Public Health- The School Nurse
School Health index
A self-guided tool to evaluate adequacy of school health programs Developed by CDC Examines several aspect of Coordinated School Health Programs 1. Degree of establishment (per component): Ex, is the school health services "not in place" "under development" "partially in place", or "fully in place"? 2. How is each component functioning and performing? Includes performance-related evaluation (Ex. Of topics: physical activity, physical education, nutrition, tobacco use prevention, asthma, safety, and sexual health
Individuals with Disabilities Education Act (IDEA)
Enacted in 1990 & reauthorized in 1997 designed to protect the rights of students with disabilities by ensuring that everyone receives a free appropriate public education & early intervention, regardless of ability. strives to grant equal access to students with disabilities & to provide additional special education services and procedural safeguards. Mainstreaming: integrating children with serious illnesses or handicapping conditions in regular school settings and classrooms whenever possible.
Specific Evaluation Tools for Coordinated School Health Programs
Health Education -can be evaluated using Health Education Curriculum Analysis Tool (HECAT) Physical Education-can be evaluated using Physical Education Curriculum Analysis Tool (PECAT) Continuous Quality Improvement Tool for School-based Health Centers is available to evaluate SBHC performance. It helps school health team organize in reporting risk assessments. ex. tobacco use, pregnancy risk, parent/child conflict, & depression.
Primary Prevention Strategies for school populations
Promoting health: Health education in the school setting provides a foundation for health behaviors in adulthood • Provide anticipatory guidelines for growth and development & support parents in effective parenting, promoting • nutrition at home and in schools, dental health, physical activity, & positive social skills Preventing Illness & Injury: Prevent mortality, prevent communicable diseases (raising the rate of complete up to date immunization records at school), eliminate hazards, prevent pregnancy, sports injuries, chronic conditions, injuries, bullying, violence, suicide
Evaluation Tool for School Health Programs
School Health Index (SHI): developed by CDC Healthy School Report Card: developed in Canada
Goals of a Coordinated School Health Program
To increase health-related knowledge, attitudes, & skills among members of the school population To increase positive health behaviors & outcomes & to decrease risk behaviors To improve educational outcomes To improve social outcomes, such as self-discipline and respect for and tolerance of others
Tertiary Prevention Strategies for school populations
(Restoring Health & Managing Long Term Conditions) Assist with rehabilitation, prevent consequences, and promote adjustment to chronic illness/disability, Promote recovery after a disaster, sustaining SBHCs
Behavioral Determinants of the Health of School Populations
Attendance organization of the school day safety precautions physical activity/sleep patterns TV/ computer use Diet and nutrition Risky lifestyle behaviors substance use parents behaviors
What is the Coordinated School Health Program
An integrated set of planned, sequential, school-affiliated strategies, activities, and services deigned to promote the optimal physical, emotional, social, & educational development of students
Americans with Disabilities Act (ADA)
Enacted in 1990 that is intended to make American society more accessible to people with disabilities.
The major role of a school nurse
Facilitate normal development Promote student health & safety Provide quality care for potential and actual health problems Provide case management services Collaborate with others to enhance student and family
Sociocultural Determinants of the Health of School Populations
Family structure/living arrangement Cultural, ethnicity, religion Language barriers Economic resources (edu. level, income, employment) Media Latchkey (child care) Policy Bullying Crime in neighborhood
Components of a Coordinated School Health Program
Health education, Physical education, health services, Nutrition services, Counseling, Psychological and Social Services, Healthy and Safe School Environment, Health promotion for staff, Family and community involvement
Health System Determinants of the Health of School Populations
Individual level Is there access to and use of regular source of health care? Use of health-promotive, illness-preventive, and curative services? Or healthcare is crisis oriented, treating acute conditions Are there unmet health needs because their families cannot afford care? Population level Presence or absence of a coordinated school health program & school-based health centers
Biological determinants of the health of school populations
Maturation and aging Genetic inheritance Physiologic function
Psychological Determinants the Health of School Populations
Mental illness and the school setting Family dynamics, Parental expectations, & discipline Parental coping and their mental health abuse and treatment School climate
Education for All Handicapped Children Act
PL 94-142 passed in 1975. SHNs provide more complex care for conditions such as Seizures, Asthma, CF
Early Periodic Screening, Diagnosis, and Treatment (EPSDT)
Passed in 1969, requires that children & adolescents < 21 yrs of age have access to periodic screenings
Environmental Determinants of the Health of School Populations
Physical environment of school, home, and surrounding areas Safety hazards noise levels Food sanitation Accessibility Effective disaster response plan
Secondary Prevention Strategies for school populations
Resolving existing health problems Screen for health problems, referral, counseling, & treatment for minor or chronic conditions. Development of Individualized Health Plans (IHPs), Policies for self-admin medication. (after knowing dx)
