Presence of food allergy emergency action plans in Mississippi.

BACKGROUND: Multiple national, state, and local organizations recommend that emergency action plans (EAPs) direct therapy of allergic reactions in schoolchildren. OBJECTIVE: To investigate the school nurse's perception of food allergies and the presence of EAPs for food allergic students in Mississippi. METHODS: An investigator-developed food allergy survey was offered to all Mississippi public school nurses in 2008 and 2009. RESULTS: The survey had a combined response rate of 29% (194/659) for the 2 years of the study. In both years, most participating school nurses had at least 1 food allergic student at their school (mean [SD], 11 [10] students per school). In 2008, 30% (28/93) of the school nurses reported that food allergy EAPs were present for all of their food allergic students, whereas 29% (27/93) of school nurses had 0% to 10% of their known food allergic students on EAPs. Similarly, in 2009, 37% (34/93) of school nurses reported all of their food allergic students possessed a food allergy EAP, whereas 26% (24/93) of school nurses had 0% to 10% of their known food allergic students on EAPs. In 2008, students were more likely to have food EAPs if the nurse received information on food allergies from parents or a physician or if the student attended a school in an urban area. However in 2009, only if the nurse received information from a physician were they more likely to have an EAP for their students. CONCLUSION: Although numerous organizations recommend food allergy EAPs for allergic students, our study highlights their inconsistent use in Mississippi.

Disparity between the presence and absence of food allergy action plans in one school district.

The Joint Task Force of the American College of Allergy, Asthma and Immunology and the American Academy of Allergy, Asthma and Immunology; the American Academy of Pediatrics; and the National Association of School Nurses all recommend emergency action plans (EAPs) that direct therapy of allergic reactions in children. This study investigated the school nurse's perception of food allergies and their use of EAPs in food-allergic students in a large, socioeconomically diverse school district. An electronic and paper survey was developed and administered to all elementary and middle school nurses in Greenville County, SC. Forty-three of the eligible school nurses participated for a response rate of 64% (43/67). All of the participants worked at schools that had at least one student with food allergies (mean, nine students with food allergies per school; SD, seven students). Forty-four percent (19/43) of schools had a written action plan for all their food-allergic students, whereas in 42% (18/43) of schools, one-half or less of the food-allergic students, had an action plan. Seventy percent (30/43) of schools made at least one accommodation for students with food allergies and 23% (10/43) of schools made multiple accommodations. At least three additional school personnel were trained in administering rescue medications besides the school nurse in 86% (37/43) of schools, but in 5% (2/43) of schools no additional adults were trained to give rescue medications. Although multiple organizations recommend EAPs for food-allergic students, our study highlights their inconsistent use in this school district.