Contains Instructions, Individualized Health Plans, Standards of Care, Provider Order forms, Documentation records/logs & resources
STANDARDS AND GUIDELINES:
- Standards of Care for Diabetes Management in the School Setting & Licensed Child Care Facilities – Colorado 2022:
- 2023 Standards of Care: These standards of care for students with Type 1 Diabetes are to be used in conjunction with the Colorado Provider Orders (DMMP) & Individualized Health Plans (IHP). The student’s health care provider may indicate exceptions to these standards on the student’s individual orders. Standards of Care with highlighted changes/additions: 2023 Final SOC with highlights
- Standards of Care in Spanish 2021: Spanish Standards of Care
- These Standards were originally developed in 2013 by the Colorado Kids with Diabetes Care and Prevention Collaborative of local health care providers, nurses and stakeholders and are updated annually. 2023 Collaborative Standards Review Committee
- 2023 Standards of Care: These standards of care for students with Type 1 Diabetes are to be used in conjunction with the Colorado Provider Orders (DMMP) & Individualized Health Plans (IHP). The student’s health care provider may indicate exceptions to these standards on the student’s individual orders. Standards of Care with highlighted changes/additions: 2023 Final SOC with highlights
- Final Collaborative Guidelines CGM 2022: Final Collaborative Guidelines CGM 2022: These guidelines are to be used if parents have requested to use the Dexcom G5 & G6 of Abbott Freestyle Libre 2 for Non-Adjunctive Insulin dosing. CGM Guidelines with highlighted changes/additions: Final Collaborative Guidelines CGM 2022 revisions highlighted
- Guiding Principles Chronic Health Conditions: Guidance from the Colorado Department of Education and the American Diabetes Association
- Bus Emergency Medication on Bus 2013: Provided by the Colorado Department of Education – guidelines for medication administration on school buses.
- ADA Guidelines for the use of Continuous Glucose Monitors (CGM) and Sensors in the School Setting: Guidance from the American Diabetes Association regarding the use of CGM in the school setting (September, 10, 2018)
- CO Nurse Practice Act Chapter 13 rules
- Allowed Delegation for DC Field trips
- OCR Dept of Ed – 504 activities copy
- Helping the Students with Diabetes Succeed: A Guide for School Personnel/ADA
GETTING STARTED:
- 2020 #500 Nurse Intake: School Nurse documentation tool for interviewing parent/guardian of student with diabetes
- 2020 #501 School Nurse Checklist: Provides a detail list for the processing of a new student with Type 1 Diabetes or for the returning student for the start of the school year
- 2020 #520 School Nurse FAQ
- NOTE: The Barbara Davis Center will provide its own computer generated orders which align with the orders on this website. Additional school or district specific medication forms are unnecessary unless they contain additional information not specified here for this student’s diabetes care.
- 201-Provider-Orders-Injections 2020: Orders to be completed by healthcare provider for student receiving insulin by injection and/or oral medications
- 202-Provider-Orders-Pump-2020: Orders to be completed by healthcare provider for student receiving insulin by pump
INDIVIDUALIZED HEALTH PLANS: The Individualized Health Plan (IHP): Diabetes in School Setting and Addendums should be used in conjunction with the 2023 Standards of Care and the individual student’s orders from their Health Care Provider.
I. HEALTH CARE PLANS FOR THE STUDENT THAT NEEDS ASSISTANCE WITH SELF CARE: (Updated 2020-04)
2020 Instructions for IHP and addendums: Provides specific directions for using the Individualized Health Plan and appropriate addendum(s)for the student with diabetes. These are meant for the delegated unlicensed personnel (health assistants, teachers, coaches) providing services
- 2021-100-IHP-Diabetes 121021: This IHP should be used for all students in which school nurse/delegated Unlicensed Assistive Personnel (UAP) will provide diabetes management or assistance. Includes Emergency Action Plan! Previous IHP: 100-IHP-Diabetes-May-2014
- 2020 #100A Emergency Action Plan: A stand alone emergency action plan for staff who only provided emergency care (e.g. School Emergency Response Team)
- 2021-100B-Insulin-Medication-Addendum fillable 121021: To be used for students receiving insulin by injection and/or oral medication
- 2020 #100C Pump-Addendum: To be used for students on insulin pump
- 2021-100D-CGM-Addendum 121021: To be used for students with Continuous Glucose Monitor
- 2021-100E-DiabetesSupplies: (Optional) To be used to document supply needs.
- 2020 #100F Daily Health Check Addendum: Daily Health Check for Child Care Centers
- 2021-300-Diabetes-Classroom-Daily-Care: Specifically, for classroom teachers, use with Hypo-Hyper Flowsheet
- 2020 #303 Hypo-HyperFlowsheet-Plan
II. HEALTH CARE PLANS FOR THE INDEPENDENT STUDENT :
- 2021 400 Self-Management Emerg plan 121021: Designed for teachers of students that are independent – should be used with the Hypo-Hyper Flowsheet (below).
- 2021-401-Agreement-for-Student-Self-Management: Agreement to be signed by student, parent and school nurse
- 2020 #303 Hypo-HyperFlowsheet-Plan
III. OPTIONAL HEALTH CARE PLANS & FORMS:
- 2021-300-Diabetes-Classroom-Daily-Care: Individualized plan for the classroom
- #301 Hypoglycemia Flowsheet: Visual tool for responding to hypoglycemia
- #302 Hyperglycemia Flowsheet: Visual tool for responding to hyperglycemia
- 2020 #303 Hypo-HyperFlowsheet-Plan: Visual tool that includes response to both hypoglycemia & hyperglycemia
- 2020-502-Insulin-Carb-Calculation-worksheet-update Documentation tool for daily Insulin Carb dosing
- #505 School Reporting Form-BDC: Optional form to report Blood Glucose that are out of range
- NEW: Pump flowsheet 4.8.2019: Great Visual flow sheet for Unlicensed Assistive Personal
SCHOOL LOG RECORDS
- Diabetes-school-log-record-for-UAP-2018: to be used by the unlicensed assistive personal(UAP) and school nurse in documenting care including BG/CGM reading, insulin, snacks, etc.
- Diabetes-school-log-record-for-RN-use update: to be used by the school nurse providing care to document care.
PROVIDER ORDER FORMS: The provider orders should be used in conjunction with the 2023 Standards of Care. The standards provide details of regarding standard of care for students with diabetes in the school setting. NOTE: The student’s health care provider may indicate exceptions to these standards on the student’s individual orders. These Standards were developed in 2013 by the Colorado Kids with Diabetes Care and Prevention Collaborative of local health care providers, nurses and stakeholders.
- NOTE: The Barbara Davis Center will provide its own computer generated orders which align with the orders on this website. Additional school or district specific medication forms are unnecessary unless they contain additional information not specified here for this student’s diabetes care.
- 201-Provider-Orders-Injections 2020 Orders to be completed by healthcare provider for student receiving insulin by injection and/or oral medications
- 202-Provider-Orders-Pump-2020 Orders to be completed by healthcare provider for student on an insulin pump.
- #203 One Time Order for BG Correction: To be used by the school nurse to Fax to provider for one-time orders or can be used to document verbal orders taken by the school nurse from provider.
For more information on clarifying orders, see Clarification of Pump Orders from BDC. The school nurse can contact their region’s Diabetes Resource Nurses or contact the Barbara Davis Center for further clarification.
Emergency Response Tools: Emergency Bucket for T1D
RESOURCES:
2020 #520 School Nurse FAQ Answers questions related to stabilizing snack, correction factors, out of state orders, lack of supplies, field trips, etc.
TSlim-X2-School-RN-Tips Jan 2020: This is a tip sheet for using the new Tandem Tslim X2 closed loop pump system
MiniMed-670G-System-School-Nurse-Guide: This guide is intended to help school nurses with the basic operation of a student’s MiniMed 670G system.
Medtronic 670G School RN Final: Quick guide for School Nurses and for training school staff
- Helping the Students with Diabetes Succeed: A Guide for School Personnel/ADA: The purpose of this guide is to educate school personnel about effective diabetes management and to share a set of practices that enable schools to ensure a safe learning environment for students with diabetes, particularly those who use insulin to control the disease (all students with type 1 and some with type 2 diabetes).
NASN Diabetes Position Statement 2017
2018 ISPAD Position Statement on Type 1 Diabetes in Schools ispad_position_statement_on_ T1D
ISPAD Clinical Practice Consensus Guidelines 2018 https://www.ispad.org/page/ISPADGuidelines2018
#728 Developmental Stages and Diabetes: Students need to be encouraged and supported to gradually assume diabetes self-care as they mature and demonstrate confidence. Newly diagnosed students may temporarily be unable to perform tasks per their developmental age until they adjust to their diagnosis and new life. This general list can help guide discussions as a child matures and advances in responsibility.