School Health Office Data Collection and Responsibilities

Emergency Care Data Collection (NYSCSH)

The following data collection is being done on a voluntary basis.  This is not mandated but data collection is important to demonstrate the response of the school nurse in a medical emergency, to help advocate for staffing needs, create policy and programs, and to create a healthy and safe environment.  Please complete the following forms if the emergency medication or treatment listed is used:

AED Administration Sample Reporting Tool 

Concussion Injury Sample Reporting Tool 

Diastat Administration Sample Reporting Tool 

Epinephrine Administration Sample Reporting Tool 

Glucagon Administration Sample Reporting Tool 

Opioid Overdose Prevention Sample Reporting Tool 

*Note: All naloxone use should be reported in accordance with district policy utilizing the NYSDOH Reporting Form located on the NYSDOH website.  Click here for the form

Health Data Documentation and Tracking Forms:

Beginning of School Checklist for the Professional School Nurse - List of tasks for the beginning of the school year.

End of School Checklist for the Professional School Nurse - List of tasks for the end of the school year

Class Screening Record Log (Word) - Tracks vision, hearing, height, weight, and scoliosis by teacher/class.

Class Screening Record Log (Excel) - Tracks vision, hearing, height, weight, and scoliosis by individual students. 

Data Collection Calendar for Secondary School Nurses (can be customized) 

Data Collection Calendar for Elementary School Nurses (can be customized)

Student Daily Visit Form- Aids school health personnel in tracking follow-up on student visits to the health office. It is available in landscape and portrait and is customizable. (1/2018)

Students Healthcare Needs Tracking Form- Customizable chart to list health concern, orders, medications, ECP status, and notes (NYSCSH 2/2021)

School Nurse Weekly Worksheet (Excel)

School Nurse Monthly Activities Recording Form 5/11/20

School Nurse Responsibilities | Checklists | Monthly Overview of Tasks:

Nursing Monthly Responsibilities

Nursing Quarterly/Semiannual Responsibilities

Nursing Annual Responsibilities

Page updated 4/7/21