2008/2009
School Nurse Needs Assessment
Office of Healthy Schools
WVDE
Coordinated School Health
Program/Model
Definition of School Nursing:
"School nursing is a specialized practice of professional nursing that
advances the well being, academic success, and life-long
achievement of students. To that end, school nurses facilitate
positive student responses to normal development; promote health
and safety; intervene with actual and potential health problems;
provide case management services and actively collaborate with
others to build student and family capacity for adaptation, self
management, self advocacy and learning."
Staffing
• Recommended Ratio by NASN:
 1:750 for regular education students
 1:225 for students requiring daily school nursing services
and interventions
 1:125 for students with complex health care needs
• WV Code §18-5-22:
 1:1500 for students in grades K-7
• SB 53
 1:1500 for students in grades Pre-K-12 in 18 counties
receiving funding (funding decreases 20% per year from
2008 until zero since approval of new School Funding
Formula)
2008/2009
WEST VIRGINIA
Distribution of School Nurses
and
School Based Health Centers
Hancock 4
Brooke
6
3
Ohio 4.67
Marshall
7
6
Wetzel
Morgan
2 Berkeley
Monongalia
2
9
Marion
Mineral
14
Preston
Hampshire
5
5.22
Jefferson
7.25
1
3
Taylor
6
Harrison
Wood
Grant
2
Doddridge
Ritchie
8
19.50
1
1
1
Barbour
Tucker
Wirt
Hardy
Lewis
2
1
1
Gilmer
Upshur
2
2
Jackson
Calhoun
1
3
Randolph
Roane
Mason
1
3
6.50
5
Braxton
2
Pendleton
3 `
1
Putnam
Webster
Clay
Kanawha
8
Cabell
2
1
33
8
Pocahontas
Nicholas
Number of Certified School
3
#
1
Nurses provided through
3
Lincoln
Wayne
Education
Fayette
2
Boone
5
Greenbrier
5
School-Based Health
6
Centers serving one or
4
Logan
more schools
Mingo
Raleigh
6
3
8
Wyoming
Summers Monroe
#
The Regional Education
3
Service Agency (RESA)
1
1
Mercer
McDowell
7
3
Tyler
1
5
8
3
4
2
1
Number of School Nurses
according to the 2008/09 School
Nurse Needs Assessment
WV State Board of Education
School Health Policies
• Policy 2422.7, Standards for Basic and Specialized Health
Care Procedures plus accompanying BSHCP Manual
(Care Plans and management of all specialized health
procedures by certified school nurse)
• Policy 2422.8, Medication Administration
(Prescribed and OTC)
• Policy 2423, Communicable Disease
(Immunizations, education and protocol regarding
communicable diseases)
Screening Services
•
•
•
•
•
•
•
Immunizations
Hearing
Vision
Growth & Development
Height/Weight
Blood Pressure
Other Conditions
2008/09
Student Screenings
2008/09 Student Screenings
20815
96027
Blood Pressure
22582
Dental
34417
24281
25091
58343
Ht/Wt
Body Mass Index
Hearing
68420
Scoliosis
6763
Vision
Cholesterol
5735
Lice
Immunizations
Number of Students Screened
in 2008/09
Incorporating collaborative efforts with
Community and Local Health Care Providers
through parent approved sharing of health information
HealthCheck includes:
 Comprehensive health and developmental history
 Comprehensive physical examination
 Age appropriate immunizations
 Labs as recommended from well child visit
 Developmental screening including speech and language
 Vision and hearing screening
 Dental screening
Case Management
The certified school nurse’s role includes major responsibility
for students with medical or other health problems. School
nurses delegate, train, monitor and supervise school personnel
performing health care procedures. The school nurse reviews
provider orders, ensures medication dosage levels are accurate,
monitors side-effects, assesses daily health and chronic disease
status of students, documents, communicates with community
medical providers and educates students, parents, staff and the
community in health promotion. These actions do not describe
the complete role of the school nurse but enable us to see the
complexity especially when dealing with extremely high student
ratios along with 15-20% needing specialized health care.
Nursing/Health Care
Procedures
Children needing management of chronic
health care conditions attend WV schools
daily. Several students require school nursing
services in combination with home visits to
support and sustain their school attendance.
Specialized Health Care
Procedures
Specialized health care procedures range from
administration of an oral medication to inhalation
therapy, blood glucose monitoring and suctioning
for students who need tracheotomy care. In
some cases, more than one procedure is provided
for an individual student.
Medication
School nurses are facing a crisis regarding how
medications administered to students at school are
going to be done legally and safely. Emergency
medications require higher skill levels and less
delegation, at times. The ability to monitor for
side effects and low/high dosage levels are skilled
assessments needing a certified school nurse.
Epilepsy/Seizures
Epilepsy affects about 2.7 million Americans, results in
an estimated annual cost of $15.5 billion in medical costs
and lost or reduced earnings and production. People of
all ages are affected, but particularly the very young and
elderly. About 10% of Americans will experience a
seizure sometime during their lifetime and about 3% will
have had a diagnosis of epilepsy by age 80.
(CDC, 2006)
2006/07 and 2008/09
Epilepsy/Seizures Comparison
Attention Deficit
Hyperactivity Disorder
(ADHD)
• Most commonly diagnosed childhood behavior disorder
• Affects 3 to 5 percent of school-aged children
• Core symptoms = lack of attention & concentration and
a high level of activity/distractibility/impulsivity
2006/07 and 2008/09
ADD/ADHD Comparison
Diabetes
Diabetes is a disease in which the body does not
produce or properly use insulin. Insulin is a
hormone that is needed to convert sugar,
starches and other food into energy needed for
daily life. The cause of diabetes is a mystery,
although both genetics and environmental factors
such as obesity and lack of exercise appear to
play roles. There are two major types of diabetes:
Diabetes
Type 1 - A disease in which the body does not
produce any insulin, most often occurring in children
and young adults. People with Type 1 diabetes must
take insulin injections daily to stay alive. Type 1
diabetes accounts for 5 to 10 percent of diabetes.
The administration of insulin CANNOT be delegate
to WV school personnel due to its complexity. A
potential error in the administration of insulin can
lead to severe complications or
even the DEATH of a student.
2006/07 and 2008/09
Diabetes Type I Comparison
Diabetes
Type 2 - A metabolic disorder resulting from the
body's inability to make enough, or properly
use, insulin. It is the most common form of the
disease. Type 2 diabetes accounts for 90 to 95
percent of diabetes. Type 2 diabetes is nearing
epidemic proportions, due to an increased
number of older Americans, and a greater
prevalence of obesity and sedentary
lifestyles.
2006/07 and 2008/09
Diabetes Type II Comparison
Asthma
• The most common serious childhood disease
• Is the most common cause of missed school days
• Cause of more than 3 million physicians visits in
U.S. yearly
• Over 13,000 reported cases in WV schools last year
2006/07 and 2008/09
Asthma Comparison
Conclusion
The number of students with chronic health
conditions require schools to provide even more
complex health care, necessitates a careful look
at the numbers of nurses who provide daily care
to our WV public school students. The health
services provided by certified school nurses in
WV are essential, not only to the health, safety
and educational progress of students, but also to
the academic mission and school climate of
schools.
Rebecca King
Coordinator
rjking@access.k12.wv.us
304-558-8830
Office of Healthy Schools Website
http://wvde.state.wv.us/osshp/main/