比较有无预防和管理过敏反应立法的学校环境。
Comparing school environments with and without legislation for the prevention and management of anaphylaxis.
机构信息
National Jewish Health Faculty of Nursing, University of Toronto, Ontario, Canada.
出版信息
Allergy. 2012 Jan;67(1):131-7. doi: 10.1111/j.1398-9995.2011.02721.x. Epub 2011 Sep 27.
BACKGROUND
School personnel in contact with students with life-threatening allergies often lack necessary supports, creating a potentially dangerous situation. Sabrina's Law, the first legislation in the world designed to protect such children, requires all Ontario public schools to have a plan to protect children at risk. Although it has captured international attention, the differences a legislative approach makes have not been identified. Our study compared the approaches to anaphylaxis prevention and management in schools with and without legislation.
METHODS
Legislated (Ontario) and nonlegislated (Alberta, British Columbia, Newfoundland and Labrador, and Quebec) environments were compared. School board anaphylaxis policies were assessed for consistency with Canadian anaphylaxis guidelines. Parents of at-risk children and school personnel were surveyed to determine their perspectives on school practices. School personnel's EpiPen5 technique was assessed.
RESULTS
Consistency of school board policies with anaphylaxis guidelines was significantly better in a legislated environment (P=0.009). Parents in a legislated environment reported more comprehensive anaphylaxis emergency forms (P<0.001), while school personnel in nonlegislated environments reported more comprehensive forms (P=0.004). Despite school personnel in both environments receiving EpiPen5 training (>80%), suboptimal technique was commonly observed. However, school personnel in the legislated environment had better technique (P<0.001).
CONCLUSION
Our results suggest that school boards in legislated environments have made greater efforts to support students at risk for anaphylaxis compared to nonlegislated environments. However, significant gaps exist in both environments, especially with respect to EpiPen5 administration, content, and distribution of anaphylaxis emergency forms, and awareness of school procedures by school personnel and parents.
背景
接触有生命威胁过敏症学生的学校人员经常缺乏必要的支持，从而造成潜在的危险情况。萨布丽娜法案是世界上第一项旨在保护此类儿童的立法，要求安大略省所有公立学校制定保护高危儿童的计划。尽管该法案引起了国际关注，但立法方法的差异尚未确定。我们的研究比较了有立法和无立法（阿尔伯塔省、不列颠哥伦比亚省、纽芬兰和拉布拉多省和魁北克省）环境下的学校过敏反应预防和管理方法。
方法
比较了立法（安大略省）和非立法（阿尔伯塔省、不列颠哥伦比亚省、纽芬兰和拉布拉多省和魁北克省）环境。评估了学校董事会的过敏反应政策是否符合加拿大过敏反应指南。调查了高危儿童的家长和学校人员，以确定他们对学校做法的看法。评估了学校人员的 EpiPen5 技术。
结果
在立法环境中，学校董事会政策与过敏反应指南的一致性明显更好（P=0.009）。在立法环境中，家长报告了更全面的过敏反应紧急情况表（P<0.001），而在非立法环境中，学校人员报告了更全面的表格（P=0.004）。尽管两个环境中的学校人员都接受了 EpiPen5 培训（>80%），但仍普遍观察到技术不佳的情况。然而，在立法环境中的学校人员技术更好（P<0.001）。
结论
我们的研究结果表明，与非立法环境相比，立法环境中的学校董事会在支持有过敏症风险的学生方面做出了更大的努力。然而，两个环境中都存在明显的差距，特别是在 EpiPen5 管理、内容和过敏反应紧急情况表的分配以及学校人员和家长对学校程序的认识方面。
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