Transcript “Defining the Role of the School Nurse in the 21st Century” Rebecca King MSN, MEd, CSN, RN School Nurse Liaison WVDE-Office of Healthy Schools.

“Defining the Role of the School Nurse
in the 21st Century”
Rebecca King MSN, MEd, CSN, RN
School Nurse Liaison
WVDE-Office of Healthy Schools
With Much Appreciation
to School Nurses
Healthy Schools Updates
• Centers for Disease Control and
Prevention (CDC) Funding
• New Executive Director…Keith Burdette
• Restructuring
• Future positions
• Policy 2422.8-Medication
Administration revisions slated for
public comment in December/January
• Monthly WebExs
• June 11 and 12, 2013 Conference
Objective #1:
Participants will reflect
with updates on the
past year of school
nursing and school
health services.
Reflections
• 99.85% of 7th and 12th graders
vaccinated with Tdap and MCV in the
state of WV! Thanks to school nurses!
• We the Parents versus WVDHHR in
Kanawha Circuit Court was dismissed
citing CDC recommendations, WVa
Code and WVBE policy
Reflections
• WVSIIS becomes the only repository for
immunization data. WVDE and
WVDHHR/BPH currently working
towards a School Nurse Reporting
module with data sharing and reports
per school.
• The hope and plan is to view WVSIIS
within the WVEIS screen for each
student record to make it user-friendly.

Reflections
• Survived the ongoing revisions to
WVEIS and continue to endure.
• WVEIS reports also on the EHCP site.
• We, as a team, continue to move
WVEIS toward a more sophisticated
system for school health data
collection.
Reflections
• Continue with iPad usage for not only
data but face-time with students and
staff with assignment/delegation of
health care, collaboration with other
school nurses regarding student needs
and multiple health Apps.
• Moved into Universal PreK…not the
Head Start, Child Care and Public School
Kids….the Universal PreK students. The
2012/13 is the year of celebrating.
Reflections
• We continue to braid funding, share data
and understand state and federal
regulations for the good of Universal
PreK students.
• You have continued to mange the added
17,000 PreK students, high acuity needs
such as insulin administration, Diastat in
school and on a bus, sterile suctioning,
anaphylactic shock, etc. with FEW to
Zero NEW SCHOOL NURSE HIRES.
Congrats for making this conference
title a reflection of your
daily nursing care…
Skilled Nurses + Healthy Students =
Educational Success
Objective #2:
• Participants will be
knowledgeable and
actively discuss the
collective vision for
school health
services in the State
of West Virginia.
WE MUST…
Think Outside of the BOX
Student Needs
+ Staffing
+ Resources =
Lack of sufficient services,
Lack of health promotion,
Lack of disease prevention efforts
Which leads to
SAFETY CONCERNS & BURNOUT
The DIRTY FACTS
•
•
•
•
•
•
•
•
•
Lack of proper nursing supports during the school day;
Lack of preventive care;
Lack of health promotion activities;
Adolescents without well-child visits and
immunizations;
Poor oral hygiene and health;
17% increase in teen pregnancy population;
Below proficiency on HEAP scores throughout the
state;
Leading in Asthma, Obesity, Hepatitis B and C,
prescription drug abuse, etc.; and
Etc.
Top 5 Medical Diagnoses/Procedures
2010/11 School Nurse Needs Assessment
Medical Diagnoses
In-School Specialized
Health Care Procedures
Asthma
Inhalers for Asthma
Behavioral Disorders
Emergency Medications
Anaphylactic Reaction
Long-Term Medications
Obesity
Special Diets per Federal Form
Mental Disorders (Depression,
Bipolar, Schizophrenic, Suicidal)
Seizure Management
Close 5th places…..
Ear, Nose and Throat/
Migraine or Severe
Headache/Seizures
Diabetes Type II
2010/11
Student Medical Diagnoses
Diabetes Type I
16145
Seizures
18000
16000
11491
14000
Anaphylactic
Reaction
12000
10000
4213
8000
6000
4000
2000
0
238
852
2147
Behavioral
Disorders/ADD/
ADHD/OCD/Anxi
ety
Asthma
IDEAS
• Round Robin
More Ideas…
• New models which move school
health closer to a medical model
instead of an education model.
– A School Nurse Practitioner at the RESA
to support school nursing through
leadership, technical assistance,
professional development and
guidance related to complex care
situations.
More Ideas…
• Utilizing electronic devices to connect
students to medical and dental
specialist such as endocrinologist and
neurologist at school.
– Face time and other electronic programs
are currently used around the US for
nursing practice. We can move student
health into the 21st century to break
down the barriers of rural and medically
underserved WV.
More Ideas…
• New funding ideas which moves school
health closer to case managers for
enrollment of Medicaid.
– Funding to support the enrollment of
students into Medicaid and CHIP, ensuring
medical and dental homes along with
annual recommended Well Child and Oral
Examination, Asthma Action Plans and
Immunizations.
More Ideas…
• Moving toward Full Service Schools.
– Offering WVDHHR services within an office
at the school, mental health, dental and
medical services. Using the school as a
community building for services and
events in the evening hours. Linking
families and students to the supports they
need to be healthy, happy and successful
in today’s world.
Objective #3:
• Participants will be
familiar with future
legislation and rules
which actively affect
the role of school
nurses.
2012 Resolution Studies
• HCR 107 Reproductive Health
• HCR 128 AEDs
• HCR 129 Safety with Student Athletes
and Concussions
• HCR 132 Expected Teenage Mothers
• SCR 33 Wellness, Nutrition and PE
• SCR 81 Exemptions for Immunizations
• SCR 84 Religious Freedom Act
• SCR 95 Student Harassment
“Unsuccessful”
2012 Legislation
•
•
•
•
•
School Nurse Ratio bills of 1:750;
AED in every school bill;
Concussion bill;
Religious Exemption bill;
Epinephrine bill for training and
prescriptions by anyone over 18 years
of age; and
• Teenage Expected Parents Pilot
Program.
Objective #4:
• Participants will be
provided with
information on the
vision of Full Service
School models
throughout West
Virginia Public
Schools.
Full Service School
• A school which provides for the whole
child with integration of the eight
components of school health through
school nurses, Health and Physical
educators, school staff, community
partners, medical, behavioral and dental
services, parent supports and services in
the school, WVDHHR and community
supports…Making your school friendly
with a whole child, family and
community focus.
Health Care Reform
• WV children with increased insurance
coverage
• Expansion of Primary Care Center
services and funding
(currently serving 1 in 5 West Virginians)
– School-Based Health Services
• Dental
• Mental Health
• Family Planning
Helping us move to full-service communities/schools
How do we get there?
Strategies
• Know legislative rule, state rules and county
policy.
• Know your nursing practice act and the role
of LPN and UAPs.
• Support the Medical and Dental Home
concept to move West Virginia towards
preventive health.
• Validate immunization records and follow
provisional enrollments through to
completion.
• Make adolescent vaccinations and well-child
visits YOUR priority NOT an AFTER THOUGHT!
Strategies
• Follow and implement evidence-based
practice. Obtain a medical consultant or form
medical advisory board for your county’s
school health services program.
• Form collaborative teams/
relationships with public health and local
WVDHHR entities.
• Form collaborative teams/initiatives with
medical, dental and behavioral health
providers/communities.
2012
RESA-RSWS Focus
• Work Plan
– Local Wellness
– Safe Schools (Policy 4373)
– Substance Abuse (SBIRT)
– Suicide Prevention (ASPEN)
– Teen Pregnancy (HEAP, PREP grants)
– Physical Activity (Let’s Move)
– Nutrition (current WVDE-OCN
initiatives)
– Tobacco Prevention (Quit Kits)
Together we serve the
WHOLE CHILD, THEIR FAMILY
& THE COMMUNITY
THANK YOU!
Have a WONDERFUL
Thanksgiving!
Rebecca King
WVDE-Coordinator
School Health
and
Coordinated School-Public Health
[email protected]
304.558.8830