The goal of Food Allergy Exposure Prevention (FAEP) is to provide a safe environment for children who have life-threatening food allergies while minimizing the impact on the educational and nutritional experience of other students.
Intake:
For each child with a food allergy enrolled in school, the nurse or designee will take the following steps:
The school nurse or designee will be notified regarding students with food allergy, preferably before enrollment. New students will be queried as part of the health history questionnaire regarding the presence of food allergies. Current students who become diagnosed with food allergy while enrolled will immediately notify the nurse of their allergy and an action plan will be developed.
The school nurse or designee will contact parents of allergic students to request (i) a detailed Emergency Care Plan (ECP)/Food Allergy Action Plan (FAAP) (see Appendix E) from each student’s clinician and (ii) other required documentation, including (if not part of the Action Plan):
licensed health care provider orders with instructions for foods to avoid
licensed health care provider orders for medication self-administration if age appropriate
symptoms to anticipate
medication orders
emergency procedures to follow if an exposure and/or reaction occurs
a recent photo of the student
Physician Medical Statement for students requiring special meals
The school nurse or designee will contact parents of students with allergies to set up allergy intake meetings with school staff and each parent. The intake meeting may be performed by phone, if necessary. The meeting should be completed prior to the start of each school year, in order to provide parents and school staff adequate time to make necessary arrangements. During the allergy intake meeting, parents will meet with appropriate school staff (including, where applicable, an administrator, a school nurse, teachers, transportation director, and/or food service manager) to:
complete required paperwork
discuss action plan/necessary accommodations
provide medication
During (or after) each intake meeting, the school nurse or designee will complete, as appropriate, a Emergency Care Plan (ECP)/Food Allergy Action Plan (FAAP) and/or an Individualized Health Plan (IHP), and will contact the IEP/504 coordinator if indicated.
Medication Handling and Storage:
The school nurse or designee will distribute parent-provided medications (including antihistamines and epinephrine auto-injectors) to those individuals specified in the ECP/FAAP.
The school nurse or designee will maintain a schedule for tracking medication status and expiration dates.
School-provided epinephrine auto-injectors will be placed in an easily accessible location in each nurse’s office, cafeteria or any other appropriate location, and will be maintained by the school nurse.
The school nurse or designee will delegate the administration of emergency medications to properly trained school staff members supervising the child with a food allergy.
Documentation:
An essential part of exposure prevention is documenting all the steps that were taken during the intake process to ensure a safer school environment. The saying goes “if it is not written down, it did not happen.”
The school should maintain on file for each child the following:
ECP/FAAP
Licensed health care provider orders and instructions
Nursing encounters and all allergic events
The school should also maintain records on:
Medication expiration dates and location
School faculty and staff training including attendee names, dates and topics
System for retaining actual food labels for at least 24 hours after food is served
Faculty and Staff Responsibilities:
All school staff with significant contact with the student will receive a copy of the student’s individualized Emergency Care Plan (ECP)/Food Allergy Action Plan (FAAP) and are to familiarize
themselves with action plan components.
All school staff with significant contact with the child will receive training from the school nurse at least annually and as needed:
food allergy and anaphylaxis information
food label reading
proper hand washing
avoidance of cross-contact
effective environmental cleaning (i.e., table and desk washing)
provision of allergen-free tables
clear marking of foods with potential allergens
medication location, storage, usage and expiration date
emergency procedures
peer support and psychosocial needs
proper reporting and documentation
Schools are encouraged to arrange a food allergy/anaphylaxis expert presentation to
staff annually or as needed.
All school staff with significant contact with the child will take part in anaphylaxis drills at least annually and as needed.
All school staff will be made aware of the potential for students who have life threatening food allergies becoming targets for harassment, intimidation, and bullying.
The school maintenance/custodial department will identify all potential non-food allergens, including these items: cleaning supplies, paints, work materials, or other substances in the school and remove. Only non-allergenic items will be used. Cleaning protocols should include but not be limited to frequency of cleaning and type of cleaning solutions.
Substitute teachers will receive instruction regarding each student’s ECP/FAAP from the school nurse or other designated staff. Substitute teachers will receive training on food allergies and use of epinephrine at least annually and as needed.
If a reaction occurs at school, the school nurse or designee will review policies/procedures with all school staff and the child’s parents (and the child, when appropriate).
Additional School Responsibilities:
School Culture: Schools will provide education in the school community as appropriate. This may include:
letters/newsletters to parents
food allergy workshops during professional development
parent presentations/discussion
Schools will educate students regarding:
hand washing before and after eating
the importance of not trading/sharing food or drinks
food allergy prevalence, symptoms and reaction prevention
importance of taking more responsibility for their food allergies as they grow older and are developmentally ready to accept responsibility
School Nutrition Requirements:
Prior to meals, school nutrition staff or other designated staff will clean tables and chairs for use by students with life-threatening food allergies (LTFA) with your district approved cleaning solutions. It is recommended to use separate cleaning cloths or appropriate disposable wipes effective in removing allergen traces.
School nutrition staff will procure labels of all foods served in the cafeteria and compile a manual and/or computerized database of all foods and ingredients.
School nutrition staff will review all labels for potential allergens, with special attention to (i) new products, (ii) products from new suppliers and (iii) will annually do a complete review of labels.
When feasible, school nutrition staff will select distributors and products based on their ability to provide foods that (i) are thoroughly labeled and (ii) limit content of potential allergens.
The School Nutrition Director or Dietician will provide instruction to all school nutrition staff in food labeling, cross contamination, safe food handling and food item labeling requirements annually and as needed.
School Nutrition personnel will notify the school nurse or teacher of any changes in menu. The school nurse will refer to each student’s Emergency Care Plan (ECP)/ Food Allergy Action Plan (FAAP) or Individual Health Plan (IHP) and will notify parents of the student with LTFA of menu changes.
Have a process in place for identifying students with LTFA.
School Nutrition personnel will make any pre-determined substitutions or modifications for meals served to students with food allergies as necessary.
School Food Allergy Exposure Prevention Checklist:
Food allergy documented
School nurse-parent-teacher-staff meeting
Individualized Health Plan (IHP), Emergency Care Plan (ECP)/Food Allergy Action Plan (FAAP), and/or 504 complete
Licensed health care provider orders and instructions obtained
Epinephrine accessible
Expiration dates documented
School-provided epinephrine
School faculty and staff training complete
Action plan received
School food service requirements are met
School staff role specific training completed
Potential special situations considered and included in action plan
