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To FASN members-

To FASN members- Here is a PowerPoint presentation that you can use when you have an opportunity to speak to influential groups- like School Boards, PTA groups, or other local community groups

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To FASN members-

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  1. To FASN members- • Here is a PowerPoint presentation that you can use when you have an opportunity to speak to influential groups- like School Boards, PTA groups, or other local community groups • Make it personal- use statistics from your district or school, tell personal stories – they often are what really grabs someone’s attention! And we know that school nurses have LOTS of stories! • After personalizing the presentation- delete this slide • Good Luck! • Rita Becchetti, Advocacy Chair, FASN

  2. Why do we need School Health Services Place your name here

  3. History of School Health

  4. Protect the school environment Multiple possibilities; protect the students School health content fixed by external issues School health contained Focus on individual student health, incorporation of mandated services Importance of external education and health policies for shaping school health SCHOOL HEALTH – THE 100 YEARS 1880s 1990s 1970s 1980s 1950s 1960s 1920s Physicians and nurses hired to exclude the potentially contagious students (Boston & NYC) Early 1900s • New provider types: nurse practitioners, SBHCs. • New emphasis on health care to poor children. • Federal law mandates health-related services for students with disabilities School health = health ed, immunization documentation, screenings, tx for minor injuries, referrals for problem dx & tx • Spread of SBHCs • Influence of changes in education (accountability, testing, success for all) and health systems (accountability, managed care, outcomes focus) • School health services spread • First full-service schools 1910 • Conflict between public health and private medicine • AMA opposition to all publicly-funded treatment services in schools

  5. School nursing is a specialized practice of professional nursing that advances the well-being, academic success and life-long achievement and health of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety including a healthy environment; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self-management, self advocacy, and learning. • (NASN 2010) School Nursing- Who is your school nurse?

  6. It is the position of the National Association of School Nurses that school districts should provide a full-time professionally prepared registered nurse all day, every day in each building (NASN, 2003). “Every student deserves a school nurse.”

  7. Today- • Sicker kids in the hospital  sicker kids getting out of hospital earlier (i.e. in schools) • Youths high risk behavior starting at an earlier age (as early as 8th grade) • Era of resistant infections (MRSA, VRE…) • Age of natural and man-made disasters • Violence • School shooting • Terrorism • Hurricanes School Health Challenges Today

  8. The percentage of children and adolescents in the United States with chronic health conditions (CHC) increased from 1.8% in the 1960s to more than 25% in 2007 (Halfon & Newacheck, 2010). Asthma: Over 10 million U.S. children aged 17 years and under (14%) have ever been diagnosed with asthma; 7 million children still have asthma (10%). 13 million school days are missed each year due to asthma. About 1 in 10 children (10%) had asthma. (Centers for Disease Control and Prevention, Vital Signs, May 2011). School Health Today

  9. Allergies: • Number has doubled from 1997-2002 (Study from Mount Sinai school of Med and the Food Allergy and Anaphylaxis network) • Centers for Disease Control and Prevention reports that one out of every 25 children has a food allergy, representing about a 20% increase between 1997 to 2007. • Approximately 6 million children have a life-threatening allergy-peanuts being the most common School Health Today

  10. More medications given during the day at school More than 3.5 million school children take medication at school every day Includes 200 types of prescription drugs, about 3x the number taken in 1980s (Iowa Univ) School Health Today

  11. Poor nurse to student ratio: Estimates 56,000 nurses FT at schools  1:950 students (2004 Census) Real estimate 1:1,461 students (NASN) Some communities 1:7,200 (Tuolumne County, CA) Federal guidelines: 1:750 students Almost 47% of schools fall short of the federally recommended nurse-to-student ratio (CDC) Where are We Now?

  12. NASN recommends minimum ratios of nurses to students depending on the needs of the student populations: 1:750 for students in the general population, 1:225 in the student populations that may require daily professional school nursing services or interventions, 1:125 in student populations with complex health care needs, and 1:1 may be necessary for individual students who require daily and continuous professional nursing services. “Every student deserves a school nurse.”

  13. More Medication errors University of Iowa research: 600 school nurses surveyed in year 2000 50% of respondents reported medication errors at the schools they worked at, mistakes made by teachers, secretaries, health aides LA school district - 86% of med doses administered last year came from unlicensed staff members Schools Without a Nurse Have more medication errors

  14. More lost days from school CDC Study in 2002 school year Students across the nation lost roughly 14.7 million school days to asthma A 2003 study from 16 elementary schools in Toledo, OH Asthmatic students who attended schools with a full time nurse averaged 3 more school days than asthmatic students at schools with part-time nurses. Schools Without a Nurse Have

  15. The percent of students in federally supported special education program increased from 8% to 14% from 1977 – 2006 (NCES, 2007). • Within this group, the rates of children with health conditions have doubled since 2001 (NCES, 2007). • As rate of NICU survival has risen, so do the numbers of children with neurodevelopmental problems. Healthy People 2020

  16. “Schools without nurses are putting children in harm’s way. If we cannot afford school nurses, we’ve got our priorities skewed”. Dr. William Sears; Physician and Author

  17. The national average of nurse to student ratios is abysmal right now: • Only 13 states met the recommended 1:750- The state with the healthiest ratio was Vermont, at 1:311- The state with the worst ratio was Michigan, at 1:4,836 • Florida – now at #47 Every Student Deserves a School Nurse

  18. Inconsistent laws between States: NASBE, NASN: Only in one State (DE) a nurse is required in every school Only in 15 states, District MUST offer nursing services Poor Pay: Median salary $36,000 (2004 survey of > 4,000 school nurses) –that is$20,000 less than the median salary for a clinical nurse School district budget cuts Where are We Now?

  19. Main issues surrounding health management of students with chronic health conditions in schools are as follows: • Health care services must be provided for students who qualify for services under IDEA or Section 504 to meet requirements of federal laws. The school nurse has an important role in interpreting a student’s health status, in explaining the impairment, and in interpreting medical and other health information in relation to the expanded e standards for eligibility under Section 504 (Zirkel, 2009). The Issues Today

  20. Development of individualized health care plans (IHP) is a nursing responsibility and is based on standards of care that are regulated by State Nurse Practice Acts and cannot be delegated to unlicensed individuals (National Council of State Boards of Nursing [NCSBN], 2005). • Effective and safe management of chronic health conditions is complex, requires careful planning by a school nurse, and may involve delegation of nursing tasks to both licensed and unlicensed assistive personnel (UAP). The Issues Today

  21. A full-time school nurse is essential to achieve quality student health services and to meet student health needs. • Dependable funding is required to ensure quality student health services. The Issues Today

  22. More risk taking: 1999 US Supreme court ruling: Public school districts to provide medical care short of a doctor to students with disabilities (Devices e.g. trachs, G-tubes, feeding pumps) Dealing with Emergencies: In Florida 6,007 calls made to 911 in 2003-2004 school year according to FL DOH Schools Need a Nurse

  23. The Student-to-School Nurse Ratio Improvement Bill has been introduced in both the House and Senate.  Ask your Representative to support H.R. 2730 and your Senators to support S. 2750. Advocate

  24. Among toddlers and infants in this group who show no or mild disability, a significant number of them have moderate – severe disabilities at school age (Marlow, Wolke,& Bracewell,2005;Hoestra,Ferrara,Coeser,Payne Connet, 2004) • Each year, as these survivors enter early intervention services and Kindergarten, the need for school health services increases. • Medically fragile children in school require ventilators, tube feedings, medication, and other complex nursing cares (Clement, Barfield, Ayadi, & Wilber, 2007). Healthy People 2020

  25. Reducing Health Disparities and increasing access to care: • Children are 25% of the population, but 35% of the population living in poverty (US Census, 2005) • 40.9% of the nation’s K–12 students are low income and receive free- and reduced price-lunch (National Center for Education Statistics, 2006) • Almost 12% of children do not have health insurance, but 19% of children in poverty lack insurance (US Census, 2007) Future planning

  26. Foreign-born immigrant children are now 5.7% of high school population and 3.3% of the primary school population (National Governors Association, 2008). • Over 900,000 children are homeless (National Coalition for the Homeless, 2007) • All of these factors affect access to care. • The school nurse may be the only health care the children have available Future planning

  27. The predominant funding of school health services through education budgets needs to be reexamined. • School nurses are extensions of the public health system and a vital component of the care of children with disabilities. • Investigation of adequate funding models (such as a combination of health and education funding) that do not impinge local education instructional budgets is needed. Healthy People 2020

  28. Health of young people is strongly linked to their academic success- and academic success of youth is strongly linked with their health. • Helping students stay healthy is a fundamental part of the mission of schools. • Health-related factors, such as hunger, chronic illness, or physical and emotional abuse, can lead to poor school performance.1 • Health-risk behaviors such as substance use, violence, and physical inactivity are consistently linked to academic failure and often affect students' school attendance, grades, test scores, and ability to pay attention in class Coordinated School Health

  29. School Health Services • Health Education • Physical Education • Nutrition Services • Psychology, Social Services, Counseling • Healthy and Safe School Environment • Health Promotion for Staff • Family and Community Environment Coordinated School Health

  30. It is the position of the National Association of School Nurses that school districts should provide a full-time professionally prepared registered nurse all day, every day in each building (NASN, 2003). “Every student deserves a school nurse.”

  31. Thank you • For more information, contact: • Put your contact info here How can you help our children?

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