What is School Nursing?

1. What is School Nursing? Rachel Gallagher, RN, CPNP, NCSN (608) 266-8857 Rachel.gallagher@dpi.wi.gov http://dpi.wi.gov/sspw/schlnurse.html

2. What are the objectives? • Identify the definition of school nursing. • Identify the Wisconsin requirements for a school nurse. • Understand the recommendations of national organizations and school nursing capacity. • Know the nurse to pupil ratio in Wisconsin. • Knowledge regarding the five roles of a school nurse.

3. What are the objectives? • Understand the federal and state laws regarding nursing services in schools. • Knowledge regarding the link between school nursing and student achievement. • Identify the time saving of other school personnel in school with school nurses. • Understand the difference between a school nurse and a LPN/EMT. • Understand the possible funding sources for school nursing.

4. What is the school nursing history? • Lilian Wald – Lina Rogers (1902) • Nurses treat communicable disease – New York city • Rate of exclusion and illness dramatically went down.

5. What is the Wisconsin definition of school nursing? • Registered nurse licensed through Department of Safety and Professional Services (formerly Department of Regulation and Licensing). • A course in public health nursing. • Passed November 2, 2011. Wis. Adm. Code 34.01(52m) • No grandfather clause.

6. What is school nursing? • School nurse is a specialized practice of professional nursing that advances the well-being, academic success and lifelong achievement and health of students. • To that end, school nurses facilitate normal development and positive student responses to interventions; promote health and safety including a healthy environment; intervene wit actual and potential health problems; provide case management, self advocacy and learning (NASN, 2010)

7. What are the five roles of school nursing? • Facilitate normal development and positive student response to intervention. • Provides leadership in promoting health and safety, including a healthy environment. • Provides quality health care and intervenes with actual and potential health problems. • Utilizes clinical judgment in providing case management services. • Collaborates with others to build student and family capacity for adaptation, self-management, self advocacy and learning.

8. What do the national organization say about school nursing capacity? • American Academy of Pediatrics • One school nurse per every school building • National Association of School Nurse • 1 school nurse per every 750 students • 1 school nurse per every 250 students with special health care needs • 1 school nurse per every 1 student with complex and unpredictable health care needs

9. How does Wisconsin compare to school nursing resources in other states? • 1 nurse per every 1625 students or 36th in the nation (DPI, NASN 2010) • Insert your nurse to pupil ratio in your school district. May want to compare with other school nurse to pupil ratios in your geographical area. • Calculated by number of school nurse full-time equivalent divided the number of students in the school district (See note section for information on how to calculate this data point.)

10. What are the federal requirements for nursing services? • IDEA - 34 CFR 300.34(13) • Section 504 of the Rehabilitation Act of 1973 • Cedar Rapids vs. Garrett F

11. What are the state requirements for nursing services? • Wis. Adm. Code PI 8.01(2)(g) Emergency Nursing Services • Wis. Stat. sec. 118.29 Medication Law • Wis. Stat. sec. 118.13 Pupil Discrimination Prohibited

12. What is the research regarding school nursing care and keeping students in school (academic achievement)? • (Allen, 2003) • (Pennington and Delaney, 2008) • (Wyman, 2005) • (Baisch, 2011)

13. What is the time saving of other personnel in schools with school nurses? Analysis of Time Spent by Selected School Staff Addressing Health Concerns Without a School Nurse Total Average Mean Difference Time Spent Per School Staff Minutes Spent/day #of Staff Minutes Spent/Day ______________________________________________________________________________ Principal/Assist. 56.63 1.82 103 Teachers 19.98 31.59 631 Secretaries 45.96 1.47 68 Total Minutes 802 Savings in Hours Per day 13.36 __________________________________________________________________________ Baisch, 2011: http://www.msno.org/Value.pdf

14. Understand the difference between a school nurse and a LPN/EMT • Licensed Practical Nurses (LPN) – 1 year of training • Licensed to practice under the supervision of a registered nurse or physician • Cannot delegate tasks to others. • Cannot initiate teaching with students or staff. • Emergency Medical Technicians - (140-1200 hours) • Licensed to practice under supervision of a physician or emergency protocols. • Limited pediatric training Both cannot make nursing assessments nor practice registered nursing without a license.

15. What are some funding sources for school nursing services? • Local funding • IDEA flow through grants • Medicaid School Based Services • Categorical Aide • High Cost Categorical Aid • Title 1 Funding

17. Mandy Major – “I Am A Nurse. I am a Leader.” Video Link http://www.youtube.com/watch?v=3OuCy-34o68&feature=youtu.be

18. Any comments regarding this webcast? Any suggestions on future school nursing topics? Contact: Rachel Gallagher (608) 266-8857 E-mail: rachel.gallagher@dpi.wi.gov

19. To take required post-assessment: • Close course window by clicking on the red X in the right hand corner. • Go to the TRAIN home page by clicking on Home in the green ribbon. • Look at My Learning Record in the right hand blue box. • Click on My Learning. • Select the M (Manage) to the right of the title. • Select completed. • Select assessment. • You must answer 5 out of the 5 questions correctly to complete the course. • To get a certificate: • Go to TRAIN home page. • Go to My Learning Record and click on certificate in right hand column and print.