Hanover Public Schools Health Services

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Hanover Public SchoolsHealth Services

• School Health Update
• 2007-2008
• Prepared by
• Jean Hight R.N., BSN
• Nurse Leader
• February 2008

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Mission Statement
The primary mission of the Hanover Public Schools
Health Services is to support educational
achievement for all students. The Hanover School
Nurses strive to accomplish this goal by
providing quality holistic health care to all
students. Through health education and promotion
we encourage the establishment of healthy
behaviors and healthy life choices. A healthy
child is a better learner Author Unknown
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Sept. 2007 - Jan. 2008 Health Office Visits
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Health Screenings 2006 - 2007

• Vision Screening 2,474 71 Referrals
• Hearing 2,294 107 Referrals
• Postural Screening 895 36 Referrals
• Heights and Weights 1,027

Please note These are in addition to Health
Office visits
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Body Mass Index (BMI) Percentiles2006 - 2007
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Impact of Obesity
Obesity puts children at risk for debilitating or
life threatening health problems such as type 2
diabetes, heart disease, high blood pressure, and
stroke.
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Medications Sept. 2007 - Jan. 2008

• Total Medication Orders 204 (approximately 7.5
  of students)
• Total Medications Administered 4,579
• Staff Medications 137

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Medical Conditions 2006-2007
This does not include other medical conditions
such as mental health (depression, bi-polar,
anxiety), Down Syndrome, Celiac Disease,
Migraines, Orthopedic Problems, Cystic Fibrosis,
Cancer, Genetic Disorders, and others.
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Nursing Procedures Sept. 2007 - Jan. 2008

• 3,251 Nursing Procedures Total
• Blood Glucose Testing 1,029
• Insulin Pump Care - 212
• Respiratory Procedures 263
• Blood Pressure Monitoring 40
• Wound Care - 695
• Orthopedic Procedures 110
• Head Checks for Pediculosis 265
• Other - 637

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Dismissals Sept. 2007 - Jan. 2008
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Communications Sept. 2007 - Jan. 2008

• 1,752 Parent Phone Conferences
• 1,105 Meetings/Conferences With Staff
• 144 Communication with Community
  Agencies
• 102 Referrals to Primary Care Physician
• 5 Other Referrals

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Staff Health Sept. 2007 - Jan. 2008

• 117 Visits For Illness Assessments
• 137 Medications
• 55 Visits For First Aid

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Education Laws and Regulations

• 603 CMR 7.11
• Professional Support Personnel Licenses
• School Nurse (LevelsAll)
• (a) Initial License.
• Valid license to practice as a Registered Nurse
  in Massachusetts.
• A bachelors or masters degree in nursing.
• A minimum of 2 full years of employment as a
  Registered Nurse in child health, community
  health, or other relevant clinical nursing.

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Laws and Regulations (continued)

• 4. Completion of an orientation program based on
  the requirements for delivery of school health
  services as defined by the Department of Public
  Health.
• 5. Passing score on the Communication and
  Literacy Skills test.

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Laws and Regulations (continued)

• (b) Professional License
• Possession of an Initial License.
• 3 years of employment as a school nurse.
• Completion of one of the following
• a. Achievement and maintenance of
  certification or licensure from a nationally
  recognized association as a school nurse,
  community health nurse, or pediatric/family/school
  nurse practitioner.
• b. A masters degree program that may
  include credits earned in masters degree program
  for the Initial license in community health,
  health education, nursing, or public health.

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Documentation

• All Health events must be documented by the
  school nurse.
• Health Records are a critical component for the
  documentation of health events.
• All medications
• Immunization Status
• Vision, Hearing, Scoliosis Screening Results
• Health History
• Physical Exams

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Documentation (continued)

• ALL students with a special health condition
  (e.g. diabetes, asthma) MUST have a nursing Care
  Plan Massachusetts General Laws (M.G.L.) 244
  CMR 3.02
• Each medication order MUST have a written
  medication administration plan per M.G.L., 105
  CMR 210.005

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What does the School Nurse do?

• Stocks and maintains health care office.
• Episodic assessment and nursing care.
• Writes Individual Health Care Plans (IHCP) for
  each student with special needs, i.e. Life
  Threatening Food Allergy (LTA), Diabetes, Cystic
  Fibrosis, Cancer, Asthma, etc.
• Communicates with administration and staff about
  health needs.
• Does screenings and makes referrals.
• Acts as a resource.
• Provides individual and group health education
  and promotion to students, staff, and parents.
• Communicates with physicians and community
  agencies on an as needed basis to promote the
  health of students.
• Documents care and events.
• Much more

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What does the Nurse Leader do?

• Plans and coordinates district-wide health
  services program.
• Communicates and collaborates with local board of
  health, school physician, and Massachusetts
  Department of Public Health (MDPH).
• Collaborates with school personnel and supports
  team approach for student physical, social,
  mental, and emotional health.
• Attends quarterly MDPH School Nurse Leader
  meetings
• Attends regional Nurse Leader Meetings.
• Does Monthly Activities Report for MDPH
  electronic submission.
• Does Annual reports for MDPH.
• Participates in Continuous Quality Improvement
  Program (CQI). Currently doing Vision CQI.
• Co-chairs Health Advisory Council, a diverse
  group from the schools and the community that
  promotes wellness and healthy behaviors.

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Nurse Leader (continued)

• Chairs Healthy Schools Committee which evaluates
  and manages school facilities for environmental,
  safety, and health issues.
• Assists in maintaining school health management
  system (Healthmaster) which enables ongoing data
  analysis.
• Promotes the use of the new MDPH School Health
  Manual.
• Collaborates with Superintendent and others to
  develop health policies, i.e. Life Threatening
  Allergy (LTA) and Emergency Preparedness.
• Maintains Automated External Defibrillators
  (AEDs) and provides CPR/AED training
  opportunities.
• Supervises and manages school nurses. Holds
  monthly meetings.
• Orients, trains and supervises substitute nursing
  staff.
• Collaborates with school business manager in
  preparing school health supplies budget and
  Essential School Health Services (ESHS) Program
  Budget Plan.

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Nurse Leader (continued)

• Does yearly review of school nurse procedure
  manual.
• Promotes school nurse networking in community
  with private, collaborative, and vocational
  schools.
• Ensures that these schools receive information
  from the MDPH (weekly e-mails and alerts) as well
  as other health information.
• Member of groups promoting health and safety
  within the community, i.e. the Hanover Alliance
  for the Prevention of Substance Abuse (HAPSA) and
  the Regional Emergency Management Systems (REMS)
  task force.

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Recommended RatioSchool Nurse to Student

• In the 1998 Report to the Massachusetts
  Legislature, Options for Developing School
  Health Services in the Commonwealth of
  Massachusetts, the Department of Public Health
  recommended the following
• One fulltime equivalent (FTE) licensed school
  nurse for each building (both public and
  nonpublic) with 250 to 500 students
• An additional 0.1 FTE for each additional 50
  students in buildings with more than 500
  students and
• 0.1 FTE for each 25 students in buildings with
  fewer than 250 students.
• When developing staffing plans, other factors to
  consider include the number of children with
  special health care needs, the number of
  buildings, and the distance and/or travel time
  between buildings.

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Hanover Schools Enrollment
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Closing Summary
The goal of the Health Services is to support
education by keeping students healthy, in school
and ready to learn. Student health needs have
grown increasingly complex through the
advancement of medical technology and requires
professional nursing staff for school
attendance. Student health complexities have
increased the demand for continuous
documentation. The need for nursing staff and a
nurse leader is evidenced by the volume and
complexity of health office visits and the volume
and complexity of health issues encountered in
our schools today.