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Transforming Michigan and the Nations Schools Through Appropriate School Nurse Staffing
Presented by Kathleen Wiejaczka RN BSN Ferris State University March 25, 2009
Objectives
To understand the variety of roles of the school nurse.
To gain knowledge of key issues related to school nurse-to-student ratios.
To understand key statistics related to school nurses and children in school.
To understand negative impact of less school nurse-to-student ratios.
To gain knowledge of current legislation related to school nurse-tostudent ratios.
To be able to identify political strategies to effect change.
immunizations
Policy Development
School Nursing Roles
Student Health
Staff CPR
Scoliosis Screening
Individual Health care report
Participate Individualized Education Planning Committee
QuickTimeª and a decompressor are needed to see this picture.
Emergenc y Care Plan Sex Education
Crisis intervention Student & Staff Counseling
Health record
Protective Service Reporting
Dental Screening
Vision & Hearing Screening
medications
Staff Health
Communicable disease control
CSNO website at: http://www.csno.org/docs/2-23-09 SNOR Legal Aspects-Dale-Revised.pdf
Key Issues Related to School Nurse-to-Student Ratios
School administrators are delegating nursing functions to unlicensed assistive personnel (UAP), endorsed by the Michigan Department of Education.
The Public Health Code of Michigan and the Nurse Practice Act state that only a Registered Nurse can delegate nursing acts, functions or tasks.
When a school nurse delegates a nursing function, that nurse must supervise the UAP on a regular basis.
The recommended ratio of school nurse-to-student is 1:750 in general education and 1:125 in special education per NASN, CDC and AAP.
Key Statistics
There are 73 million children in the US and 97% attend school.
11% of children under the age of 18 do not have health insurance
19% of children live in poverty in US
17% of all students attending public schools receive special education
13% of children receive medication at school
15% to 31% of children under age 18 have chronic health conditions
More Statistics
Less than 25% of schools provide necessary services for children with chronic illnesses.
Only 19 states and D.C. have laws mandating school nursing
More than 50% of public schools do not meet the recommended ratio of school nurses-to-students.
Negative Impact
Mistakes are 3 times as likely to happen with UAP being responsible for health needs of students.
Only 25% of UAP received training and half of these were only a two hour training, one time.
Michigan is the second worst in the nation for school nurse-to-student ratios. One nurse for every 4,204 children.
5% of students seen by RN are sent home compared to 18% seen by UAP
Parents are managing their child’s health needs at the school.
Current Legislation with School Nursing
Representative Carolyn McCarthy and Lois Capps introduced new bill June 5, 2008.
Called Student to School Nurse Ratio Improvement Act of 2008 or HR 6201
Will authorize Secretary of Health and Human Services to give grants to eligible States to reduce student-to-school nurse ratio
Status: Referred to House Committee on Energy and Commerce
Will require a report to the CDC evaluating the effectiveness of the program in improving ratios and evaluate increased health benefits on the students ability to learn.
HR 6201 continued
Eligible States are those who have a ratio greater than 1:1,000 of school nurses-to-students
Mary Louise Embrey, Director of Government Affairs through NASN believes this bill will be an amendment on a larger health care reform bill.
Mary Louise states that evidence-based data from this study will prove that school nurses make a difference on student health and learning.
Political Strategies to Effect Change
School nurses should speak to: ~~~ the public ~~~ administrators ~~~ legislators ~~~ Board meetings ~~~ PTO
School nurses should: ~~~ join professional organizations and become active ~~~ invite legislators into their schools and give them a tour ~~~ write editorials or offer to be an expert for newspapers
Become politically active and support HR 6201. Believe in the power of many to make a difference!
Summary
Through the passage of HR 6201, safe levels of school nurses will occur nationally. I support this bill and encourage you to also.
Through the data from this study, it will validate the contribution school nurses make to the health of students.
Improvement of school nurse-to-student ratios.
Nursing procedures, tasks and functions will be supervised by registered nurses and keep our children medically safe while at school.
References
Annie E. Casey Foundation (2008). Growing up in America: child safety in Canada, United States and Mexico. Retrieved from http://www.aecf.org Broussard, L. (2207). Empowerment in school nursing practice: a grounded theory approach. The Journal of School Nursing, 23 (6), 322-328. California School Nurses Association (2008). School nursing services. http://www.csno.org/docs/2-23-09 SNOR Legal Aspects-Dale- Revised.pdf Canham, DE., Bauer, l., Concepcion, M., Luong, J., Peter, J., & Wilde, C. (2007). An audit of mediction administration: a glimpse into school health offices. The Journal of School Nursing, 23 (1), 21-27. Hillemeier, M. M., Gusic, M. E., & Bai, Y. (2006). Rural and urban children with asthma: are school health services meeting their needs? Pediatrics,118 (3), 1097-1103. doi:10.1542/peds.2005-2239 House of Representatives, Student to school nurse ratio improvement act of 2008: H.R. 6201. Retrieved from http://thomas.loc.gov/ McCarthy, A. M., Kelly, M. W., Johnson, S., Roman, J., & Zimmerman, M. B. (2006). Changes in medications administered in schools. The Journal of School Nursing, 22 (2), 102-107. Michigan Association of School Nurses (2006). Position papers. Retrieved from http://www.michiganshcoolnurses.org/extras/contact_us.php
References
Michigan Department of Education (2002). Medication policy and guidelines for administering medications to pupils. State of Michigan official website. Retrieved from http://www.michigan.gov/documents/Medications_Policy_Nov_25,_2002_51010_7.pdf Murphy, J. & Lechtenberg, J. (2008). Michigan school nurse-to-student ratio:second worst in nation. National Association of School Nurses. Retrieved from http://www.nasn.org/default.aspx?taabid=523 Nwabuzor, O. M. (2007). Legislative:shortage of nurses: the school nursing experience. The Online Journal of Issues in Nursing: A Scholarly Journal of the American Nurses Association. Retrieved on March 8, 2009 from Pub Med Database. Pennington, N. & Delaney, E. (2008). The number of students sent home by school nurses compared to unlicensed personnel. The Journal of School Nursing, 24 (5), 290-297. doi:101177/1059840508322382 Rodewald, A. (2009). Ranks of school nurses dwindling despite need. School Nurse News, 26 (2), 31.
Presented by Kathleen Wiejaczka RN BSN Ferris State University March 25, 2009
Objectives
To understand the variety of roles of the school nurse.
To gain knowledge of key issues related to school nurse-to-student ratios.
To understand key statistics related to school nurses and children in school.
To understand negative impact of less school nurse-to-student ratios.
To gain knowledge of current legislation related to school nurse-tostudent ratios.
To be able to identify political strategies to effect change.
immunizations
Policy Development
School Nursing Roles
Student Health
Staff CPR
Scoliosis Screening
Individual Health care report
Participate Individualized Education Planning Committee
QuickTimeª and a decompressor are needed to see this picture.
Emergenc y Care Plan Sex Education
Crisis intervention Student & Staff Counseling
Health record
Protective Service Reporting
Dental Screening
Vision & Hearing Screening
medications
Staff Health
Communicable disease control
CSNO website at: http://www.csno.org/docs/2-23-09 SNOR Legal Aspects-Dale-Revised.pdf
Key Issues Related to School Nurse-to-Student Ratios
School administrators are delegating nursing functions to unlicensed assistive personnel (UAP), endorsed by the Michigan Department of Education.
The Public Health Code of Michigan and the Nurse Practice Act state that only a Registered Nurse can delegate nursing acts, functions or tasks.
When a school nurse delegates a nursing function, that nurse must supervise the UAP on a regular basis.
The recommended ratio of school nurse-to-student is 1:750 in general education and 1:125 in special education per NASN, CDC and AAP.
Key Statistics
There are 73 million children in the US and 97% attend school.
11% of children under the age of 18 do not have health insurance
19% of children live in poverty in US
17% of all students attending public schools receive special education
13% of children receive medication at school
15% to 31% of children under age 18 have chronic health conditions
More Statistics
Less than 25% of schools provide necessary services for children with chronic illnesses.
Only 19 states and D.C. have laws mandating school nursing
More than 50% of public schools do not meet the recommended ratio of school nurses-to-students.
Negative Impact
Mistakes are 3 times as likely to happen with UAP being responsible for health needs of students.
Only 25% of UAP received training and half of these were only a two hour training, one time.
Michigan is the second worst in the nation for school nurse-to-student ratios. One nurse for every 4,204 children.
5% of students seen by RN are sent home compared to 18% seen by UAP
Parents are managing their child’s health needs at the school.
Current Legislation with School Nursing
Representative Carolyn McCarthy and Lois Capps introduced new bill June 5, 2008.
Called Student to School Nurse Ratio Improvement Act of 2008 or HR 6201
Will authorize Secretary of Health and Human Services to give grants to eligible States to reduce student-to-school nurse ratio
Status: Referred to House Committee on Energy and Commerce
Will require a report to the CDC evaluating the effectiveness of the program in improving ratios and evaluate increased health benefits on the students ability to learn.
HR 6201 continued
Eligible States are those who have a ratio greater than 1:1,000 of school nurses-to-students
Mary Louise Embrey, Director of Government Affairs through NASN believes this bill will be an amendment on a larger health care reform bill.
Mary Louise states that evidence-based data from this study will prove that school nurses make a difference on student health and learning.
Political Strategies to Effect Change
School nurses should speak to: ~~~ the public ~~~ administrators ~~~ legislators ~~~ Board meetings ~~~ PTO
School nurses should: ~~~ join professional organizations and become active ~~~ invite legislators into their schools and give them a tour ~~~ write editorials or offer to be an expert for newspapers
Become politically active and support HR 6201. Believe in the power of many to make a difference!
Summary
Through the passage of HR 6201, safe levels of school nurses will occur nationally. I support this bill and encourage you to also.
Through the data from this study, it will validate the contribution school nurses make to the health of students.
Improvement of school nurse-to-student ratios.
Nursing procedures, tasks and functions will be supervised by registered nurses and keep our children medically safe while at school.
References
Annie E. Casey Foundation (2008). Growing up in America: child safety in Canada, United States and Mexico. Retrieved from http://www.aecf.org Broussard, L. (2207). Empowerment in school nursing practice: a grounded theory approach. The Journal of School Nursing, 23 (6), 322-328. California School Nurses Association (2008). School nursing services. http://www.csno.org/docs/2-23-09 SNOR Legal Aspects-Dale- Revised.pdf Canham, DE., Bauer, l., Concepcion, M., Luong, J., Peter, J., & Wilde, C. (2007). An audit of mediction administration: a glimpse into school health offices. The Journal of School Nursing, 23 (1), 21-27. Hillemeier, M. M., Gusic, M. E., & Bai, Y. (2006). Rural and urban children with asthma: are school health services meeting their needs? Pediatrics,118 (3), 1097-1103. doi:10.1542/peds.2005-2239 House of Representatives, Student to school nurse ratio improvement act of 2008: H.R. 6201. Retrieved from http://thomas.loc.gov/ McCarthy, A. M., Kelly, M. W., Johnson, S., Roman, J., & Zimmerman, M. B. (2006). Changes in medications administered in schools. The Journal of School Nursing, 22 (2), 102-107. Michigan Association of School Nurses (2006). Position papers. Retrieved from http://www.michiganshcoolnurses.org/extras/contact_us.php
References
Michigan Department of Education (2002). Medication policy and guidelines for administering medications to pupils. State of Michigan official website. Retrieved from http://www.michigan.gov/documents/Medications_Policy_Nov_25,_2002_51010_7.pdf Murphy, J. & Lechtenberg, J. (2008). Michigan school nurse-to-student ratio:second worst in nation. National Association of School Nurses. Retrieved from http://www.nasn.org/default.aspx?taabid=523 Nwabuzor, O. M. (2007). Legislative:shortage of nurses: the school nursing experience. The Online Journal of Issues in Nursing: A Scholarly Journal of the American Nurses Association. Retrieved on March 8, 2009 from Pub Med Database. Pennington, N. & Delaney, E. (2008). The number of students sent home by school nurses compared to unlicensed personnel. The Journal of School Nursing, 24 (5), 290-297. doi:101177/1059840508322382 Rodewald, A. (2009). Ranks of school nurses dwindling despite need. School Nurse News, 26 (2), 31.
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