Contains Instructions, Individualized Health Plans, Standards of Care, Provider Order forms, Documentation records/logs & resources
STANDARDS AND GUIDELINES:
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- Standards of Care for Diabetes Management in the School Setting & Licensed Child Care Facilities – Colorado 2022:
- 2024 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: 2024 SOC final 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. 2024 Collaborative Standards Review Committee
- Collaborative CGM Guidelines 2024: These guidelines are being updated as there is much controversy over the use of “remote” CGM monitoring in the schools. We advise each district to create a policy on “remote” monitoring. General guidelines are outlined in the 2024 Standards of Care.
- 2024 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: 2024 SOC final with highlights
- Standards of Care for Diabetes Management in the School Setting & Licensed Child Care Facilities – Colorado 2022:
- Emergency Medication on the Bus: 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:
- Nurse Intake Form-2020 #500 : School Nurse documentation tool for interviewing parent/guardian of student with diabetes
- School Nurse Checklist-2020 #501 : 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
- School Nurse FAQ-2020 #520
- 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.
- Provider Orders Injections 2020- 201: Orders to be completed by healthcare provider for student receiving insulin by injection and/or oral medications
- Provider Orders Pump 2020-202: 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 2024 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
- IHP-Diabetes 2024-100 : 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!
- Emergency Action Plan-2020 #100A: A stand alone emergency action plan for staff who only provided emergency care (e.g. School Emergency Response Team)
- Insulin-Medication-Addendum fillable 2021-100B-: To be used for students receiving insulin by injection and/or oral medication
- Pump Addendum 2024-100C: To be used for students on insulin pump
- CGM Addendum 2024: To be used for students with Continuous Glucose Monitor
- Type 2 Diabetes plan 2024 : This IHP should be used for students with Type 2 Diabetes in which school nurse/delegated Unlicensed Assistive Personnel (UAP) will provide diabetes management or assistance.
- Emergency Action Plan T2D : A stand alone Type 2 Diabetes emergency action plan for staff who provide emergency care (e.g. School Emergency Response Team)
- Diabetes Supplies 2021-100E-: (Optional) To be used to document supply needs.
- Daily Health Check Addendum-2020 #100F: Daily Health Check for Child Care Centers
- Diabetes Classroom Daily Care 2021-300-: Specifically, for classroom teachers, use with Hypo-Hyper Flowsheet
- Hypo-HyperFlowsheet-Plan 2020 #303
II. HEALTH CARE PLANS FOR THE INDEPENDENT STUDENT :
- Self-Management Emerg plan 2021-400: Designed for teachers of students that are independent – should be used with the Hypo-Hyper Flowsheet (below).
- Self Management Agreement 100-IHP-Diabetes_2024: Agreement/care plan to be signed by student, parent and school nurse
- Hypo-Hyper Flowsheet-Plan 2020 #303
III. OPTIONAL HEALTH CARE PLANS & FORMS:
- Diabetes Classroom Daily Care 2021-300-: Individualized plan for the classroom
- Hypoglycemia Flowsheet #301 : Visual tool for responding to hypoglycemia
- Hyperglycemia Flowsheet #302 : Visual tool for responding to hyperglycemia
- Hypo-Hyper Flowsheet Plan 2020 #303 : Visual tool that includes response to both hypoglycemia & hyperglycemia
- Insulin carb calculation worksheet 2024-502 Documentation tool for daily Insulin Carb dosing
- School Reporting Form-BDC #505 : Optional form to report Blood Glucose that are out of range
- 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 2024 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 Clinical Practice Guidelines
ADA Position Statement-Diabetes Care in School 2024
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.