Transcript DNP Scholarly Project Proposal: Improving Management of

Seizure Smart Schools Initiative:
Improving Awareness and Care of
Children with Epilepsy in Minnesota
Public Schools
Cynthia M. Hiltz, MSN, RN, NCSN, Health Service Coordinator
Heather A. Brook, BSN, RN, DNP Student, U of MN
Seizure Smart Schools Project at
Anoka-Hennepin School District
• How the partnership occurred
• The importance of community collaboration
• How care is delivered in a school
About the project site…
– Largest school district in MN: 39,000 students
– One student with epilepsy in each of its 42
schools.
– 2012-2013 school year: 312 students with a
seizure diagnosis and 514 Responses.
– Partnered with the Epilepsy Foundation of
Minnesota to start an Initiative to become a
Seizure Smart School district.
School Nurse involvement with Seizures
LSNs were already:
- providing some seizure education for staff
- developing and updating student health and
seizure emergency plans
- working with families
- communicating children's needs to staff.
Determine the needs unique to each
school district
• RN Needs Assessment:
• standardized training program for staff
• new seizure resources
• improved electronic documentation
avenues.
• Despite this, nurses identified lack of staff training and
knowledge about seizures as the greatest obstacle for
children with epilepsy.
• School nurses and teachers are in key positions to support
these students if well trained.
First School District to gain “Seizure
Smart Schools” status
Project Achievements:
• Seizure Management Guideline – standardize nursing care
• Individualized Health Plan (IHP) and Emergency Care Plan (ECP)
updated to improve seizure care documentation.
• Resources made available to LSNs (Seizure Action Plan and other
documentation records)
• Two training sessions for 26 LSNs in a “Train the Trainer” model.
• LSNs conducted trainings with school staffs in 21 Schools.
Level of Nursing Confidence with 1=
Disagree Strongly and 10= Agree Strongly:
10
Pre-test
Post-test
9
8
7
6
5
4
3
2
1
0
recognize partial
seizures
recognize
generalized
seizures
when to contact
essential
medical/social
creating a
EMS
components of a supports needed safe/supportive
seizure action
environment
plan
training to
school staff
skills to manage
students with
epilepsy
Total
Website: http://www.anoka.k12.mn.us/Page/17379
Seizure awareness
and response
posters modified for
the school setting.
Distributed to all
LSNs in the state.
How helpful were each of the following
interventions in supporting your RN role in the care
and management of students with seizures?
Response to the Project
 “I learned a lot about managing seizures and ways to help school
staff respond to seizures. It created a better awareness of seizures and
a better comfort level for school staff.”
 “Many staff communicated their appreciation of the brief training.”
 “It was nice to have the training via e-mail so staff could keep it as
a resource to review.”
 “I have had multiple teachers thank me for presenting the
information. They have stated they are not as scared of witnessing a
seizure and feel they can better help a student who has seizures with
feeling a part of school/keeping up with any missed work.”
Future Steps
For A-H School District:
– Nurses continue to train the rest of the schools that did not receive
education.
– Focus on the classrooms and working with students to reduce the
stigma of epilepsy
– Evaluate the perspectives and needs of parents of children with
epilepsy.
For Epilepsy Foundation of MN:
– Expand the program to all school districts in MN and eastern ND.
– Other school districts are seeking “Seizure Smart School” status
– Foundation Funding to expand the program.
Website: http://www.epilepsyfoundationmn.org/programs/youth/seizure-smart-schools/
School Tips
• If you have a child with epilepsy get to know
your school nurse.
• Keep the health office aware of changes in
your students seizures and treatment plans.
• Attend the school team plan meetings for your
student to have input on his/her seizure
action plan at school.
Questions?
Helpful Resources/References
Austin, J. K., Kakacek, J. R., & Carr, D. (2010). Impact of training program on school nurses' confidence levels in
managing and supporting students with epilepsy and seizures. The Journal of School Nursing, 26, 420-429.
doi:10.1177/1059840510380206
Bishop, M., & Boag, E. M. (2006). Teachers' knowledge about epilepsy and attitudes toward students with epilepsy:
Results of a national survey. Epilepsy & Behavior, 8(2), 397-405.
Bishop, M., & Slevin, B. (2004). Teachers' attitudes toward students with epilepsy: Results of a survey of elementary
and middle school teachers. Epilepsy & Behavior, 5(3), 308-315. doi: 10.1016/j.yebeh.2004.01.011
Children's Hospital of Orange County: Epilepsy Group. (2003). Managing children with epilepsy: School nurse guide.
Retrieve from www.choc.org/userfiles/file/EpilepsyHandbook.pdf
Department of Education - Virginia. (2010). Guidelines for Seizure Management. Retrieved from
http://www.doe.virginia.gov/support/health_medical/seizure_management.pdf
Erickson, C. D., Splett, P. L., Mullett, S. S., & Heiman, M. B. (2006). The healthy learner model for student chronic
condition management -- Part 1. Journal of School Nursing, 22(6), 310-318. doi: 10.1177/10598405060220060201
Flower, D. (2009). Epilepsy part 3: Planning for emergencies. British Journal of School Nursing, 4(5), 164-168.
McNelis, A. M., Johnson, C. S., Huberty, T. J., & Austin, J. K. (2005). Factors associated with academic achievement in
children with recent-onset seizures. Seizure, 14(5), 331-339. doi: 10.1016/j.seizure.2005.04.005
Mississippi Department of Education, the Mississippi Board of Nursing, the Mississippi Department of Health, and the
Mississippi School Nurse Association. (2007). Mississippi school nurse procedures & standards of care. Retrieved
from www.healthyschoolsms.org/.../documents/ProceduresStandardsofCare.pdf
Mott, J., Shellhaas, R., Joshi, S. (2013). Knowledge of epilepsy and preferred sources of information among elementary
school teachers. Journal of Child Neurology, 28(6), 740-744. doi:10.1177/0883073812451775
Wodrich, D. L., Jarrar, R., Buchhalter, J., Levy, R., & Gay, C. (2011). Knowledge about epilepsy and confidence in
instructing students with epilepsy: Teachers' responses to a new scale. Epilepsy & Behavior, 20(2), 360-365.