Much of what a school nurse does in schools is governed by state statute and/or rules. School nurses should be familiar with where to find relevant legislation, and how they can become involved in the legislative process.

All nurses should know what the Nurse Practice Act says, and understand how to implement it correctly. Below are links to some of the most commonly questioned statutes relating to schools.

Nurse Practice Act (58-31b)
https://le.utah.gov/xcode/Title58/Chapter31b/58-31b.html?v=C58-31b_1800010118000101

Nurse Practice Act Rule (R156- 31b)- 701b is specific to school nursing
https://rules.utah.gov/publicat/code/r156/r156-31b.htm

Vision Screening (53G-9-404)
https://le.utah.gov/xcode/Title53G/Chapter9/53G-9-S404.html?v=C53G-9-S404_2019051420190514

Vision Screening Rule (R384-201)
https://rules.utah.gov/publicat/code/r384/r384-201.htm

Medication (53G-9-501)
https://le.utah.gov/xcode/Title53G/Chapter9/53G-9-P5.html?v=C53G-9-P5_2018012420180124

Stock Epinephrine, Stock Albuterol, and Stock Glucagon (26B-4-406-412)
https://le.utah.gov/xcode/Title26B/Chapter4/26B-4-P4.html

Immunization Requirements (53G-9-301)
https://le.utah.gov/xcode/Title53G/Chapter9/53G-9-P3.html?v=C53G-9-P3_2018012420180124

Nurses are expected to follow the scope and standards of nursing practice. The American Nurses Association has worked with stakeholders to provide this for specific nursing specialties, including school nursing. There is a book available for purchase from a variety of vendors. Below you can find a presentation on the Scope and Standards of School Nursing Practice given by one of our own school nurses who contributed to the book:

Scope and Standards of School Nursing Practice by Cescilee Rall.pptx

Delegation of School Nursing Tasks in Utah

All students attending public schools must have access to health care during the school day and for extracurricular school activities if necessary to enable the student to participate fully in the program. The federal laws include the Americans with Disabilities Act (ADA), Individuals with Disabilities Education Act (IDEA), and Section 504 of the Rehabilitation Act of 1973. Since most schools in Utah do not have a full time nurse in each school it is often necessary to delegate specific nursing tasks to Unlicensed Assistive Personnel (UAP) so that children with special healthcare needs can attend school. Knowing when and how to delegate specific nursing tasks is essential for the school nurse. Only a professional nurse can delegate nursing care. Further, nursing delegation is not appropriate for all students, all nursing tasks, or all school settings (NASN, 2014). Tasks commonly performed by a parent/guardian at home take on a more complex dimension in the school setting. What appears to be a simple task is held to a much higher standard at school. Any health- related procedure in school requires medical orders, and licensed nurses are held to a higher standard than a parent would be for the same procedure (Resha, 2010).

Delegate means to transfer to an unlicensed person the authority to perform a task that, according to generally-accepted industry standards or law, does not require a nursing assessment (R156-31b-102 SS 10,C)

Assessment, planning, evaluation and nursing judgment cannot be delegated. Delegation is a student and situation specific activity in which the nurse must consider all components of the delegation process for each delegation decision.

The above was adapted from a similar tool previously developed by Colorado titled “Guidance on Delegation for Colorado School Nurses & Child Care Consultants”.

References

National Association of School Nurses. (2014). Nursing delegation to unlicensed assistive personnel in the school setting. Position Statement. Silver Springs, MD. Author.

Resha, C. (2010). Delegation in the school setting: Is it a safe practice? OJIN: The Online Journal of Issues in Nursing. 15(2).

Delegation tree 5-12-2022.jpg

Delegation tree 5-12-2022.pdf