning any needed school accommodations.

Students who become ill during the school day must report to the school health office for assistance. Health office staff will provide care and contact a parent/guardian if the student needs to be released from school.

Early Childhood Screening

Early Childhood Screening (ECS) is offered to all children whose third birthday falls on or before September 1. This program is a careful, simple screening of vision, hearing, growth, development, and speech—and includes a discussion with a nurse on the health, nutritional, and immunization status of your child. ECS aims to identify any concerns to allow sufficient time to assist parents in obtaining remedial care. Nurses will assist parents in follow-up care where indicated.

ECS is part of our district's Child Find process in the identification of children with needs. ECS program participation is required by the State of Minnesota for entrance into kindergarten.

Screening Location:
Goodview Elementary School
5100 West 9th Street
Winona, MN 55987

More Information & Registration

Elizabeth McGrory

School Nurse, RN, BSN, LSN

Kathleen Calvey

Community Education Clerical Supervisor

Head Lice

Head lice (pediculosis) can be a nuisance. School health staff will follow these steps to assist students, families, and the community for prevention and when cases occur. Parents are encouraged to contact the school health office with any concerns.

Prevention at School

  • Assign individual coat hooks or lockers to students.
  • Assign permanent mats, soft toys, towels, pillows, or blankets to each student.
  • Discourage sharing of combs, brushes, barrettes, hats at school.
  • Keep students hats and scarves in coat sleeves or pockets.
  • Discourage use of dress-up centers at school, especially during outbreaks.
  • Educate teachers and staff about prevention, control, and signs and symptoms of head lice.
  • Inform staff to refer any child with the following observable signs for a screening: scratching of head, possible nits, any suspicious bug or insect in hair, red scratch marks on scalp or nape of neck.
  • Inform parents about general information and referral procedures through school handbook.
  • REINFORCE TO PARENTS THE IMPORTANCE OF REGULAR HOME SCREENINGS and of notifying school when they discover head lice at home.
  • Parents should not rely on school staff to check for head lice as this will delay treatment.
  • Parent inquiries about head lice should be forwarded to the health secretary or school nurse.

Initial Referral

  • Live lice and/or untreated nits identified by school personnel.
  • Parent contacted to complete treatment.
  • Siblings identified and checked by health staff.
  • Education of parent and letter with checklist by health secretary or school nurse.
  • Cases documented on confidential pediculosis flow sheet for follow up.
  • Custodial staff notified to vacuum classroom on the day a case identified-includes carpets, upholstered furniture, pillows, stuffed animals, etc.
  • INSECTICIDE SPRAYS ARE NOT RECOMMENDED due to allergic reactions and toxicity.
  • Fumigation or "bombing" by pest control agent are ineffective and possibly harmful.

Returning to School

  • Health secretary or nurse discusses treatment plan with parent.
  • Health staff checks child's head for evidence of live lice if symptoms continue. Some shampoos do not immediately kill lice, buy parent should not treat child again until recommended by package directions or physician.
  • Recheck of child in 7 to 10 days if necessary. If live lice found contact parent again and offer assistance.

Control at School

  • If three non-related cases are reported in a classroom within 2 weeks, consideration will be given to additional screening. The school nurse is responsible to confer with the building principal as needed.
  • The district does not have a "no nit" policy. If a student has chronic concerns, the school nurse will offer a public health nurse and/or physician referral. Parents may be asked to accompany the child to school so that the nurse can discuss and demonstrate treatment if necessary.
  • Repeated school exclusions for head lice can become educationally significant and the nurse will make a referral to the building principal to determine a plan of action.


Immunizations

Minnesota Statutes Section 121A.15 requires that all children who are enrolled in a Minnesota school be immunized against diphtheria, tetanus, pertussis, polio, varicella, Hepatitis B, measles, mumps, and rubella, allowing for certain specified exceptions. Additionally, Meningococcal (Meningitis) vaccine and a Tdap at age 11 years or later are both required for students in grades 7-12.

Exemptions to these requirements can be met by:

* A statement signed by a qualifying health care provider stating that the student has commenced a schedule of the immunizations, and the dates of the initial immunizations and planned dates for further immunizations are included.
* A statement signed by a physician stating that the immunization is contra-indicated for medical reasons, or that laboratory confirmation of the presence of adequate immunity exists.
* A notarized statement signed by the student's parent or legal guardian stating that the prescribed immunizations are contrary to conscientiously held beliefs of the parent or guardian.

Is your child protected? Not sure your child has had all the shots required for school?
Talk to your health care provider or contact your school nurse.

Please notify your School Health Office with any new immunization dates.

Resources:
"No Shots and No Exemptions..No School"

Influenza

Influenza is a respiratory disease caused by a virus. Symptoms include fever, dry cough, sore throat, headache, and body aches. Influenza is not the same as the “stomach flu”. Students who have a fever of at least 100 degrees with a cough or sore throat should stay at home, rest, and drink plenty of fluids. Students can return to school 24 hours after the fever is gone (without fever-reducing medication) if they are feeling well enough to participate in school. Check with your child’s doctor if you are concerned about your child’s illness.

At school, we work to prevent the spread of influenza by promoting handwashing and covering coughs; encouraging influenza vaccination for students, families, and staff; and supporting staying home when sick for both students and staff.

Medication

Medications should be administered at home under the supervision of the parent/guardian whenever possible. However, some students require administration of medications or provision of medical procedures during the regular school day. In those situations, the specific procedures will be followed. Additionally, if you have concerns about your child's health, it is not the responsibility of our school staff to recommend any medications, drugs, or health remedies. Please contact your health care provider for advice.


Students who need medication, including over the counter medication, during the school day must have a written order of a licensed physician AND a written authorization of a parent/guardian on file. A form for this is available online or from any school health office. Medication provided to school must be in a pharmacy labeled container. For safety reasons, the medication must be brought to school by a parent or an adult. By law, schools can no longer dispose of any unused medications at the end of the school year. Therefore it is the parent’s responsibility to pick up all medications by the last day of school.

If you need further information about medication administration at school, please contact your school nurse or the District Health Office.

Health Screening Programs

Student Health Services staff provide health screening programs as noted below and in accordance with recommendations from the Minnesota Departments of Health and Education. Parents are always informed if screening results for any program indicate there may be a concern. School nurses can provide assistance seeking resources if needed. Please contact your child’s school nurse if you need assistance or would like a screening of your child at any other grade level.

Vision and Hearing: Screening occurs each year all students in Grades 1, 4, 7, and 10. Individual school screening dates are available on the school calendar.

Color Vision: Screening occurs each year for all males in Grade 1

Scoliosis Screening: Screening occurs each fall for all females in Grade 5 and each spring for all females in Grade 6

Height and Weight: Screening as requested by parents

Communicable Disease

School nurses and health staff follow Minnesota state laws, public health policies, and medical infectious disease guidelines regarding all communicable diseases with regards to admittance, attendance, and elimination from school. General information regarding a variety of those diseases is listed on this page. Please contact your school nurse or health office with any specific questions.

Chicken Pox
Excuse until all the blisters have dried into scabs and no new blisters or sores have started within the last 24 hours; usually by day 6 after the rash began.
Chickenpox is still a common disease. It takes 10-14 days after receiving the vaccine to develop immunity, vaccine failure occasionally occurs, and the incubation period is 10-21 days. Therefore, exclude children who:
** appear to have chickenpox regardless of whether or not they have received varicella vaccine, or
** develop blisters within 10-21 days after vaccination.

Conjunctivitis
Usually no exclusion. Call your healthcare provider if the student has a fever or other symptoms (e.g., pus, eye pain, or eyelid redness). Once antibiotic treatment is started, the student may return to school unless they are unable to keep their hands away from their eyes and pose a risk to other students.

Diarrhea (Infectious) Exclusion not usually necessary. However, A student that is not feeling well and/or needs to use the bathroom at frequent intervals should not be in school. Exclusion may be necessary during outbreaks or in other circumstances.

E. Coli 0157:H7 Infection
Exclusion not usually necessary. However, students that are not feeling well and/or need to use the bathroom at frequent intervals should not be in school. Exclusion may be necessary during outbreaks or in other circumstances.

Fifth Disease
No exclusion, if other rash-causing illnesses are ruled out by the healthcare provider, since students with fifth disease are no longer infectious once the rash begins.

Hand, Foot, & Mouth Disease
Exclude until fever is gone and the student is well enough to participate in routine activities (sores or rash may still be present).

Head Lice
Exclude until first treatment is completed and no live lice are seen. (Nits are NOT considered live lice.)

Hepatitis A
Exclusion usually not recommended. Consult with your local or state health department. Each situation must be looked at to decide if the student with hepatitis A can spread the virus to others.

Hepatitis B
No exclusion. A student who is infected with hepatitis B virus may attend school. If they have unusually aggressive behavior (e.g., biting), a behavior plan may need to be made. A team of medical experts should assess oozing sores that cannot be covered or bleeding problems on a case-by-case basis to determine whether exclusion from some activities is necessary. Exclusion from school will rarely be necessary as more students become vaccinated against hepatitis B.

Hepatitis C
No exclusion. A student who is infected with hepatitis C virus may attend school. A team of medical experts should assess oozing sores that cannot be covered or bleeding problems on a case-by-case basis to determine whether exclusion form some activities is necessary.

Herpes, Oral infection
No exclusion

Herpes Gladiatorum
Exclude from contact sports until all sores are dry and scabbed. Treatment with oral (by mouth) medication may shorten exclusion time. National Collegiate Athletic Association (NCAA) guidelines recommend exclusion of wrestlers for 5 full days after treatment with oral antiviral medication has begun before they can return to competition.

Impetigo
Exclude until treated with antibiotics for 24 hours and sores are drying or improving.

Influenza
Exclude until fever is gone at least 24 hours without the use of fever-reducing drugs; and the student is well enough to participate in classroom activities.

Lyme Disease
No exclusion

Measles
Exclude for 4 days after the rash appears. A student with measles should NOT attend any activities during this time period.

Meningococcal Disease
Exclude until the student has been on appropriate antibiotics for at least 24 hours.

Methicillin-Resistant Staphylococcus aureus (MRSA) Colonization and Infection
Exclude if draining sores are present that cannot be covered or contained.

Mononucleosis (infectious)
No exclusion

Mumps
Exclude until 9 days after swelling begins.

Pertussis (Whopping Cough)
Exclude until 5 days after appropriate antibiotic treatment begins. During this time the student with pertussis should NOT participate in any school or community activities.

Ringworm
Exclude until 24 hours after treatment has been started. After this period participants of contact sports (such as wrestling) may return if lesions can be covered. If lesions cannot be covered participants should be excluded for 5 days.

Rubella (German Measles)
Exclude until 7 days after the rash appears.

Scabies
Exclude until 24 hours after treatment begins.

Shigellosis
Exclusion not usually necessary. However, a student that is not feeling well and/or needs to use the bathroom at frequent intervals should not be in school. Exclusion may be necessary during outbreaks or other circumstances.

Shingles (Zoster)
No exclusion, if blisters can be covered by clothing or a bandage. If blisters cannot be covered, the student should be excluded until the blisters have crusted. A Student with severe, disseminated shingles should be excluded regardless of whether the lesions can be covered.

Staph Skin Infection
Exclude if draining sores are present that cannot be covered or contained.

Streptococcal Infection (Sore Throat/Scarlet Fever)
Exclude until 24 hours after antibiotic treatment begins and the student is without fever.

Tuberculosis
Consult with the local or state health department. Each situation must be evaluated individually to determine whether the student is infectious and poses a risk to other students.

Viral Meningitis
No exclusion

Warts
No exclusion

For more information, contact your Healthcare Provider, School Health Services at 494-1065, or call the local Health Department.

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Laurie Jackels

Health Secretary
Winona Middle School

Mitzi Girtler

District Health Services Coordinator, RN, MSN, LSN
Winona Senior High School, Winona Middle School

Kristin Coudron

School Nurse, RN, BSN, LSN
Washington Kosciusko Elementary School, Goodview Elementary School, Jefferson Elementary School, Rollingstone Elementary School, Madison Elementary School

Elizabeth McGrory

School Nurse, RN, BSN, LSN
District Wide
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