Chapter 30: 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)
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
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
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
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
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 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 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
When was the CDC Division of Adolescent & School Health formed?
1990s
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
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 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
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
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
School Health Services
Goals vary by state, community, & school Promote positive behaviors for students for all ages
confidentiality of personal health information
HIPAA
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
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 school nurse health services that can be done?
Immunization monitoring/identifying needs, Health screenings, Emergency care, Medication administration, Acute illnesses, & Chronic illnesses
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
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
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
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
What are the violence prevention programs?
Stress management, conflict & anger resolution, & personal & self esteem development
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
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
Conducted biannually in selected high schools & reports prevalence/trends of health risk behaviors
Youth Risk Behavior Surveillance System Survey
Health problems lead to an increase in what?
absenteeism
What can the school nurse never delegate?
assessments, diagnosis, goal setting, & evaluations
What to teach for injury prevention?
bicycle safety & helmets, proper use of backpacks, schoolyard & playground safety, & sports safety
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
When is the scoliosis screening done?
girls age 10 & 12 years old boys age 13 or 14 years old
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