Chapter 30: School Health

When was the CDC Division of Adolescent & School Health formed?

1990s

What other health & education topics that can be taught on?

Tattoos & body piercing, dental health, physical education, obesity, eating disorders, violence, & terrorism

Examples of Primary Prevention within the school?

Teaching health promotion concepts in the classroom Prevention of childhood injuries Substance abuse prevention education Disease prevention education Vaccinations for school children

every school is expected to have an emergency management plan for this

Terrorism

caring for children with chronic health problems, making health referrals, & continuing care

Tertiary Prevention

Why are the CDC's school self-assessment tools so important?

helps to identify strengths & weaknesses & give insight on creating effective action plans for improving school health

True of False The school nurse does not have to have a doctors order to administer medications.

False; MUST HAVE orders from HCP!

What has the biggest impact on child development?

Family

strong privacy protection act of education & health records

Family Educational Rights & Privacy Act (FERPA)

all students & staff have the right to learn & work in a healthy school environment

National Association of School Nurses (NASN)

Does increased access to services (like school health centers) increase immunization rates?

No

What to teach about with dental health?

Proper oral hygiene & regular dental check ups are needed The relationship between high sugary foods & dental cavities

major public health problem because it threatens the health & well-being, both physical & psychological, of many children & adolescents

Violence

Example of emergency care the school nurse can do

minor school injuries to severe life threatening events

School nurses can help identify what & implement what?

identify risks & implement changes to assure a healthy school environment

What acute illnesses does the school nurse most commonly see?

identifying allergies (peanuts, fish, etc.) cough, colds, febrile issues Stomach aches

What are the 8 health promotions for school staff?

1. Positive effects on BP control 2. Daily physical activity 3. Smoking cessation 4. Stress management 5. Weight control 6. Improve morale 7. Reduce job stress & absenteeism 8. Heighten interest in teaching health related topics to students

Why do we have school nurses?

Achieve success in school

What are the CDC health education priority areas?

Alcohol & Drug Use, Injury & Violence, Tobacco Use, Poor Nutrition, Lack of Physical Activity, & Sexual Behavior

out of control eating of large amounts of food whether the person is hungry or not

Binge Eating

Chaotic eating patterns with recurrent episodes of binge eating followed by purging or using laxatives Usually weight remains the same

Bulimia

established to promote positive health behaviors for students in all grades; targets grades 2, 5, 8, & 12

CDC's National Health Education Standards

framework for addressing health in schools; it is student-centered & emphasizes the role of the community in supporting the school & the importance of evidence-based policies & practices

CDCs Whole School Whole Community Whole Child Model

School Health Services

Goals vary by state, community, & school Promote positive behaviors for students for all ages

confidentiality of personal health information

HIPAA

How do School Based Health Centers (SBHC) bill?

If the student has insurance or Medicaid, the SBHC will file an insurance claim If the student does not have insurance, they will still receive services

What are the care roles of school nurses?

Provide direct care to students Provide screening & referral for health conditions Promote health by providing health education Provide leadership for the provision of health services Promote a health school environment Serve as a leader for health policies & programs serve as liaison between Schoo, family, healthcare, & the community

right for severely handicapped children to attend public education in least restrictive environment

Public Law 99-142 Enacted (1976)

What are the roles of a school nurse?

Resource to the community Educator Resource/Leadership role Consultant Advocate

What to teach about sexual behavior?

STDs & unwanted pregnancies

What are 3 surveillance systems used by the CDC to monitor health behaviors, practices, & policies in the school?

Youth Risk Behavior Surveillance System School Health Policies & practices Study School Health Profiles

Health problems lead to an increase in what?

absenteeism

What can the school nurse never delegate?

assessments, diagnosis, goal setting, & evaluations

When is the scoliosis screening done?

girls age 10 & 12 years old boys age 13 or 14 years old

What are the CDC's 8 National Health Education Standards?

1. Comprehend concepts r/t health promotion & disease prevention to enhance health 2. Analyze the influence of family, peers, culture, media, technology, & other factors on health behaviors 3. Access valid information, products, & services to enhance health 4. Use interpersonal communication skills to enhance health & avoid or reduce health risks 5. Use decision making skills to enhance health 6. Use goal setting skills to enhance health 7. Practice health enhancing behaviors & avoid or reduce health risks 8. Advocate for personal, family, & community health

What chronic illnesses does the school nurse most commonly see?

Asthma (#1): inhalers & air quality index Diabetes (mainly Type 1): insulin administration & glucose monitoring & carb counting with meals/snacks Spina Bifida: possible urinary catheterization

What to teach about with alcohol & drug use and tobacco use?

Alcohol & Drug Use: teach about problems that can occur with Schoo, injuries, violence, & MVAs Tobacco Use: teach the negative consequences of smoking

multifactorial; primarily seen in females Often correlated with family dysfunction or a history of sexual abuse Severely restricts their intake of food based on an extreme fear of weight gain

Anorexia

What does the CDC health schools promote?

Healthier nutrition options & education Comprehensive physical activity programs & PE Improved processes & better training to help students manage chronic conditions Health education that instills lifelong healthy habits & health literacy Practices that improve school health services & links to clinical & community resources

What are the school nurse health services that can be done?

Immunization monitoring/identifying needs, Health screenings, Emergency care, Medication administration, Acute illnesses, & Chronic illnesses

works with states, school systems, communities, & national partners to prevent chronic diseases & promote the health & well-being of children & adolescents in schools

CDCs Whole School Whole Community Whole Child Model

What is included in the student's health record?

Immunization status Pertinent history: physical or psych Results of screenings & exams Individualized Health Care Plan (IHP) Detailed documentation

What are the violence prevention programs?

Stress management, conflict & anger resolution, & personal & self esteem development

Counseling, Psychological, & Social Services reduction or removal of threats to mental health?

Depression Substance Abuse Conduct Disorders Self Esteem Issues Suicidal Ideation Eating Disorders Under or Over achievement

What is the Female Athlete Triad?

Disordered/Inadequate Energy Intake Osteoporosis Amenorrhea

comprehensive child health program for children on Medicaid

Early & Periodic Screening, Diagnosis, & Treatment (EPSDT)

negative self-esteem whether this occurs due to family dysfunction or a history of sexual abuse, etc.

Eating disorders

children previously served in acute care & long term care settings access to public education

Education for All Handicapped Children Act of 1973 & subsequent Individuals with Disabilities Education Act of 1990

What are the 4 areas that the CDC focuses on for School Health Services?

Family Engagement Chronic Disease Management Care Coordination Acute & Emergency Care

How does the CDC Whole School Whole Community Whole Child Model provide resources?

Funding is from state education agencies based on the CDCs research

Examples of Tertiary Prevention within the school?

Individual Education Plans (IEPs) for students with long term health needs: allergies, asthma, DM, autistic, ADHD, special needs in school, DNR orders, homebound children, & pregnant teenagers & teenage mothers

What to teach about tattoos & body piercing?

MRSA & Hepatitis C can easily be acquired by non sterilized equipment

What does a healthy school environment consist of?

Minimized distractions Free of physical hazards & psychological health risks

Examples of Secondary Prevention within the school?

Nursing care for emergencies in the school (emergency plan, crisis teams, emergency equipment available, snacks for low blood sugars) Giving HCP prescribed medications Assessing & screening children at school (vision, hearing, height, weight, oral health, scoliosis, lice) Identification of child abuse/neglect

health promotion activities, teaching healthy lifestyles, & immunizing children for school entry

Primary Prevention

the center of health in the schools where they are based

School Based Health Centers (SBHC)

What are the 3 Self-Assessments for assessing school health?

School Health Index (SHI) Physical Education Curriculum Analysis Tool (PECAT) Health Education Curriculum Analysis Tool (HECAT)

Conducted every 6 years & helps place new policies/practices into place after looking at data

School Health Policies & Practices Study

Conduced biannually & monitors the current status of PE, practices related to bullying/sexual harassment, tobacco use prevention, school-based health services, etc.

School Health Profiles

Framework for developing & designing health education programs in schools

School Health Services

screening for health problems & caring for ill/injured children & staff

Secondary Prevention

Conducted biannually in selected high schools & reports prevalence/trends of health risk behaviors

Youth Risk Behavior Surveillance System Survey

What to teach for injury prevention?

bicycle safety & helmets, proper use of backpacks, schoolyard & playground safety, & sports safety

What does the Early & Periodic Screening, Diagnosis, & Treatment (EPSDT) include?

health & developmental history, physical exam, immunizations, & lab tests

What to teach about with proper nutrition?

proper growth & development depends on proper nutrition

What are examples of School Health Services provided?

sick visits, wellness exams with vaccinations, sports physicals, dental, eye, & behavioral health/counseling services

Research shows that poor academic performance is strongly correlated with what?

uninsured status of youth

Examples of health screenings done by the school nurse?

vision, hearing, scoliosis, lice, scabies