SCHOOL NURSING: DEFINING THE ROLE

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SCHOOL NURSING:
DEFINING THE ROLE
REBECCA KING RN, CSN, MSN, MED
SCHOOL NURSE LIAISON
WEST VIRGINIA DEPARTMENT OF EDUCATION
OFFICE OF HEALTHY SCHOOLS
John Allen King II
A BIG THANK YOU TO ALL SCHOOL NURSES!
REFLECTION FOR 2007/08:
POLICIES & PROCEDURES:


Policy 4336–WV Bus Transportation Policy and
Procedures Manual-incorporated school nurses
throughout with language relating to health care plans, 6
hour initial and 1 hour training annually for transportation
of students with specialized health care with continuation
of all drivers and transportation aides required to have
first aid and CPR.
Policy 6200-Planning for School Facilities(newly
constructed schools)- continuation of the School Health
Unit(Section 303.10) and added “optional” specifications
for School-Based Health Center(Section 303.11).
LAWS
School Aid Formula
SCHOOL NURSES MOVED FROM
STEP #1(Professional Educators) to STEP #5(administrative cost):
↓
(5) An allowance for administrative costs in an
amount appropriated by the Legislature
All certified school nurses funded under school aide in 2007/08
were fully funded in school aide formula.
LAWS
Addition School Nurses Funding from SB 53 in 2006

The allocation for school nurses authorized under WVC 18-9A-10a
is for the employment of additional nurses to meet the ratio of one
nurse per each 1,500 students in grades Pre-kindergarten through
12, less existing nurses employed during the 2005-06 year, the
base year for this purpose. These funds are to be used solely for
the employment of additional nurses.

The amount appropriated for this purpose for the 2008-09 year
was $1,107,618, which is roughly 80% of the amount appropriated
the previous year, and the amount appropriated will continue to
decrease by 20% a year over the next four years.
LAWS
High Acuity Health Care Needs

The allocation for high acuity health care needs authorized
under WVC 18-5-22 is for distribution to county boards to
support school health service needs that exceed the capacity
of staff as mandated in this code.

The Legislature intends to keep appropriating the $1,000,000
per year for high acuity health care needs. This allocation will
continue to be distributed in two separate installments based
on the number of high acuity services provided each semester,
as reported by each county board via the WVEIS – Web-based
Electronic Health Care Plan.
REFLECTION FOR 2007/08:
SURVEYS/DATA:

Youth Risk Behavior Survey and Youth Tobacco Survey
(YRBS/YTS) 2007 was finally released-poor outcomes.

Health Education Assessment Project (HEAP)-Posted per
participating school on Office of Healthy Schools website.

RWJ survey on Healthy Lifestyles Act to be released this
2008/09 school year.
REFLECTION FOR 2007/08:
EDUCATION:







2007 WVASN Conference in Bridgeport
2007 Children’s Health Conference
2008 NASN HANDS training in Beckley and
Morgantown
2008 School Health Services Conference
2008 NASN Conference
Marshall University School Health Workshops
throughout 2007/08.
Take Action! Asthma and Diabetes Website
REFLECTION FOR 2007/08:
COLLABORATION/COMMUNICATION:

WV State Board of Education

WV Association of School Nurses

WV Asthma Coalition

WV Immunization Network

CHIP

WVDHHR HealthCheck Program

WVDHHR Dental Program

Governor’s Work Group on KIDS FIRST
REFLECTION FOR 2007:
Bureau for Public Health Divisions of :
1. Abstinence
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Adolescent Health Initiative
Asthma
Diabetes
Epidemiology
HIV/AIDS
Immunizations
OMCFH
Paternity
Pregnancy Prevention
STDs
TB Control
Healthy Lifestyles
REFLECTION FOR 2007/08:
COMMITTEES/GROUPS:

SBOE Wellness Committee

Policy 4336-WV School Transportation Regulations

Policy 6200-Planning for School Facilities

Health and Physical Education Academy
REFLECTION FOR 2007/08:

WVCOSN
•
Intervention Guides for Asthma, Seizures,
Anaphylactic Shock, Diabetes
•
School Nurse Performance Evaluation Guideoptional (not in Policy 5310)
•
Recommendations for Conjunctivitis
•
Position Statement on Immunizations
FUTURE PLANS :
2008/09 SCHOOL YEAR
WVDE/WVCOSN
Defining the role of the School Nurse
 Revise Policy 2422.7-Standards for Basic and
Specialized Health Care Procedures(BSHCP)
 Revise BSHCP manual
 Revise “Supplement Guidelines for School
Nurses”-Checklist as needed per manual changes.
 WVCOSN Recommendations and Information
Sheets in the Supplement Guidelines
 WVCOSN revising hearing and vision screening
recommendations

WVDE/WVCOSN
School Nurse Needs Assessment and collection
of data
 Online instructions for EHCP
 KIDS FIRST-staying with kindergarten
 WVEIS HealthCheck Screen with statewide
webinar
 WVEIS web-based application for health
screens with SN input

WVDE/WVCOSN
WVSBOE Position Statement on Coordinated
School Health
 Mountain State BCBS possibility for improving
school health technology
 World AIDS Day-Quilt on display at CAMCMemorial(home of Ryan White Program)
 Immunization Q&A
 Defining the role of LPN
 Quarterly conference calls

LEGISLATURE IMPROVEMENT REQUEST:

Funding for School Health Services Consultant
SAVE THE DATE
WV School Health
Conference
on
June 9 and 10, 2009
at the Charleston Civic Center
LET’S TALK ABOUT
SEX…
2007 YRBS
SEXUAL HEALTH
Q: Percentage of HS students who ever had sexual
intercourse~53.4% = ↑ from 52.5 in 2005
Q: Percentage of HS students who ever had sexual
intercourse with ONE or MORE people during the past three
months~40.8% ↑ from 39.3 in 2005
Q: Among students who had sexual intercourse during the
past three months, the percentage who drank alcohol or
used drugs before last sexual intercourse~21.4% ↑ from
20.7 in 2005
2007 YRBS
SEXUAL HEALTH

WHY Sexual Health….
 High rates of ATOD lead to ↑ sexual encounters,
vice versa
 Risk behaviors are RELATED
 Can lead to school climate, mental and physiological health issue and
possibly tragedy

How can you assist your county?
 Review your statistics (YRBS, HEAP, PRIDE, etc)
 Work with county health educators, parents and community
 Assist with evidenced based programs/curriculum for schools and/or
communities
 Know the resources(Local Health Dept., BPH-HIV/AIDS/STDS, BPHAbstinence, BPH-APPI, BPH-AHI, CBO, PTA, others…)
WV AIDS/HIV CASES 2007 BPH
 HIV

 5-12
y.o.----0 cases
 13-19 y.o.—44 cases
(6%)
 20-29 y.o.—262 cases
(36%)
NOTE:
94% of Pediatric cases from HIV + mothers!
White males lead in WV
Behavior=MSM(50%) and Heterosexual(17%)
AIDS




Under 5-----9 cases
5-12 y.o.----3 cases
13-19 y.o.—16 cases
(1%)
20-29 y.o.---242 cases
(16%)
KNOW YOUR HIV STATUS---GET TESTED!

1 in 5—or roughly
21%—don’t know
their status in US.
CDC’S NEW ELECTRONIC TRACKING SYSTEM
CDC
estimates that 56,300 new HIV infections
occurred in the United States in 2006. Prior to the
availability of STARHS,
CDC
previously estimated that approximately
40,000 new HIV infections occurred annually
since the 1990s.
WHAT IS THE PROBLEM?
SEXUAL RISK BEHAVIORS
54% EVER HAD SEXUAL INTERCOURSE.
6% HAD SEXUAL INTERCOURSE FOR THE FIRST TIME BEFORE AGE 13 YEARS.
17% HAD SEXUAL INTERCOURSE WITH FOUR OR MORE PERSONS DURING
THEIR LIFE.
41% WERE CURRENTLY SEXUALLY ACTIVE. (1)
39% DID NOT USE A CONDOM DURING LAST SEXUAL INTERCOURSE. (2)
ALCOHOL AND OTHER DRUG USE
22% DRANK ALCOHOL OR USED DRUGS BEFORE LAST SEXUAL
INTERCOURSE.
3% USED A NEEDLE TO INJECT ANY ILLEGAL DRUG INTO THEIR BODY ONE OR
MORE TIMES DURING THEIR LIFE.
WHAT ARE THE SOLUTIONS?
• Better health education
• Supportive policies
WHAT IS THE STATUS?
THE 2006 WEST VIRGINIA
SCHOOL HEALTH PROFILES
INDICATES THAT AMONG MIDDLE SCHOOLS
AND HIGH SCHOOLS:
HEALTH EDUCATION
• 59% required students to take two or more health education courses
• 31% taught 11 pregnancy, HIV, or STD prevention topics in a required
health education course.
• 92% taught abstinence as the most effective
method to avoid pregnancy, HIV, and STDs in a required health
education course.
• 91% taught how HIV is transmitted in a required health education
course.
HEALTH EDUCATION
• 34% taught how to correctly use a condom in a required health
education course.
• 81% taught how to find valid information or
services related to HIV or HIV testing in a required health education
course.
• 24% had a lead health education teacher who received
staff development during the two years before the survey on HIV
prevention.
TEEN PREGNANCY RATES
BETWEEN 1991 AND 2005, THE TEEN BIRTH RATE DECREASED
35 PERCENT TO A RECORD LOW OF 40.5 IN 2005. HOWEVER,
THE TEEN BIRTH RATE BETWEEN 2005 AND 2006 INCREASED 3
PERCENT. THE INFORMATION REFLECTS BIRTHS PER 1,000
TEEN GIRLS AGED 15-19 IN THE UNITED STATES AND ARE THE
MOST RECENT NATIONAL DATA AVAILABLE.
*DATA FOR 2006 ARE PRELIMINARY
STUDY: 1 IN 4 TEEN GIRLS HAS AN STD
18% HPV
4% Chlamydia
2.5% Trichomoniasis
2% Herpes simplex
CNN LIVE:
http://www.cnn.com/video/?/video/health/2008/03/12
/gupta.girls.and.stds.cnn
WVBPH POSTING ON SEPT. 5, 2008:
Statewide, the number of reported cases of early syphilis in West
Virginia has increased 67% since 2003. Therefore, the Bureau
for Public Health is encouraging all county health departments,
especially those located in counties that border Ohio County or
are located in the northern part of West Virginia, to screen and
test for syphilis all individuals at risk for sexually transmitted
diseases. The Office of Laboratory Services has been informed
of this situation and will provide supplies to accommodate
county health department needs.

Significant increase in syphilis infections recently reported in
Ohio County(7 cases).
THANK YOU
Have a WONDERFUL Thanksgiving!
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