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School Nursing Orientation in Washington State

Join us on 8/13/2019 for an introduction to school nursing with key topics, roles, and resources in Washington State. Hear from experts and engage in valuable discussions on school nursing practices.

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School Nursing Orientation in Washington State

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  1. School Nurse Orientation Introduction to School Nursing In Washington State

  2. Housekeeping Welcome and Thanks to Chelan-Douglas Health District Restrooms Breaks Emergency Evacuation Expectations: • Courtesy • Engagement • Active Listening • Participation • Questioning • Mutual Support • Follow-Through Introduction to School Nursing: 8/13/2019

  3. Introduction to Presenters Cathy Meuret, MAEd, BSN, RN, ESA School Nurse Corps Nurse Administrator for OSPI Director of nursing serving programs for NCESD Michelle Rogge, RN, BSN School Nurse and Teacher for Manson School District Healthy Schools Washington Team for OSPI Introduction to School Nursing: 8/13/2019

  4. Participant Introductions Briefly summarize your nursing background. What motivated you to pursue a School Nurse position? What do you consider the most valuable contribution a School Nurse can make to students? Introduction to School Nursing: 8/13/2019

  5. Orientation Purpose Introduce key elements of school nurse role Familiarize school nurses with regulations & standards Identify resources & resource locations Introduction to School Nursing: 8/13/2019

  6. School Nurse Orientation MODULE I Introduction to Practice

  7. Topics Introduction to: Education System Educational Service Districts School Nurse Corps Role of the School Nurse Scope and Standards of Practice Legal Guidance for Schools State and Federal Laws Policies and Procedures Introduction to School Nursing: 8/13/2019

  8. School School District State Education US Department of Education Introduction to School Nursing: 8/13/2019

  9. Office of the Superintendent of Public Instruction OSPI is the primary agency charged with overseeing public K - 12 education in Washington State. State School Superintendent - Chris Reykdal OSPI works with 295 public school districts & 6 state-tribal education compact schools, allocating funding and providing tools, resources, and technical assistance in support of high- quality public education for all students. Introduction to School Nursing: 8/13/2019

  10. OSPI School Health Services OSPI School Health Services provides consultation to school nurses, administrators, staff, families, and students in order to reduce barriers to learning and better assure a safe and healthy school environment. School Health Services Administrator – Dr. Nicole Klein (360) 725-6040 or Nicole.klein@k12.wa.us http://www.k12.wa.us/HealthServices/ Introduction to School Nursing: 8/13/2019

  11. School District Leadership Structure http://www.actionforhealthykids.org Introduction to School Nursing: 8/13/2019

  12. School District Classifications Class I Districts Student Enrollment > 2000 Class II Districts Student Enrollment < 2000 Introduction to School Nursing: 8/13/2019

  13. Educational Service Districts Educational Service Districts (ESDs) are regional education agencies. They allow districts to work, plan & purchase collectively to reduce costs & share district goals of student success. Washington has a network of 9 ESDs. Each serves multiple school districts within a geographic area. Districts depend on ESDs to provide essential services for districts and communities. ESDs also help OSPI implement legislatively- supported education initiatives. Introduction to School Nursing: 8/13/2019

  14. Washington ESDs Introduction to School Nursing: 8/13/2019

  15. NCESD 171 29 School Districts 4 Counties 12,600 Square Miles Class 1 School Districts: 5 Class 2 School Districts: 24 48,029 Students* ____________ SNC Districts: 12 Case Management Districts: 2 *2018 - 2019 Introduction to School Nursing: 8/13/2019

  16. WA State School Nurse Corps Began in 1999 in response to a 1997 study by the Joint Legislative Audit & Review Committee (JLARC). SNC Vision: All children receive equitable, full access to school nursing services to be healthy, safe and successful in school and life. Funded by the State Legislature, the program focuses on Class II districts with limited school nursing services. Introduction to School Nursing: 8/13/2019

  17. SNC Services Funding to support direct nursing services Coordinating RN services for small districts Recruit & retain RNs Orient, train & mentor RNs Consultation / Technical assistance Resources & Lending Library Professional development opportunities Collaboration with other organizations to promote student learning & student health Introduction to School Nursing: 8/13/2019

  18. SNC Nursing Responsibilities Resource Access OSPI Health Services District Assessment District Site Visits Quality Improvement Activities Professional Development Opportunities Introduction to School Nursing: 8/13/2019

  19. Resource Access SNC website serves as the repository of: Nurse Directories School Nurse Manuals: OSPI, DOH Online School Nurse Resource Guide Events Calendar Workshop Materials Refer to: http://www.ncesd.org/service/school-nurse-corps/ Introduction to School Nursing: 8/13/2019

  20. School Health Services Introduction to School Nursing: 8/13/2019

  21. School Health Services Purpose To promote the maximum physical, social, emotional, and educational growth of children by providing, on school site, direct health services, health education, consultation for faculty and staff, and health promotion/prevention for staff and students. Catawba County Schools, North Carolina, 2018 Introduction to School Nursing: 8/13/2019

  22. Staff Model for the Delivery of School Health Services The staff model consists of a nursing assessment to determine levels of care needed for individual students in a school and an overall school district model with staffing level recommendations. The staff model is used to predict the nursing care and staff needs of individual schools and school districts. Refer to: OSPI and NCQAC Staff Model for the Delivery of School Health Services Introduction to School Nursing: 8/13/2019

  23. Three Levels of Supervision Immediate – The licensed nurse is within audible and visual range of the student. Direct – The licensed nurse is on the premises & is quickly and easily available to the student. Indirect – The licensed nurse is not on the premises, but has given written or verbal instructions for the care or treatment of the student. Introduction to School Nursing: 8/13/2019

  24. Who Delivers School Health Services? ESA (Educational Staff Associate) or Certificated RN Health Aide/Health Assistant Parent Designated Adult (PDA) Classified RN Unlicensed Assistive Personnel (UAP) LPN Contracted/Agency RN/LPN Introduction to School Nursing: 8/13/2019

  25. Nursing Practice Levels RNs are licensed for independent nursing practice utilizing the nursing process and are accountable for their actions at all times. LPNs are not licensed for independent nursing practice, but are accountable for their actions at all times. Refer to: RCW 18.79.260 Registered Nurse-Activities Allowed-Delegation of Tasks WAC 246-840 and WAC 246-840-705 Functions of a RN and LPN RCW 28A.210.305 Nurses in Schools—Authority--Supervision Introduction to School Nursing: 8/13/2019

  26. School Nursing Definition School nursing, a specialized practice of nursing, protects and promotes student health, facilitates optimal development, and advances academic success. School nurses, grounded in ethical and evidence-based practice, are the leaders who bridge health care and education, provide care coordination, advocate for quality student-centered care, and collaborate to design systems that allow individuals and communities to develop their full potential. Adopted by the NASN Board of Directors, 2/2017 Introduction to School Nursing: 8/13/2019

  27. Primary Goal Support Student Learning The school nurse implements strategies that promote student and staff health and safety. Introduction to School Nursing: 8/13/2019

  28. School Nursing Standards and Code of Ethics NASN adopts the American Nurses Association’s (ANA) Code of Ethics for Nurses with Interpretive Statements (2015), which establishes an ethical foundation for all nurses. This foundation is supported by School Nursing: Scope and Standards of Practice, 3rd Edition (2017) and ethical guidelines provided by state boards of nursing. School nursing practice is grounded in the NASN core values of child well-being, diversity, excellence, innovation, integrity, leadership and scholarship. (2017) Introduction to School Nursing: 8/13/2019

  29. Introduction to School Nursing: 8/13/2019

  30. Standards of Practice + Competency NASN and ANA guide to contemporary school nursing. The Standards of School Nursing Practice and their accompanying competencies describe & measure the expected level of school nursing practice & professional performance. Introduction to School Nursing: 8/13/2019

  31. RN Credentials in Academic Setting BSN = Professional School Nurse Title BSN with State Certification = ESA Certification BSN with National Certification = NBCSN Certification ___________________________________________________ Classified Staff = ADN or BSN (based on district classification) Certificated Staff = BSN or MSN (based on district classification) Introduction to School Nursing: 8/13/2019

  32. RN ESA Certification Educational Staff Associate Certificate 1. Initial Certification 2. Conditional ESA 3. Continuing ESA Introduction to School Nursing: 8/13/2019

  33. RN as School Nurse Provides expertise and oversight for the provision of school health services and promotion of health education. Uses clinical knowledge and judgment to provide health care to students and staff, coordinates health screenings, and exercises nurse case management skills in identifying issues and coordinating referrals to healthcare providers and service agencies. Introduction to School Nursing: 8/13/2019

  34. RN as Assessor Assessment of the student population, development and implementation of appropriate individualized health care plans and emergency care plans is of highest priority. Assessment process includes identification of students with health concerns, assessment of those students development of plans, dissemination and implementation of plan components (training, delegation, supervision, ongoing evaluation). Introduction to School Nursing: 8/13/2019

  35. RN as Case Manager Using the nursing process, provides case management services for at-risk students: Helps students with special health care needs safely engage in learning & school-related activities. Assesses/screens for social determinants of health, makes appropriate referrals to support students & families. Introduction to School Nursing: 8/13/2019

  36. RN as Health Expert District Activities: Presentations/Training: Special Education Committee IEP Committee Student Support Team School Wellness Committee School Safety Committee Health Curriculum Committee Health Screening Programs Medications/Treatments District Administrators District Personnel School Board Parent Groups Families Workshops/Conferences Student Nurse Rotations

  37. RN as Communicator & Referrer Communicates with, and refers students to, local, regional, state and national agencies: Shelters Clothing Sources Managed Care Services Medical Healthcare Services Mental Health Services Family Planning Services Dental Services Vision Services Audiology Services WIN 211 WA Connection WA MYIR.net Parent 123 County Public Health Department WA State Department of Health WA DSHS Food Banks Transportation

  38. RN as Collaborator Collaboration, not isolation. Develop a relationship with: Athletic Director Food Services Director Administrative Staff 504 Coordinator Safety Committee Wellness Committee Policy & Procedure Committee Alternative School Staff Superintendent and Principals Health Services Assistant School Counselors Case Manager/Student Support Team McKinney-Vento Staff Migrant Health Staff Special Education Director/Teachers Front Desk Secretaries Introduction to School Nursing: 8/13/2019

  39. RN as Quality Improvement Oversight Review delegated nursing tasks verbally & via direct observation: medication administration, procedures, emergency response Conduct Health Services documentation audits Conduct compliance audits: immunizations, screenings Review health policies and procedures – ensure they reflect current laws & practice standards Introduction to School Nursing: 8/13/2019

  40. RN as Researcher Study and refer to evidence-based practices & data sources: OSPI, DOH, CDC, NASN Complete annual OSPI District Assessment of Health Services Participate in surveys and research projects Introduction to School Nursing: 8/13/2019

  41. Guidance for School Nurse Services Office of Superintendent of Public Instruction (OSPI) School Nurse Organization of Washington (SNOW) National Association of School Nurses (NASN) Washington State Nurses Association (WSNA) American Nurses Association (ANA) Nursing Care Quality Assurance Commission (NCQAC) WA State Legislature (RCWs and WACs) Regional School Nurse Corps Nurse Administrator (SNCA) Washington State School Directors Association (WSSDA) Introduction to School Nursing: 8/13/2019

  42. RN Professional Development Professional Development Basic Requirements BLS/First Aid/AED SafeSchools Assignments Suicide Prevention RN Renewal Requirements CEUs vs. CNEs vs. Clock Hours Maintaining a Professional Portfolio Refer to: RCW 43.70.442 and RCW 28A.410.226 for information on suicide prevention training. Introduction to School Nursing: 8/13/2019

  43. Questions Introduction to School Nursing: 8/13/2019

  44. Legal Guidance For Schools Introduction to School Nursing: 8/13/2019

  45. Revised Code Of Washington Revised Code of Washington (RCW) are statutes written by the Washington State Legislature. Once legislation is signed by the Governor, it becomes law. Introduction to School Nursing: 8/13/2019

  46. Washington Administrative Code The Washington Administrative Code (WAC) consists of rules that are adopted by agencies, including OSPI, to enact RCWs or Legislation. Introduction to School Nursing: 8/13/2019

  47. Finding RCWs and WACs Revised Code of WA Title 28A: Common School Provisions Washington Administrative Codes Title 392: Public Instruction, Superintendent of Introduction to School Nursing: 8/13/2019

  48. Functions of RN and LPN (as defined in RCW and WAC) RCW 18.79.260 RN - Activities Allowed - Delegation of Tasks WAC 246-840 LPN and RN (Directory of WAC Sections) WAC 246-840-705 Functions of a RN and LPN RCW 28A.210.305 RN – Duties Related to Nursing Care of Students WAC 181-87-070 Unauthorized professional practice RCW 28A.210 Health - Screening and Requirements Introduction to School Nursing: 8/13/2019

  49. School Health Related RCWs RCW 70.02.030 Medical Records - Patient Authorization of Disclosure Outlines what constitutes written patient authorization for disclosure of health information Introduction to School Nursing: 8/13/2019

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