Rebecca King MSN, MEd, CSN, RNSchool Nurse Liaison

WVDE-Office of Healthy Schools

“Defining the Role of the School Nurse

in the 21st Century”

With Much Appreciationto School Nurses

Healthy Schools Updates• Centers for Disease Control and

Prevention (CDC) Funding• New Executive Director…Keith Burdette• Restructuring• Future positions• Policy 2422.8-Medication Administration

revisions slated for public comment in December/January

• Monthly WebExs• June 11 and 12, 2013 Conference

Objective #1:

Participants will reflect with updates on the past year of school nursing and school health services.

Reflections

• 99.85% of 7th and 12th graders vaccinated with Tdap and MCV in the state of WV! Thanks to school nurses!

• We the Parents versus WVDHHR in Kanawha Circuit Court was dismissed citing CDC recommendations, WVa Code and WVBE policy

Reflections• WVSIIS becomes the only repository for

immunization data. WVDE and WVDHHR/BPH currently working towards a School Nurse Reporting module with data sharing and reports per school.

• The hope and plan is to view WVSIIS within the WVEIS screen for each student record to make it user-friendly.

Reflections

• Survived the ongoing revisions to WVEIS and continue to endure.

• WVEIS reports also on the EHCP site.

• We, as a team, continue to move WVEIS toward a more sophisticated system for school health data collection.

Reflections• Continue with iPad usage for not only

data but face-time with students and staff with assignment/delegation of health care, collaboration with other school nurses regarding student needs and multiple health Apps.

• Moved into Universal PreK…not the Head Start, Child Care and Public School Kids….the Universal PreK students. The 2012/13 is the year of celebrating.

Reflections

• We continue to braid funding, share data and understand state and federal regulations for the good of Universal PreK students.

• You have continued to mange the added 17,000 PreK students, high acuity needs such as insulin administration, Diastat in school and on a bus, sterile suctioning, anaphylactic shock, etc. with FEW to Zero NEW SCHOOL NURSE HIRES.

Congrats for making this conference title a reflection of your

daily nursing care…

Skilled Nurses + Healthy Students =

Educational Success

Objective #2:

• Participants will be knowledgeable and actively discuss the collective vision for school health services in the State of West Virginia.

WE MUST… Think Outside of the BOX

Student Needs + Staffing+ Resources =Lack of sufficient services, Lack of health promotion,Lack of disease prevention efforts

Which leads to SAFETY CONCERNS & BURNOUT

The DIRTY FACTS• Lack of proper nursing supports during the school day;• Lack of preventive care;• Lack of health promotion activities;• Adolescents without well-child visits and

immunizations;• Poor oral hygiene and health;• 17% increase in teen pregnancy population;• Below proficiency on HEAP scores throughout the

state;• Leading in Asthma, Obesity, Hepatitis B and C,

prescription drug abuse, etc.; and• Etc.

Top 5 Medical Diagnoses/Procedures2010/11 School Nurse Needs Assessment

Medical Diagnoses In-School Specialized Health Care Procedures

Asthma Inhalers for Asthma

Behavioral Disorders Emergency Medications

Anaphylactic Reaction Long-Term Medications

Obesity Special Diets per Federal Form

Mental Disorders (Depression, Bipolar, Schizophrenic, Suicidal)

Seizure Management

Close 5th places…..Ear, Nose and Throat/Migraine or Severe Headache/Seizures

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

238 8522147

4213

11491

16145

2010/11 Student Medical Diagnoses

Series1

IDEAS

• Round Robin

More Ideas…

• New models which move school health closer to a medical model instead of an education model.– A School Nurse Practitioner at the RESA

to support school nursing through leadership, technical assistance, professional development and guidance related to complex care situations.

More Ideas…• Utilizing electronic devices to connect

students to medical and dental specialist such as endocrinologist and neurologist at school.– Face time and other electronic programs

are currently used around the US for nursing practice. We can move student health into the 21st century to break down the barriers of rural and medically underserved WV.

More Ideas…

• New funding ideas which moves school health closer to case managers for enrollment of Medicaid.– Funding to support the enrollment of

students into Medicaid and CHIP, ensuring medical and dental homes along with annual recommended Well Child and Oral Examination, Asthma Action Plans and Immunizations.

More Ideas…

• Moving toward Full Service Schools.– Offering WVDHHR services within an office

at the school, mental health, dental and medical services. Using the school as a community building for services and events in the evening hours. Linking families and students to the supports they need to be healthy, happy and successful in today’s world.

Objective #3:

• Participants will be familiar with future legislation and rules which actively affect the role of school nurses.

2012 Resolution Studies• HCR 107 Reproductive Health• HCR 128 AEDs • HCR 129 Safety with Student Athletes and Concussions• HCR 132 Expected Teenage Mothers • SCR 33 Wellness, Nutrition and PE• SCR 81 Exemptions for Immunizations• SCR 84 Religious Freedom Act• SCR 95 Student Harassment

“Unsuccessful” 2012 Legislation

• School Nurse Ratio bills of 1:750;• AED in every school bill;• Concussion bill;• Religious Exemption bill;• Epinephrine bill for training and

prescriptions by anyone over 18 years of age; and

• Teenage Expected Parents Pilot Program.

Objective #4:

• Participants will be provided with information on the vision of Full Service School models throughout West Virginia Public Schools.

Full Service School• A school which provides for the whole

child with integration of the eight components of school health through school nurses, Health and Physical educators, school staff, community partners, medical, behavioral and dental services, parent supports and services in the school, WVDHHR and community supports…Making your school friendly with a whole child, family and community focus.

Health Care Reform• WV children with increased insurance

coverage• Expansion of Primary Care Center

services and funding (currently serving 1 in 5 West Virginians)– School-Based Health Services • Dental• Mental Health• Family Planning

Helping us move to full-service communities/schools

How do we get there?

Strategies• Know legislative rule, state rules and county

policy.• Know your nursing practice act and the role

of LPN and UAPs.• Support the Medical and Dental Home

concept to move West Virginia towards preventive health.

• Validate immunization records and follow provisional enrollments through to completion.

• Make adolescent vaccinations and well-child visits YOUR priority NOT an AFTER THOUGHT!

Strategies• Follow and implement evidence-based

practice. Obtain a medical consultant or form medical advisory board for your county’s school health services program.

• Form collaborative teams/ relationships with public health and local

WVDHHR entities.• Form collaborative teams/initiatives with

medical, dental and behavioral health providers/communities.

2012 RESA-RSWS Focus

• Work Plan – Local Wellness– Safe Schools (Policy 4373)– Substance Abuse (SBIRT)– Suicide Prevention (ASPEN)– Teen Pregnancy (HEAP, PREP grants)– Physical Activity (Let’s Move)– Nutrition (current WVDE-OCN

initiatives)– Tobacco Prevention (Quit Kits)

Together we serve the WHOLE CHILD, THEIR FAMILY

& THE COMMUNITY

THANK YOU!

Have a WONDERFUL Thanksgiving!

Rebecca KingWVDE-Coordinator

School Healthand

Coordinated School-Public Health

rjking@access.k12.wv.us

304.558.8830