School Nursing (5) Flashcards
Briefly describe the history of School Nursing.
By 1918, all states in the U.S. had compulsory education laws
* Massachusetts was the first in 1642 andMississippi was the last in 1918.
* Since attendance in school was mandated, the original intent of school health services was to address an illness that kept children out of school.
* In 1897, NYC hired “medical inspectors’ ‘ – usually physicians to examine sick children at school.
* This usually resulted in excluding children from school.
Describe how public health got its start.
Lillian Wald coined the term “public health nursing”
* 1893, Wald and Mary Brewster, graduates of the New York State Hospital School of Nursing, moved to the Lower East Side of NYC to provide nursing care to the poor residents of the community
* In 1895, they bought a house and started the Henry Street Settlement.
* Wald and Brewster hired 6 additional nurses
* By 1933, there were 245 nurses working at the Henry Street Settlement
* They provided comprehensive care, addressing a variety of medical and social issues
* They got the attention of NYC school officials because they were caring for the sick children sent home by medical inspectors.
How did nurses get involved in the school system in NYC?
In 1902, the NYC schools asked Wald to help with the staggering absenteeism in the school
* Lina Rogers, a public health nurse at the Henry Street Settlement, was recruited to conduct a 1 month experiment in holistic care to school children.
* Rogers saw students in 4 schools during the day and did home visits after school
* She gained amazing insight into the struggles of families that affected their health and worked with them to find solutions.
After one month, there was a dramatic decrease in absenteeism! (from 10,000, down to 1,000)
* Rogers documented her interventions and kept records
* She developed protocols & conducted research
* She instituted hearing, vision and dental screenings
* Soon other cities & states started school nurse programs.
Describe school nursing today.
A subspecialty of Public Health Nursing
* Approximately 73,000 school nurses are working in U.S. schools today (HRSA, 2010)
* Most schools (86.3%) had at least a part-time nurse,
* Less than half of schools have the nationally recommended ratio of one nurse for every 750 students.
* School nurses increase health and decrease absentee rates.
What are School-Based Health Centers?
- Almost 2000 SBHC’s in the United States
- Urban 57%; Suburban 16%; Rural 27%
- Model uses a NP or PA with supervision by MD
- Some models include a mental health professionals, health educators, & case managers
- Address many barriers to health care providing health assessments, acute illness care, med prescriptions, vision and hearing screening, sports participation exams, and nutrition counseling.
What is the National Association of School Nurses?
- Originally created in 1968 as the Department of School Nurses; formally became the NASN in 1979
- Dedicated to the advancement of school nursing practice and the health of school-age children
- Develops educational programs, provides resources, performs research, and influences stakeholders to support school nursing through advocacy
- 2013 – School nurse consultants to serve as resources to educators, parents and the public.
What are the educational requirements of a school nurse?
- Minimum qualifications of professional school nurse include licensure as a baccalaureate prepared registered nurse from an accredited college or university. (NASN, 2003a)
- The American Academy of Pediatrics suggests national certification of school nurses by the National Board for Certification of School Nurses.
What are the Healthy People 2020 Goals of School Nursing?
- Increase the proportion of the nation’s elementary, middle, junior high, and senior high schools that have a nurse-to-student ratio of at least 1:750
- Increase the proportion of schools that provide school health education to promote personal health and wellness. . .
- Increase the proportion of schools that provide comprehensive school health education to prevent health problems. . .
What recommendations does the American Academy of Pediatrics (AAP) have for school nursing?
- A full-time nurse for every school
- Supports Healthy People 2020 goal - 1 nurse/750 students
- 1 nurse/225 students if they require daily services/interventions
- 1 nurse/125 students if they have complex health needs
What is the prevalence of chronic disease in children?
Increased rates of chronic health conditions since WWII.
* prevalence of chronic health conditions in children is 12.8%
* activity limitation from chronic illness - 9%
* 2% of 9% have limitations in ability to walk, care for themselves, participate in other activities
* vaccines/abx have reduced communicable diseases
* Social & economic conditions contribute to health risk behaviors
* Behaviors that reflect developmental stages in children & adolescents continue to contribute to mortality and morbidity in the U.S.
* Unintentional injuries are the leading cause of death for children in all groups
* In ages 5 to 19 years: 67% of all deaths are injury-related; 48% from motor vehicles, 21% from other injuries, 16% from homicides,** &14%** from suicides
* For adolescents, injuries are responsible for 80% of deaths.
* Nearly 18% of children ages 6-11 are obese and 21% of adolescents ages 12-19 are obese (CDC, 2015)
* In 2015, 8.3% of school age children had** asthma** (CDC, 2015)
* In 2013,** 8%** of school age children** 4 – 17 years old** had serious emotional and behavioral difficulties.
What are some health issues of school-age children?
*Asthma & Allergies
*Diabetes
*Autism spectrum disorders
*Seizures
*Attention Deficit Hyperactivity Disorder (ADHD)
*Mental Health Issues.
What are the effects of chronic health conditions for kids?
*Difficult social & emotional adjustment
* Absenteeism/Truancy
*Family and peer relationships
*Chronic conditions require an Action Plan developed by the physician and parents and implemented by the School Nurse
*Ongoing communication between the School Nurse, teachers, and parents is necessary to manage any condition
What are the goals of school health?
Health Services
Health Education
Health Promotion
Counseling, Psychological, and Social Services
School Nutrition
Physical Education
School Environment
Family and Community Involvement
What are the different levels of prevention?
Primary - Employing measures to avoid illness or injuries from occurring
Secondary - Detection of health problems while in subclinical
stages
Tertiary -
* **Reduce the severity **of a health problem
* Minimize disability and restore/preserve function
* Prevention of recurrence of problems
* Prevent complications of acute or chronic conditions
What are examples of primary prevention in the school setting?
- Childhood immunizations
- Education on safe-sex practices
- Nutrition education
- Handwashing/cough hygiene
- Gun violence
- Mental health awareness
Interactions with staff: - Health fairs
- Health information
- Classroom presentations
- COVID 19
