An audit on schools’ policy regarding emergency adrenaline auto-injector use and provision of spare pens in the East and North Hertfordshire region of the UK

Abstract

With the increase in the incidence of food allergies and recent adrenaline auto-injector (AAI) shortage in the UK, it is important that schools remain updated about the policy on the emergency use of AAI in schools for children at risk of anaphylaxis. The purpose of this audit is to review current practice in schools in a UK region covered by the Paediatric Allergy Service at the East and North Hertfordshire NHS Trust. We were then able to identify whether schools are aware of and following the national Department of Health guidance regarding emergency AAI use, including provision of spare pens. An online questionnaire was developed to gather information on the schools’ respective policies regarding emergency AAI use, and their awareness and engagement with the recent “Spare Pens” policy. This was sent to all 230 schools within the districts of East and North Hertfordshire, Stevenage and Welwyn Hatfield, covering 78,450 students. Out of 230 schools, 180 completed the questionnaire, covering 62,695 children aged 3-18 years. Of this cohort, 814 children are diagnosed to be at risk of anaphylaxis and prescribed with AAIs. 649 (79.7%) have allergy action plans in school. 179 (99.4%) schools train their staff regarding management of anaphylaxis, with 138 (77.1%) training every year or less. Although 136 (75.6%) were aware of the Spare Pen policy, only 32 (17.8%) stock their own AAIs. 164 (91.1%) schools keep children’s own AAIs on site, (159/164) 97% of which have them within 5 minutes’ reach, and (118/164) 72.0% store them appropriately. Majority of the respondent schools are compliant with current guidance and are aware of the “Spare pen” policy. However, there remains a need to ensure that children at risk of anaphylaxis are provided with their own action plans and AAIs that are readily accessible, because only a minority of school’s stock spare pens.