The Effects of an Evidence-Based Food Allergy Management Plan to Keep Children with Food Allergies Safe at School

Primary Submission Contact

Scarlet R Spain MSN, CNS, FNP-BC

Faculty Sponsor

Suzanne Zentz DNP, RN, CNE

Faculty Sponsor Email Address





Doctorate of Nursing Practice

Document Type

Oral Presentation


Spring 4-30-2015


The Effects of an Evidence-Based Food Allergy Management Plan to Keep Children with Food Allergies Safe at School

Scarlet R. Spain MSN, CNS, FNP-BC

The prevalence of food allergies in children has increased 18% between 1997 and 2007 (CDC, 2013). Furthermore, 84% of food allergic children will experience a reaction at school (Powers, Bergren, & Finnegan, 2007). An exposure in a sensitive child may progress quickly into potentially life threatening symptoms and death if not treated. The purpose of this evidence based practice (EBP) project was to determine if implementation of a food allergy management policy in a school setting reduced overall incidence rates of food allergy reactions in school children and to examine compliance to policy guidelines. This EBP project was conducted at a charter school in Northwest Indiana that educates approximately 500 children, grades kindergarten through eighth grade. The project encompassed implementation of a revised food allergy policy based on best practice guidelines. Best practice recommendations reflect a multilevel model that includes an individualized plan for each child. Key factors for food allergy management include avoidance, a personalized emergency care plan (ECP), and staff education. A 60-minute educational session for staff members and volunteers was provided reviewing the best practice policy and demonstration of two common epinephrine auto injectors. Independent t tests were conducted to compare numbers of food allergy exposures and incidence of reactions from Spring 2014 (pre policy implementation) to Fall 2014 (post policy implementation). Analyses revealed there were no significant differences between groups. Secondary analyses examined policy compliance via chi-square test of independence and significant interactions were found. An increase in food allergic children having ECPs on file at school, recommended medications readily available, and medications consistently traveling with food allergic children for use in emergency situations occurred post policy implementation. Statistically, policy implementation did not result in a significant difference in incidence rates of food allergy reactions from the pre policy implementation phase to the post policy implementation phase. However, a policy did improve compliance with having appropriate medication available if a reaction occurred. The findings support the overall need for a policy addressing food allergies within school systems.

Keywords: school nursing, food allergy, best practice, management, school, emergency care plan, epinephrine, elementary

Biographical Information about Author(s)

biographical material

Scarlet R. Spain

Ms. Spain graduated with her ASN from Purdue University in 2004. She began her career as an RN working on an intermediate care cardiac unit at a regional hospital. Ms. Spain continued her education and obtained her BSN from Valparaiso University in 2006 and graduated from Valparaiso University in 2008 with a MSN degree. She completed the Family Nurse Practitioner program in May of 2009 and has been practicing as a board certified family nurse practitioner since. Her experiences as a nurse practitioner have included working in internal medicine and her current employment as an occupational health nurse practitioner in a large industrial setting.

Ms. Spain is currently enrolled at Valparaiso University obtaining her Doctorate in Nursing Practice degree with an anticipated graduation of May 2015. Ms. Spain developed an interest in the management and treatment of food allergies after her daughter was diagnosed with severe allergies to peanuts, shellfish, and fish at age two after many sleepless nights and a storm of diagnostic tests. Ms. Spain’s passion to keep her daughter safe has spilled over into her professional life as her DNP project focuses on keeping the child with food allergies safe in school. Her goal is to increase awareness to keep all children affected by food allergies safe. Ms. Spain had the privilege of performing a podium presentation at the FARE Teen Summit on her research in November 2014 in Washington DC. Ms. Spain is an active member of the American Association of Nurse Practitioners, Sigma Theta Tau- Zeta Epsilon Chapter, and the Society of Nurses in Advanced Practice. She also remains involved in FARE with her daughter with the goal of supporting awareness of food allergies.

Additional Presentation Information

Tabletop Poster

This document is currently not available here.