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.