Field Trip Preparedness

Policies and Procedures

Each school district should consider developing a policy and/or procedures related to fieldtrips. Minimally, a district’s medication administration policy and procedures should address medication administration on field trips. In most schools, health or education staff is assigned responsibility for handling and administration of medications. Parents/legal guardians may choose, but are not required, to accompany their students and administer medications or perform specialized care procedures.

Field Trip Accommodations

Accommodating students with health conditions, Individual Education Programs (IEPs), and 504 plans on a field trip requires careful planning and consideration to ensure their safety and well-being.

Advance planning for fieldtrips is necessary to allow time for communication and collaboration between administrators, teachers, nurses, parent/guardians, students, and other necessary school staff. It is also important for everyone to know and understand the school’s policies and/or procedures related to fieldtrips.

• Does your school or district have fieldtrip notification timelines outlined in the school policy or procedure?
  • Which team members are involved in field trip planning?
  • Who approves the field trip?
  • Which team members communicate dates for upcoming field trips and to whom?
  • How is the school nurse included in the communication?
  • If there are last minute changes to field trip dates/times/staff accompanying students, who will notify the school nurse?
• When timelines are not followed, what factors might be considered to determine the feasibility of the fieldtrip preparation request?
  • How many students will be participating in the field trip that may require health services such as students with emergency care plan (ECP), daily medications, emergency medications, and/or specialized care procedures requiring additional training and delegation?
  • Can the school nurse safely train and ensure staff competency within the shortened timeline?
  • Is adequate transportation available to meet the needs of all students, including specialized transportation to accommodate a student’s health condition?

Healthcare Needs: Arrangements must be made for students who require medication administration or specialized care procedures during the fieldtrip.

• The Licensed School Nurse (LSN) or Registered Nurse (RN) determines if there is a need for a health service staff member to accompany the trip to provide to meet the medical/nursing needs of the student(s).
  • For students with medical needs involving frequent or unpredictable changes with complex modifications, delegation to unlicensed staff should be carefully considered for student safety. Does the school or district have a plan for providing additional staff or arranging for a substitute nurse to accompany the child on the field trip?
  • If the LSN or RN determines that a nurse does not need to accompany the student/s on the trip and the medication and/or treatment can be safely delegated or assigned, the LSN or RN will either delegate or assign needed medications and/or treatments to a staff member who is going on the trip.  
• What information is communicated, and by whom, to the teachers regarding ECP review and any training needed if necessary?

Medication Administration Procedures provides specific guidance on how to prepare medications for a field trip.

Field Trips Outside of Regular School Hours

When planning for a fieldtrip outside of regular school hours, the school nurse or other health services staff may not be available to answer questions; therefore, it is important that all involved in planning the fieldtrip, including parents/guardians, are aware of health services staff availability and the plan for how medical emergencies will be handled.

If medication administration or procedures are being delegated during a fieldtrip, including a field trip that leaves before the school day begins or returns after the school day ends, part of the training for delegation should outline exactly what the person responsible for medication administration or a procedure should do if they have questions related to the task being delegated or if an emergency occurs while the school nurse is unavailable. This plan may include directing questions directly to the parents/guardians, guidance on when to call emergency medical services (911), and instructions to follow up with the school nurse once he or she is available.

Out-of-State and Out-of-Country Field Trips

Planning for out-of-state or out-of-country field trips requires careful consideration of various factors to ensure the health and safety of students throughout the trip:

• Is the school nurse licensed to practice nursing in the state(s) where the field trip occurs?
• Does the district and school nurse have a clear understanding of the nursing scope of practice and delegation regulations in all states where the students’ health care may be provided?
• Does the state(s) where the field trip occurs allow for delegation of nursing services, including medication administration, to unlicensed assistive personnel (UAPs)?
• Nursing licenses are not recognized outside of the United States.

When nursing delegation is not possible, the professional nurse can provide consultation which is a professional (RN) activity of collaborating and coordinating with others in the management of care across systems.  This is not “student specific” like delegation but population based and can include general health information to others regarding a health condition, safe medication administration procedures and emergency response.

Out-of-State and Out-of-Country Role and Responsibility

Role of the RN/LSN:

• Provide consultation on safe planning and preparation processes including considerations for identifying students with health and medical needs.
• Provide school leaders with a framework for decision making including, but not limited to:
  • Administration and storage of student medications
  • Allowance for students to self-administer medication when appropriate.
  • Considerations for individualized health needs or plans
  • Allowance for parent/guardian to train school staff (lay-person to lay-person) on their child’s medication or health needs during the trip.

District/School Responsibility:

• Creating a registration process that allows parents/guardians to identify their child’s specific medical or health needs.
• Communicating with students and parent/guardians the plan for training and delivery of health services during the trip to meet the students’ needs.
• Developing a plan for carrying and storing students’ prescription medications and copies of prescriptions during travel.
• Communicating the plan to parents/guardians and chaperones for how health and sudden illness emergencies will be communicated.

Out-of-Country Specific

District/School Responsibility:

• Understanding the applicable laws for the country where the field trip occurs.
• Determining who provides health insurance for medical care needed while on the trip.
• Understanding immunization requirements for entry into the destination country. CDC Travel Destinations provides helpful information.