Transcript school nurse

Grow Where You Are Planted:
Bringing Health to the Education Model
Rebecca King
WVDE-State School Nurse Consultant
Throughout HistorySchool Nurses
Have Made a BIG Difference!
Objectives
 Participants will celebrate the successes of school
nursing services and the positive effects on students
in WV schools.
 Participants will learn about updates in school
nursing and school health services.
 Participants will be knowledgeable and actively
discuss the collective vision for school health
services in the State of West Virginia.
 Participants will be knowledgeable of the important
role school nurses play in the enrollment and
reenrollment of students and families into insurance
coverage.
Salute to 2016/17
School Nurse of the Year!
Congratulations
Diane Godwin of
Upshur County!
Remember…
Families and Friends Matter
How Do We Grow in an
Education Model?
Through providing the student supports needed
for health and wellness...
How Do We Grow in an
Education Model?
• Through providing the student supports needed
for health and wellness...
– School nurses for disabled students is a REQUIREMENT
IN PUBLIC EDUCATION NOT AN OPTION!
– Ensure immunization are up-to-date and records are
complete and infectious disease outbreaks are
minimal…work with local health departments.
– Ensure classroom teachers and bus drivers have
intervention guides to properly care for students with
Individualized HCPs and Emergency HCPs.
How Do We Grow in an
Education Model?
• Through providing the student supports needed for
health and wellness...
– Be active in IEP meetings or share student health needs
with IEP teams to ensure students get related nursing
services included in their PLANS for a quality education.
– Be active and lead Section 504 teams to ensure students
with disabilities who have a mental or physical impairment
which self limits life's major activities are provided with
accommodations.
– Work with school principals far in advance to ensure
students with disabilities may attend all field trips and
PREVENT DISCRIMINATION.
WV Code
§30-7-2. License required to practice
(a) It is unlawful for any person not licensed under the provisions of this
article to practice or to offer to practice registered professional nursing in this
state, or to use any title, sign, card or device to indicate that such person is a
registered professional nurse: Provided, That any professional nurse holding
an active, unencumbered license to practice in another state, who
accompanies a patient to whom he or she administers nursing care while
such patient is in transit or being transported into, out of, or through this
state, may practice without a license issued under this article with the
following limitations: (1) Such nurse may only administer nursing care to the
patient whom they are accompanying in this state; and (2) under no
circumstances is any such nurse authorized to practice nursing in this state
for longer than forty-eight hours within any three-month period; and (3)
under no circumstances shall any such nurse hold him or herself out as a
registered professional nurse licensed in this state. Such forty-eight hour
period shall commence and run from the time such nurse first enters the
borders of this state in the
How Do We Grow in an
Education Model?
• Through providing the student supports needed
for health and wellness...
– Be active in Local Wellness Teams…incorporate school
health into the policies and plans!
– Develop student and staff wellness initiatives in each
school. Setting models of health does count!
– Complete IHCPs and EHCPs in a timely manner to
ensure quality care.
– Develop systems for substitute school nurses to ensure
student SAFETY in your absence
How Do We Grow in an
Education Model?
• Through providing the student supports needed
for health and wellness...
– DATA MATTERS!! Step Up and Be Counted!
Complete the School Nurse Needs Assessment annually!
All but 2 districts participated in 2015/16…thank you!
How Do We Grow in an
Education Model?
– Always remember, you have been planted in the school
system for a reason. Although the model is not of
health, it has a vast need for the integration of the
knowledge of school health and the support of school
nurses. Without YOU many students and staff would
not have a safe, healthy and caring environment.
West Virginia School Health
Status and Stats
WV School Nurses
Stepped Up and
Were Counted in
2014/15 and 2015/16
School Nurses Make a
Difference in Schools
The 2015/16 School Nurse Needs Data
showed West Virginia School Nurse RNs
kept students in school more than one
half of a million days (641,700) by
returning students to class instead of
sending them home. This means that
school nurses returned 3,565 students
back to the classroom each day during the
2015/16 school year! This is up 28% from
500,000 days in 2014/15 and returning 2,777
students back to the classroom each day.
Profoundly Awesome!
What’s the Numbers???
1 in 4 students with a
medical order and/or
health care plan in WV
schools=
70, 253 students
2016/17
WV Stats
During the 2015/2016 school year, 302 School
Nurse RNs collaborated with parents/guardians,
communities and school personnel to assist in
prevention, health maintenance, education and
the health screening of 277, 137 students in
713 public schools in West Virginia.
2012/13 Student Medical Diagnoses
Diabetes Type I
Diabetes Type I
14000
12855
12000
10878
Seizures
10000
8000
Anaphylactic Reaction
6000
4000
2000 220 859
0
3846
1771
Behavioral
Disorders(ADD/ADHD/OCD/An
xiety)
Asthma
2015/16
Top 5 Medical Diagnoses/Procedures
Medical Diagnoses
Asthma
In-School Specialized
Health Care Procedures
Long-Term Medication
Administration
#3
Behavioral Disorders
(ADD/ADHD, OCD/ODD and
Anxiety)
Emergency Medications
Anaphylactic Reaction
Inhalers for Asthma
Obesity
Measurement of Blood Sugar
with Glucometer
Autism
Epinephrine Auto Injector
(Epi-Pen)
84 WV School Nurse
with National CSN
Congratulations WV School Nurses!
WV School Nurses are
Highly Educated!
• 97% (294) school nurses with BSN and CSN
• 21% (63) with Masters = WV School Nurses
represent 2% statewide of only 12 % of all WV
RNs with a Masters degree!!
• 28% (84) with National CSN
Resource: WV board of Examiners for Registered Professional Nurses FY 2015
Annual Report (July 1, 2013-June 30, 2015) at
http://www.wvrnboard.wv.gov/Publications/Documents/RNBoard%20Annual%20
Report%202015.pdf and WVDE data.
Reflection and Updates
• Medical Exemptions moved to state
level… Remember LHD and schools
still the local gate keepers and
decision makers for immunizations.
• TB Testing for schools Removed
• Option for counties to develop stock
epinephrine auto-injectors and
naxolone IN (2mg dose)
Reflection and Updates
• All Universal PreK Collaboratives
including “off-sites” fall under public
school system and school nursing
care.
• Remember “Nursing Practice Act”
…orders come from physicians,
dentist and mid-level providers NOT
parents
WV Council of School Nurses
Reflection and Updates
• 2015 revision of WVBE Policy 2422.7- Standards
for Basic and Specialized Health Care
Procedures
– Revision of Manual
– New Procedures
•
•
•
•
•
•
•
Continuous Glucose Monitor
Insulin Pen
Ativan/Klonopin SL/BUC
Nasal Versed (RN and LPN only)
AuviQ
Condom Cath
NP Suctioning
WV Council of School Nurses
Reflection and Updates
• Revision of School Nurse Mentorship
Manual which will lead to revisions of the
WVLearns “Introduction to School Nurses”
course.
• Revision of Supplemental Guidelines
– Lice Recommendation
– Vision Screening
– Injectable Cortisol
WV Council of School Nurses
Reflection and Updates
• Working on revisions to School Nurse Needs
Assessment to modernize with current
practice, ensure clarity and provide
reliability and validity.
• Please share nursing practice concerns
Immunizations….
What is Provisional Enrollment?
• Must have first dose to enter school OR be current on the last dose
[waiting on next dose(s)].
• The next dose MUST be administered based on the CDC-Advisory
Committee on Immunization Practices (ACIP) researched-based
recommendations NOT a blanket 8 months for all vaccinations.
• Each vaccination dose thereafter must be administered according to
the CDC-ACIP recommended timeframe for the next dose.
• If the dose is not administered as recommended by CDC and WVBPH
then the student has not meet enrollment requirements and state
public health laws and MUST be exited from the program.
• Follow guidance for notification of removal from FAPE.
Other Health Information
for Enrollment
• HealthCheck (EPSDT) and Dental
Examination
– 2015/16 PreK and K
– 2016/17 PreK , K and grade 2
– 2017/18 PreK, K, grades 2 and 7
– 2018/19 PreK, K and grades 2, 7 and 12
Grade 7 and 12 campaign
Collective Vision
• Resolution of Field Trip concerns
– National Outreach to National Council of State
Boards of Nursing (NCSBN)
• Develop new courses for WVLearns nondegree graduate school nurse credit
– School Nurse Leadership-starts January 2017
– Nursing Skills –started in October 2016
– Section 504- starts January 2017
Total of 6 non-degree graduate courses for
school nurses in 2016/17 (Introduction,
Diabetes and Infectious Disease)
Collective Vision
• Annual WV School Nurse Needs Data collection for
State and Nation
Step Up and Be Count WV!!
– NASN/NASSNC Standardized Data Collection
– Incorporated into the WV School Nurse Needs
Assessment for 2014/15 and 2015/16 with promising
data.
– No new data components for 2016/17.
• Ensuring Medical and Dental Home
• Check points to promote Health and Wellness for
academic success for new enterers and Grades 2, 7
and 12
– Immunizations
– HealthCheck
– Dental Exam
Collective Vision
• Section 504 and Homebound/Hospital supports
• Proper case-management for students with
chronic diseases
• Increase Medicaid billing for students (Targeted
Case Management/TCM)…in 2015 school nurses
only billed $114, 032 out of 28 Million dollars
statewide
• Billing for case-management of students with
chronic diseases (HCP/504) …where is WV?
• Assisting students and families with
enrollment/reenrollment into Health and Dental
Insurance Coverage (Vermont Model)
Collective Vision
• TeleHealth/TeleDentistry/TeleMental
Health led by the school nurse starting
with specialist like Pediatric
Endocrinologist, Neurologist,
Pulmonologist and Oral Health Care for
Pregnant and Parenting Teens
• Ensuring student and family enrollment
into Health and Dental Insurance
Coverage (Pilots from WVCHIP/WVDHHR
coming soon-12 counties $4K)
• Support for adolescent pregnant and
parenting teens
Collective Vision
• Crisis Planning at School Level…must include
school nurses to ensure students with
disabilities/health care needs have medication
and care with inclusion of the overall wellness
for all students during emergency situations.
What’s your role?
• Be Present, Be Involved…Local Health
Departments, Student Nurses (RNs and LPNs),
WV Council of School Nurse Meetings, WVASN
Board and membership or Email Discussions,
SBHC Advisory Boards, Local and Regional
Wellness, State and National presentations
• Be Prepared for Nursing Shortage…
– Develop Substitute SN Program Outlines for your
County
– Recruit and Be Innovative
#GetCovered
Student Successes include
the School Nursing Factor!
WV Graduation Rates: 2012-2016
All
SWD
100
90
81.41
79.32
84.46
Graduation
80
Graduation rate (%)
70
gap =
Graduation
gap =
12.9%
76.87
19.4%
60
50
89.81
86.53
59.91
62.09
2012
2013
70.25
69.13
2014
2015
40
30
20
10
0
School year
Graduation rate = 4 year adjusted cohort, standard diploma.
Graduation gap % = difference in percentage points, not percent change.
*As of October 26, 2016, SY 2016 data have not undergone final certification, rates are subject but not expected to
change; data should be used for planning purposes.
2016 *
SO REMEMBER TO:
Grow Where You Are Planted!
QUESTIONS & IDEAS?
Thank You!
Rebecca King
WVDE
School Health and Section 504
[email protected]
304.558.2696
June 21-22, 2017
Charleston Civic Center