Student Individual Healthcare Plan (IHP)

A nurse-developed school healthcare plan for documenting a student's chronic condition, daily care needs, nursing interventions, emergency actions, and delegation procedures during the school day.

Plan Identification

• Student full name
• Student ID
• Date of birth
• Grade level
• School name
• Plan effective date
• Planned review date
• Primary health condition
  Briefly describe the chronic condition or health need this plan addresses.

Health Status and Care Needs

• Condition summary
  Describe the condition in school-appropriate terms, including how it may affect attendance, learning, mobility, nutrition, or participation.
• Common symptoms or warning signs
  List observable symptoms staff should recognize.
• Known triggers or aggravating factors
• Activity limitations
  Describe any restrictions or accommodations for PE, recess, field trips, or transportation.
• Nutrition or hydration needs
  Include meal timing, snacks, water access, or feeding support if applicable.
• Required healthcare equipment or supplies

Routine Nursing Interventions

• Is daily monitoring required?
• Monitoring details
  Describe what should be monitored, how often, and what values or observations should be documented.
• Routine nursing interventions
  List the interventions to be performed during the school day, including timing and any required supplies.
• Medication or treatment provided at school
• Medication or treatment details
  Include the treatment name, schedule, route, and any school handling instructions. Do not collect unnecessary PII.
• Special accommodations

Emergency Response Plan

• Emergency signs or red flags
  Describe the symptoms or situations that require immediate action.
• Immediate actions for staff
  Provide step-by-step actions to take before the nurse arrives or emergency services are contacted.
• When to call parent or guardian
  State the situations that require family notification and the preferred contact order.
• When to call emergency services
  List the criteria for calling 911 or local emergency services.
• Emergency contact instructions
  Include any school-specific escalation or after-hours instructions.

Delegation and School Staff Instructions

• Is delegation required?
• Delegated tasks
• Authorized staff roles
  Identify the staff roles or positions authorized to carry out delegated tasks after training and competency validation.
• Training and competency validation
  Document training topics, competency checks, and any refresh schedule required for safe delegation.
• Supervision requirements
  Describe when the nurse must be present, available by phone, or provide direct supervision.
• Substitute coverage plan
  Explain what happens if the assigned staff member is absent or unavailable.

Consent, Communication, and Review

• Parent or guardian consent to share relevant health information with school staff
  Consent is limited to the minimum necessary information needed to support the student during the school day.
• Communication preferences
  List preferred contact methods and any language or accessibility needs.
• Additional notes
  Use this field only for information directly related to the healthcare plan.
• Plan review frequency
• Reviewer name
• Review date