Virginia School Age Health Needs Assessment: 2013 Survey Responses

1. Virginia School Age Health Needs Assessment: 2013 Survey Responses Janet Wright BSN, RN, NCSN Jyoti Gupta MPH Shahid Hafidh MPH

2. SURVEY DESCRIPTION Survey Purpose: • Describe Virginia School Age Health Care Providers • Assess School Nurses’/Unlicensed Assistive Personnel’s Knowledge of Available Resources for Education, Training and Professional Development • Identify Additional Training Needs • Identify Useful Information to Enhance School Health Practice Survey Recipients: • Virginia School Nurses and Unlicensed Assistive Personnel (UAP) • Coverage across 132 Public School Divisions • Included Private Parochial School Nurses(PPSN) Survey Respondents: 679

3. HEALTH CARE PROVIDER DESIGNATION

4. Years of school health experience 2008 2008 N=723 N=678

5. Work location N=723 N=678

6. Work setting 55% (approx.) 17-19% (approx.) 3-6% (approx.) Work Settings were Similar in 2008 and 2013

7. Highest education achieved High School Some College AAS/AD BA/BS/BSN MA/MS/MSN/ MPH PhD

8. orientation for school nurses Oriented to Job-Role (Yes Response) Orienting Person

9. Orientation Resources

10. Most Helpful Orientation Topics Clinic Practices/Nursing Activities School Health Policies School Health Guidelines First Day Laws/ Regulations Resources Other Orientation Topics

11. Most Helpful Orientation Topics (2013 Data (N=115) CLINIC PRACTICES / NURSING ACTIVITIES: --Tasks & Responsibilities --Day-to-Day Clinic Flow --Medical Procedures --Documentation --Immunizations & Screenings SCHOOL HEALTH POLICIES: --State/County/School District Policies --Medication Policies --Training, certifications, licensure VA SCHOOL HEALTH GUIDELINES: --Overview of Guidelines --Immunization & Medication --Day-to-Day Guidelines --Emergency Protocols --Computer Systems OTHER: --Health Conditions/Diseases --First Aid

12. Medication administration by unlicensed assistive personnel (UAP)

13. Annual employee evaluation Receive Annual Employee Evaluation

14. Annual employee evaluation Annual Employee Evaluator

15. Investment in professional development 2008 2013 N=723 N=677 Similar Responses in 2008 & 2013

16. Investment in professional development Attended Virginia Department of Education Summer Institute for School Nurses (SISN)

17. professional development opportunities Access/Support/Feasibility Access to Webinars & Teleconferences Able to Travel to Trainings / Conferences Financial Support from School/School Division

18. professional development opportunities Interest in Leadership Development Training

19. professional development opportunities Source of Knowledge/Information School Nurse Coordinator List Serve (DOE) VASN Website VDH School Age Health Newsletter CDC Website Private/Parochial School Nurse List Serve Note: DOE School Nurse Coordinator Meetings Number Held Annually: 3 Perceived Need for 3 Annual Meetings: 99.1% (2013 Data, N=116)

20. TOPICS IN NURSING PRACTICE Research

21. TOPICS IN NURSING PRACTICE Program Planning And Implementation

22. TOPICS IN NURSING PRACTICE Community Collaboration/Partnership Building

23. TOPICS IN NURSING PRACTICE Comfortable to Perform Health Screening Skills

24. TOPICS IN NURSING PRACTICE Coordination Of Care More than 60% Respondents (2013; N=642) knew how to:  Create/Use: Individualized Healthcare Plans (IHPs) : Emergency Care Plans (ECPs)  Use Section 504 plans for Students with Disabilities  Work with Physicians Under “Standing Orders” in the School Setting  Maintain Student Confidentiality & Legal Issues More than 60% Respondents (2013; N=642) were aware of :  School Nurse Role in Special Education  School Nurse Role in Child Study Team (Special Education)  School Nurse Role in Individualized Education Program (IEP) Team 59% were aware of HIPAA & FERPA Note: HIPAA=Health Insurance Portability and Accountability Act of 1996; FERPA=Family Education Rights and Privacy Act

25. TOPICS IN NURSING PRACTICE Understand HIPAA and FERPA Note: HIPAA=Health Insurance Portability and Accountability Act of 1996; FERPA=Family Education Rights and Privacy Act

26. Interest in health-related training/information 2013: 70-72% 2013: 52-61% 2013: 65% 2008: 80-81% 2008: 76-81% 2008: 82% (Physical Assessment, Allergies, Asthma) (Physical Assessment, HTN, Blood Disorders) (Physical Assessment) Interest Seems Lower in 2013 than in 2008 Note: 2013 N=627; 2008 N=584

27. Interest in health-related training/information 2013: 66-72% 2013: 71% 2013: 64% 2008: 84-87% 2008: 88% 2008: 85% (Physical Assessment, Seizure Disorders) (Diabetes) (Physical Assessment) Interest Seems Lower in 2013 than in 2008 Note: 2013 N=627; 2008 N=584

28. Interest in health-related training/information Behavioral Health

29. RESOURCES USED IN CLINICAL SETTING • Manuals • Journals • Texts • Websites • Additional Resources • Note: • Greater Use of Websites and Journals in 2013 (N=627) compared to 2008 (N=573) • Slightly Lower Use of Manuals in 2013 compared to 2008

30. RESOURCES USED IN CLINICAL SETTING Manuals

31. RESOURCES USED IN CLINICAL SETTING Journals

32. RESOURCES USED IN CLINICAL SETTING Texts

33. RESOURCES USED IN CLINICAL SETTING Websites

34. RESOURCES USED IN CLINICAL SETTING Additional Resources

35. SUGGESTED TOPICS FOR ADDITIONAL TRAINING

36. Suggested Topics for Additional Training (2013 Data (n=218) HEALTH CONDITIONS / DISEASES: --Asthma --Diabetes --Allergies --Health System Disorders (e.g. arrhythmias, seizures, rashes) --Health & Hygiene CLINIC PRACTICES / NURSING ACTIVITIES: --Medical Care at School, IEP --Continuing Education --Communication with Parents --Medical Alert Problems --Leadership MENTAL HEALTH: --ADD/ADHD --Anxiety/Panic/OCD Disorders --Autism Spectrum --Behavioral & Emotional Health --Bullying TRAINING & EDUCATION: --Professional School Nurse Evaluation Tools --Resources: Research, Finance --Grant & Policy Writing --Collaboration Skills --Nurse Management Issues HEALTH SCREENING / ASSESSMENT: --General Assessment Skills --Health Systems Assessments --Ear Examinations --Assessments of Autistic and other Special Needs Children OTHER: --Policies & Legal issues --Injuries --Nutrition/Weight --First Aid

37. SUMMARY • School Health Professional Profile in Virginia: Most work in Public Schools, are RNs, have a Bachelor’s degree, have >5 years’ School Health Experience • Improvements from 2008-2013: • Almost All Nurses Have Internet Access • Increased use of Websites (e.g. VASN/NASN) and other Resources (e.g. VDH First Aid Guide, Handwashing Poster) in clinical setting • Increased interest in being more active in Community Partnerships • Increased interest in Leadership Development Training • Increased attendance at SISN (VDOE) • Increase in awareness of HIPAA and FERPA (still <60%) • Low Engagement in Professional Development Activities: • Less than Half (42%) Attended SISN Conference • 35% Attended VASN Conference and Participated in SHAB • 27% are VASN/NASN Members • Low Access/Support for Capacity Building: • Not All (84%) Have Access to Webinars/Teleconference • Less than Half (39%) Receive Financial Support from Schools • Not All Nurses Receive Annual Employee Evaluations (86%)

38. SUMMARY • Gaps in Orientation: • Only 73% were oriented to the Nursing Role (N=164) • Gaps in School Health Practice: • Only 55% applied Research-Based Interventions in nursing practice • Less than 40% understood Program Planning Process • Less than half (48%) were comfortable to implement New School Health Programs • Only 44% knew where to access help with Planning and Implementing new programs • Less than half (46%) actively participated in Community Partnerships • Less than 60% were aware of HIPAA and FERPA • While 97% of UAPs Administered Medication, only 84% of UAPs’ Medication Administration Skills were tested annually • Perceived Orientation Needs: • Clinic Practices / Nursing Activities • Job Issues (e.g. nursing roles, duties, protocols, time management, legal issues) • Perceived Training Needs: • Health Conditions / Diseases • Clinic Practices / Nursing Activities • Mental Health • Training & Education

39. RECOMMENDATIONS • Improve Access to & Awareness of: • Webinars / Teleconferences for professional development • Resources for professional development: Improve financial support to school health professionals and time available to engage in professional development • Resources for planning and implementing new school health programs • Opportunities to participate in community partnerships • Enhance Training & Education in: • Applications of research-based interventions in nursing practice • Planning & implementation processes in school health programs • HIPAA and FERPA • Clinic practices / nursing activities; ie., daily workflow expectations, collaboration skills, nurse management issues • Health conditions / diseases, including mental health • Ensure Appropriate Orientation for School Health Professionals (RN/LPN/UAP) • Increase % of school health personnel who receive an annual employee evaluation using an evidenced-based school health professional self-evaluation tool (Example: School Nurse (RN) Self-Evaluation Form) • Increase Annual Medication Administration Competencies for Unlicensed Assistive Personnel (UAPs)

40. Contact: Janet Wright, BSN, RN, NCSN School Age Health Specialist Office of Family Health Services Virginia Department of Health Janet.wright@vdh.virginia.gov www.vdh.virginia.gov Thank you